Electrical stimulation has been commonly used for neuromodulation, strengthening, pain, and somatosensorial management in physiotherapy and rehabilitation disciplines for many years. Electrical stimulation of the tissue is carried out by time-varying voltage or current pulses. The specific functional objectives and capability of target structures are the primary criteria for the choice of stimulus parameters. Unit pulses of applied charge are characterized by polarity, width, intensity, frequency, amplitude (volts or amperes), duration (pulse width), shape (rectangular, triangular, sinusoidal), and transcutaneous or invasive application, and stimulation site (the nerve, muscle). The methodologies and applications that concerns these parameters are mainly focused on the functional body treatment and assessment objectives. Electrical stimulation approaches have many advantages over conventional and movement-based rehabilitation, mainly in terms of accuracy in stimulation of the movement through the participation of all muscle fibers. Although electrical stimulation approaches are commonly used in physiotherapy and rehabilitation, the mechanisms of action are still not described well. Besides there is no standardization even in definitions, such as electrical stimulation, neuromuscular electrical stimulation, transcutaneous electrical stimulation, somatosensorial electrical stimulation...etc. Because of such differentiation in definitions and treatment protocols (frequency, intensity, etc…) the level of the quality of electrical stimulation is being questioned. However, in general, despite the unstandardized application procedures electrical stimulation has great potential for use in clinical practice for diagnosis, progress monitoring of patients, guidance for further rehabilitation therapy depending on the capabilities affected, and allowing rehabilitation where the active motion is forbidden or could not be initiated, etc.
The lack of knowledge in the field of electrotherapy causes physiotherapists not to use this approach and affects clinical decision-making process since physiotherapists have a unclear clinical focus. This confliction is well known by professional associations at the national and European level, such as Turkish Physiotherapy Association, Order of Physiotherapists in Romania, Lithuanian Physiotherapy Association, and Estonian Association of Physiotherapists. The professional associations believe in the importance of providing additional training to their associates in order to complete their professional skills.
The knowledge on electrical stimulation already exists and is commonly being used in universities. The Pamukkale University (PAU), Hatay Mustafa Kemal University (HMKU), Suleyman Demirel University (SDU), Baskent University (BU), University of Craiova, Šiauliai State University of Applied Sciences, and Burdur Mehmet Akif Ersoy University have been working for years in the electrotherapy and electrophysical agents’ field. These universities have also provided several training courses and workshops in this area for physiotherapists besides undergraduate and graduate level physiotherapist students. However, the transference of knowledge from the universities to the professionals is punctual and the actual training needs in electrical stimulation applications of physiotherapists are not fully compensated. Besides, it is known that there are regional differences in professional training and transference of knowledge from the universities around Europe.
CK4Stim project targeted academic staff, physiotherapists, supervisors, researchers, national and international physiotherapy associations in addition to BSc, MSc, and PhD students. This project provides a common language for electrical stimulation in physiotherapy and rehabilitation education and practice in accordance with the European standards. The project also supports vocational education and training by digital education for excellence. CK4Stim project has scientific, academic, economic, and social outcomes.