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CONTRAINDICATIONS (C-I)
•
Malignancy/neoplasia: risk of spreading metastases. Risk of
increasing tumour growth. Cancer (or suspected cancer) is a local
contraindication to electrotherapy currents; they may therefore be
used away from the affected site. In the case of metastases, use of
electric current is generally contraindicated. Patients who have already
had cancer are recommended to wait until the remission period is
completed before restarting use of TENS or NMES on the affected
site. However, under certain conditions (e.g. palliative care), with
informed consent provided by the patient and by the interdisciplinary
team, use of TENS or NMES is possible.
•
Cardiac pacemaker: absolute or local contraindication. Risk of
interference with the normal function of the cardiac pacemaker.
A cardiologist's permission is needed.
LOCAL CONTRAINDICATIONS
•
Transcranial: risks of applying the electrodes transcranially are
unknown.
•
Eyes: the risks of treating this part of the body are unknown.
•
Anterior cervical region/carotid sinus: risk of stimulating the vagus
nerve, phrenic nerve, pharyngeal muscles or carotid sinus.
•
Infection: the infection may spread.
•
Skin weakened by radiation therapy: could stimulate the growth
of remaining malignant cells.
•
Damaged or delicate skin: resistance is decreased, which increases
the risk of burns.
•
Do not apply stimulation to open wounds, erythema or rashes, or to
swollen, red, infected or inflamed areas.
•
Undiagnosed persistent pain.
LOCAL CONTRAINDICATIONS
•
Do not apply stimulation to the patient's torso because the passage of
an electrical current through the chest can cause life-threatening heart
rhythm disturbances.
•
Electronic implant: risk of interference with normal implant function.
•
Heart disease: risk that the heart will have difficulty keeping up with
the high metabolic demand. Patients with a suspected or diagnosed
cardiomyopathy should follow the recommendations of their doctor.
•
Pregnancy: endogenous opiates released during muscle
contractions induced by electrical stimulation may stimulate
myometrial contractions. Electrical muscle stimulation of large
muscle groups should therefore be avoided during pregnancy
(NMES). Risk of affecting the development and growth of the foetus.
Risk of triggering premature uterine contractions. The effects
of the use in the perineal area during pregnancy are unknown (TENS
and NMES).
•
Recent surgery, unstable fracture, osteoporosis: muscle contractions
could cause a muscle tear or even a displacement of the fracture.
•
Epilepsy: local C-I on the head and neck. Precautions on the trunk
and extremities. Electrical stimulation could trigger a seizure.
•
Sensory disorder: risk that the patient does not feel the current
adequately, which increases the risk of burns or skin irritation. (Loss of
sensation. Proceed with caution if stimulation is applied to areas of
the skin with a lower than normal level of sensation).
•
DVT/blood clot/embolism: a blood clot could move into
the bloodstream.
•
Tuberculosis: there is a risk of spreading infection.
•
Bleeding (or risk of bleeding): risk of promoting bleeding.
DO NOT APPLY TO THESE REGIONS
OR USE UNDER MEDICAL OR
INTERDISCIPLINARY SUPERVISION
