Stroke & Traumatic Brain Injury (TBI): How NEUBIE and Laser Therapy can help
What are stroke and TBI?
By the time most people reach us, the emergency is over. The clot was treated, the bleed has settled, the acute scans are done. What is left is the slower, harder question: how much movement can you get back, and how do you get it? That is the part rehabilitation answers, and it is where this article lives.
A stroke happens when blood stops reaching part of the brain, either because a clot blocks the supply or a vessel bleeds, and the tissue in that area is damaged. A traumatic brain injury (TBI) comes from an outside force: a fall, a blow, a crash. The principle behind both is the same. An area of the brain is damaged, and the functions it ran are affected. Where the injury sits decides what you feel: weakness or paralysis down one side, spasticity, trouble walking, problems with balance and coordination, changes in sensation. The injury is a single event rather than a worsening condition, and that changes the task ahead. Your brain's job afterwards is to recover and reorganise, not to manage a steady decline.
How the NEUBIE can help
Recovery after stroke or TBI leans on neuroplasticity, the brain's ability to rebuild and remap the pathways it lost. The NEUBIE feeds that process. It uses pulsed direct current stimulation with a mapping function, finds where usable function remains, and stimulates the affected motor pathways again and again, reinforcing the signal each time so the brain starts forming new working connections.
The waveform is part of the rationale. TENS and conventional muscle stimulators run on alternating current. The NEUBIE runs on a pulsed direct current, and a built-in carrier waveform clears the charge that once made direct current impractical, so it can use long, comfortable pulses. Long, single-direction pulses are also the kind best able to reach muscle whose nerve supply has weakened, which is the situation a stroke creates when the brain's drive to a limb is cut.
That remapping responds most to active, task-specific movement, so sessions pair stimulation with guided exercise. You work on weakness, on bringing down spasticity, and on the learned non-use that sets in when a limb becomes hard to move and you stop trying to move it.
How low-level laser therapy can help
THOR low-level laser therapy delivers near-infrared light that supports mitochondrial energy production and lowers inflammation at the cellular level, with the strongest evidence in soft-tissue and musculoskeletal work. In stroke and brain-injury rehab that suits the secondary musculoskeletal pain, the soft-tissue problems and the spasticity-related tension that follow an injury. The brain itself needs a straight answer, though. Large randomised trials of transcranial laser through the skull in acute stroke showed no benefit, and the pivotal NEST-3 trial was stopped for futility. The skull blocks most light before it reaches brain tissue. So the laser here supports your body and eases the symptoms around your recovery. It is not a proven, direct treatment of the brain injury.
The combination within treatment
Together the modalities give recovery both a stimulus and a setting that helps it hold. Laser brings down secondary inflammation and supports cellular energy in recovering tissue. The NEUBIE then delivers the repeated, targeted neuroplastic stimulus, paired with movement, that drives the brain to rebuild lost pathways. Dry needling can sit alongside to settle the spasticity and protective tension that follow an injury, freeing up movement before retraining starts.
The mechanism: why this approach works
A stroke or TBI destroys some brain tissue. The surrounding brain holds a striking capacity to take over those functions, given the right stimulus. Three things drive that recovery: repetition, attention, and meaning. The pathways the brain activates again and again, and activates for a reason, are the ones it strengthens and reorganises around.
The combined approach targets exactly that. The NEUBIE's repeated, mapped stimulation, coupled with goal-directed movement, delivers the focused, high-repetition signal that drives remapping, and it works only where viable function survives. Photobiomodulation backs that up by cutting the secondary inflammation that would slow recovery and by supporting the energy demands of healing tissue. You get the signal that prompts the brain to rewire and the cellular conditions that help the rewiring stick.
Conclusion
Recovery from stroke and brain injury comes down to the brain's ability to relearn. Rehab that sends a focused, repeated stimulus to the right pathways, in the right setting, gives that ability its best chance. Pairing NEUBIE neuromuscular stimulation with THOR laser therapy drives neuroplastic recovery, lowers spasticity, and rebuilds functional movement, alongside the medical and therapy care you already have. Every recovery runs differently, and progress turns on many factors. The brain's capacity to adapt is real, and a clear, repeated, well-targeted plan is how you put it to work.
Ready to take the next step?
If you or someone you care for is recovering from a stroke or brain injury and wants to find out whether this approach could help, book a free 30-minute consultation, in person or by phone. We will talk through the history, the goals and what a realistic plan looks like, with no pressure.
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Evidence & references
Honest summary of the evidence behind this article:
Neuroplasticity-driven recovery, and the principles it depends on (repetition, intensity, and task-specific, meaningful practice), are well established [1].
Electrical stimulation (NMES/FES) after stroke has a reasonable evidence base. Meta-analyses show it improves activity and activities of daily living as part of rehabilitation, though it is not clearly superior to conventional therapy and works best as one component alongside active practice [2,3]. NEUBIE-specific stroke trials have not been published, so claims rest on this broader stimulation literature plus mechanism.
On the waveform itself: the NEUBIE is a pulsed direct current (DC) device rather than a continuous-DC or alternating-current one [6,7]. The brand-independent evidence sits at the waveform level. Long-duration, single-direction (monophasic) pulses are the established way to recruit muscle that has lost reliable nerve supply, something biphasic/AC currents struggle to do [8], and one small crossover study found monophasic pulsed current produced higher muscle torque than a popular alternating-current waveform at the same tolerated intensity [9]. The one published clinical RCT of the NEUBIE itself (in diabetic neuropathy, not stroke) found it outperformed TENS on several nerve-conduction and symptom measures, but it was open-label, NeuFit-affiliated, and several effects weakened after statistical correction [6]. Two honesty points. First, the stronger NMES/FES stroke evidence above [2,3] came mostly from biphasic/AC devices, so it supports stimulation-plus-movement as a principle rather than pulsed DC specifically. Second, the heavily studied "DC" technique in stroke, transcranial direct current stimulation (tDCS), is a different, low-intensity brain-surface method with mixed, low-to-moderate-certainty evidence [10]. It is not what the NEUBIE delivers, and its results should not be read across to this approach. Further NeuFit pulsed-DC trials in low back pain and radiculopathy are registered but not yet reporting [11].
On transcranial laser in stroke, the caveat matters: the major randomised controlled trials (NEST-2, and the pivotal NEST-3, halted for futility) showed no benefit [4,5], and the skull substantially limits light reaching the brain. Laser's better-supported role here is peripheral: soft-tissue, musculoskeletal pain and inflammation, not direct treatment of brain injury.
On TBI and laser, the evidence is small and mixed. A 2025 randomised controlled trial in mild TBI reported improvements in cognition, sleep and post-concussion/PTSD symptoms with transcranial PBM [12], while a 2023 randomised controlled trial in persistent post-concussion symptoms found no benefit over placebo [13]. Earlier work was limited to case reports. Treat it as emerging and unsettled, not established, and note these trials used transcranial devices/protocols, which differ from peripheral laser application.
Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008;51:S225–S239. https://pubs.asha.org/doi/10.1044/1092-4388(2008/018)
Howlett OA, Lannin NA, Ada L, McKinstry C. Functional electrical stimulation improves activity after stroke: a systematic review with meta-analysis. Arch Phys Med Rehabil. 2015. https://www.sciencedirect.com/science/article/abs/pii/S0003999315000441
Neuromuscular electrical stimulation improves activities of daily living post-stroke: a systematic review and meta-analysis. 2021. https://www.sciencedirect.com/science/article/pii/S2590109521000811
Zivin JA, et al. Effectiveness and safety of transcranial laser therapy for acute ischemic stroke (NEST-2). Stroke.2009;40(4):1359–1364. https://pubmed.ncbi.nlm.nih.gov/19233936/
Hacke W, Zivin JA, et al. Transcranial laser therapy in acute stroke treatment: results of NEST-3 (terminated for futility). Stroke. 2014;45(11):3187–3193. https://pubmed.ncbi.nlm.nih.gov/25293665/
Kostopoulos D, et al. An open-label comparative study of pulsed direct current (Neubie) versus alternating current (TENS) in the physical therapy treatment of diabetic peripheral neuropathy. J Diabetes Res. 2025. https://pubmed.ncbi.nlm.nih.gov/39949402/
NeuFit. More about the Neubie (device description: pulsed direct current and dual-waveform design). https://www.neu.fit/more-about-the-neubie/
Optimizing stimulation parameters in functional electrical stimulation of denervated muscles: a cross-sectional study (long-duration monophasic/triangular pulses for muscle with lost nerve supply). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458019/
Scott W, et al. Electrically elicited muscle torque: comparison between 2500-Hz burst-modulated alternating current and monophasic pulsed current. J Orthop Sports Phys Ther. 2015. https://pubmed.ncbi.nlm.nih.gov/26556393/
Transcranial direct current stimulation (tDCS) for improving capacity in activities and arm function after stroke: a network meta-analysis of randomised controlled trials (Cochrane; mixed/limited-certainty evidence). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598049/
NeuFit-sponsored pulsed direct current trials (registered, results pending): mechanical low back pain, ClinicalTrials.gov NCT06984224 (https://clinicaltrials.gov/study/NCT06984224); lumbosacral radiculopathy, ClinicalTrials.gov NCT06421558 (https://clinicaltrials.gov/study/NCT06421558).
Lee TL, Chan DY, Chan DT, et al. Transcranial photobiomodulation improves cognitive function, post-concussion, and PTSD symptoms in mild traumatic brain injury. J Neurotrauma. 2025. https://pubmed.ncbi.nlm.nih.gov/40485299/
Taylor AM, Mannix R, Zafonte RD, Whalen MJ, Meehan WP. A randomized, double-blinded, placebo-controlled clinical trial evaluating transcranial photobiomodulation as treatment for concussion (no benefit over placebo). Med Sci Sports Exerc. 2023. https://pubmed.ncbi.nlm.nih.gov/38109202/
Important information
This article is for general education and is not medical advice. It does not replace assessment, diagnosis or treatment from your GP, neurologist or stroke team, and nothing here should be used to delay or stop conventional medical care.
The treatments described are delivered as part of individualised, off-label clinical care. In the UK, THOR low-level laser therapy is approved for tendinopathies, chronic joint pain, back and neck pain, and oral mucositis. Use for any other condition, including the one discussed here, is off-label and is not a claim to treat or cure that condition. The NEUBIE is a regulated neuromuscular stimulation device cleared for general indications such as neuromuscular re-education, preventing disuse atrophy, reducing muscle spasm and pain management. Its use in specific neurological conditions is supportive and off-label rather than an approved disease treatment.
Where evidence is referred to, its strength is described honestly (established, emerging, preclinical or mechanistic), and individual responses vary. No specific outcome is promised.
