Augmented feedback as a therapeutic approach for gait rehabilitation in patients with cerebral palsy: a systematic review
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Published on: May 16, 2025
Leonie Hirsch1, Natalie Mrachacz-Kersting1,2
1Department of Neuroscience, Institute of Sport and Sports Science, Albert-Ludwigs Universität, Freiburg, Germany.
Objectives:
To evaluate the effectiveness of augmented feedback (AF) in improving gait function in individuals with cerebral palsy (CP) and assess the strength of evidence across different gait parameters.
Eligibility Criteria:
We included peer-reviewed interventional studies involving children or adults with CP who received AF during gait training, with gait-related outcomes assessed.
Information Sources:
A systematic search was conducted in July 2025 across PubMed, Cochrane Library, IEEE Xplore, and PEDro database.
Risk Of Bias:
Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs and MINORS criteria for other study designs.
Included Studies:
Of 477 screened records, 25 studies met inclusion criteria, comprising 612 total participants (409 intervention, 203 control). Studies included 13 single-session and 12 multi-session interventions.
Synthesis Of Results:
Using systematic evidence synthesis, velocity improvements showed strong evidencial support for AF, while ankle kinematics demonstrated moderate to strong evidence. Visual feedback had the most consistent effects across parameters, particularly for kinematic outcomes. Most other gait parameters (step length, stride length, cadence) showed inconclusive evidence due to conflicting findings across studies of varying quality.
Limitations Of Evidence:
High heterogeneity in protocols, outcome measures, and study quality (32% high, 52% moderate, 16% low quality) prevented a meta-analysis. Limited long-term follow-up data (only 5 studies) restricts conclusions about sustained effects.
Interpretation:
AF shows promise for enhancing gait velocity and ankle function in CP, particularly for spastic subtypes. However, evidence remains insufficient for widespread clinical adoption. Standardized protocols, larger sample sizes, and long-term follow-ups are essential for evidence-based implementation.
