ng252 Rehabilitation for chronic neurological disorders including acquired brain injury. 15 October 2025. https://www.nice.org.uk/guidance/ng252
These clinical guidelines are intended to provide guidance on the rehabilitation of people with long term neurological conditions that are not already covered by disease specific guidelines, for example stroke, cerebral palsy, dementia, myalgia encephalomyelitis and epilepsy. Included conditions are:
- Progressive neurological disease such as Parkinson’s and Parkinsonian presentations, MS, MND, Fredrich’s disease, spina bifida amongst other conditions
- Acquired brain injury from many causes including tumours, TBI, chronic encephalitis and alcohol or drug misuse
- Acquired spinal cord injury resulting from tumours, traumatic injury, infections, vascular infarction or haemorrhage and transvers myelitis
- Acquired peripheral nerve disorders
- Functional neurological disorders
The guidelines have the following recommendations for the use of FES/NEMS
Electrical Stimulation
1.16.13
Consider neuromuscular electrical stimulation in addition to muscle strengthening exercise and functional activity.
1.16.14
If the person has muscle weakness of the lower limbs, caused by an upper motor neurone lesion, consider functional electrical stimulation in addition to gait training. See also NICE’s interventional procedures guidance on functional electrical stimulation for drop foot of central neurological origin. (IPG278)
The committee used their knowledge and experience to make recommendations on electrical stimulation. They noted that neuromuscular electrical stimulation can add muscle strength for both upper and lower limbs for people with a peripheral or central nerve disorder. The committee also noted that functional electrical stimulation can optimise the timing and strength of muscle contractions during walking for people with muscle weakness caused by lower motor neuron lesions.
While electrical stimulation will not be appropriate for all the neurological conditions listed and, in particular, is only appropriate for peripheral lesions where the nerve lesion is incomplete, this is the first time that guidelines have been produced that cover the full range of patients typically seen in an FES clinic.