Freda presents with persistent shoulder pain following rotator cuff repair surgery. The therapist considers using electrical stimulation for pain management. The patient has a history of mild hypertension controlled with medication and reports occasional muscle spasms in the surgical area. Which of the following would MOST likely require avoidance of electrical stimulation?

A) Metal anchors used during surgical fixation

B) Recent use of anti-hypertensive medication

C) Active muscle spasms near the surgical site

D) Impaired sensation over the affected shoulder

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