Capacitive and Resistive Energy Transfer Therapy versus Other Electrophysical Modalities, Both Combined with Exercise, for Improving Pain, Functionality, and Range of Motion in Patients with Musculoskeletal Disorders: A Systematic Review

Capacitive-resistive energy transfer (CRet) is a recognized treatment for musculoskeletal conditions; however, its effectiveness compared to other electrophysical agents is unknown. The aim is to review CRet and other electrophysical agents and present the findings of the literature review using a systematic review PRISMA approach. The databases used were PubMed, Trip Database, Science Direct, Google scholar, Cochrane library, and UpToDate. Sixteen articles met eligibility criteria, and the assessor evaluated their quality using the Physiotherapy Evidence Database for randomized controlled trials (RCT). After risk of bias analysis and meta-analysis, level of evidence assignment was done using the Oxford Centre for evidence-based medicine recommendations. Seven RCT studies were analyzed for risk of bias to obtain evidence recommendations on neck pain, knee osteoarthritis, low back pain, and pain pelvic syndrome. Non-RCT studies were on tendonitis, myofascial pain syndrome, muscle soreness, lateral ankle ligament sprain, shoulder pain, and proximal humerus fracture. Despite five of seven high- and moderate-quality RCTs showing pain reduction compared to sham controls, heterogeneity prevented data pooling. When combined with exercise, CRet showed significant improvements in clinical outcomes compared to exercise alone. The random-effects meta-analysis found no significant difference in pain, stiffness, and physical function scores of knee osteoarthritis between CRet and sham controls at the three-month follow-up. Additionally, CRet alone did not show significant differences in clinical outcomes when compared to ozone therapy, laser, cryo-ultrasound, or combined EPAs in any of the musculoskeletal conditions studied.