How Can Electrical Stimulation Help After a Stroke?
Jun 27, 2019
How Can Electrical Stimulation Help After a Stroke?

Electrical stimulation therapy consists of taking electrodes and attaching them on to the skin over a muscle. Once the electrical stimulation unit is activated, it sends electrical currents to the muscle causing it to contract. Sending these electrical currents to the muscle and forcing the muscle to contract repeatedly will, in short, help the brain to create new neuro pathways which will in turn allow for muscle re-education. This happens through neuroplasticity. The principles behind neuroplasticity state that in order for the brain to rewire itself, it requires repetitive exercises to be done in order to build new neuro pathways. Therefore, it is very important to perform repetitive exercises with the affected limb or find a device that incorporates repetitive movements passively if you can not perform them actively.

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What is Electrical Stimulation Therapy?

Electrical stimulation therapy is a type of therapy that can be used in order to address many different issues that one may exhibit after a stroke. Electrical stimulation therapy can be used to address the following issues:

Edema- Electrical stimulation causes the affected limb to perform repetitive movements which will help increase blood flow ultimately decreasing the edema.
Muscle weakness- In order to increase muscle strength after a stroke, it is important to perform repetitive exercises in order to retrain the brain. By performing repetitive exercises overtime it will help increase muscle strenth.
Sensory loss- Unfortunately, there is not a lot of research on how electrical stimulation can help a stroke survivor however a lot of therapists have found it to help their patients as it is believed to help wake up the nerves in the affected limb.
Increased tone- In order to decrease tone, it is important to perform repetitive exercises in order to retrain the brain through neuroplasticity. Electrical stimulation can allow someone to perform repetitive exercises even if they can not do it actively independently.
Prevent muscle atrophy- Electrical stimulation causes the muscles to contract repeatedly for any given period of time. Passive muscle contractions allows the muscles to keep working which in turn will help prevent atrophy.
Chronic or acute pain- Electrical stimulation therapy helps prevent pain signals from reaching the brain and therefore, temporarily decreasing pain levels.
Impaired circulation- Electrical stimulation therapy causes the affected limb to perform repetitive motions which in turn will help increase circulation by keeping the blood flowing through the affected limb.

Electrical Stimulation Treatment Options

There are a few different types of electrical stimulation that can be used to treat stroke survivors. The most common are:

Functional Electrical Stimulation(FES)- FES is commonly used to restore function to a paralized limb.
Electrical Muscle Stimulation (EMS) / Neuromuscular Electrical Stimulation(NMES)- EMS and NMES are both used to provide stimulation to muscular tissues via electrical impulses.
Transcutaneous Electrical Nerve Stimulation(TENS)- TENS is primarily used to address chronic or acute pain management. A TENS unit will help encourage one's body to produce more endorphins.
EMG Triggered Stimulation(ETS)- ETS is used with stroke survivors who have some movement in the affected limb. The ETS device will detect the stroke survivor's movements and provide stimulation based on those movements.
Electromyogram-Triggered stimulation (EMG)- EMG is a combination of biofeedback and stimulation. EMG uses the stroke survivor's own movements in order to provide stimulation.
Reciprocal EMG Triggered Stimulation(RETS)- RETS is most commonly used with stroke survivors who have increased tone or have a hard time relaxing the muscles on the affected limb.

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Although, Electrical stimulation therapy can be very helpful for many, it is contraindicated for some. Therefore, it is very important that you get cleared from your physician before you start using electrical stimulation therapy. Some common contraindications are:

  • Over carotid sinus
  • Over an active deep vein thrombosis or thrombophlebitis
  • Anywhere near the uterus including the lower back during pregnancy
  • Over cancerous lesions
  • Over superficial metal such as staples, pins, or external fixators
  • Over areas of localized infection
  • Over any open wounds
  • Over the neck
  • Over the heart
  • In the presence of a cardiac pacemaker or defibrillator
  • Over untreated osteomyelitis
  • Seizures

Research has shown that in order to see the best results with electrical stimulation therapy, you should combine it with massed practice of repetitive functional exercises. Many occupational therapists and physical therapists will utilize electrical stimulation in their practice. Some therapists may recommend you purchase your own electrical stimulation unit to use at home in between therapy sessions and or once you are discharged from therapy as an outpatient therapy tool. Your therapist will help you learn what settings to utilize. It is important to always perform a skin check after using the electrical stimulation unit. You want to make sure you are not having any adverse reactions. If you notice any adverse reactions make sure to reach out to your therapist or doctor before continuing to use the device.

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To find out about how the NEOFECT Smart Glove and Smart Board can be paired with electrical stimulation therapy to help strengthen your upper extremities in a fun and motivating way please call us at 888-623-8947 or email us at contactus@neofect.com.

Becky Alter
Clinical Manager / Occupational Therapist

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