A Japanese hospital team ran a peer-reviewed randomised controlled trial of NMES, a form of EMS , after acute stroke.
They measured quadriceps muscle thickness by ultrasound on day 1 and day 14.
The weak thigh lost 2.65 mm with NMES versus 4.64 mm without it.
In milder stroke (NIHSS under 12), that thigh stayed at 0.00 mm versus a 3.88 mm drop.
Ankle tone was also lower after NMES.
The full group result was not statistically firm, so this is a signal, not proof.
The work came from Steel Memorial Yawata Hospital and is open access. The full post gives the protocol, safety notes, and limits.
https://oriems.fit/blogs/research-digest/japanese-nmes-trial-stroke-quadriceps-muscle