Electrical stimulation for stroke patients offers a wide range of benefits.
From improving motor skills to reducing numbness, electrical stimulation offers hope for recovering many side effects of stroke.
If your physical therapist has recommended electrical stimulation, you might be wondering how it works and if it’s painful.
Here’s everything you must know:
How Does Electrical Stimulation for Stroke Patients Work?
Electrical stimulation involves placing electrodes on your skin which then send electrical impulses to your muscles.
This physical therapy technique is often used during stroke rehabilitation when a patient struggles with post-stroke paralysis, weakness, pain, or sensory issues.
Often times, electrical stimulation (e-stim) is applied gently. However, more intense e-stim can be used when your physical therapist finds it appropriate.
Electrical stimulation may feel uncomfortable, but it should not hurt. If you feel pain, it’s important to tell your PT. (S)he can adjust the intensity.
Types of Electrical Stimulation
There are many different types of electrical stimulation available for use in stroke rehabilitation.
Here are the most common types of e-stim used:
- Neuromuscular electrical stimulation (NMES). This is used for muscle strengthening and motor recovery of paralyzed or weakened limbs.
- Functional electrical stimulation (FES). This is a type of NMES that is commonly used in stroke rehabilitation.
- Transcutaneous electrical neuromuscular stimulation (TENS). This is often used to treat and manage pain.
- Iontophoresis. This type of e-stim is used to administer medication.
- Russian stimulation. Similar to NMES but more tolerable.
- Interferential current. Electrodes are used in a criss-cross pattern to “interfere” with each other, allowing for higher intensity.
During stroke rehabilitation, neuromuscular electrical stimulation is most often used, which includes functional electrical stimulation too.
Example of Electrical Stimulation for Stroke Rehab
To understand how electrical stimulation for stroke patients works, watch this video. It show how e-stim helps the weakened muscles contract during stroke rehabilitation.
By applying the electrodes to the muscles that control dorsiflexion, the electrical stimulation helps the affected muscles contract.
Even though the patient could not lift her foot before the treatment, the e-stim helped create muscle contraction.
E-Stim Should Be Active for Stroke Rehabilitation
During stroke rehabilitation, electrical stimulation used in combination with physical therapy exercise is more effective than just exercise alone. [American Heart Association]
While some forms of electrical stimulation are passive (involving no participation on your behalf), e-stim for stroke patients should be active (requiring your participation).
When patients are engaged in physical therapy exercises during e-stim, it helps to further engage the brain-muscle connection.
All movement starts in the brain. When stroke has damaged the part of the brain that controls movement, new areas of the brain must take over (via neuroplasticity).
Electrical stimulation helps boost neuroplasticity after stroke by increasing the stimulation sent to the brain.
Then, by performing physical therapy exercises during e-stim treatment, your brain has even more stimulation to work with.
Benefits of Electrical Stimulation for Stroke Patients
So, what exactly can electrical stimulation help with? Here are the major stroke side effects that e-stim has been proven to help with:
1. Hemiplegia (Post Stroke Paralysis)
Electrical stimulation may help introduce movement into paralyzed muscles after stroke. (You likely saw it with your own eyes if you watched the video above.)
When electrical stimulation activates the paralyzed muscles, you can capitalize on the opportunity and practice paralysis recovery exercises to help rewire the brain.
Ideally, though massed practice, this can help stroke patients with paralysis slowly regain movement.
2. Hemiparesis (Partial Loss of Movement)
If you struggle with weakness after stroke, but not paralysis, then e-stim can still help. By combining electrical stimulation with physical therapy exercises, you can maximize your gains.
3. Spasticity and Gait (Walking)
Interferential e-stim has been shown to help reduce spasticity in stroke patients, even after massive stroke. [PubMed]
Stroke patients that wish to improve their balance and gait can also benefit from electrical stimulation because it can be applied to lower extremities with the help of a physical therapist.
4. Shoulder Subluxation and Pain
Some stroke patients struggle with a shoulder issue called shoulder subluxation where the arm becomes dislocated from the shoulder socket. This condition is often painful.
Studies have found that functional electrical stimulation can help reduce the severity of shoulder subluxation and pain. It can also help improve arm function, too. [Physical Medicine and Rehabilitation]
5. Sensory Issues
The stimulation from electrical stimulation can potentially help improve sensory issues after stroke, such as numbness or tingling. One study found that repetitive electrical stimulation may be particularly useful for sensory loss in stroke patients.
6. Swallowing Problems (Dysphagia)
With the help of a highly trained therapist, you can use electrical stimulation to improve swallowing problems after stroke. [PubMed]
It’s critical to work with a therapist here. Do not attempt to do this yourself because e-stim on the neck can be dangerous. Only a skilled therapist knows where to safely place the electrodes.
Risks of Electrical Stimulation
With all these amazing benefits of e-stim for stroke patients, you may want to dive right in – but be sure you’re aware of potential side effects!
Work with your medical team to make sure e-stim is a safe option for you. They can determine if you should work alongside a physical therapist or if you can be trained to use it on your own at home.
Some of the potential risks of e-stim are muscle tears and skin irritations and burns. If the intensity is too high, these adverse effects may occur.
Also, do not use electrical stimulation if you have an implanted electrical device like a pacemaker. Be sure to avoid placing electrodes in inappropriate places such as over the eyes, heart, or reproductive organs.
A trained physical therapist can either help you place the electrodes during therapy, or train you to apply them to approved locations yourself.
If you didn’t get the hint already, working with a therapist is critical, especially in the beginning.
Should You Try Electrical Stimulation?
Overall, electrical stimulation offers promising benefits to stroke patients such as improved mobility, improved sensation, and reduced pain.
Combining electrical stimulation with physical therapy exercise is critical for achieving maximum results.
It’s also critical to work alongside a therapist who can either control the treatment or train you how to safely use e-stim at home.
We hope this guide to e-stim helps you on the road to recovery!