Advancing forward: The role of functional electrical stimulation in enhancing lower limb function in children with cerebral palsy

Abstract

Purpose: This systematic review explores the effectiveness of functional electrical stimulation in improving lower limb motor function, gait dynamics, and related physical outcomes in individuals diagnosed with cerebral palsy. It addresses inconsistencies across intervention protocols while identifying the clinical value of functional electrical stimulation in modern rehabilitation. Methodology: An extensive literature search was conducted using PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar for research papers published between 2005 and 2025. After screening 128 initial records, five studies met the inclusion criteria after screening and full-text review. Included studies involved participants with cerebral palsy who received lower limb functional electrical stimulation compared to conventional therapy or no intervention. A qualitative synthesis was performed based on key outcome domains such as gait, muscle strength, spasticity, and postural control. Results: Functional electrical stimulation interventions were associated with improvements in gait speed (12–20%), stride length (up to 15%), and gross motor function scores (by 8–10 points). Protocols included 30–60 minute sessions, 3–5 times per week over 8–12 weeks. Outcomes varied depending on the subtype of cerebral palsy, age, stimulation type, and adherence. Studies using functional electrical stimulation during walking or cycling showed the highest gains in functional mobility and satisfaction. However, limitations included small sample sizes, heterogeneity in study design, and short follow-up durations. Scientific novelty: This review synthesizes updated evidence regarding lower limb functional electrical stimulation parameters and patient characteristics. It also discusses emerging trends in individualized and home-based applications Conclusion: Functional electrical stimulation presents valuable strategy for improving motor performance in cerebral palsy, particularly for lower limb function. Future research should prioritize protocol standardization, large-scale trials, and long-term effects to support clinical integration of functional electrical stimulation into personalized rehabilitation plans.