Which of the following is a contraindication to NMES?

• A. Regular exercise
• B. Pacemaker/implanted device
• C. Hydration status
• D. Low blood pressure

Answer: (B)

Electrical stimulation carries currents through the body, and an implanted electronic device can be affected by that activity. A pacemaker or implanted device is a contraindication to NMES because the electrical current can interfere with the device’s function or provoke unintended stimulation, especially if electrodes are placed near the device or its leads. The other options don’t carry this direct device-interference risk: regular exercise is compatible with NMES in many rehab plans, hydration status doesn’t by itself bar NMES, and low blood pressure isn’t an inherent contraindication. If a patient has a pacemaker or similar implanted device, alternative modalities or clearance from the device physician should be pursued.