For some people, the obstacle to standing up is not weakness. It is the opposite problem: legs that are too stiff, too tense, or too unpredictable to cooperate. You go to move and the leg pushes out straight when you wanted it to bend, or a spasm arrives at the worst possible moment, or simply getting your feet into a sensible position feels like a negotiation. This is spasticity, and for a great many people, after an incomplete spinal cord injury or stroke, it is the single thing standing between them and a useful sit-to-stand.

We have written before about spasticity after spinal cord injury and the limits of medication. This article looks at a more specific question: when spasticity is the thing blocking a functional goal like standing, what can electrical stimulation do about it, and how do the pieces fit together?

Ask someone in the early stages of recovery from a spinal cord injury or stroke what they most want to do again, and the answers are often smaller and more specific than you might expect. Not "run a marathon." More often, it is something like rising from a chair without help, managing a transfer to the bed, or pushing up to standing so that getting to the toilet is your own business and nobody else's.

Sit-to-stand sits at the centre of all of that. It is one of the most important movements in daily life and one of the first functional milestones a therapist will work on. If you can move reliably between sitting and standing, a great deal of independence follows. This article looks at how electrical stimulation, and in particular a responsive electrical stimulation device like the Stim2Go, can support sit-to-stand practice as part of a wider rehabilitation programme.

Transcutaneous spinal cord stimulation (tSCS) has moved quickly from a research curiosity to a recognised tool in neurological rehabilitation. People living with spinal cord injury, stroke, and multiple sclerosis are asking us about it. Clinicians want to know which device to recommend. Equipment commissioners want evidence-led guidance before authorising spend that can run into tens of thousands of pounds per system.

A paper published in Nature Biomedical Engineering on 12 May 2026 has added something important to that conversation. It is not a clinical trial. It is a careful study of the physics and physiology that govern which nerve fibres a tSCS device actually recruits. The finding is consequential, and it bears directly on the choice of device.

In short: the waveform you choose determines whether tSCS does the thing rehabilitation needs it to do.

Heel pressure injuries are one of those problems where the evidence has been ahead of everyday practice for years. We have known for many years that pillows and improvised supports rarely keep a heel clear of the bed for long, and that a heel touching anything is a heel under pressure and shear. The 2025 International Pressure Injury Guideline (the fourth edition produced by NPIAP, EPUAP, and PPPIA) has now caught up to that reality, and in doing so it has changed the language clinicians and commissioners should use when they think about heel protection.

The guideline introduces a phrase worth noticing: "floating heels."

It is not a marketing line. It is a clinical description of what an effective heel offloading intervention has to achieve, taken from the guideline itself. And it has practical implications for any service that has to choose, fund, or audit heel protection equipment.

It is quite common for us to meet clients who have tried electrical stimulation on a limb and found that nothing happened. No matter how high the intensity was set, the muscle simply would not contract. They arrive frustrated, sometimes having been told that nothing more can be done. When we then use the RISE Stimulator, a specialist device capable of producing the long-impulse-duration waveforms that denervated muscle actually requires, they are often surprised and relieved to see a contraction for the first time.

That moment of surprise reveals an important gap in understanding. The muscle did not fail to respond because it was beyond help. It failed because the wrong electrical 'language' was being spoken. A denervated muscle is not simply a weak muscle. It is, in a very real sense, a different tissue with altered structure, electrical properties, and activation rules. Understanding these differences is the foundation for making sense of any treatment approach.

Intensive care patients face the highest pressure ulcer prevalence of any hospital setting—14.32% according to international prevalence surveys. The heels account for a substantial proportion of these injuries. And unlike many ICU complications, heel pressure ulcers are largely preventable with appropriate intervention.

Yet in the complex, high-acuity environment of intensive care, heel protection can be overlooked. The focus—rightly—is on keeping the patient alive. Organ support, haemodynamic stability, ventilation, sedation. Heel protection rarely tops the priority list. But if a heel pressure ulcer occurs then this complicates continuity of care.

This article makes the case for implementing prophylactic heel offloading as a standard component of ICU care, and examines what effective implementation looks like in practice.