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Transcutaneous neuromuscular electrical stimulation (NMES) can modify the order of motor unit recruitment and has a profound influence on the metabolic demand associated with producing a given muscle force. Because of these differences, interventions that combine NMES with voluntary contractions can provide beneficial outcomes for some individuals. The adaptations evoked by NMES are not confined to the activated muscle but also involve neural adaptations through reflex inputs to the spinal cord and supraspinal centers.
Vanderthommen et al. (Mon,) studied this question.