Electrodes for transcutaneous (surface) electrical stimulation

In therapeutic and functional applications transcutaneous electrical stimulation (TES) is still the most frequently applied technique for muscle and nerve activation despite the huge efforts made to improve implantable technologies. Stimulation electrodes play the important role in interfacing the tissue with the stimulation unit. Between the electrode and the excitable tissue there are a number of obstacles in form of tissue resistivities and permittivities that can only be circumvented by magnetic fields but not by electric fields and currents. However, the generation of magnetic fields needed for the activation of excitable tissues in the human body requires large and bulky equipment. TES devices on the other hand can be built cheap, small and light weight. The weak part in TES is the electrode that cannot be brought close enough to the excitable tissue and has to fulfill a number of requirements to be able to act as efficient as possible. The present review article summarizes the most important factors that influence efficient TES, presents and discusses currently used electrode materials, designs and configurations, and points out findings that have been obtained through modeling, simulation and testing