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NMES - Neuromuscular Electrical Stimulation

NMES - Neuromuscular Electrical Stimulation

Neuromuscular Electrical Stimulation (NMES) is a non-invasive, non-addictive means of muscle rehabilitation after injury, surgery or disease. Patients with a wide range of orthopedic and neurologic diagnoses can benefit from NMES, which applies customized electrical stimulus to cause a muscle to contract.

The major benefit of integrating NMES in the treatment of patients is the reduction of total rehabilitation time and concomitant reduction in the total cost of recovery. (Electrotherapy in Rehabilitation, Meryl Roth Gersh, 1992).

Mechanism of NMES

A portable stimulator generates customized electrical pulses. These flow through leads to electrodes placed on motor points over a targeted muscle or muscle group. Between the electrodes, the current passes into the body and causes an electrical reaction in motor nerves that results in muscle contraction.

Stimulus parameters including rate, amplitude and waveform, are adjusted to facilitate a quality contraction without causing fatigue. Dual waveforms allow clinicians to choose the one best suited for the muscle being stimulated.

Clinical Application

By assisting with muscle contraction, NMES can help a patient regain function and resume their daily activities more quickly.

NMES is indicated for:

  • Prevention of disuse atrophy
  • Muscle re-education
  • Relaxation of muscle spasm
  • Maintaining or increasing range of motion
  • Prevention of venous thrombosis in selective muscles immediately post-surgery
  • Increasing local blood circulation
  • Strengthening weak or injured muscles


For patients that benefit from NMES in the clinical setting, home NMES can augment or replace ongoing clinical treatments. The clinician can adjust the NMES device to provide the maximum efficiency for the patient.

To enhance patient compliance, home NMES systems should be:

  • As effective as the clinic NMES device
  • Easy-to-use, easy-to-read
  • Comfortable
  • Equipped with clinician-adjustable parameters
  • Capable of locking a program to insure correct use
  • Preprogrammed with multiple regimens
  • Compact and portable for use at home, work, or for travel

Neuromuscular electrical stimulation (NMES) has been used for muscle strengthening, maintenance of muscle mass and strength during prolonged periods of immobilization, selective muscle retraining, and the control of swelling (edema).

Some Suggested Settings for NMES

Muscle Strengthening

  • 30 - 35Hz @ 400 µs
  • 4 sec ON / 4 sec OFF (minimum) but usually 10 sec ON / OFF
  • at least 15 mins alt days, but usually 30 min / day
  • Need strong contraction (not just mild twitch) + voluntary as well

Muscle Endurance

  • 20Hz @ 400 µs
  • 2 sec ON / 2 sec OFF (minimum)
  • at least 1 hr day

Minimal contractions

  • Very Weak Muscles / Marked Atrophy
  • 10Hz @ 400 µs
  • 2 sec ON / 2 sec OFF (minimum)
  • minimum 1 hr day
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