Comparison Between the Effects of Transfer Energy Capacitive and Resistive Therapy and Therapeutic Ultrasound on Hamstring Muscle Shortness in Male Athletes: A Single-Blind Randomized Controlled Trial
DOI:
https://doi.org/10.31661/gmj.v12i.2981Keywords:
Hamstring Muscle, Physical Therapy Modalities, Static Stretching, Radiofrequency Therapy, DiathermyAbstract
Background: Transfer energy capacitive and resistive (TECAR) therapy (TT) is a newly developed deep heating therapy that can generate heat within tissues through high-frequency wave stimulation. Compared to conventional physiotherapy methods, the application of TT especially in sports rehabilitation is becoming more popular. This study aimed to investigate the comparative effect of TT and therapeutic ultrasound (US) on hamstring muscle shortness. Additionally, the effects of TT with static stretching (SS) were compared with US combined with SS.
Materials and Methods: Totally, 39 male athletes with hamstring shortness were randomly assigned into three groups: A, B, and C. Group A received 15 minutes of TT plus SS, while Group B received 15 minutes of US with SS, and Group C only performed SS. Hamstring flexibility was measured by active knee extension (AKE), passive knee extension (PKE), and the sit and Reach (SR) tests before the intervention, and following the first, and third treatment sessions.
Results: The range of motion of the AKE and PKE, and displacement range in the SR test improved significantly after the first and third sessions in all three groups (P<0.0001). The improvement of the three flexibility indices in the TT group was greater than in the other two groups.
Conclusion: The present study showed that TT could increase the flexibility of hamstring muscles more than US therapy. However, TT in combination with SS had a similar effect to SS alone.
References
Koli BK, Anap DB. Prevalence and severity of hamstring tightness among college student: A cross sectional study. IJCBR. 2018:65-8. https://doi.org/10.5455/ijcbr.2018.42.14 Hopper D, Deacon S, Das S, Jain A, Riddell D, Hall T et al. Dynamic soft tissue mobilization increases hamstring flexibility in healthy male subjects. Br J Sports Med. 2005;39(9):594-8. https://doi.org/10.1136/bjsm.2004.011981PMid:16118294 PMCid:PMC1725327 Shadmehr A, Salemi P, Fereydounnia S. The immediate effect of static hamstring stretching on dynamic balance and gait biomechanical variables in athletes with hamstring tightness: A preliminary study. JMR. 2021; 15:141-50. https://doi.org/10.18502/jmr.v15i3.7749 Nakano J, Yamabayashi C, Scott A, Reid WD. The effect of heat applied with stretch to increase range of motion: a systematic review. Phys Ther Sport. 2012;13(3):180-8. https://doi.org/10.1016/j.ptsp.2011.11.003PMid:22814453 Herda TJ, Costa PB, Walter AA, Ryan ED, Hoge KM, Kerksick CM et al. Effects of two modes of static stretching on muscle strength and stiffness. Med Sci Sports Exerc. 2011;43(9):1777-84. https://doi.org/10.1249/MSS.0b013e318215cda9PMid:21364485 Ichihashi N, Ibuki S, Nakamura M. Effects of static stretching on passive properties of muscle-tendon unit. J Sports Med Phys Fit. 2014;3(1):1-10. https://doi.org/10.7600/jpfsm.3.1 Barton CJ, Webster KE, Menz HB. Evaluation of the scope and quality of systematic reviews on nonpharmacological conservative treatment for patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2008;38(9):529-41. https://doi.org/10.2519/jospt.2008.2861PMid:18758046 Silva LM, Neiva HP, Marques MC, Izquierdo M, Marinho DA. Effects of warm-up, post-warm-up, and re-warm-up strategies on explosive efforts in team sports: A systematic review. Sports Med. 2018;48(10):2285-99. https://doi.org/10.1007/s40279-018-0958-5PMid:29968230 Garrett CL, Draper DO, Knight KL. Heat distribution in the lower leg from pulsed short-wave diathermy and ultrasound treatments. J Athl Train. 2000;35(1):50-5. Giombini A, Di Cesare A, Casciello G, Sorrenti D, Dragoni S, Gabriele P. Hyperthermia at 434 MHz in the treatment of overuse sport tendinopathies: a randomized controlled clinical trial. Int J Sports Med. 2002;23(03):207-11. https://doi.org/10.1055/s-2002-23180PMid:11914985 Rabini A, Piazzini DB, Tancredi G, Foti C, Milano G, Ronconi G et al. Deep heating therapy via microwave diathermy relieves pain and improves physical function in patients with knee osteoarthritis: a double-blind randomized clinical trial. Eur J Phys Rehabil Med. 2012;48(4):549-59. Bito T, Tashiro Y, Suzuki Y, Kajiwara Y, Zeidan H, Kawagoe M et al. Acute effects of capacitive and resistive electric transfer (CRet) on the Achilles tendon. Electromagn Biol Med. 2019;38(1):48-54. https://doi.org/10.1080/15368378.2019.1567525PMid:30663425 Lounsberry NL. Therapeutic heat: effects of superficial and deep heating modalities on hamstring flexibility. Osprey Journal of Ideas and Inquiry. 2008;7 :138. Miller DL, Smith NB, Bailey MR, Czarnota GJ, Hynynen K, Makin IR. Overview of therapeutic ultrasound applications and safety considerations. J Ultrasound Med. 2012;31(4):623-34. https://doi.org/10.7863/jum.2012.31.4.623PMid:22441920 PMCid:PMC3810427 Rose S, Draper DO, Schulthies SS, Durrant E. The stretching window part two: Rate of thermal decay in Deep Muscle Following 1-MHz Ultrasound. J Athl Train. 1996;31(2):139-43. Beltrame R, Ronconi G, Ferrara PE, Salgovic L, Vercelli S, Solaro C et al. Capacitive and resistive electric transfer therapy in rehabilitation: a systematic review. Int J Rehabil Res. 2020;43(4):291-8. https://doi.org/10.1097/MRR.0000000000000435PMid:32909988 Kumaran B, Watson T. Thermal build-up, decay and retention responses to local therapeutic application of 448 kHz capacitive resistive monopolar radiofrequency: A prospective randomized crossover study in healthy adults Int. J Hyperth. 2015;31(8):883-95. https://doi.org/10.3109/02656736.2015.1092172PMid:26524223 Vahdatpour B, Haghighat S, Sadri L, Taghian M, Sadri S. Effects of transfer energy capacitive and resistive on musculoskeletal pain: A Systematic Review and Meta-Analysis. GMJ. 2022;11: e2407. https://doi.org/10.31661/gmj.v11i.2407PMid:36698689 PMCid:PMC9838110 Oh D-G, Kim S-K, Yoo K-T. Effect of Physiotherapeutic Intervention using TECAR therapy on pain self-awareness and hip joint function in hip impingement syndrome: A Case Study. KSPM. 2021;16(3):45-53. https://doi.org/10.13066/kspm.2021.16.3.45 Osti R, Pari C, Salvatori G, Massari L. Tri-length laser therapy associated to tecar therapy in the treatment of low-back pain in adults: a preliminary report of a prospective case series. Lasers Med Sci. 2015;30(1):407-12. https://doi.org/10.1007/s10103-014-1684-3PMid:25376670 Ribeiro S, Henriques B, Cardoso R. The effectiveness of tecar therapy in musculoskeletal disorders. Int J Public Health. 2018;3(5):77-83. Yeste-Fabregat M, Baraja-Vegas L, Vicente-Mampel J, Pérez-Bermejo M, Bautista González IJ, Barrios C. Acute effects of tecar therapy on skin temperature, ankle mobility and hyperalgesia in myofascial pain syndrome in professional basketball players A Pilot Study. Int J Environ Res Public. 2021;18(16):8756. https://doi.org/10.3390/ijerph18168756PMid:34444508 PMCid:PMC8392258 Kim YJ, Park J-H, Kim J-h, Moon GA, Jeon H-S. Effect of High-frequency Diathermy on Hamstring Tightness. Phys Ther Korea. 2021;28(1):65-71. https://doi.org/10.12674/ptk.2021.28.1.65 Mohamadi P, Ghotbi N, Bashardoust S, Naghdi Dorbati S, Salehi S. Comparison of the Effect of TECAR Therapy and Static Stretching on Hamstring Flexibility in Male Athletes. Babol-Jbums. 2021;23(1):53-9. Minkler S, Patterson P. The validity of the modified sit-and-reach test in college-age students. Res Q Exerc Sport. 1994;65(2):189-92. https://doi.org/10.1080/02701367.1994.10607614PMid:8047711 Reurink G, Goudswaard GJ, Oomen HG, Moen MH, Tol JL, Verhaar JA et al. Reliability of the active and passive knee extension test in acute hamstring injuries. Am J Sports Med. 2013;41(8):1757-61. https://doi.org/10.1177/0363546513490650PMid:23735425 Nakao G, Taniguchi K, Katayose M. Acute effect of active and passive static stretching on elastic modulus of the hamstrings. Sports Med Int Open. 2018;2(06): E163-E70. https://doi.org/10.1055/a-0733-6957PMid:30539134 PMCid:PMC6277241 Rodríguez-Sanz J, López-de-Celis C, Hidalgo-García C, Canet-Vintró M, Fanlo-Mazas P, Pérez-Bellmunt A. Temperature and current flow effects of different electrode placement in shoulder capacitive-resistive electric transfer applications: a cadaveric study. BMC Musculoskelet Disord. 2021;22(1):139. https://doi.org/10.1186/s12891-020-03918-7PMid:33541324 PMCid:PMC7860630 Quarato CMI, Lacedonia D, Salvemini M, Tuccari G, Mastrodonato G, Villani R et al. A Review on Biological Effects of Ultrasounds: Key Messages for Clinicians. Diagnostics. 2023;13(5):855. https://doi.org/10.3390/diagnostics13050855PMid:36899998 PMCid:PMC10001275 Garrett CL, Draper DO, Knight KL. Heat distribution in the lower leg from pulsed short-wave diathermy and ultrasound treatments. J Athl Train. 2000;35(1):50. Clijsen R, Leoni D, Schneebeli A, Cescon C, Soldini E, Li L et al. Does the application of Tecar therapy affect temperature and perfusion of skin and muscle microcirculation A pilot feasibility study on healthy subjects. J Altern Complement Med. 2020;26(2):147-53. https://doi.org/10.1089/acm.2019.0165PMid:31580698 PMCid:PMC7044785 Sellani G, Fernandes D, Nahari A, de Oliveira MF, Valois C, Pereira WC et al. Assessing heating distribution by therapeutic ultrasound on bone phantoms and in vitro human samples using infrared thermography. J Ther Ultrasound. 2016; 4:13. https://doi.org/10.1186/s40349-016-0058-7PMid:27051520 PMCid:PMC4820859 Nuri L, Ghotbi N, Faghihzadeh S. Acute effects of static stretching, active warm up, or passive warm up on flexibility of the plantar flexor muscles of Iranian professional female Taekwondo Athletes. J Musculoskelet Pain. 2013;21(3):263-8. https://doi.org/10.3109/10582452.2013.827771 Gajdosik RL. Passive extensibility of skeletal muscle: review of the literature with clinical implications. Clin Biomech (Bristol, Avon). 2001;16(2):87-101. https://doi.org/10.1016/S0268-0033(00)00061-9 Konrad A, Tilp M. The time course of muscle-tendon unit function and structure following three minutes of static stretching. J Sports Sci Med. 2020;19(1):52-8. https://doi.org/10.15203/CISS_2020.003 Takeuchi K, Akizuki K, Nakamura M. Time course of changes in the range of motion and muscle-tendon unit stiffness of the hamstrings after two different intensities of static stretching. PLoS One. 2021;16(9): e0257367. https://doi.org/10.1371/journal.pone.0257367PMid:34520498 PMCid:PMC8439484 Peres SE, Draper DO, Knight KL, Ricard MD. Pulsed shortwave diathermy and prolonged long-duration stretching increase dorsiflexion range of motion more than identical stretching without diathermy. J Athl Train. 2002;37(1):43-50. Herda TJ, Herda ND, Costa PB, Walter-Herda AA, Valdez AM, Cramer JT. The effects of dynamic stretching on the passive properties of the muscle-tendon unit. J Sports Sci. 2013;31(5):479-87. https://doi.org/10.1080/02640414.2012.736632PMid:23113555 Neto T, Jacobsohn L, Carita AI, Oliveira R. Reliability of the active knee extension and straight leg raise tests in subjects with flexibility deficits. J Sport Rehabil. 2015;24(4):1. https://doi.org/10.1123/jsr.2014-0220PMid:25364856 Baltaci G, Un N, Tunay V, Besler A, Gerçeker S. Comparison of three different sit and reach tests for measurement of hamstring flexibility in female university students. Br J Sports Med. 2003;37(1):59-61. https://doi.org/10.1136/bjsm.37.1.59PMid:12547745 PMCid:PMC1724584 akınoğlu B, Paköz B, Hasanoğlu A, Kocahan T. Investigation of the relationship between sit-and-reach flexibility and the height, the leg length and the trunk length in adolescent athletes. Balt J Health Phys Act. 2021;13:29-37. https://doi.org/10.29359/BJHPA.13.4.04