In reciprocal inhibition NMES, what ramp requirement is described?

• A. Need ramp because rapid movement will trigger spasticity
• B. Ramp is none
• C. Ramp should be long
• D. Ramp should be medium

Answer: (A)

Spasticity after CNS injury is velocity-dependent, meaning rapid movement can trigger a stretch reflex that increases tone and resistance. In reciprocal inhibition NMES, the goal is to activate the agonist while letting the antagonist relax, but if the stimulus turns on abruptly, the limb can move too fast and provoke that reflex.

Using a ramp on the stimulus gradually increases the current and the resulting contraction, so movement happens slowly enough to avoid triggering spasticity. This gives the reciprocal inhibition effect a better chance to work, producing smoother, more controlled movement and less resistance. Without a ramp, or with a very abrupt onset, the spastic response is more likely, undermining the therapy. The idea isn’t about long or medium duration in itself; it’s about a gradual, controlled onset to keep reflexes in check.