Muscle Stimulator Market Size
The Global Muscle Stimulator Market size was USD 586.22 million in 2024 and is projected to reach USD 606.74 million in 2025, USD 627.98 million in 2026, and USD 826.93 million by 2034, exhibiting a CAGR of 3.5% during the forecast period (2025–2034). Growth in this market is primarily supported by increasing adoption of electrotherapy devices for rehabilitation, pain management, and sports recovery. Over 45% of demand originates from clinical settings, while nearly 30% comes from home-based therapy devices, reflecting the growing consumer preference for non-invasive, easy-to-use muscle recovery solutions.
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The US Muscle Stimulator Market continues to expand steadily, accounting for approximately 23% of the global share. This growth is driven by increasing healthcare expenditure and rising cases of musculoskeletal disorders across the country. Around 40% of physiotherapy clinics in the United States currently use electrotherapy devices, while 35% of consumers prefer smart, portable stimulators for home rehabilitation. The integration of digital features and wearable designs has enhanced therapy efficiency by 25%, contributing to wider market acceptance across hospitals, clinics, and fitness centers nationwide.
Key Findings
- Market Size: Valued at USD 586.22 million in 2024, projected to touch USD 606.74 million in 2025 and USD 826.93 million by 2034, growing at a CAGR of 3.5%.
- Growth Drivers: Over 45% demand driven by rehabilitation therapies and 35% growth attributed to increased adoption of portable and wearable electrotherapy devices globally.
- Trends: Around 40% of new devices feature wireless connectivity, 30% are AI-enabled, and 25% focus on personalized treatment modes for user convenience.
- Key Players: Omron, Zynex, NeuroMetrix, DJO Global, RS Medical & more.
- Regional Insights: North America holds 35% share with advanced healthcare adoption, Europe captures 25% driven by rehabilitation programs, Asia-Pacific leads 30% through fitness and recovery growth, while Middle East & Africa contributes 10% with expanding physiotherapy infrastructure.
- Challenges: Nearly 28% of regions face regulatory complexities and 20% experience limited awareness impacting large-scale device adoption worldwide.
- Industry Impact: Over 50% of hospitals and 40% of physiotherapy centers globally use electrical stimulation, improving rehabilitation outcomes by 30% across patient groups.
- Recent Developments: About 38% of manufacturers launched smart-connected stimulators, and 25% introduced sustainable models to improve therapy efficiency and environmental compliance.
The Muscle Stimulator Market is undergoing rapid technological transformation with increased adoption of wireless, AI-powered, and multi-functional devices. Over 45% of new models are designed for home users, while clinical applications continue to dominate with 55% usage. Manufacturers are increasingly focusing on ergonomics, digital integration, and sustainability to meet growing consumer demand and improve rehabilitation efficiency.
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Muscle Stimulator Market Trends
The muscle stimulator market is witnessing a surge in demand across healthcare, fitness, and rehabilitation sectors. Wearable and portable muscle stimulators have gained significant traction, accounting for over 50% of product usage worldwide, driven by the convenience of at-home therapy. Within application segments, pain management leads with nearly 55%–60% share of total demand due to increasing cases of chronic pain and musculoskeletal disorders. By product type, neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS) devices collectively contribute about 40%–60% of the market share. Regionally, North America dominates with approximately 30% share, followed by Europe at around 25% and Asia-Pacific growing rapidly with double-digit percentage expansion in adoption. Integration of digital health, IoT, and data-tracking features is further driving innovation, as over 35% of new muscle stimulators now include smart connectivity options.
Muscle Stimulator Market Dynamics
Growth in smart and connected device adoption
The demand for smart muscle stimulators with app-based and IoT functionalities is increasing rapidly. Over 30% of new devices sold globally are integrated with connectivity features. In advanced markets, users adopting connected units show a 50% higher retention rate than those using conventional devices.
Rising demand for non-drug pain relief and rehabilitation tools
Increasing incidences of musculoskeletal and neurological disorders are fueling the adoption of muscle stimulators. Around 20%–25% of the global adult population suffers from chronic pain, and nearly 40% of them prefer non-drug-based solutions.
RESTRAINTS
"Limited awareness and inadequate infrastructure in developing regions"
In emerging economies, awareness of muscle stimulation technology remains below 10% among healthcare practitioners. A shortage of trained professionals and limited access to power or technical maintenance facilities hinder the adoption rate.
CHALLENGE
"Regulatory and reimbursement complexities"
Inconsistent approval and reimbursement frameworks present a major challenge to market growth. Globally, less than 20% of muscle stimulator devices receive reimbursement coverage in public healthcare systems.
Segmentation Analysis
The Global Muscle Stimulator Market, valued at USD 586.22 million in 2024, is projected to reach USD 606.74 million in 2025 and USD 826.93 million by 2034, registering a CAGR of 3.5% during the forecast period (2025–2034). The market is segmented by type and application, with the type segment showcasing a diverse range of electrical stimulation devices catering to neurological, muscular, and rehabilitative treatments. Among the types, Transcutaneous Electrical Nerve Stimulation (TENS) and Neuromuscular Electrical Stimulation (NMES/EMS) Devices collectively dominate the market share due to their non-invasive and therapeutic benefits. By application, hospitals, physiotherapy clinics, and home-care units remain key contributors to overall demand, driven by the increasing prevalence of chronic pain, post-operative recovery, and physical therapy procedures worldwide.
By Type
Spinal Cord Stimulation (SCS) Devices
Spinal Cord Stimulation devices are primarily used for chronic pain management and neuropathic conditions by sending low-voltage electrical currents to the spinal cord. Their clinical adoption is steadily growing in developed regions where advanced healthcare infrastructure supports neurostimulation-based therapies.
SCS Devices Market Size was USD 60.7 million in 2025, representing 10% of the total share, with a projected CAGR of 3.5%, driven by increasing cases of spinal injuries and the shift toward minimally invasive pain management systems.
Major Dominant Countries in the SCS Segment
- The United States led the SCS segment with a market size of USD 22 million in 2025, holding 3.6% share due to high neurostimulation device adoption.
- Germany followed with USD 18 million in 2025, holding 3% share driven by strong clinical research and neurorehabilitation facilities.
- Japan recorded USD 12 million in 2025, representing 2% share supported by technological advancements in medical devices.
Deep Brain Stimulation (DBS) Devices
Deep Brain Stimulation devices are mainly employed in neurological treatments such as Parkinson’s disease and epilepsy. Their use is concentrated in specialized hospitals with skilled neurosurgeons and advanced imaging technologies.
DBS Devices Market Size was USD 30.3 million in 2025, capturing 5% of the market with a CAGR of 3.5%, supported by the rise in neurodegenerative disorders and improvements in surgical implant accuracy.
Major Dominant Countries in the DBS Segment
- United States led with USD 11 million in 2025, holding 1.8% share due to higher neurological procedure volumes.
- France followed with USD 10 million, accounting for 1.6% share, supported by favorable healthcare reimbursement structures.
- Japan held USD 9 million, capturing 1.4% share from growing brain stimulation therapy demand.
Vagus Nerve Stimulation (VNS) Devices
Vagus Nerve Stimulation devices are used to treat epilepsy, depression, and stress-related neurological conditions. The demand for these devices is expanding as non-drug-based neurological therapies gain popularity globally.
VNS Devices Market Size was USD 42.5 million in 2025, representing 7% of the total share with a CAGR of 3.5%, driven by increasing awareness of alternative treatments and mental health-related applications.
Major Dominant Countries in the VNS Segment
- United States led with USD 16 million in 2025, holding 2.6% share due to clinical adoption in epilepsy care.
- Germany followed with USD 14 million, representing 2.3% share due to advancements in implantable medical devices.
- China recorded USD 12 million, accounting for 2% share driven by increasing neurological research activities.
Sacral Nerve Stimulation (SNS) Devices
Sacral Nerve Stimulation devices are used to treat urinary and bowel disorders by stimulating the sacral nerves. Adoption has grown steadily in urology and pelvic health applications, enhancing patient recovery and therapy precision.
SNS Devices Market Size was USD 18.2 million in 2025, representing 3% share of the market with a CAGR of 3.5%, supported by increased pelvic health awareness and higher urological disorder treatment rates.
Major Dominant Countries in the SNS Segment
- United States led with USD 7 million, holding 1.1% share, supported by high surgical procedure rates.
- France followed with USD 6 million, representing 1% share from growing bladder disorder therapies.
- India posted USD 5 million, accounting for 0.8% share due to rising women’s healthcare initiatives.
Gastric Electric Stimulation (GES) Devices
Gastric Electric Stimulation devices treat gastrointestinal motility disorders through mild electrical pulses. They are gaining traction as alternative treatments for patients who do not respond to conventional therapies.
GES Devices Market Size was USD 12.1 million in 2025, representing 2% of the total market, with a CAGR of 3.5%, supported by emerging clinical trials and innovative applications in gastrointestinal therapy.
Major Dominant Countries in the GES Segment
- United States led with USD 5 million, holding 0.8% share due to strong GI device development pipelines.
- Germany followed with USD 4 million, accounting for 0.6% share from hospital-based research programs.
- China recorded USD 3 million, capturing 0.5% share driven by expanding digestive health awareness.
Transcutaneous Electrical Nerve Stimulation (TENS) Devices
TENS devices are widely used for pain relief and physical rehabilitation. Their non-invasive nature and affordability have made them the most popular product category, particularly among physiotherapists and home users.
TENS Devices Market Size was USD 303.4 million in 2025, representing 50% of the total share, with a CAGR of 3.5%, driven by increased sports injury recovery, muscle relaxation, and home healthcare demand.
Major Dominant Countries in the TENS Segment
- United States led with USD 100 million, holding 16.5% share due to strong consumer and clinical usage.
- China followed with USD 90 million, representing 14.8% share from expanding retail distribution networks.
- India recorded USD 80 million, accounting for 13.2% share through rising physiotherapy adoption and sports medicine usage.
Neuromuscular Electrical Stimulation (NMES/EMS) Devices
NMES/EMS devices are primarily used for strengthening muscles, preventing atrophy, and rehabilitation after injuries. These devices are widely adopted by sports professionals and physiotherapy clinics globally.
NMES/EMS Devices Market Size was USD 121.3 million in 2025, representing 20% of the total market with a CAGR of 3.5%, driven by increasing use in sports training, muscle conditioning, and post-surgical recovery programs.
Major Dominant Countries in the NMES/EMS Segment
- United States led with USD 40 million, holding 6.6% share supported by sports medicine growth.
- Japan followed with USD 35 million, representing 5.8% share due to strong consumer electronics integration.
- Germany recorded USD 30 million, accounting for 5% share from clinical rehabilitation programs.
By Application
Hospitals
Hospitals represent the largest end-user segment in the muscle stimulator market, primarily due to their adoption for post-operative recovery, chronic pain management, and neurological rehabilitation. Around 45% of advanced care hospitals globally utilize electrotherapy devices for patient treatment and recovery enhancement, supported by government healthcare investments and clinical integration.
Hospitals Market Size was USD 212.36 million in 2025, representing 35% of the total share with a CAGR of 3.5%, driven by higher surgical volume, patient rehabilitation demand, and adoption of technologically advanced stimulators.
Major Dominant Countries in the Hospitals Segment
- The United States led the Hospitals segment with a market size of USD 58 million in 2025, holding a 9.5% share due to advanced healthcare infrastructure and adoption of electrotherapy systems.
- Germany followed with USD 41 million, holding a 6.7% share due to the expansion of rehabilitation departments and insurance-backed therapy programs.
- Japan recorded USD 36 million, representing 5.9% share supported by aging population treatment and chronic pain management practices.
Sports Clinics
Sports Clinics widely use muscle stimulators for muscle conditioning, recovery after injuries, and athlete performance enhancement. Nearly 30% of sports rehabilitation centers incorporate electrical stimulation therapy in physical training, helping in faster muscle reactivation and prevention of sports fatigue.
Sports Clinics Market Size was USD 121.35 million in 2025, accounting for 20% of the market share with a CAGR of 3.6%, driven by the rising number of sports injuries and adoption of non-invasive recovery treatments.
Major Dominant Countries in the Sports Clinics Segment
- The United States led the Sports Clinics segment with a market size of USD 36 million in 2025, holding a 6% share due to widespread physiotherapy integration in athletic centers.
- Australia followed with USD 28 million, holding 4.6% share driven by increasing athlete participation and physiotherapy expansion.
- The United Kingdom recorded USD 24 million, representing 4% share supported by growing sports therapy adoption.
Home Care Units
Home Care Units have seen significant adoption of compact and wireless muscle stimulators for personal pain relief and rehabilitation. Over 35% of global consumers prefer at-home therapy for convenience and cost efficiency, driven by growing awareness of digital healthcare tools.
Home Care Units Market Size was USD 109.21 million in 2025, representing 18% of total share with a CAGR of 3.8%, driven by the rise in self-treatment preferences, wearable technologies, and elderly population care demand.
Major Dominant Countries in the Home Care Units Segment
- Japan led with USD 31 million in 2025, holding 5% share due to high consumer adoption of smart portable devices.
- Germany followed with USD 27 million, holding 4.4% share supported by remote healthcare integration.
- China recorded USD 24 million, representing 4% share driven by affordability and retail distribution expansion.
Physiotherapy Clinics
Physiotherapy Clinics form one of the strongest market segments, utilizing muscle stimulators for rehabilitation, pain therapy, and muscle strengthening. Over 40% of clinics globally employ electrotherapy equipment for recovery programs and physical performance improvement.
Physiotherapy Clinics Market Size was USD 133.48 million in 2025, representing 22% of the market share with a CAGR of 3.4%, driven by rehabilitation needs, chronic pain treatment, and expanding physiotherapy infrastructure.
Major Dominant Countries in the Physiotherapy Clinics Segment
- Canada led with USD 38 million in 2025, holding 6.2% share due to insurance-covered rehabilitation programs.
- India followed with USD 34 million, representing 5.6% share from physiotherapy clinic expansion and awareness.
- France recorded USD 29 million, holding 4.8% share from increased use of electrotherapy in physical therapy programs.
Ambulatory Surgical Centers
Ambulatory Surgical Centers (ASCs) use muscle stimulators for post-surgical pain management and recovery support in orthopedic and neurology procedures. Around 25% of surgical centers globally have incorporated stimulation therapy to improve recovery efficiency and reduce patient hospitalization time.
Ambulatory Surgical Centers Market Size was USD 30.34 million in 2025, representing 5% of total share with a CAGR of 3.5%, driven by outpatient surgery growth, recovery-based therapy adoption, and cost-effective care models.
Major Dominant Countries in the Ambulatory Surgical Centers Segment
- The United States led the ASCs segment with USD 9 million in 2025, holding 1.5% share due to high outpatient care adoption.
- Germany followed with USD 7 million, holding 1.2% share supported by advanced post-surgical recovery procedures.
- The United Kingdom held USD 6 million, representing 1% share from expansion in day-surgery and rehabilitation centers.
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Muscle Stimulator Market Regional Outlook
The Global Muscle Stimulator Market, valued at USD 586.22 million in 2024, is projected to reach USD 606.74 million in 2025 and USD 826.93 million by 2034, growing at a CAGR of 3.5% during the forecast period (2025–2034). Regional growth is distributed across North America, Europe, Asia-Pacific, and the Middle East & Africa, reflecting varying levels of technological adoption and healthcare development. North America accounts for 35% of the total market, followed by Europe at 25%, Asia-Pacific at 30%, and the Middle East & Africa at 10%. This balanced regional contribution highlights widespread demand for advanced rehabilitation and pain management solutions worldwide.
North America
North America leads the global muscle stimulator market with strong adoption across hospitals, physiotherapy centers, and home-care units. Over 40% of rehabilitation facilities in the region use electrotherapy equipment, supported by favorable healthcare policies and high consumer awareness. The presence of major manufacturers enhances product innovation and accessibility across the United States and Canada.
North America held the largest share in the Muscle Stimulator Market, accounting for USD 212.36 million in 2025, representing 35% of the global market. The region’s growth is primarily driven by advanced healthcare infrastructure, rising chronic pain cases, and increasing preference for portable therapeutic devices.
North America - Major Dominant Countries in the Muscle Stimulator Market
- The United States led the North America market with a market size of USD 140 million in 2025, holding a 23% share due to widespread clinical use and consumer adoption.
- Canada followed with USD 48 million, representing 7.9% share, driven by strong physiotherapy penetration and growing medical device imports.
- Mexico recorded USD 24 million, accounting for 4.1% share, supported by increasing sports injury treatments and public healthcare investment.
Europe
Europe demonstrates steady growth in the muscle stimulator market, fueled by the region’s emphasis on rehabilitation care, advanced physiotherapy facilities, and awareness of non-invasive treatments. Nearly 50% of physiotherapists in Europe use muscle stimulators as part of treatment plans, and wearable electrotherapy devices are increasingly popular among fitness-conscious consumers.
Europe accounted for USD 151.68 million in 2025, representing 25% of the global Muscle Stimulator Market share. Growth in this region is supported by government-backed healthcare programs, increased sports participation, and the integration of digital rehabilitation technologies.
Europe - Major Dominant Countries in the Muscle Stimulator Market
- Germany led Europe with a market size of USD 55 million in 2025, holding 9% share driven by advanced rehabilitation programs and clinical research.
- France followed with USD 50 million, accounting for 8.2% share, supported by strong healthcare funding and expanding physiotherapy centers.
- The United Kingdom recorded USD 46 million, holding 7.6% share through expanding post-surgical recovery applications and sports therapy demand.
Asia-Pacific
Asia-Pacific is the fastest-growing region in the Muscle Stimulator Market due to expanding healthcare infrastructure, rising disposable income, and greater focus on fitness and wellness. About 60% of regional consumers are adopting wearable muscle stimulators for pain relief and recovery. Increased investment in healthcare modernization and digital rehabilitation solutions has further accelerated growth in major economies.
Asia-Pacific accounted for USD 182.02 million in 2025, representing 30% of the global market share. Rapid urbanization, the rise of physiotherapy awareness, and local manufacturing initiatives are boosting demand across China, Japan, and India.
Asia-Pacific - Major Dominant Countries in the Muscle Stimulator Market
- China led Asia-Pacific with a market size of USD 70 million in 2025, holding 11.5% share due to robust manufacturing and strong retail adoption.
- Japan followed with USD 58 million, representing 9.6% share, supported by healthcare digitization and a large aging population.
- India recorded USD 54 million, accounting for 8.9% share, driven by growing physiotherapy clinics and sports medicine awareness.
Middle East & Africa
The Middle East & Africa region is gradually emerging as a potential market for muscle stimulators, backed by growing investments in medical infrastructure, rehabilitation programs, and sports healthcare. Around 30% of hospitals in urban areas now employ electrotherapy devices for muscle reconditioning and pain therapy.
Middle East & Africa accounted for USD 60.67 million in 2025, representing 10% of the global Muscle Stimulator Market share. Growth is supported by increasing healthcare modernization, adoption of advanced therapeutic equipment, and higher focus on physical rehabilitation in Gulf and African countries.
Middle East & Africa - Major Dominant Countries in the Muscle Stimulator Market
- United Arab Emirates led the region with a market size of USD 21 million in 2025, holding 3.5% share due to expanding physiotherapy networks and sports injury recovery facilities.
- Saudi Arabia followed with USD 20 million, representing 3.3% share, driven by healthcare infrastructure development and government initiatives.
- South Africa recorded USD 19 million, accounting for 3.2% share supported by improving access to rehabilitation centers and private medical investments.
List of Key Muscle Stimulator Market Companies Profiled
- Omron Corporation
- Zynex Inc.
- NeuroMetrix Inc.
- DJO Global Inc.
- RS Medical
Top Companies with Highest Market Share
- Omron Corporation: held approximately 24% share of the global muscle stimulator market, driven by its extensive product portfolio and dominance in home-use devices.
- Zynex Inc.: accounted for nearly 18% of the global share, supported by strong demand in pain management and rehabilitation applications.
Investment Analysis and Opportunities in Muscle Stimulator Market
The muscle stimulator market presents considerable investment opportunities across medical rehabilitation, fitness, and sports recovery sectors. Nearly 45% of ongoing investments are directed toward wearable and wireless muscle stimulation technologies, highlighting the trend toward patient convenience and mobility. Around 30% of healthcare providers are integrating connected electrotherapy devices into their rehabilitation programs, while 25% of investors are targeting home-based solutions due to surging demand for self-administered treatments. Moreover, 40% of startups entering this space focus on AI-enabled or app-integrated stimulators, suggesting a rapid digital transformation in patient care. Rising investments in physiotherapy equipment manufacturing in emerging markets such as India and China further create lucrative avenues for production expansion and cost optimization.
New Products Development
Continuous product innovation defines the competitive landscape of the muscle stimulator market, with approximately 35% of manufacturers launching upgraded models featuring enhanced connectivity and intensity control. Around 40% of new developments focus on compact, portable devices catering to at-home users and sports recovery applications. Roughly 28% of recent product launches integrate biofeedback mechanisms and mobile app interfaces, enabling real-time progress tracking and therapy personalization. Nearly 20% of new products now feature rechargeable battery systems and ergonomic electrode designs to improve efficiency and comfort. Furthermore, more than 50% of R&D initiatives emphasize energy efficiency, safety certifications, and multi-frequency adaptability to target both medical and wellness consumers, highlighting a shift toward sustainable and user-friendly solutions in the muscle stimulator industry.
Recent Developments
- Omron launched AI-integrated portable stimulator: In 2024, Omron introduced an AI-powered muscle stimulator with intelligent pain-mapping technology. The new model improved therapy accuracy by nearly 40% and reduced session time by 25%, offering enhanced personalization for home users and clinical professionals alike.
- Zynex expanded its pain management portfolio: Zynex unveiled a new generation of electrotherapy units that incorporated multi-frequency control and cloud connectivity. The innovation increased user engagement by 35% and enhanced remote patient monitoring across physiotherapy networks globally.
- DJO Global upgraded its professional-grade devices: DJO Global released advanced neuromuscular electrical stimulation systems designed for rehabilitation clinics. These devices delivered a 30% improvement in stimulation precision and a 20% reduction in device setup time, optimizing workflow for therapists.
- NeuroMetrix enhanced its wearable stimulators: NeuroMetrix launched a next-gen wearable system featuring skin-adaptive electrodes. The innovation increased comfort by 45% and boosted treatment compliance among chronic pain patients by nearly 50% compared to conventional electrodes.
- RS Medical introduced eco-friendly stimulators: RS Medical unveiled a sustainability-focused muscle stimulator line, using recyclable materials and low-power circuitry. The new range reduced energy consumption by 32% while maintaining the same therapeutic efficiency, reflecting the brand’s focus on green innovation.
Report Coverage
The Muscle Stimulator Market report provides a comprehensive analysis of current market dynamics, regional growth patterns, and competitive landscape. Covering over 120 data points, the report offers deep insights into type, application, and regional segmentation. Approximately 40% of the study focuses on technological advancements such as wireless, AI-based, and portable stimulators, while 25% emphasizes healthcare and sports recovery applications. The analysis identifies key drivers, including the 50% rise in rehabilitation equipment adoption and the 30% surge in home therapy devices. Around 20% of the report is dedicated to regulatory frameworks, highlighting product approvals and safety standards that shape market entry strategies. The coverage includes detailed assessments of leading players—Omron, Zynex, DJO Global, NeuroMetrix, and RS Medical—accounting collectively for nearly 60% of the market share. Moreover, the report evaluates investment opportunities, product development trends, and strategic alliances driving innovation. Nearly 35% of the report content is devoted to market trends, consumer behavior, and integration of IoT in muscle stimulators. The scope also extends to emerging markets, representing 40% of future demand growth, offering actionable intelligence for investors, manufacturers, and healthcare institutions focused on sustainable expansion within the global muscle stimulator ecosystem.
| Report Coverage | Report Details |
|---|---|
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By Applications Covered |
Hospitals, Sports Clinics, Home Care Units, Physiotherapy Clinics, Ambulatory Surgical Centers |
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By Type Covered |
Spinal Cord Stimulation (SCS) Devices, Deep Brain Stimulation (DBS) Devices, Vagus Nerve Stimulation (VNS) Devices, Sacral Nerve Stimulation (SNS) Devices, Gastric Electric Stimulation (GES) Devices, Transcutaneous Electrical Nerve Stimulation (TENS) Devices, Neuromuscular Electrical Stimulation (NMES/EMS) Devices, Other |
|
No. of Pages Covered |
86 |
|
Forecast Period Covered |
2025 to 2034 |
|
Growth Rate Covered |
CAGR of 3.5% during the forecast period |
|
Value Projection Covered |
USD 826.93 Million by 2034 |
|
Historical Data Available for |
2020 to 2023 |
|
Region Covered |
North America, Europe, Asia-Pacific, South America, Middle East, Africa |
|
Countries Covered |
U.S. ,Canada, Germany,U.K.,France, Japan , China , India, South Africa , Brazil |
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