REVIEW article
Front. Neurosci.
Sec. Neuroprosthetics
Electrical stimulation in upper limb assistance: opportunities and challenges
Provisionally accepted
- 1University of Bath, Bath, United Kingdom
- 2University of Bath Department of Electronic & Electrical Engineering, Bath, United Kingdom
- 3Bath Institute for the Augmented Human, Bath, United Kingdom
- 4Centre for Bioengineering & Biomedical Technologies, Bath, United Kingdom
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The global rise in non-communicable diseases, alongside an ageing population, is expected to increase the prevalence of motor impairments and, therefore, the need for assistive care. Upper limb impairments can significantly affect independent living and increase long-term care costs. Wearable assistive devices incorporating electrical stimulation offer a promising solution to support independence and help alleviate pressures on both formal and informal care provision. The development of hybrid systems, which integrate aspects of robotics and electrical stimulation, aim to overcome the limitations associated with single-modality devices. However, there is limited information on the most appropriate electrical stimulation protocols to use, or on what challenges may be faced in doing so. Correspondingly, this narrative review addresses this gap through assessing the role of electrical stimulation in upper limb assistive technology. By evaluating user requirements and identifying challenges with current stimulation strategies, this review highlights the potential benefits of exploring alternative protocols, beyond conventional functional electrical stimulation (FES) techniques, for upper limb assistance. In particular, addressing practical difficulties of stimulation is likely to be critical for successful user uptake and minimising device abandonment. The paper subsequently reviews several stimulation strategies which may offer novel research directions and opportunities in the development of upper limb assistive technologies.
Keywords: Assistive Technology (AT), Electrical stimulation (ES), hybrid assistive devices, nerve stimulation, Neuromuscular stimulation, Neuroprosthesis, Upper Limb (UL)
Received: 10 Sep 2025; Accepted: 18 Dec 2025.
Copyright: © 2025 Routledge, Zhang and Metcalfe. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Nathan Routledge
Benjamin Metcalfe
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