Effectiveness of Functional Electrical Stimulation (FES) Alone or Combined with Rehabilitation on Gait Recovery in Chronic Stroke: A Systematic Review of Randomized Controlled Trials

(1) Introduction: Stroke remains a leading cause of long-term disability, with 80–90% of survivors experiencing gait disturbances. Functional electrical stimulation (FES) is widely used to improve motor recovery and gait; however, its effectiveness remains uncertain because outcomes vary across studies. (2) Objectives: To evaluate the effectiveness of FES, alone or combined with rehabilitation strategies, for gait recovery in individuals with chronic stroke. (3) Review Summary: A systematic search of the PubMed/MEDLINE, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (Cochrane CENTRAL), and PEDro (Physiotherapy Evidence Database) identified randomized controlled trials published between 2016 and 2026. Adults with chronic stroke receiving lower-limb FES, alone or combined with conventional rehabilitation, were included. Outcomes included gait performance, balance, motor function, and activities of daily living. Methodological quality was assessed using the Cochrane Risk of Bias 2 tool. Five studies involving 109 participants met the inclusion criteria. FES improved gait speed, balance, lower-limb motor function, and functional independence, particularly when combined with task-specific rehabilitation. Improvements in coordination, neuromuscular activation, and corticospinal excitability also supported its role in motor recovery. (4) Conclusions: FES is a relevant adjunctive intervention for post-stroke rehabilitation. Although methodological heterogeneity remains, current evidence supports its potential to improve gait and functional outcomes.