Electrical Modalities in the Rehabilitation of Peripheral Nerve Injuries: State of the Literature and Current...

Peripheral nerve injuries (PNIs) are a common cause of long-term motor and sensory disability despite advances in microsurgical repair. Functional recovery following PNI depends not only on axonal regeneration, but also on preservation of distal nerve pathways, maintenance of neuromuscular junction integrity, prevention of irreversible muscle degeneration, and adaptive central nervous system reorganization. Electrical rehabilitation modalities have been proposed as adjunctive strategies to enhance recovery across these domains, yet their clinical utility in PNIs remains incompletely defined. This review summarizes the pathophysiology of peripheral nerve injury and critically evaluates the current evidence for commonly used electrical rehabilitation modalities, including transcutaneous electrical nerve stimulation (TENS), neuromuscular and functional electrical stimulation (NMES/FES), and surface electromyographic (sEMG) biofeedback. Across modalities, the existing literature is heterogeneous and limited by small sample sizes, reliance on animal models, and substantial variability in stimulation parameters and timing. While TENS may play a role in pain management during the acute phase and sEMG biofeedback shows promise for facilitating motor relearning-particularly following nerve transfer surgery-robust evidence supporting routine use of electrical muscle stimulation in PNIs is lacking. Future investigations should prioritize standardized protocols, appropriate patient selection, and adequately powered clinical trials to clarify the role of electrical modalities in peripheral nerve rehabilitation.