How Long Should I Use Electrical Stimulation for My Stroke?

NeuroRehab Team
Monday, January 9th, 2023

Electrical Stimulation

Electrical Stimulation. How much is enough?

Over the years, many stroke survivors have stated that their therapist recommended 20-30 minutes of electrical stimulation to a targeted area for daily home use.  Are we are missing an opportunity to maximize the therapeutic benefit of stimulation by limiting the total treatment time under 30 minutes?

Generally, most standard NMES (cyclical stim) units have an On/Off time that is a 1:1 ratio (5 or 10 sec on and 5 or 10 seconds off). Given this ratio, twenty minutes of total treatment using stimulation is really 10 min of “true” stimulation. The research is mixed when it comes to the benefits of NMES/FES and stroke recovery. In addition, there is no consensus regarding the ideal stimulation treatment time.

Is 10 minutes of “actual” stimulation enough?

Let’s challenge the traditional durations and get more intensive. Why not? Many stroke survivors have plenty of time to perform much more… like double! There is more to gain cortically by increasing the treatment duration. The brain is starving. Feed it!

Have the clients also perform functional electrical stimulation (FES). With FES, highly repetitive task training can be encouraged to accelerate neuroplasticity. With FES, the patient will do a purposeful task (i.e., food to mouth, grab a cup) and time the stimulation at the precise moment the muscle is needed to fire. The stimulation is typically triggered buy pushing a button on the unit.

Over the years, many stroke survivors have stated that their therapist recommended 20-30 minutes of electrical stimulation to a targeted area for daily home use.  Are we are missing an opportunity to maximize the therapeutic benefit of stimulation by limiting the total treatment time under 30 minutes?

Side Note: if your patient has a 2-channel device, to maximize their time, be sure to use both channels simultaneously. For instance, if the client has impaired wrist/finger extension and foot drop, consider having one channel on the wrist/finger extensors and the second channel on the dorsiflexors.

To learn more about electrical stimulation and other stroke interventions, visit www.ebrsr.com.