Electrical stimulation is one of several stroke recovery products that therapists use to treat patients. This type of treatment can be used to improve blood flow, relieve pain, ease muscle tension, and increase strength. Due to the variety of benefits this modality has, occupational (and physical) therapists have been using electrical stimulation to treat orthopedic concerns and help those who have experienced neurological incidents such as a stroke.
This event is quite common, since over 795,000 people have a stroke each year. As a result, electrical stimulation devices for stroke patients have been more widely used outside of therapy clinics. This stroke recovery product is compact, user-friendly, and affordable, which is why electrical stimulation devices for stroke patients are being used in the home to help individuals take a more active role in managing their symptoms.
Electrical stimulation uses small electrical impulses to cause muscle contraction. This is done by placing small, sticky pads (called electrodes) on parts of the skin, on top of the muscles that will be targeted. After making some adjustments to the settings on the device’s screen, a mild electrical current travels from the unit to the electrodes. These electrodes transfer those impulses to the underlying muscles, which then contract.
Anything involving electricity may seem daunting, but this evidence-based treatment is considered very safe. The impulses are provided at such low doses that they serve a therapeutic purpose. Depending on the intensity of the current, the placement of the electrodes, and a person’s movements during electrical stimulation, muscle contractions can encourage someone to regain motion after a stroke or other brain injury.
When this modality is used to retrain stroke patients on basic movements, it is more commonly referred to as neuromuscular electrical stimulation (aka NMES). Studies show that over 65% of individuals who experienced a stroke struggle with using their affected hand several months later. Electrical stimulation devices can serve this population with great benefits in terms of recovery potential.
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As we mentioned, the initial result of electrical stimulation is a muscle contraction. However, muscles can only contract with the help of the brain, which is really the focus of the electrical stimulation device. The electrical current helps wake up certain parts of the brain that were impacted by the stroke. This activation encourages the brain to start its own healing by rewiring itself in a process called neuroplasticity. Such intricate rewiring does not happen overnight, which is why neuroplasticity prepares healthy parts of the brain to take over some functions until the injured brain areas are ready.
As a result, neuroplasticity can help:
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This is the most common type of electrical stimulation used to benefit stroke patients. This follows the same process as we described above, but it is often used to increase muscle strength, lower spasticity (or tone), and increase active motion in the muscles being targeted.
When individuals use FES, they are aiming to improve their performance in practical, functional activities that have a distinct purpose in their daily life. This can mean self-care tasks that allow them to independently get themselves ready for the day, or leisure activities and hobbies. Individuals who use FES will use the unit to improve active motion while they are practicing tasks such as gripping a doorknob, holding a pencil, or buttoning their shirts.
We mentioned that electrical stimulation can help individuals relieve pain. TENS is a form of electrical stimulation that may be used for stroke patients who experience discomfort. But it can also help those with orthopedic concerns such as muscle sprains, fractures, and post-surgical pain. TENS uses a very low electrical current – so low that individuals using it will not experience any muscle contractions. However, they will experience a slight tingling sensation, which is used to calm pain receptors that communicate with the brain.
Similar to TENS, SES is a low-current type of electrical stimulation that does not cause muscle contraction. The mild electrical currents are intended to trigger the sensory system to relieve spasticity, improve sensory function, and remediate neglect. Neglect is a stroke-related symptom that causes someone to lack awareness of one side of their body. As you can see, the sensory input would be given to that side of the body to assist with neglect.
While most of the other forms of electrical stimulation involve a muscle contraction that occurs solely due to the electrical current, ETS requires more participation from the patient. When receiving ETS, a patient must attempt the muscle movement (which ideally will elicit some or partial motion), and the electrical stimulation will complete the remainder of the movement with the current.
RETS is especially suited for individuals who have experienced overactive muscles as a result of a stroke. For example, if a patient’s hand is shut into a tight fist, which is usually the result of spasticity in those muscles, RETS can assist in helping them gradually open their hand. In this case, RETS is used to relax a patient’s tight hand muscles before providing electrical current to the muscles that allow the hand to open.
If you are looking for a simple, portable device that provides both pain relief and muscle stimulation, we recommend the iReliev TENS & EMS Pain Relief System. This dual-channel unit delivers TENS and EMS, offering 2 popular modes of electrical stimulation.
We like how easy it is for individuals to use this device at home between therapy sessions to stay active and manage discomfort. The preset programs and adjustable intensity levels make it straightforward to personalize treatment. It can be used to manage complications for stroke survivors, such as spasticity and muscle loss. We find the iReliev system to be a reliable, accessible companion for ongoing stroke recovery, improving comfort and engagement.
For people managing chronic pain or recovering from muscle weakness, we recommend wearable devices such as the ActiTENS Portable TENS Machine that offer a convenient way to bring electrical stimulation therapy into your daily life.
This compact, smartphone-controlled device delivers targeted electrical impulses through skin electrodes, helping block pain signals and relax tense muscles. We like it because it’s flexible enough to wear under clothes, tracks your progress through a convenient app, and offers multiple stimulation programs for different pain or recovery goals. The ActiTENS device gives people a safe, noninvasive way to manage discomfort and support ongoing muscle recovery wherever they are.
 | Digital 5-Mode TENS Unit - PM365 by ProMed View Product |
People often use TENS at home or during therapy as part of a pain-management routine. A small portable unit, such as the Digital 5-Mode TENS Unit, lets the user place electrodes on sore areas and select a setting that feels right for them. It has two channels for treating more than one spot if needed and a built-in timer, so the session is simple to start and finish without extra steps.
 | Functional Electrical Stimulation and Neuromuscular Electrical Stimulation Device - Pace XL by Neuro Rehab Recovery View Product |
A device like the Pace XL FES/NMES System supports this type of therapy by providing targeted stimulation to both upper and lower extremities. It blends FES and NMES in one unit, allowing people to practice functional tasks while also strengthening their muscles and reducing spasticity.
We like the Pace XL System because it includes multiple stimulation programs, it’s rechargeable, and has adjustable settings to support home or clinic-based rehab for conditions such as stroke, multiple sclerosis, cerebral palsy, TBI, and Parkinson’s disease.
Individuals who have pacemakers, are pregnant, suffer from epilepsy, or have an irregular heartbeat (called atrial fibrillation) should not use any form of electrical stimulation. Since this modality uses electrical currents, that energy can cause complications in any of the above individuals.
Electrical stimulation is most suitable for individuals who are active and motivated to regain movement after sustaining a stroke. This treatment produces the best results if someone regularly adheres to a program and uses their device daily (or as frequently as is recommended by their therapist). Electrical stimulation is also ideal for individuals who are adding it to physical or occupational therapy, since this produces the best functional outcomes.
For most units, no. Usually, individuals can get and use an electrical stimulation device without a prescription. However, some combo units do require a prescription. And if you have any questions or concerns about using a unit, it’s best to consult with your doctor or another healthcare professional.
There is a range of benefits associated with electrical stimulation devices for stroke patients. Individuals can get pain relief from TENS, improvements in functional use with FES, greater active motion with NMES, better sensation with SES, and more. Many devices can help individuals who have experienced strokes by reducing complications such as edema, shoulder subluxation, and foot drop.
Interested in learning more? Check out all stroke recovery articles, where we provide product reviews, buying guides, stroke exercises, and more information on stroke recovery! And check out our main blog, Caregiver University, for content on aging in place, wheelchairs, caregiving, special needs, and many more important topics.
Thanks for reading!
Co-Founder of Rehabmart and an Occupational Therapist since 1993. Mike has spent his professional career working in multiple areas of Occupational Therapy, including pediatrics, geriatrics, hand therapy, ergonomics and inpatient / outpatient rehabilitation. Mike enjoys writing articles that help people solve complex therapeutic problems and make better product choices.
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