NMES activates sensory and motor fibers. What should you educate your patient about?

• A. Tingling sensation precedes motor twitch
• B. Immediate full contraction with no sensation
• C. Painful activation occurs first
• D. No sensory feedback occurs

Answer: (A)

When NMES is used, sensory fibers respond at a lower electrical threshold than motor fibers. So as you gradually increase the current, the patient usually feels a comfortable tingling under the electrodes before the muscle begins to twitch. This sequence is something you should educate the patient about: expect sensation first, then movement, and the sensation should never be painful. If pain is felt before any contraction, that’s a sign to lower the intensity or adjust electrode placement. If there’s no sensory feel at all but you do see a contraction, check for skin impedance or electrode contact. This approach helps patients know what to expect and stay within safe, comfortable limits.