What is selective stimulation, and who is it for?
The selective stimulation is a special form of electrotherapy suitable for treating denervated — that is, muscles that have lost their motor nerve. (The term “selective stimulation” is a Hungarian professional expression; internationally the term “denervated treatment” is more precise.) It is typically used in peripheral paralysis: peroneal palsy, facial nerve palsy, or muscle treatment after nerve injury caused by a herniated disc, spinal fracture, or spinal surgery.
It is called “selective” because it specifically targets denervated muscle. A healthy, normally innervated muscle does not need this — it is treated with standard muscle stimulation (short, biphasic square wave).
Two important things to know up front
1. Selective stimulation is not suitable for post-stroke (central) paralysis — it can be counterproductive. 2. Not every muscle stimulator can treat denervated muscle; a capable, more advanced device that delivers long pulses is required. We cover this in the detailed selection guide below the products.
The Globus Genesy 1500 — one device for hundreds of complaints.
A Globus Genesy 3000 is a single device for hundreds of complaints.
Genesy 600: multifunctional electrotherapy device. TENS /EMS /MCR-MENS /FES /iontophoresis/denervated. 4 channels, battery-operated.
Price includes: device, 4 cables, 2 cables for microcurrent treatment, 4 pcs 50x50mm and 4 pcs 50x90mm TENS electrodes, battery charger, carrying bag
A selective stimulation device specialized for treating peripheral paralysis (e.g. peroneal or Bell's facial nerve palsy). Optimized for muscles that have lost their motor nerve (denervated muscles). Provides both conventional and EMG-triggered stimulation.
Which device should you choose?
Important: not every muscle stimulator is suitable for treating denervated muscle — only devices capable of delivering long pulses. There are four such devices in our offering.
| If you are looking for… | Check these first |
|---|---|
| Device specialized for denervated, single-muscle treatment (peroneal, facial nerve) – with EMG-trigger option (relearning walking) | PeroBravo |
| Multifunction device that also provides a denervated mode alongside other treatments | Genesy 600, Genesy 1500, Genesy 3000 |
| Top-end for home use, widest program selection | Genesy 1500 |
| Top-end for therapists | Genesy 3000, PeroBravo |
If the muscle’s innervation is intact (a healthy motor nerve), selective stimulation is not needed — standard muscle stimulation is appropriate. See the muscle stimulators. For post-stroke motor relearning, feedback-providing biofeedback devices can be helpful.
How does selective stimulation work?
During the treatment, an electrode placed on the skin delivers a current of milliamps (mA) with a long duration (about 100–900 milliseconds) to the denervated muscle, which causes it to contract. The pulse waveform can be triangular, trapezoidal, or square. This is the essential difference: a healthy muscle is moved by a short, microsecond biphasic square wave, whereas a denervated muscle responds only to long triangular or trapezoidal pulses.
The treatment of peripheral paralysis typically follows a characteristic "curve": it usually starts with triangular pulses and, as the nerve regenerates, progressively switches to trapezoidal and finally square pulses.
Peripheral or central paralysis? — this is decisive!
In peripheral paralysis (the nerve running to the muscle is damaged), selective stimulation is appropriate. In central paralysis (e.g., after stroke, when the nerve is intact but brain control is impaired), selective stimulation is not recommended — it can increase muscle stiffness (spasticity). In stroke cases, standard low-frequency biphasic square-wave muscle stimulation is the correct approach. An accurate diagnosis is essential here — start in consultation with a specialist.
Why is persistent treatment important?
Nerve pathways regenerate very slowly — even with optimal, continuous stimulation they grow at most a few tenths to one millimeter per day. Complete regeneration of a long nerve fiber can therefore take years, and during this time daily, persistent stimulation is required. Regular selective stimulation can help preserve muscle tissue until the nerve reaches it again — without sustained stimulation the denervated muscle may progressively atrophy. Stimulation also helps with the "relearning" of the nerve–muscle connection, which requires a very large number of repetitions.
Dr. Zátrok's advice
For denervated muscle never buy a cheap general-purpose stimulator — it cannot deliver the long triangular/trapezoidal pulses these muscles require.
The key to success is patience and daily consistency: nerve regeneration is slow, and treatment must be continued for a long time. Begin under professional supervision if possible, because the correct pulse shape and the treatment “curve” need individual adjustment.
When NOT to use it?
Selective stimulation is a treatment that requires professional supervision. In the following cases seek medical advice before purchasing or using:
- Central (e.g., post-stroke) paralysis – not suitable here; may increase muscle stiffness
- Pacemaker or other implanted electronic device
- Severe cardiac arrhythmia
- Pregnancy
- Epilepsy
- Cancer in the treated area
- Damaged, inflamed or irritated skin – do not place electrodes on such skin
Accurate diagnosis is key here
Treating a denervated muscle differs from stimulating a healthy muscle, and incorrect settings will not produce results. Therefore start treatment after clarifying the exact cause of the paralysis, preferably under professional supervision.
