Hence the inclusion of a control group was beneficial to account for muscular changes from growth or conventional therapy input. The results from this time point support current literature that muscular changes following NMES are use-dependent and do not facilitate long-term or prolonged/lasting neuromuscular adaptations. While it may be preferable to continue to use NMES to maintain the muscle hypertrophy and strength changes, ongoing use could increase dependence on an external stimulus.19 To limit this, devices should only be used for as long as needed in order to promote movement control.