Background <p>Post-stroke patients often suffer from impaired postural stability and a heightened risk of falls due to neu- romuscular deficits. Russian current stimulation, a medium-frequency neuromuscular electrical stimulation technique, has shown promise in enhancing muscle strength and mo- tor control.</p> Purpose <p>This study aimed to investigate the effect of Russian current stimulation applied to the ante-rior tibial muscle group, in conjunction with a structured physiotherapy program, on postural stability and fall risk in stroke survivors.</p> Methods <p>A randomized controlled trial was conducted with 40 stroke patients aged 40–60 years (BMI &lt; 30 kg/m²), divided equally into study (n=20) and control (n=20) groups. Both groups received a standard 40-minute physiotherapy regimen three times weekly for six weeks. The study group also received Russian current stimulation (2.5 kHz, 50 bursts/sec, 20 min/session) target- ing the anterior tibial group. Outcomes were assessed pre- and post-intervention using the Biodex Balance System in- dices (overall, anterior-posterior, and medial-lateral stabil- ity), and fall risk index</p> Results <p>Significant improvements were observed in the study group compared to controls as reductions in overall stability index, anterior-posterior and medial-lateral sway indices (all p &lt; 0.05). No significant dif- ference was noted between groups in fall risk under eyes- closed conditions (p &gt; 0.05).</p> Conclusion <p>The addition of Russian current stimulation to conventional physical therapy significantly improves postural stability and reduces fall risk in stroke patients under eyes-open conditions. These findings support the integration of neuromuscular electrical stimulation into stroke rehabilitation protocols targeting the anterior tibial muscle group.</p> Trial registration <p>Clinical-Trials.gov Identifier: NCT06793865</p>