Abstract

Most stroke and spinal cord injury (SCI) patients are usually left with permanent or severe motor neurological deficits that remain as a major contributor to the global disability epidemic, especially in the settings of limited access to physical therapy and advanced rehabilitation facilities. Nonetheless, electrical stimulation has emerged as a feasible adjunct intervention to conventional therapy, supporting motor neurological recovery through neuroplasticity and neuromodulation. This narrative review included studies published between 1985 and 2025 with literature searches in PubMed, Scopus, and Web of Science. Animal studies, clinical trials, and observational research were identified examining neuromuscular electrical stimulation, functional electrical stimulation (FES), transcutaneous spinal cord stimulation (tSCS), and epidural spinal cord stimulation (eSCS). Studies were included if they reported outcomes related to neurological motor recovery after stroke or SCI, and studies addressing unrelated outcomes were excluded. It was found that neuromuscular and FES enhanced sensory feedback and cortical reorganization, improving upper-limb function after stroke, especially when combined with task-specific rehabilitation programs. Furthermore, spinal cord stimulation increased spinal network excitability through posterior sensory afferents, thereby facilitating motor output and improving neurological function. Additionally, eSCS has been used to improve standing, stepping, and autonomic function in SCI patients, while noninvasive tSCS improves limb, gait, and respiratory outcomes. Across modalities, electrical stimulation stands out as a promising intervention for patients with stroke or SCI, especially when combined with appropriate rehabilitation programs. However, heterogeneity in protocols, trials, and study designs requires further high-quality research before implementation.

Key words: Electrical stimulation, stroke, spinal cord stimulation, motor function, review article