###### Abstract  
Post-stroke sequelae, spinal cord injury and multiple sclerosis are the most common and disabling diseases of upper motor neurons. These diseases cause functional limitations and prevent patients from performing activities of daily living. This review aims to identify the potential of functional electrical stimulation (FES) for locomotor rehabilitation and daily use in upper motor neuron diseases. A systematic search was conducted. For the search strategy, MeSH terms such as \"stroke\", \"functional electrical stimulus\" and \"FES\", \"post-stroke\", \"multiple sclerosis\", and \"spinal cord injury\" were used. Of the 2228 papers from the raw search results, 14 articles were analyzed after inclusion and exclusion criteria were applied. Only four articles were randomized clinical trials, but with low numbers of participants. RehaMove, Microstin and STTWELL were reported in three independent studies, whereas Odstock was used in four articles. The results of the studies were very heterogeneous, although for lower extremity stimulation (11 out of 14 papers), walking speed was reported only in 6. Berg Balance Scale, Timed Up and Go, Functional Ambulation Category, 6-Minute Walk Test, 10-Meter Walk Test, Fugl-Meyer Assessment, Motricity Index and Action Research Arm Test were reported for functional assessment. For clinical assessment, the Modified Barthel Index, the Rivermead Mobility Index and the Stroke Impact Scale were used. Four studies were spread over 6 months, two investigated the effects of FES during one session, and the other eight were conducted for 3 to 8 weeks. Improvements were reported related to gait speed, functional ambulation, hand agility and range of motion. FES can be considered for large-scale use as a neuroprosthesis in upper neuron motor syndromes, especially in patients with impaired gait patterns. Further research should focus on the duration of the studies and the homogeneity of the reported results and assessment scales, but also on improvements to devices, accessibility and quality of life. functional electrical stimulation; assistive technology; post-stroke; multiple sclerosis; spinal cord injuries +
Footnote †: journal: Medical  
practitioners and researchers shall be presented different perspectives so as to start new practice methods and trials. Stroke and SCI have common motor loss manifestations on human body extremities, such as muscle weakness in distal segments. In addition, muscle overactivity can be encountered, altering activities of daily living (ADL) task performance and gait pattern [5]. Following a stroke or other UMN injury, the nervous system takes intrinsic repair actions, modifying neural circuits by suppressing some existing ones and forming new ones; it may also redesign cortical and spinal cord regions. In addition to the restoring blood flow, the neuroplasticity may cause a surprising level of spontaneous recovery in the UMN following post-traumatic events or brain injuries. Rehabilitation training and pharmacological interventions could modify and boost these neuronal processes, especially within the first three months after stroke onset, with significant improvements in neuromotor function [6; 7]. The results of previous research suggest that neuroplasticity is more pronounced during the first 3-6 months after stroke. At the same time, in the chronic stage, its intensity decreases over time and with the formation of new patterns [8]. Moreover, individuals who have suffered incomplete spinal cord injuries (SCI) can regain some motor functionality in the 6 months following the incident, determined mainly by neuroplasticity. However, rehabilitation can take several years [9] and new research suggests that the rehabilitation window should be extended to at least one year after the onset of stroke or SCI event [10; 11; 12]. Although the symptoms of multiple sclerosis (MS) vary depending on its subtype, patients have neuromotor manifestations similar to those of post-stroke patients or SCI, related to the distal segment of the lower limbs.