Electrical Muscle Stimulation better explained



This post is copied and pasted, with a few notes from myself, from a post by Saebo Co-founder Henry Hoffman on Linkedin.  The reason I copied and pasted it?  Because Henry Hoffman has forgotten more about this subject, than I will ever know.  The advantage that I have, is that I personally benefit from using Electrical Muscle Stimulation on myself post strokes, if you want to consider that an advantage.

New Podcast: Meet Henry Hoffman of Saebo – Know-Stroke.org Recovery ...

Here is what Henry wrote.  I added some pictures, because that's the way I roll.

How to keep stroke survivors from making this one common mistake.

It is fairly routine for neurological patients to be introduced to electrical stimulation early on in their rehab journey.

Electrical muscle stimulation (EMS) or neuromuscular electrical stimulation (NMES) is considered an important part of the neurorecovery process. It allows the muscles to contract and move (I.e., finger extension, shoulder elevation, reduce subluxation etc.).

Electrodes, controlled by a unit, are placed on the skin over a predetermined area. Electrical current is then sent from the unit to the electrodes and delivered into the muscle or nerve causing a contraction.

(1) Electrode placement : Wrist and Finger extension - YouTube

This is form of stimulation (NMES) is not TENS which is another type of stimulation.

On the one hand, studies show that TENS can improve pain, sensation, corticomotor excitability, etc., however, on the other hand, if the patient is looking to adequately contract a muscle or augment movement, TENS is not the solution.

TENS vs EMS: What's The Difference?Freezing of Gait & Parkinson's Disease | APDA

By the time patients are in outpatient therapy, many have already purchased a device, but they are not quite sure what type of unit they actually have. Yikes!

Spoiler Alert: Many patients are getting it wrong. They are hoping for one thing (NMES/EMS) but getting another (TENS).

It’s not their fault. They just don’t know.

I could see why it’s confusing for patients. Just look at the different types available with all the funny letters.

NMES, TENS, SES, FES, ETS…wait what?

Pretty much alphabet soup.

NMES (Neuromuscular Electrical Stimulation)
EMS (Electrical Muscle Stimulation)
FES (Functional Electrical Stimulation)
TENS (Transcutaneous Electrical Nerve Stimulation)
ETS (EMG Triggered Stimulation)
RETS (Reciprocal EMG Triggered Stimulation)
SES (Sensory Electrical Stimulation)

Stroke recovery is hard enough. Let’s not make it harder.

Therapists can help by explaining the differences between the various forms of electrical stimulation and guiding them along with appropriate purchase recommendations to provide the best recovery possible.

#noplateauinsight #simplifystrokerehab #electricalstimulation

This is where Henry ends, and I begin.

In my opinion, Guy speaking here, not Henry, and someone who went through this whole process as a patient, both Stroke Inpatient and Outpatient Rehab, it is my belief that every Inpatient Rehab Center, should decide on a Electrical Muscle Stimulation Device, that:

a.  They are going to stock enough units to use daily on all the patients, while explaining how to operate, the short and long them benefits, different muscle group electrode placements, etc..

b.  Then have this same unit readily available for patient purchase upon discharge.

c.  Be familiar enough with the unit to program the unit for the patient to meet his/her specific needs if necessary, before discharge.

Now, there are many devices out there, and I am going to give you my opinion on what I find to be the best, and why, then you decide for yourself.

If you live in the USA, or the UK, consider yourself lucky, because you have access to some of the greatest Stim devices on the market today.  Here are my top picks by area.  I cannot import or sell Saebo Electrical Stimulation Devices, Why can't I buy this Electrical Stimulation Device in Canada? – JGH Rehab so this isn't a sales pitch, but everything that I have listed here, I have and use on my own body.


DISTRIBUTOR:  JGH Rehabilitation & Consulting Services Ltd.

inTENSity Twin Stim III | Liberty Medical Solutions

GOOD: Twin Stim - TENS & EMS Combo – JGH Rehab

This unit offers both TENS and EMS, and I have used it, and it does what you need it to do.  But we have a GOOD, BETTER & BEST device, and this is level one.  So if you can go higher, please do.  If you cannot, this one will perform the task you need.

BETTER:  INTENSITY Twin Stim III TENS/EMS With Ac Power, Wall Plug / 9 V Batter – JGH Rehab

Now, I recently broke a lead wire on my own personal unit, so I started playing around with this one.  This one will do everything you want it to do, and I can even program it for you before we ship.  This unit also gives you the option of either a 9 volt battery, or an AC plug, which will save on batteries over the long term.  Worth the extra investment.

BEST: Phase-5 TENS + EMS Combo – JGH Rehab

This unit offers TENS, EMS & NMES, has 16 preset programs, and 3 programmable programs, which we can set up for you upon request prior to shipping.  This unit is really all you need if you live in Canada.


DISTRIBUTOR: Saebo | Stroke Rehabilitation Therapy & Products for Home, Clinic 

SaeboStim One | Saebo UKSaeboStim Micro | SaeboToGo


SaeboStim Pro I Neuromuscular Electrical Stimulation | Stroke Recovery

This unit has it all, and has everything you will ever need.  I am fortunate enough to have one, and use it several hours a day, everyday.  This even has a Trigger Stim, where it can be used for functional task, or exercise programs, by delivering Electrical Stim at the push of a button.  The unit comes pre programmed, for everything you need, with an easy step by step manual to follow.  It also gives you the option of 3 AA batteries, or AC adapter. 

Spasticity or pain in your feet or ankles?  Let me introduce the SaeboStim Spa.

SaeboStim Spa | Neuropathy Foot Bath/Spa | Foot Drop Treatment

(4) Introducing the SaeboStim Spa - YouTube

When I first starting using the SaeboStim Spa, I could not believe how it melted away the Spasticity in my stroke affected foot and ankle, in just 30 minutes!  I also found that if I use this unit everyday, the Spasticity in my foot and ankle was manageable, which not only improved my walking, but my overall balance and stability. It is easy to use, with no programming involved.  Just follow the simple directions and start stimming!!

SaeboStim One:

Pain & Neuropathy Therapy | SaeboStim One | Stroke Recovery

SaeboStim One | Saebo UK

(4) Introducing the SaeboStim One - Wireless, Wearable Electrical Stimulation for Stroke Recovery - YouTube

This unit is as simple as it gets.  Place the wings on the muscle you want to stim, and turn up the intensity.  It is even wearable, and great for shoulder subluxation. This unit charges up by using the included USB charger.  Note:  When you purchase the SaeboStim One, order the extra wings and gel replacement pads.  They are durable, if you follow the storage instructions, but it's nice to have replacements in case something happens

SaeboStim Micro:

Pain & Neuropathy Therapy | SaeboStim Micro | Stroke Recovery

SaeboStim Micro | SaeboToGo

(4) Why SaeboStim Micro: Sensory Stimulation Device? Henry Hoffman Q&A Video Series - YouTube

Passive e-stim activates neural pathways to improve sensation and reduce pain and muscle tightness.

When I first started used my SaeboStim Micro, I could wear it while wearing my SaeboStretch at night while I slept.  This would greatly reduce the Spasticity in my hand, wrist and fingers.  The only problem we really had was getting the Glove on my Stroke Affected hand.  So, Jane would place tongue depressors out each finger of the glove, and slowly slide each finger in place, while the depressors would keep the fingers of the glove straight, then simply pull out the depressors, one by one.


Saebo UK


SaeboStim One | Saebo UKSaeboStim Micro | SaeboToGo

Saebo UK has all of the same stim devices as Saebo.com in the U.S.A., with one exception:

SaeboStim Pro Foot Accessory Kit instead of the SaeboStim Spa

(4) Quick set up of Saebo sensory stimulation sock - YouTube

This stimulation sock, works in conjunction with the SaeboStim Pro, as seen in the video above.  Now, I have not tried this device YET.  That's because I only received the sock last week, so I haven't had a chance to use it.  But I assume it works similar to the SaeboStim Micro.  I have a friend in the UK, and my curiosity got the best of me, so I purchased one, and a spare, just in case, and shipped them to my friend, who mailed them to me here in Ontario.  I am planning on giving it a whirl this weekend, so I will keep you updated.

So, from my experience and in my opinion, Electrical Muscle Stimulation is one of the most effective, yet underutilized and misunderstood forms of Stroke Rehabilitation tools being used today, at both Inpatient and Outpatient Rehab, and especially when the patient goes home.  Take it from me, use the information here, and no matter where you reside, get the best Electrical Muscle Stimulation Device or even better, Devices, and use them regularly.  

As for me, I do and  I will! 

 All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.   Many opinions and viewpoints are based on my own Personal Stroke Recovery journey.  As every Stroke is different, so is every Stroke Recovery.  Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the JGH Rehab website is solely at your own risk