Effect of Capacitive and Resistive electric transfer on changes in muscle flexibility and lumbopelvic alignment after fatiguing exercise

V-EMF therapy: A new painless and completely non-invasive treatment for striae gravidarum

BACKGROUND

The appearance of striae gravidarum (SG) during pregnancy is a common problem. The most common SG are abdominal striae, which can cause the greatest sequelae after pregnancy, and in the long term. There are several solutions to prevent and treat these striae, but not all are completely effective, and not without side effects.

AIMS

The aim of this study was to evaluate the effectiveness of a treatment that applies an electromagnetic field under vacuum (V-EMF therapy) on the abdominal SG.

METHODS

A retrospective analysis was conducted on the medical records of 26 women affected by abdominal SG and treated with V-EMF therapy. The results were evaluated using two different 5-point Likert Scales: one administered to the treated subjects to evaluate their satisfaction, and one to the doctors who performed the treatment, to evaluate the improvement of the striae. The presence of side effects, and the effects of sun exposure after treatment were also considered.

RESULTS

Only two treated subjects rated their level of satisfaction with a Score III on the Liker Scale. Everyone else expressed higher levels of satisfaction. Only one doctor rated the improvement of the striae with a Liker scale score of III. All the others reported greater improvements. No discomfort or side effects were noted either during the individual treatment sessions, or at the end of the treatment. The striae showed a newfound ability to tan.

CONCLUSIONS

V-EMF therapy proves to be a valid, safe, and effective treatment modality for SG.

The application of a single session of capacitive resistive electric transfer 24 h before exercise modifies the accelerometric pattern in standardbred racing trotters

BACKGROUND

It has been reported that capacitive resistive electric transfer (CRET) increases blood circulation, hemoglobin oxygenation and temperature in muscles. The attributed benefits of these changes have been linked to improved athletic performance, enhanced muscle flexibility and fastening recovery from exercise-induced fatigue. For all of this, the present research aims to investigate whether the application of CRET 24 h before exercise affects the accelerometric pattern in horses during exercise. Six sound Standardbred trotters were subjected to a CRET session of 40 min of duration, applied on both sides of the neck, back and croup, 24 h before a training session. Training sessions consisted of a warming-up (WU) for 6400 m and a training bout (TB) at their maximal training speed for 1600 m. The same protocol was followed for the device off (sham protocol), also applied 24 h before the training session. CRET and sham experiments were separated by one week, the order of application of both was randomly defined for each individual and drivers were blinded for the duration of the experiment. During the training sessions, horses wore an accelerometer fixed at the sternal level. Speed, stride frequency (SF), length (SL), regularity and symmetry and accelerometric activities were measured during WU and TB.

RESULTS

CRET increased speed, mediolateral and total accelerometric activities during WU and speed, SL, dorsoventral, longitudinal and total accelerometric activities during TB, but stride regularity and symmetry decreased.

CONCLUSION

The application of CRET 24 h before exercise increased speed and accelerometric activities, results that highlight the need to evaluate the interaction between CRET and training in order to develop new methods to limit fatigue. However, the decrease in stride regularity and symmetry after CRET application could be negative effects, which could be attributed to the increased speed.

Immediate Effects of TECAR Therapy on Gastrocnemius and Quadriceps Muscles with Spastic Hypertonia in Chronic Stroke Survivors: A Randomized Controlled Trial

BACKGROUND

The aim of this study was to assess changes in muscle properties after a single session of capacitive and resistive energetic transfer (TECAR) therapy on spastic gastrocnemius and quadriceps muscles in chronic post-stroke.

METHODS

A total of 36 chronic stroke survivors with lower limb hypertonia were enrolled in a double-blind randomized controlled trial. The experimental group (n = 18) received a single 30 min session of TECAR therapy in combination with functional massage (FM) on the gastrocnemius and quadriceps muscles. The control group (n = 18) received a sham treatment of TECAR therapy (without electrical stimulation) in combination with real FM. The primary outcome was muscle tone of the lower limb muscles assessed with the Modified Ashworth Scale (MAS). The secondary outcomes were goniometric degrees of the MAS (goniometer), neuromuscular properties of the gastrocnemius/quadriceps (myotonometer), and passive range of motion (inclinometer). All measurements were performed at baseline (T0), immediately after treatment (T1), and at 30 min post-treatment (T2) by a blinded assessor.

RESULTS

The MAS score ankle dorsiflexion significantly decreased at T0-T1 (p = 0.046), and the change was maintained at T0-T2 (p = 0.019) in the experimental group. Significant improvements were noted in the passive range of motion for knee flexion (p = 0.012) and ankle dorsiflexion (p = 0.034) at T2. In addition, knee flexion improved at T1 (p = 0.019).

CONCLUSION

A single session of Tecar therapy at the same time with FM on the gastrocnemius and rectus femoris immediately reduces muscle tone and increases the passive range of motion of both ankle and knee in chronic stroke survivors. There were no significant changes in the neuromuscular properties measured with myotonometer.

Effect of Transfer Energy Capacitive and Resistive Therapy on Shoulder Pain, Disability, and Range of Motion in Patients With Adhesive Capsulitis: A Study Protocol for a Randomized Controlled Trial

Objective

We describe a protocol to evaluate the effectiveness of transfer energy capacitive and resistive (TECAR) therapy on shoulder passive range of motion, shoulder pain, and disability index in patients with adhesive capsulitis.

Methods

This study will be a double-blinded randomized clinical trial with a 1-month follow-up. For the purpose of this research, 30 patients with a 3-month history of shoulder pain and disability diagnosed as adhesive capsulitis will be selected and then randomized into 2 groups, including conventional physiotherapy consisting of electrophysical modalities and therapeutic exercises, which will be given to the control group. In the intervention group, after conventional physiotherapy, 10 minutes of TECAR therapy in resistive mode will be applied on both the anterior and inferior aspects of the shoulder joint. Outcome measures will be related to shoulder passive range of abduction, flexion, and external rotation that will be measured using a digital inclinometer, as well as shoulder pain and disability index that will be assessed by the validated questionnaire. Assessment will be done at baseline, 1 day after the intervention, and by passing 1 month.

Results

The statistical analysis will describe within-group and between-group comparisons; the findings will be illustrated in tables and charts.

Conclusion

Given the reason that the effectiveness of TECAR therapy has not been widely evaluated in adhesive capsulitis, the findings of this pilot study would provide baseline information on the effectiveness and complications of this treatment method and possibly propose a more appropriate protocol for patients with adhesive capsulitis.

Physiotherapeutic Strategies and Their Current Evidence for Canine Osteoarthritis

Osteoarthritis (OA) is a common and debilitating condition in domestic dogs. Alongside pharmaceutical interventions and weight loss, exercise and physiotherapy (PT) are important measures in maintaining patient mobility and quality of life. Physiotherapy for OA aims to reduce pain, optimize muscular function and maintain joint function. Physiotherapeutic plans typically include PT exercises combined with therapeutic modalities, lifestyle and environmental modifications to improve the patient's overall quality of life and function. Information on therapeutic clinical efficacy of physiotherapeutic measures for canine OA is still very limited. Thus, physiotherapeutic strategies are still primarily based on evidence extrapolated from human protocols tailored to people with OA. The authors propose a simple systematic PT approach for canine OA, prioritizing measures according to simplicity, cost effectiveness and practicality. This guide (the "Physiotherapy Pyramid") aims to provide a clear stratified approach to simplify decision making and planning for owners, veterinarians and veterinary physiotherapists, leading to more straightforward design and implementation of treatment plans. Measures are implemented starting at the base of the pyramid, subsequently progressing to the top, allowing effective and practical interventions to be prioritized. The levels of the pyramid are in ascending order: environmental modification, exercise plan, OA-specific home exercises and treatment by a veterinary physiotherapist.

Short-Term Efficacy of Capacitive-Resistive Electrical Transfer Therapy in Short-Haired Sled Dogs in Middle-Distance Competition

Achieving the successful recovery of sled dogs is one of the key tasks for veterinary teams involved in clinical care for middle-distance sled dog competitions. This study compares the efficacy of capacitive-resistive electrical transfer (CRet) with that of massage in the treatment of lower back pain in 40 short-haired sled dogs during a medium-distance snow sled race (Lekkarod^TM-2021). The dogs were divided into two groups: a CRet group (20 dogs) and a massage group (20 dogs). All subjects received a single 18 min treatment session and were evaluated one hour after the end of the treatment. A multivariate analysis of variance (MANOVA) was performed in which pre- and post-treatment pain measures were evaluated in relation to age and type of treatment. Older dogs were found to have higher significant pain scores before starting treatment. Both treatments reduce pain short-term in all cases. However, post-treatment pain values were significantly lower in dogs treated with CRet when compared to dogs treated with massage. The results show that capacitive-resistive electrical transfer has better short-term results and is beneficial in both younger and older dogs, making this technique attractive to veterinary teams working in canine sporting competitions.

Vacuum and Electromagnetic Fields Treatment to Regenerate a Diffuse Mature Facial Scar Caused by Sulfuric Acid Assault

Acid attacks are on the rise, and they cause extensive and deep burns, especially on the face. The treatments used to improve the aesthetic, functional and social impact of non-acid scars do not always prove useful for acid scars. This article reports the case of a woman with an extended, mature, acid facial scar, caused by sulfuric acid assault, treated with a recent new procedure that combines the application of vacuum and electromagnetic fields. Before and after the treatment, the aesthetic appearance, and motor function of the face and neck were evaluated, as well as the level of hydration, the amount of sebum, the elasticity, and the pH of the skin. The improvements highlighted after the treatment of the aesthetic and functional characteristics of the face and neck, and of the physical parameters of the skin seemed to indicate that this particular treatment induces tissue regeneration, even in the nerve component. However, it is evident that the rehabilitation pathways of facial wounds and scars must be personalized, and must include continuous psychological support for the patient.

Effects of Transfer Energy Capacitive and Resistive On Musculoskeletal Pain: A Systematic Review and Meta-Analysis:

The use of transfer energy capacitive and resistive (TECAR) therapy to treat musculoskeletal pain has not been clearly established. Hence, this study was conducted to combine the available results. We searched the main databases, including PubMed (January 1950), Web of Knowledge (January 1945), Scopus (January 1980), and ProQuest (January 1983) until December 2021, to find the related studies. Only those studies were included that assessed the pain in participants who received TECAR therapy and compared it with a control group. Using the random effect model, standardized mean difference (SMD) was calculated at a 95% confidence interval (CI). The differences between patients and control group were -1.04 after four weeks of intervention (95% CI: -1.59 to -0.48, I²=86.9%) and -1.80 after eight weeks (95% CI: -2.15 to -1.46, I²=87%), which was significant (P0.001). The intra-group pain comparison before and after two, four, and eight weeks of TECAR therapy obtained SMD levels of -3.96 (95% CI: -5.28 to -2.65, I²=96.9%), -4.12 (95% CI: -5.98 to -2.26, I²=97.3), and -5.03 (95% CI: -7.23 to -2.83, I²=92.2%), respectively. Despite some limitations, our findings may assist clinicians in decision-making about TECAR therapy for the approach to musculoskeletal pain based on evidence-based medicine.

Effects of Capacitive-Resistive Electric Transfer on Sports Performance in Paralympic Swimmers: A Stopped Randomized Clinical Trial

Throughout history a variety of therapeutic tools have been studied as possible enhancers of sports activities. This study proposes the use of Capacitive-Resistive Electric Transfer (CRET) as a performance booster to paralympic athletes, specifically those belonging to the Spanish Paralympic swimming committee. The study was a randomized, single-blind, and observer-blind, crossover clinical trial. Six athletes were randomly assigned to three groups: one treated with CRET (A); a placebo group (B) and a control group (C). The CRET group attended a twenty-minute session before being subjected to pool trials at distances of 50 and 100 m at maximum performance. Measurements were in two dimensions: time in seconds and the Borg scale for perceived exertion. Comparisons between groups were made with respect to distance and the main variables. In the case of perceived exertion, no significant changes were observed in any of the distances; however, in the case of the time variable, a significant difference was observed between Group A vs. Personal Record at 100 m distance (76.3 ± 6.8 vs. 68.4 ± 3.3). The proposed protocol and level of hyperthermia applied suggest refusal of CRET use for the 100-m distance a few minutes before sports practice. Our analysis suggests the need to modify the presented protocol. ClinicalTrials.gov identifier under NCT number: NCT04336007.

TECAR Therapy Associated with High-Intensity Laser Therapy (Hilt) and Manual Therapy in the Treatment of Muscle Disorders: A Literature Review on the Theorised Effects Supporting Their Use

Background: It has been estimated that between 30 and 50 per cent of all injuries that take place throughout participation in a sport are the consequence of soft tissue injuries, and muscle injuries are the primary cause of physical disability. Methods: The current literature review was designed between October 2021 and April 2022, according to the PRISMA standards, using the PubMed, Scopus, and Web of Science databases. At the screening stage, we eliminated articles that did not fit into the themes developed in all subchapters of the study (n = 70), articles that dealt exclusively with orthopaedics (n = 34), 29 articles because the articles had only the abstract visible, and 17 articles that dealt exclusively with other techniques for the treatment of musculoskeletal disorders. The initial search revealed 343 titles in the databases, from which 56 duplicate articles were automatically removed, and 2 were added from other sources. Results: The combination of these three techniques results in the following advantages: It increases joint mobility, especially in stiff joints, it increases the range of motion, accelerates tissue repair, improves tissue stability, and extensibility, and it reduces soft tissue inflammation (manual therapy). In addition, it decreases the concentration of pro-inflammatory mediators and improves capillary permeability, resulting in the total eradication of inflammation (HILT). It warms the deep tissues, stimulates vascularity, promotes the repose of tissues (particularly muscle tissue), and stimulates drainage (TECAR). Conclusions: TECAR therapy, combined with manual therapy and High-Intensity Laser therapy in treating muscle diseases, presented optimal collaboration in the recovery process of all muscle diseases.

The Effect of Capacitive-Resistive Electrical Therapy on Neck Pain and Dysfunction in Horses

Neck pain and stiffness are increasingly recognized in horses and often treated using multimodal pharmaceutical and rehabilitation approaches. In humans, deep tissue heating is reported to reduce neck pain and increase flexibility. The objective of this project was to determine the effects of capacitive-resistive electrical therapy on neck pain and stiffness in horses. A blinded, randomized, controlled clinical trial with 10 horses assigned to active and 10 horses assigned to sham treatment groups. Neck pain, stiffness, and muscle hypertonicity were assessed by manual palpation. Forelimb postural stability was evaluated using a portable media device with built-in inertial sensing components. All outcome parameters were recorded once weekly for four weeks. Using manufacturer recommendations, the treatment group received active capacitive-resistive electrical therapy to the lower cervical region (C4-C7), twice weekly for a total of six treatments, while the control group received a sham (inactive) treatment. Data was analyzed using a mixed model that was fit separately for each response variable. There were no significant differences noted over time or between groups for any outcome parameter evaluated. While neck pain and stiffness decreased by week three in both groups, the improvement was not significant. Limitations include the lack of a definitive pathoanatomic diagnosis of cervical pathology and in vivo temperature measurements. Capacitive-resistive electrical therapy was ineffective in reducing neck pain and dysfunction using the recommended treatment protocols. No short-term adverse effects were noted. Specific clinical applications and effective treatment parameters need further evaluation.

Effects of capacitive and resistive electric transfer and hot pack interventions on the autonomic nervous system in young women

The effects of thermotherapy on autonomic nervous system activity and subjective sensations of fatigue and arousal are unclear. This study compared the effects of capacitive and resistive electric transfer (Cret) interventions (deep thermotherapy) and hot packs (superficial thermotherapy) on autonomic nervous system activity in healthy young women (n = 16). Heart rate and RR interval were measured using electrocardiography, and the coefficient of variation (CV) of the RR interval was used to evaluate autonomic nervous system activity. The subjective relaxation effect was evaluated using the Roken Arousal Scale (RAS) - a fatigue arousal index. The intervention was performed on the lumbar region for 20 minutes for both Cret and hot pack. After each intervention, the CV values increased only in the Cret condition, whereas the heart rate decreased in both conditions. This suggests that parasympathetic activity was enhanced in the Cret condition. In contrast, the subjective relaxation evaluation observed a psychological relaxation effect under both conditions. Our results suggest that Cret application in the lumbar region has greater relaxation effects than hot pack application in the same region.

The Thermal Influence of an Electromagnetic Field with a Radio Frequency Depending on the Type of Electrode Used

Diathermy is a method used in physiotherapy based on obtaining an increase in temperature by supplying energy from the electromagnetic field to the tissues. The aim of this retrospective work, based on the data included in a medical documentation, was to assess the dynamics of temperature changes on the body surface after the application of a high-frequency electromagnetic field depending on the type of electrode used. In order to generate a radio frequency electromagnetic field, an INDIBA ACTIV^® CT9 was used. In order to measure the temperature, an HT-17 thermovision camera was used, enabling measurements within the range of -20 to 300 °C, with an accuracy of ±2% or 2 °C. The participants consisted of 30 healthy subjects (15 women and 15 men) who were physiotherapy students in the Faculty of Public Health in the Silesian Medical University in Katowice, Poland; they were divided into two comparative groups (A and B). It was found that the differences between the groups were not significant in the measurements carried out before using the electrode (p = 0.84; Mann-Whitney U test). On the other hand, at 0, 5 and 15 min, statistically significant differences were noted in the tissue temperature between the groups, depending on the electrode used (p = 0.00; Mann-Whitney U test). Based on the obtained results, it can be concluded that with the extension of the observation time, the tissue temperature increased (for Group A, Me 30.40 °C vs. 34.90 °C; for Group B, Me 30.70 °C vs. 35.20 °C). Our study confirmed that the use of both a capacitive and resistive electrode during treatment with the use of a high-frequency electromagnetic field statistically significantly increased the surface temperature of the area to which the therapy was applied. The results of the study can be used in clinical practice by physiotherapists to optimize the conditions of therapy.

The Effect of Capacitive and Resistive Electric Transfer Intervention on Delayed-Onset Muscle Soreness Induced by Eccentric Exercise

This study aimed to investigate the acute effect of capacitive and resistive electric transfer (CRet) intervention on eccentrically damaged muscle. A total of 28 healthy and sedentary male volunteers were randomly allocated to either CRet intervention or control groups. The participants performed a bout of eccentric exercise of the knee extensors with the dominant leg and received 30 min of CRet intervention of the quadriceps 48 h after the exercise. The dependent variables for the analysis were knee flexion range of motion (ROM), muscle soreness and maximum voluntary isometric (MVC-ISO), and concentric contraction (MVC-CON) torque of the knee extensors. These were measured prior to exercise (baseline) and before and after CRet intervention (48 h after the exercise). The results showed that knee flexion ROM, muscle strength (MVC-ISO and MVC-CON), and muscle soreness significantly improved after CRet intervention. CRet intervention may improve muscle soreness and loss of muscle function in an eccentrically damaged muscle.

Is Tecar Therapy Effective on Biceps Femoris and Quadriceps Rehabilitation? A Cadaveric Study

BACKGROUND

Capacitive-resistive electric transfer therapy is an interesting rehabilitation treatment to use in musculoskeletal injuries. The purpose is to analyze the temperature change and current flow in superficial and deep biceps femoris and quadriceps tissues when applying different protocols of capacitive-resistive electric transfer therapy.

METHODS

Five cryopreserved cadavers (10 legs) were included in this study. Four interventions (high/low power) were performed for 5 minutes. Dynamic movements were performed to the biceps femoris and quadriceps. Superficial, middle, and deep temperature were recorded at 1-minute intervals and 5 minutes after the treatment using invasive temperature meters placed with ultrasound guidance.

RESULTS

Low-power applications have generated a very low thermal effect and an important current flow. The high-power capacitive application achieves a greater increase in superficial temperature compared with low power (P < .001). The high-power resistive application recorded a greater increase in superficial, middle, and deep temperatures with a greater current flow compared with the other applications (P < .001).

CONCLUSION

This study could serve as basic science data to justify the acceleration of the processes of muscle recovery, improving cell proliferation without increasing the temperature in acute muscle injuries and increasing the temperature and viscoelasticity of the tissues in chronic processes with this therapy.

Effects of capacitive and resistive electric transfer therapy on pain and lumbar muscle stiffness and activity in patients with chronic low back pain

[Purpose] In this study, we investigated the therapeutic effects of capacitive and resistive electric transfer therapy in patients with chronic low back pain. [Participants and Methods] The study included 24 patients with chronic low back pain (12 patients each in the intervention and sham groups). Pain intensity, superficial and deep lumbar multifidus stiffness and maximum forward trunk flexion and associated activation level of the iliocostalis (thoracic and lumbar component) and lumbar multifidus muscles were measured. [Results] Post-intervention pain intensity and muscle stiffness were significantly lower than pre-intervention measurements in the intervention group. However, no between-group difference was observed in the muscle activation level at the end-point of standing trunk flexion. [Conclusion] Our findings highlight a significant therapeutic benefit of capacitive and resistive electric transfer therapy in patients with chronic low back pain and muscle stiffness.

Effectiveness of intracavitary monopolar dielectric radiofrequency in women with endometriosis-associated pain: A case series

BACKGROUND

and Purpose: Endometriosis-associated pain is the main cause of chronic pelvic pain in women. Endometriosis has a significant negative impact across different domains of patients' quality of life. This study aimed to evaluate the efficacy of an intracavitary application of monopolar dielectric radiofrequency in women with endometriosis-associated pain.

PATIENT PRESENTATION

Five women with endometriosis received 25 sessions of an intracavitary application of monopolar dielectric radiofrequency within three months. Outcomes, including quality of life, sex interference (Endometriosis Health Profile [EHP]-30 + section C), myofascial pain syndrome (myofascial trigger points), pain intensity (Visual Analogue Scale), frequency and referral pattern, pressure pain thresholds, allodynia and neuropathic pain (modified DN4), were examined both during and outside menses, after intervention and six months later.

RESULTS

Clinically meaningful improvements were achieved by most participants regarding pelvic pain intensity, abdominal sensitivity, and myofascial pain of the pelvic floor.

CONCLUSION

This study lays the foundation for future in-depth research, suggesting that monopolar dielectric radiofrequency could be helpful in improving the symptomatology and quality of life of women with endometriosis, also in patients who are unresponsive to medical and/or surgical treatments, or who cannot undergo them in the short term.

Observational Study on Lameness Recovery in 10 Dogs Affected by Iliopsoas Injury and Submitted to a Physiotherapeutic Approach

Simple Summary

Acute trauma of the iliopsoas muscle is often observed in sports and very active dogs. Nevertheless, the diagnosis is not always correctly addressed and can be underestimated during a clinical visit because it is generally secondary to other orthopedic and neurological issues. However, a correct diagnosis can lead to complete recovery of lameness in dogs who submit to physiotherapy. This paper has investigated, in a preliminary observational study, the recovery time for dogs affected by primary iliopsoas lesions and their return to normal activity.

Abstract

This preliminary study has investigated the outcome of physiotherapy in 10 dogs affected by a primary lesion of the iliopsoas muscle and the potential effects of sex, age, and breed on recovery. Ten dogs with primary injury of the iliopsoas muscle were retrospectively included in this study. Dogs were submitted to a rehabilitation program, characterized by a multimodal approach, including physical therapies and modalities. After recovery, patients were submitted to a further support period of rehabilitation to promote muscle strengthening and limit injury recurrence during their return to normal functional and sports activity. Border collies were highly represented. The recovery of lameness occurred after a mean of 22.6 ± 14.7 (median 18) days with a median number of five sessions. None of the examined variables affected the recovery time, except for the border collie breed, which showed a significantly faster recovery time; however, there was no difference between the breeds with regard to the number of sessions. Multimodal rehabilitation therapy may promote lameness recovery of mild-to-moderate iliopsoas lesions within 3 weeks. This preliminary study reports a clinical approach and recovery of primary iliopsoas lesions, findings that can provide clinicians with useful prognostic information for dogs involved in sports activities.

Temperature and current flow effects of different electrode placement in shoulder capacitive-resistive electric transfer applications: a cadaveric study

BACKGROUND

Impingement syndrome is currently estimated to represent 60% of all shoulder pain disorders. Capacitive-Resistive electric transfer therapy is aimed to provoke temperature and current flow changes in superficial and deep tissues. This in vitro study has evaluated the variation of temperature and current flow in the shoulder tissues during two different areas of application of the movable capacitive-resistive electric transfer electrode.

METHODS

A cross-sectional study designed, five fresh cryopreserved cadavers (10 shoulders) were included in this study. Four interventions (capacitive and resistive modes; low- and high-power) were performed for 5 min each by a diathermy "T-Plus" device in two shoulder regions: postero-superior and antero-lateral. Supraspinatus tendon, glenohumeral capsule and superficial temperatures were recorded at 1-min intervals and 5 min after treatment.

RESULTS

A statistically significant difference was found only for the superficial area and time interaction, with high power-resistive application at the postero-superior shoulder area (P< 0.035). All the applications showed a 5 min after treatment temperature increase compared with the basal data, in all the application points. Superficial temperature in the high power-resistive application showed the greatest percent increase (42.93% ± 22.58), followed by the temperature in the tendon area with the same high power-resistive application (22.97% ± 14.70). The high power-resistive application showed the greatest percent of temperature increase in the applications, reaching 65.9% ± 22.96 at 5-min at the superficial level, and 32% ± 24.25 at 4-min at the level of the supraspinatus tendon. At the capsule level, high power-resistive was also the application that showed the greatest percent of increase, with 21.52% ± 16.16. The application with the lowest percent of temperature increase was the low power-capacitive, with a mean value of 4.86% at supraspinatus tendon level and 7.47% at capsular level.

CONCLUSION

The shoulder postero-superior or antero-lateral areas of application of capacitive-resistive electric transfer did not cause statistically significant differences in the temperature changes in either supraspinatus tendon or glenohumeral capsule tissues in cadaveric samples. The high power-resistive application in the postero-superior area significantly increased superficial temperature compared with the same application in the antero-lateral position area.

Thermal and Current Flow Effects of a Capacitive-Resistive Electric Transfer Application Protocol on Chronic Elbow Tendinopathy. A Cadaveric Study

Lateral elbow tendinopathy, or "tennis elbow," is a pathology that affects around 1.3% of the general population. Capacitive-resistive electric transfer therapy aims to provoke temperature and current flow changes in superficial and deep tissues. The aim of this in vitro study was to analyze the thermal behavior and transmission of electric current on the superficial and deep tissues of the elbow during the application of different modalities of a capacitive-resistive electric transfer treatment protocol for chronic elbow tendinopathy. A cross-sectional study was designed; five fresh cryopreserved cadavers (10 elbows) were included in this study. A 30 min intervention was performed based on a protocol commonly used in clinics for the treatment of chronic lateral elbow tendinopathy by diathermy using the "T-Plus." Common extensor tendon, radiohumeral capsule, and superficial temperatures were registered after each application for the duration of the 30 min treatment protocol. During all applications, we observed a current flow of over 0.03 A. The protocol showed a statistically significant increase in superficial temperature by 24% (5.02°) (p < 0.005), the common extensor tendon by 19.7% (4.36°) (p < 0.007), and the radiohumeral joint capsule by 17.5% (3.41°) (p < 0.005) at the end of the 30 min protocol compared with the baseline temperature. The different applications of the protocol showed specific effects on the temperature and current flow in the common extensor tendon and radiohumeral capsule. All applications of the protocol produced a current flow that is associated with the generation of cell proliferation. These results strengthen the hypothesis of cell proliferation and thermal changes in deep and distal structures. More studies are needed to confirm these results.

Accelerometric Changes before and after Capacitive Resistive Electric Transfer Therapy in Horses with Thoracolumbar Pain Compared to a SHAM Procedure

Simple Summary

Capacitive resistive electric transfer (CRET), a radiofrequency at 448 kHz, has been shown to result in increased muscle oxygenation and flexibility in the quadriceps muscle of human beings. In this study, 18 sport horses with thoracolumbar pain were divided into two homogenous groups: CRET (n = 9), subjected to four sessions of CRET during two consecutive weeks and SHAM (n = 9), subjected to the same sessions but with the device off. Clinical examination and accelerometry were made at the beginning and at the end of the study. A Mann-Whitney test and a Wilcoxon matched pair test were used to compare between SHAM and CRET groups and before and after the intervention, respectively. CRET horses showed a reduction of 1 degree in thoracolumbar pain (p = 0.002) and of 2 degrees in epaxial muscle pain (p = 0.03). SHAM horses had a reduction of 1 degree in thoracolumbar pain (p = 0.01). CRET horses presented increased dorsoventral power at walk and trot (p < 0.002), probably reflecting increased dorsoventral movement and flexibility. Such changes were not found in SHAM horses. No changes were found in the dorsoventral displacement of the center of gravity in either group. Our study demonstrated that sport horses with mild to moderate thoracolumbar pain could improve clinically and biomechanically after CRET therapy.

Abstract

Capacitive resistive electric transfer (CRET), a radiofrequency at 448 kHz, increases flexibility in quadricep muscles of human athletes. To assess whether CRET would result in clinical and biomechanical improvements in horses with thoracolumbar pain, 18 sport horses were divided into two groups: CRET (n = 9), subjected to four CRET sessions, during two consecutive weeks, and SHAM (n = 9), subjected to the same procedure with the device off. Clinical examination and accelerometry were performed before and after the four sessions. During the study, horses were in training and in active competition, and did not receive any other treatment. Mann-Whitney and a Wilcoxon matched pair tests were used to compare between the SHAM and CRET groups and before and after the intervention, respectively. CRET horses showed increased dorsoventral (p < 0.002), mediolateral and total power (p < 0.01) after the intervention, suggesting increased back flexibility. SHAM horses did not show any of these modifications after the intervention. No changes were found in the dorsoventral displacement of the gravity center in either group. Thoracolumbar pain decreased one degree after CRET (p = 0.002), and it did not change after SHAM. Epaxial muscle pain decreased two degrees after CRET (p = 0.03) and one degree after SHAM (p = 0.01). These results reflected that CRET therapy would increase back flexibility and decrease thoracolumbar and epaxial pain.

Effects of the signal modulation on the response of human fibroblasts to in vitro stimulation with subthermal RF currents

Capacitive-Resistive Electric Transfer (CRET) thermotherapies aim at tissue repair and regeneration through non-invasive application of RF currents. We have reported that the cellular response to subthermal CRET currents is non-linearly dependent on the signal frequency, and that in vitro exposure to a 448-kHz CRET signal promotes ADSC proliferation, as well as collagen and glycosaminoglycan synthesis in prechondrocytic cells. The present work investigates the response of neonatal fibroblasts to subthermal exposure (100 µA/mm²) to two CRET signals: a 448-kHz, non-modulated sinusoidal wave vs. a 20-kHz amplitude-modulation of the 448-kHz carrier. To that end, cell proliferation and expression of the biomarkers Hsp47, Hsp27 and decorin were assessed by cell count, PCNA and Western blotting. The results revealed that while both signals significantly and equivalently increased early (4 h) expression of Hsp47, the modulated signal was more efficient in inducing Hsp27 and decorin overexpression and promoting cell proliferation. These data indicate that the cellular response is dependent on the RF signal modulation and suggest that the therapeutic effects of CRET could be mediated by promotion of fibroblastic proliferation and overexpression of biomarkers that are essential in skin regeneration.

Capacitive and resistive electric transfer therapy in rehabilitation: a systematic review

Capacitive and resistive electric transfer (CRET) therapy is a physical treatment modality commonly used to treat musculoskeletal pain. It normally uses a longwave radiofrequency of ~0.5 MHz. The system consists of a neutral plate and two different electrodes that can transfer energy in two modalities: capacitive and resistive. The aim of this systematic review was to identify and summarize the available data in the literature on this physical modality. From a search of articles published before December 2019 in MEDLINE and Scopus indexed journals, we retrieved 276 articles, 13 of which met the inclusion criteria for this review. Most articles dealt with musculoskeletal disorders, mainly spine disorders and knee osteoarthritis. More than 75% of the studies used a similar range of frequency (440-600 KHz). Almost all described an improvement in strength and function and reduced pain intensity after the treatment. Although nine of the 13 studies (70%) were randomized controlled trials, only two had a low risk of bias according to the Cochrane library assessment tool. CRET seems to be an effective therapy to decrease pain, and improve the quality of life and disability of patients affected by musculoskeletal disorders. There is no study on symptoms of patients with neurological disorders. Further research is necessary to standardize the therapeutic protocols across different orthopedic diseases, and to assess the benefits of CRET in other fields such as neurological or rheumatologic disorders.

Thermal and non-thermal effects off capacitive-resistive electric transfer application on the Achilles tendon and musculotendinous junction of the gastrocnemius muscle: a cadaveric study

Background

Calf muscle strain and Achilles tendon injuries are common in many sports. For the treatment of muscular and tendinous injuries, one of the newer approaches in sports medicine is capacitive-resistive electric transfer therapy. Our objective was to analyze this in vitro, using invasive temperature measurements in cadaveric specimens.

Methods

A cross-sectional study designed with five fresh frozen cadavers (10 legs) were included in this study. Four interventions (capacitive and resistive modes; low- and high-power) was performed for 5 min each by a diathermy “T-Plus” device. Achilles tendon, musculotendinous junction and superficial temperatures were recorded at 1-min intervals and 5 min after treatment.

Results

With the low-power capacitive protocol, at 5 min, there was a 25.21% increase in superficial temperature, a 17.50% increase in Achilles tendon temperature and an 11.27% increase in musculotendinous junction temperature, with a current flow of 0.039 A ± 0.02.

With the low-power resistive protocol, there was a 1.14% increase in superficial temperature, a 28.13% increase in Achilles tendon temperature and an 11.67% increase in musculotendinous junction temperature at 5 min, with a current flow of 0.063 A ± 0.02. With the high-power capacitive protocol there was an 88.52% increase in superficial temperature, a 53.35% increase in Achilles tendon temperature and a 39.30% increase in musculotendinous junction temperature at 5 min, with a current flow of 0.095 A ± 0.03. With the high-power resistive protocol, there was a 21.34% increase in superficial temperature, a 109.70% increase in Achilles tendon temperature and an 81.49% increase in musculotendinous junction temperature at 5 min, with a current flow of 0.120 A ± 0.03.

Conclusion

The low-power protocols resulted in only a very slight thermal effect at the Achilles tendon and musculotendinous junction, but current flow was observed. The high-power protocols resulted in a greater temperature increase at the Achilles tendon and musculotendinous junction and a greater current flow than the low-power protocols. The high-power resistive protocol gave the greatest increase in Achilles tendon and musculotendinous junction temperature. Capacitive treatments (low- and high-power) achieved a greater increase in superficial temperature.

Effects of capacitive and resistive electric transfer therapy in patients with painful shoulder impingement syndrome: a comparative study

Objective

Capacitive and resistive electric transfer therapy (CARE) reduces pain and improves quality of life for many orthopaedic degenerative and inflammatory disorders. The research aim was to determine the effects of CARE on painful shoulder. The outcomes were pain reduction and recovery of shoulder function.

Methods

A retrospective, observational case-control study was conducted. Participants were 46 patients (22 in the CARE group and 24 in the SHAM group). Clinical data, pain (visual analogic scale, VAS) and functional scale scores (Disabilities of the Arm, Shoulder and Hand scale, and Constant–Murley Scale) were measured at baseline T0 (before treatment), T1 (after treatment) and follow-up T2 (2 months after the end of the treatment).

Results

VAS scores in the CARE group improved from 7.23 ± 1.11 at baseline to 2.68 ± 0.99 at follow-up. The SHAM group did not experience any improvement. Similarly, functional scale scores improved in the CARE group compared with the SHAM group.

Conclusion

Considering the small number of sessions needed, low cost and long-term benefits, CARE could be a useful therapeutic option for the conservative management of shoulder pain to restore pain-free and powerful movement to the shoulder joint.

Response of neuroblastoma cells to RF currents as a function of the signal frequency

BACKGROUND

Capacitive-resistive electric transfer (CRET) is a non-invasive therapeutic strategy that applies radiofrequency electric currents within the 400-600 kHz range to tissue repair and regeneration. Previous studies by our group have shown that 48 h of intermittent exposure to a 570 kHz CRET signal at a subthermal density of 50 μA/mm² causes significant changes in the expression and activation of cell cycle control proteins, leading to cycle arrest in human cancer cell cultures. The present study investigates the relevance of the signal frequency in the response of the human neuroblastoma cell line NB69 to subthermal electric treatment with four different signal frequency currents within the 350-650 kHz range.

METHODS

Trypan blue assay, flow cytometry, immunofluorescence and immunoblot were used to study the effects of subthermal CRET currents on cell viability, cell cycle progression and the expression of several marker proteins involved in NB69 cell death and proliferation.

RESULTS

The results reveal that among the frequencies tested, only a 448 kHz signal elicited both proapoptotic and antiproliferative, statistically significant responses. The apoptotic effect would be due, at least in part, to significant changes induced by the 448 kHz signal in the expression of p53, Bax and caspase-3. The cytostatic response was preceded by alterations in the kinetics of the cell cycle and in the expression of proteins p-ERK1/2, cyclin D1 and p27, which is consistent with a potential involvement of the EGF receptor in electrically induced changes in the ERK1/2 pathway. This receives additional support from results indicating that the proapototic and antiproliferative responses to CRET can be transiently blocked when the electric stimulus is applied in the presence of PD98059, a chemical inhibitor of the ERK1/2 pathway.

CONCLUSION

The understanding of the mechanisms underlying the ability of slowing down cancer cell growth through electrically-induced changes in the expression of proteins involved in the control of cell proliferation and apoptosis might afford new insights in the field of oncology.