Knowledge, Use, and Barriers to Electrical Stimulation in Upper Limb Stroke Therapy Among German Therapists: A Cross-Sectional Survey.

Background and Purpose: Functional electrical stimulation (FES) is an effective therapeutic method for improving upper limb motor function after stroke, yet its usage among occupational and physical therapists in Germany remains uncertain. The aim of the study is to investigate the knowledge of, frequency of use, and barriers to electrical stimulation use in stroke rehabilitation. Methods: An online survey was conducted among German occupational and physical therapists working with stroke patients. Data were analyzed for frequency distributions, and associations between electrical stimulation usage and individual/organizational factors were assessed using Chi-Square or Fisher's exact tests. Results: A total of n = 111 participants completed the survey (57 occupational and 54 physical therapists). Almost half (45%) reported regular electrical stimulation use, with 57% wanting to increase it. Use was higher among therapists with additional training (85% vs. 44%, p=0.041), belief in electrical stimulation effectiveness during acute (87% vs. 59%, p=0.041) and early subacute stages (81% vs. 47%, p=0.027), sufficient time (78% vs. 60%, p < 0.001), and device access (80% vs. 44%, p=0.006). Therapists with over 10 years of experience used electrical stimulation less frequently (p < 0.001). Conclusion: Although electrical stimulation shows promise in rehabilitation, further research is needed to assess the resources-such as time, equipment, and therapist training-required for its effective integration.