In a patient with a pacemaker, which intervention is NOT contraindicated and can be used with supervision?

Biofeedback to the affected side

Active exercise on the affected upper extremity

Functional electrical stimulation to the affected side

Pacemakers require that electrical currents near the chest be used with caution because the device can misinterpret signals or be inhibited. Functional electrical stimulation to the affected limb delivers controlled, low-amplitude currents to peripheral nerves and muscles, and when used under supervision the clinician can adjust the settings and monitor the patient to avoid any interaction with the pacemaker. This allows active motor engagement and functional practice of the affected side while keeping energy delivery away from the heart device. Other options either involve modalities that don’t actively train the affected limb in a controlled way or don’t address the limb directly in a supervised manner, making them less suitable in this scenario.

Manual resistive exercise to non-affected side

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