Neuromuscular Electrical Stimulation for Heart Conditions

Being told that your blood is not flowing efficiently through your body is not a good feeling. It can make health conditions worse and lead to a lack of blood flow and muscle wasting. In this article, I’ll explore neuromuscular electrical stimulation (NMES) as a means to improve blood flow, explain who may benefit from it, plus discuss additional ways you can achieve optimal blood flow.

Now, let’s talk about all things blood flow!

Proper Blood Flow Is Crucial

Keeping proper blood flow throughout your body is essential to health. Our blood pumps nutrients, oxygen, hormones, and more through our vessels and to all of our organs.

Proper blood flow ultimately aids and maintains the following processes:

  • wound healing
  • brain function
  • heart health
  • immune function

In our body, we have three main types of blood vessels. They are:

  1. Arteries- take oxygen-rich blood away from the heart. Tip: you can remember this by saying the “A” in artery means AWAY.
  2. Veins- carry deoxygenated blood back to the heart.
  3. Capillaries- small, thin blood vessels that connect arteries and veins, carrying oxygenated and deoxygenated blood.

Normally blood flows through our body at an average of 3 to 4 miles per hour, which is around walking speed. However, it can flow faster or slower depending on where blood is in the body.

But if blood flow is restricted it can slow further or stop. This is the case if you have a narrowing of blood vessels (stenosis), a clot (thrombosis), or a blockage (embolism).

This lack of blood flow is called ischemia.

Where Is Blood Flow The Slowest?

Blood flow is slowest in your capillaries. But why is blood flow slower in capillaries?

Capillaries are the smallest (and most numerous) blood vessels you have. They are very small in diameter (3-40 micrometers) compared to veins and arteries, which makes blood flow through them slower.

This slower blood flow rate also allows the exchange of gases and nutrients.

Where Is Blood Flow the Fastest?

Blood flow is fastest in your aorta, which is a large artery connected directly to your heart. The aorta pumps oxygen-rich blood away from your heart.

It makes sense that the velocity of the blood being pumped is fastest where it is being pumped from. You can think of this using a water pump as an example, where water flows at a higher force coming from the pump and slows down the farther it gets from the pump.

What Causes Poor Blood Flow?

Lack of blood flow or a decrease in blood flow can happen for multiple reasons. Some causes are preventable lifestyle choices and sometimes it is the result of underlying conditions.

Medical Conditions That Cause Poor Blood Flow

These are a few causes of poor blood flow related to underlying health conditions:

  • Peripheral artery disease or peripheral vascular disease
  • Coronary artery disease (atherosclerosis)
  • Obesity
  • Diabetes
  • Nerve damage

Lifestyle Choices That Cause Poor Blood Flow

These are a few causes of poor blood flow caused by lifestyle choices. We have control over these factors and can choose to improve them at any time, which can make blood flow better.

  • Smoking
  • Physical Inactivity
  • Poor dietary choices- choosing a diet high in sugar, salt, and saturated fat

Caffeine from coffee, energy drinks, and other caffeinated foods may also restrict blood flow, although only temporarily.

Related article: Common Blood Pressure Questions and Answers (Nutrition Edition)

Picture of Blood Flow Through the Heart

MRI showing blood flow through the heart
Magnetic resonance imaging can show images of the heart and blood flow. Image courtesy of Bruno Bordoni, Ph.D. From: Anatomy, Blood Flow

Blood Flow Through The Heart Video

The body is a miraculous vessel with a lot of complicated processes. In many ways, our bodies are very self-sufficient, managing to maintain heart rate, body temperature, and respirations, and continuously pump blood through over 60,000 miles worth of veins, arteries, and capillaries.

This easy-to-understand, 2-minute video explains how blood flows through the heart.

What Is Neuromuscular Electrical Stimulation?

Neuromuscular electrical stimulation (NMES) is a type of therapy that uses low-level electrical currents to stimulate muscles and nerves (1).

NMES is beneficial in strengthening and retraining muscles. This involuntary muscle stimulation produces smooth muscle contractions that mimic participating in and exercise session.

NMES devices are not implanted. They are placed on the surface of the area needing to be stimulated.

For stroke patients who have hemiparesis or hemiplegia, neuromuscular electrical stimulation can help recover muscle strength and motor skill function.

NMES is commonly used as therapy for conditions that make it difficult to maintain one’s muscle mass and strength.

Benefits of Blood Flow Stimulation

The benefits of blood flow stimulation are massive in the older adult population suffering from chronic disease (2). Benefits include:

  • reduction in cell death causes by poor blood flow
  • increase in oxygenation to organs including the heart
  • increases in vascular health
  • improvements to muscle mass, strength, and ability to perform daily activities

NMES In Heart Patients

It is also a fact that markers of oxidative stress are higher in heart failure patients. The more oxidative stress there is, the more cellular damage occurs, making heart failure worse.

As heart failure worsens, muscle loss leads to weakness and loss of the ability to perform activities of daily living. The same is true of the other conditions listed above. NMES therapy reduces this oxidative stress and inflammation.

One study on patients with acute myocardial infarction shows that after only one session of NMES with muscle contraction in the legs, improvements in blood vessel function and peripheral blood flow were greater in comparison to the control group who received NMES without muscle contraction.

Additionally, another study on stroke patients with upper limb paralysis shows that NMES therapy lasting 30 minutes per session twice a day for 6 weeks results in improvements in wrist extension and function.

The benefits of NMES in these conditions are due to decreases in inflammation and oxidative stress and improvements in vascular function and oxygen uptake (2).

Who May Benefit From Blood Flow Stimulation?

Individuals who may benefit from blood flow stimulation the most include:

  • orthopedic patients following hip or knee replacement
  • those with advanced COPD
  • chronic advanced heart failure patients
  • individuals with loss of muscle function due to stroke
  • those not responsive to or unwilling to exercise
  • those who have had muscle loss related to recent surgery or prolonged hospital stay

Who Performs Neuromuscular Electrical Stimulation?

Neuromuscular electrical stimulation is typically performed by a physical therapist. Physical therapists are specially trained on how to use these devices safely and effectively.

They can use NMES devices in an outpatient setting as part of a physical therapy service or cardiac rehabilitation, but therapists can also use them in a home setting.

Occupational therapists and speech-language pathologists may also use NMES devices to treat patients following surgeries or to help strengthen muscles in the throat to help improve swallowing function.

Are There Any Disadvantages of NMES?

As with any form of medical therapy, there are precautions you need to take when participating in neuromuscular electrical stimulation. The following are a few negative outcomes that may result from NMES.

  1. nerve damage– this can cause a lack of sensation. In some cases (i.e. stroke) nerve damage is already present so therapists need to be careful not to add to this.
  2. Skin irritation or burning– this may happen to those with sensitivities to the gel or adhesive used to stick on the electrodes. Additionally, chemical and electrical burns may occur from the electrical current being too high.

It is normal for your skin to be slightly red following neuromuscular electrical stimulation, just because the blood supply to the area has increased. But be mindful of any major discomfort and communicate it with your therapist to avoid any issues.

Your doctor or therapist performing your NMES should inform you of any possible safety concerns.

Additional Ways to Improve Blood Flow

Besides blood flow stimulation therapy, there are several other ways to improve blood flow to your heart and your entire body. Some of these options are:

  • Stretching
  • Regular cardiovascular exercise
  • Including foods that improve vascular function

Getting any amount of physical activity can reduce cardiovascular disease risk and improve heart health. If possible, try incorporating a walking program into your daily routine to improve strength and your ability to perform regular daily activities. Daily stretching is also great at maintaining or increasing flexibility and assisting in blood flow.

Continue to go to your therapy appointments, trying not to cancel or reschedule. If needed, call your insurance company to see how many visits are covered so you get the most out of what you’re entitled to.

And lastly, continue to follow a heart-healthy dietary pattern. There are multiple healthy dietary patterns to choose from including the DASH diet, Mediterranean diet, healthy U.S.-style diet, and vegetarian or vegan diet.

Related article: Mediterranean Diet For Beginners (Get Started Today!)

Top 25 foods for heart health opt-in


Overall, neuromuscular electrical stimulation (NMES) is a safe and effective therapy to help those with chronic conditions improve their quality of life.

This electrical stimulation using electrodes on muscles can improve blood flow, oxygenation, and vascular function to mimic physical exercise.

It is beneficial to many populations where physical activity is either lacking or patients are unwilling to participate. Whether performed in a therapy setting or your home, NMES may be beneficial for stroke survivors or those with advanced heart failure.

There are a few safety concerns that should be communicated to you. Though it is also important for you to communicate with your therapist if you’re having any discomfort during your NMES session.

You can also take other approaches to help the healing process further. These include stretching, walking, and foods to improve vascular function.

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