Where should return electrodes be placed when using NMES for knee osteoarthritis?

• A. Proximally or distally from the quadriceps electrodes to optimize current path
• B. On the contralateral leg
• C. Around the foot
• D. On the abdomen

Answer: (A)

The key idea is that NMES works best when the current has a clear path through the target muscle group. For knee osteoarthritis, you want the quadriceps to be stimulated to help knee stability, so the return electrode should be placed either above (proximal) or below (distal) the quadriceps electrodes. This route concentrates the current through the thigh and knee region, maximizing quadriceps activation and efficiency. Placing the return pad on the opposite leg, around the foot, or on the abdomen would divert the current away from the knee and reduce the therapeutic effect, and it could increase unwanted sensations or safety concerns.