REVIEW article
Front. Rehabil. Sci.
Sec. Rehabilitation in Neurological Conditions
Augmented Feedback as a therapeutic Approach for Gait Rehabilitation in Patients with Cerebral Palsy: A systematic Review
1. Department of Neuroscience, Institute of Sport and Sports Science, University of Freiburg, Freiburg, Germany
2. Albert-Ludwigs-Universitat Freiburg BrainLinks-BrainTools, Freiburg, Germany
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Abstract
Title: Augmented Feedback as a Therapeutic Approach for Gait Rehabilitation in Patients with Cerebral Palsy: A Systematic Review 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 databases. 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. Funding: No specific funding was received for this study. Registration: This systematic review was not prospectively registered.
Summary
Keywords
Cerebral Palsy, Locomotion, Gait rehabilitation, augmented feedback, motor learning, Pediatric Motor Disability
Received
30 May 2025
Accepted
11 February 2026
Copyright
© 2026 Hirsch and Mrachacz-Kersting. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Natalie Mrachacz-Kersting
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