NMES Electrotherapy Practice Test

The key idea is that denervated muscle must be stimulated by directly depolarizing the muscle membrane, but the literature does not support using true direct current for this purpose. Sustained direct current causes continuous electrode polarization at the skin, increasing the risk of burns and irritation and providing less controllable, less efficient contractions. Instead, the recommended approach uses long-duration, pulsed waveforms (monophasic or biphasic) with appropriate ramping and on/off times to achieve direct muscle membrane depolarization safely and effectively. While older reports may mention DC, current evidence favors pulsed, long-duration stimulation rather than true direct current for denervated muscle.