If skin contact is inadequate during NMES, what is recommended?

• A. Increase amplitude
• B. Reapply gel and adjust electrode position to improve skin contact
• C. Switch to a different modality
• D. Continue and observe

Answer: (B)

Effective NMES depends on good skin-electrode contact. When contact is inadequate, the impedance between skin and electrode is high, causing uneven current flow and poor stimulation of the target muscle. Reapplying conductive gel and adjusting the electrode position improves contact by lowering impedance and distributing the current more evenly across the electrode surface. This helps deliver the intended neural activation safely and comfortably.

Raising amplitude without fixing contact can increase discomfort and create hotspots without improving effectiveness. Switching to a different modality isn’t necessary unless NMES isn’t suitable for the goal. Simply continuing and observing won’t correct poor contact and will likely yield little or no therapeutic benefit.