Hamstring Injury
Conditions
Keywords
rehabilitation, hamstring, strain
Brief summary
The goal of this clinical trial 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. The main questions it aims to answer are: Return to sports time Treatments sessions number Muscle oxygen saturation The investigators will administer the treatment to a experimental group to see if CRET therapy is effective. The investigators will also administer a standard rehabilitation program to both the control and experimental groups. Participants will: Come for treatment and evaluations 3 times a week until participants meet the criteria for returning to sports.
Detailed description
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 Union of European Football Associations (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 kilohertz (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 CRET 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. The investigators hypothesized that CRET would have positive effects on tissue healing during the subacute phase.
Interventions
DEVICET-Plus; Wintecare SA, Chiasso, Switzerland
Experimental Group (Capacitive and Resistive Electrical Transfer Therapy (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.
OTHERExercise
A standard hamstring rehabilitation program consisting of three phases will be implemented.
Sponsors
Hacettepe University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Two groups including control and experimental groups
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* History of acute onset hamstring pain. * Grade I or II hamstring strain injury confirmed by Magnetic Resonance Imaging (MRI) within the first 5 days following the injury. * No history of anterior cruciate ligament (ACL) reconstruction.
Exclusion criteria
* Presence of neurological symptoms. * Loss of superficial sensation or skin pathologies that may prevent CRET application. * Refusal to sign the approval form.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Return to Sport Time | 5 weeks | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hamstring Flexibility | 5 weeks | 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. |
| Hamstring strength | 5 weeks | 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. |
| Muscle Oxygen Saturation | 5 weeks | 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 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. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORIrem DUZGUN
Hacettepe University
Outcome results
None listed