What does level 1a evidence support regarding neuromuscular electrical stimulation?

Level 1a evidence represents the highest quality of research findings, typically derived from well-conducted randomized controlled trials (RCTs). In the context of neuromuscular electrical stimulation (NMES), this level of evidence supports that it is effective when used alongside other treatments to improve gait and balance.

The rationale for this conclusion includes the understanding that NMES can enhance muscle activation and strength when incorporated into a comprehensive rehabilitation program. Many studies have shown that utilizing NMES in conjunction with conventional therapies results in better functional outcomes in patients recovering from conditions such as stroke. The combined approach leverages the benefits of electrical stimulation to support motor learning and to improve muscle performance, leading to enhanced performance in mobility tasks.

Other options do not align with the established benefits indicated by high-level evidence. The assertion that NMES should never be combined with other treatments contradicts the findings of numerous studies demonstrating its effectiveness as an adjunct to rehabilitation strategies. Such a singular approach is not supported by the evidence. Similarly, limiting NMES effectiveness solely to upper extremity rehabilitation overlooks its broad applicability in both upper and lower limb recovery, contradicting research that highlights its benefits across multiple areas of rehabilitation. Lastly, the claim that NMES has no statistical significance in rehabilitation results directly opp