
Contraindications
Contraindications for Neuromuscular Electrical Stimulation
1) Anterior neck of the carotid sinus region
2) Electrical neuromuscular stimulation should not be administered to individuals who are or
may be pregnant.
3) Do not stimulate a patient who has a cardiac demand pacemaker.
4) Patients with implanted electronic devices should not be subjected to stimulation.
5) Placement of electrodes across the chest laterally or ante¬rior/posterior creates a possible
hazard with cardiac patients and is therefore not recommended. Do not use transthoracically
in any mode. Great care should be exercised in applying the electrical stimulus current to any
region of the thorax because the stimulus current may produce cardiac arrhythmia. In
patients with known heart disease, electrical stimulation should be used only after careful
physician evaluation and patient instruction.
6) Place electrodes in such a way to avoid stimulation of the carotid sinus (neck) region.
7) Patients with arterial or venous thrombosis or thrombophlebitis are at risk of developing
embolisms when electrical stimulation is applied over or adjacent to the vessels containing
the thrombus. If a patient has a history of deep vein thrombosis, even many years past, the
affected area should not be stimulated.
8) Do not use over swollen, infected, or inflamed areas. Do not place electrodes over skin
eruptions.
9) Fresh fractures should not be stimulated in order to avoid unwanted motion.
10) Do not apply stimulation transcerebrally (through the head).
11) Do not use on cancer patients.
12) Stimulation should not be applied immediately following trauma or to tissues susceptible to
hemorrhage.
13) Positioning electrodes over the neck or mouth may cause severe spasm of the laryngeal
or pharyngeal muscles. These contractions may be strong enough to close the airway or
cause difficulty in breathing.
14) Do not apply stimulation for undiagnosed pain syndromes, until etiology is established.
15) Do not apply electrodes directly over the eyes or inside body cavities.
16) Do not use electrical stimulation in conjunction with high frequency surgical equipment or
microwave or shortwave therapy systems.
Contraindications for therapeutic ultrasound
1) Therapeutic ultrasound should not be applied over the pregnant or potentially pregnant uterus.
Therefore, therapeutic ultrasound should not be applied over the uterus unless specific
assurance can be attained from the patient that she is not pregnant.
2) Patients who have cardiac pacemakers should be protected from direct ultrasound exposure
over the thorax to protect the lead wires and pacer from such exposure.
3) Therapeutic ultrasound should not be applied to the eye.
4) Applications of therapeutic intensities of ultrasound should be avoided over the heart.
5) Neoplastic tissues or space occupying lesions should not be exposed to ultrasound.
6) Ultrasound should not be applied to the testes to avoid increases in temperature.
7) Areas of thrombophlebitis should not be treated with therapeutic ultrasound due to the
increased possibility of clotting or dislodging a thrombus. Conditions where this might occur are