The aim of this study is to evaluate the effects of capacitive resistive electric transference (CRET), which is frequently used in clinics and sports clubs for professional soccer players with hamstring injuries. We thought that CRET could have positive effects on tissue healing in the subacute phase of hamstring injuries.
Hamstring injuries are the most prevalent pathology in professional football, primarily due to the demands of high-speed running. Beyond threatening athlete health, these injuries account for 12-17% of all time-loss injuries, directly impacting a team's seasonal performance. Research has shown that teams with fewer pre-season hamstring injuries achieve greater success, while the annual financial burden on clubs reaches hundreds of millions of pounds. Recent analyses of 21 years of data from the UEFA Elite Club Injury Study reveal that, despite advancements in preventive strategies and training science, hamstring injury rates have not decreased but rather increased by 30% in recent years (5). Given this substantial financial cost, it is evident that current prevention and rehabilitation programs are insufficient, highlighting the need to integrate new therapeutic modalities that optimize tissue healing into clinical practice. Capacitive and Resistive Electric Transfer (CRET) is a non-invasive electro-physical modality that generates deep endogenous hyperthermia using radiofrequency currents, typically at a stable frequency of 448 kHz. Recent systematic reviews highlight that this method accelerates tissue regeneration not only through its thermal effect but also via biostimulation, which enhances ion mobility by balancing cell membrane potential. By increasing the permeability of ion channels in the cell membrane, it optimizes sodium-potassium (Na/K) pump activity, thereby helping injured and depolarized cells restore their membrane potential. CRET operates through two distinct modes (capacitive and resistive) that focus energy on specific layers based on tissue resistance, allowing it to selectively increase arterial blood perfusion even in deep muscle groups. While these studies recommend Tecar therapy for muscle regeneration, there are no randomized controlled trials investigating its efficacy specifically in hamstring injury rehabilitation. Therefore, this study aims to evaluate the effects of CRET-frequently used in clinics and sports clubs-on professional football players with hamstring injuries. We hypothesized that CRET would have positive effects on tissue healing during the subacute phase
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
22
Experimental Group (CRET Therapy): In addition to the standard rehabilitation program, CRET therapy (T-Plus; Wintecare SA, Chiasso, Switzerland) will be applied at the end of each session to the experimental group. Positioning: The athlete will be placed in a prone position, with the passive electrode placed under the quadriceps muscle and the active electrode applied in the direction of the hamstring muscle fibers using classic massage maneuvers. Dosage and Duration: The treatment will last a total of 20 minutes, consisting of 10 minutes in resistive mode followed by 10 minutes in capacitive mode. Intensity: The application will start at 70% intensity. If the thermal sensation reaches a level that disturbs the athlete, the intensity will be gradually reduced by 10% to achieve the maximum tolerable thermal effect.
A standard hamstring rehabilitation program consisting of three phases will be implemented.
Hacettepe University
Ankara, Altindag, Turkey (Türkiye)
RECRUITINGReturn to Sport Time
The primary outcome measure is the number of days from the time of injury to the time when criteria for full return to sports are met.
Time frame: 5 weeks
Hamstring Flexibility
Passive straight leg raise, passive knee extension at 90° hip flexion, and active knee extension at full hip flexion angles will be measured using a smartphone-based goniometer (Goniometer Plus) with proven validity and reliability.
Time frame: 5 weeks
Hamstring strength
Hamstring muscle strength will be assessed using a hand dynamometer (MicroFet 2, Hoggan Health, USA). Measurements will be taken in the prone position with the knee flexed at 90°, in the form of isometric strength and mid-range eccentric strength tests, and the maximum value of 3 repetitions will be recorded.
Time frame: 5 weeks
Muscle Oxygen Saturation (NIRS)
Muscle oxygenation in the injured area will be monitored using a non-invasive near-infrared spectroscopy (NIRS) device (Moxy Monitor, Fortiori Design LLC). The device will be secured to the injured area with adhesive tape, and the average total hemoglobin and capillary oxygen saturation (SmO2) values obtained during the 10-second measurement period will be recorded. The Moxy device has previously been shown to be valid and reliable for measuring muscle oxygenation.
Time frame: 5 weeks
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