Efficacy of Transfer Energy Capacitive and Resistive Therapy Combined With β-Hydroxy-β-Methylbutyrate Nutritional Supplementation in Older Adults With Sarcopenic Obesity
Abstract
Objective
To investigate the comprehensive intervention effects of transfer energy capacitive and resistive (TECAR) therapy combined with β-hydroxy-β-methylbutyrate (HMB) nutritional supplementation in older patients with sarcopenic obesity (SO).
Methods
We conducted a randomized controlled trial, enrolling 140 older patients who met the Asian diagnostic criteria for SO. Participants were randomly assigned to 4 groups, including a double-placebo group (Group A), TECAR + placebo group (Group B), sham TECAR + HMB group (Group C), and TECAR + HMB group (Group D), with 35 patients in each group. The intervention lasted 12 weeks. The primary outcome measure was the total score of the Short Physical Performance Battery (SPPB). Secondary outcome indicators included the modified Barthel Index (MBI), scores of the Mini Nutritional Assessment–Short Form (MNA-SF), handgrip strength, body mass, and body mass index (BMI). A two-way analysis of variance (ANOVA) was used to assess the interaction effects between TECAR and HMB.
Results
After the intervention, Group D (TECAR + HMB) demonstrated significant improvements across all metrics. The SPPB total score increased from 6.29 ± 1.34 to 8.06 ± 1.51 (P < 0.001), with notable enhancements in walking speed (2.71 ± 0.86 vs. 1.97 ± 0.82), chair stand (2.60 ± 0.55 vs. 2.11 ± 0.47), and balance (2.74 ± 0.74 vs. 2.20 ± 0.76). MBI improved from 71.74 ± 14.41 to 79.91 ± 10.52 (P < 0.001). Handgrip strength increased from (13.65 ± 5.05) kg to (15.72 ± 4.89) kg (P = 0.001). Body mass decreased from (81.78 ± 9.02) kg to (76.95 ± 9.89) kg (P < 0.001), and BMI reduced from (30.14 ± 1.68) kg/m2 to (28.34 ± 2.33) kg/m2 (P < 0.001). Interaction analysis revealed significant synergistic effects between TECAR and HMB in improving the SPPB total scores (F = 16.374, P < 0.001, η² = 0.107) and reducing BMI (F = 14.328, P < 0.001, η² = 0.095).
Conclusion
TECAR therapy combined with HMB supplementation significantly enhances physical function, activities of daily living, and body composition in elderly patients with sarcopenic obesity, demonstrating a synergistic effect.
Keywords: Sarcopenic obesity, Transfer energy capacitive and resistive therapy, β-hydroxy-β-methylbutyrate, Randomized controlled trial
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LORENZO M, DONINI L, BUSETTO L, et al. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Clin Nutr, 2022, 41(4): 990-1000. doi: 10.1016/j.clnu.2021.11.014. KAHYAOGLU Z, DENIZ O, GÜNER M, et al. Sarcopenic obesity is independently associated with frailty in geriatric outpatients: a cross-sectional study from university hospital. Nutr Clin Pract, 2025, 40(1): 123-134. doi: 10.1002/ncp.11326.
LIANG Y X, WANG R J, JIANG J J, et al. Effect of the otago exercise program on activities of daily living in older adults with sarcopenia. J Sichuan Univ (Med Sci), 2025, 56(2): 543-548. doi: 10.12182/ 20250360608.
MO X, SHEN L, WANG X, et al. Melatonin mitigates sarcopenic obesity via microbiota and short-chain fatty acids: evidence from epidemiologic and in vivo studies. J Cachexia Sarcopenia Muscle, 2025, 16(2): 345-357. doi: 10.1002/jcsm.13869.
YANG M, HU M, ZHANG Y, et al. Sarcopenic obesity is associated with frailty among community-dwelling older adults: findings from the WCHAT study. BMC Geriatr, 2022, 22(1): 456. doi: 10.1186/s12877-022-03617-z.
LIU Y R, ZHU M L, LIU X H, et al. B-hydroxy-B-methylbutyrate in treatment of sarcopenia in the elderly: clinical research update. Chinese Journal of Multiple Organ Diseases in the Elderly, 2018, 17(4): 309-312. doi: 10.11915/j.issn.1671-5403.2018.04.068.
VIANA M V, BECCE F, PANTET O, et al. Impact of β-hydroxy-β-methylbutyrate (HMB) on muscle loss and protein metabolism in critically ill patients: a RCT. Clin Nutr, 2021, 40(8): 4872-4881. doi: 10. 1016/j.clnu.2021.07.018.
PENG L N, CHENG Y C, YU P C, et al. Oral nutritional supplement with β-hydroxy-β-methylbutyrate (HMB) improves nutrition, physical performance and ameliorates intramuscular adiposity in pre-frail older adults: a randomized controlled trial. J Nutr Health Aging, 2021, 25(6): 767-773. doi: 10.1007/s12603-021-1621-7.
VISSER M, GOODPASTER B H, KRITCHEVSKY S B, et al. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci, 2005, 60(3): 324-333. doi: 10.1093/gerona/60.3.324.
JURDANA M, ŽIBERNA L. Sarcopenic obesity and hypertension in elderly patients: a narrative review of pathophysiology and management strategies. Ann Ist Super Sanita, 2023, 59(3): 256-267. doi: 10.4415/ANN_23_03_10.
WU H, XIA Y, JIANG J, et al. Effect of β-hydroxy-β-methylbutyrate supplementation on muscle loss in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr, 2015, 61(2): 168-175. doi: 10.1016/j. archger.2015.06.020.
UZUN Ö, ÖZCAN D S N, ARSLAN H B, et al. Impact of TECAR therapy on pain and function in adhesive capsulitis: a randomized controlled trial. Lasers Med Sci, 2025, 40(1): 45. doi: 10.1007/s10103-025-04492-x. GARCÍA-RUEDA L, CABANAS-VALDÉS R, SALGUEIRO C, et al. Immediate effects of TECAR therapy on lower limb to decrease hypertonia in chronic stroke survivors: a randomized controlled trial. Disabil Rehabil, 2024, 47(5): 1234-1242. doi: 10.1080/09638288.2024. 2365992.
FORTUNA R, SAWATSKY A, FULLER J C, et al. Effects of β-hydroxy-β-methylbutyrate supplementation on muscle mass and strength in onabotulinumtoxin type-A-injected and contralateral quadriceps femoris in rabbits. J Rehabil Med, 2021, 53(9): jrm00220. doi: 10.2340/16501977-2866.
STAHN A C, MAGGIONI M A, GUNGA H C, et al. Combined protein and calcium β-hydroxy-β-methylbutyrate induced gains in leg fat free mass: a double-blinded, placebo-controlled study. J Int Soc Sports Nutr, 2020, 17(1): 33. doi: 10.1186/s12970-020-0336-1.
VAHDATPOUR B, HAGHIGHAT S, SADRI L, et al. Effects of transfer energy capacitive and resistive on musculoskeletal pain: a systematic review and meta-analysis. Galen Med J, 2023, 11: e2407. doi: 10.31661/gmj.v11i.2407.
TEZEN Ö, ATA A M, UZUN Ö, et al. Comparison of the effectiveness of ultrasound and transfer energy capacitive and resistive (TECAR) therapy in patients with carpal tunnel syndrome. Lasers Med Sci, 2025, 40(1): 38. doi: 10.1007/s10103-025-04412-z.
SATO S, NOMURA M, YAMANA I, et al. A new in vitro muscle contraction model and its application for analysis of mTORC1 signaling in combination with contraction and β-hydroxy-β-methylbutyrate administration. Biosci Biotechnol Biochem, 2019, 83(10): 1885-1893. doi: 10.1080/09168451.2019.1625261.
RODRÍGUEZ-SANZ J, PÉREZ-BELLMUNT A, LÓPEZ-DE-CELIS C, et al. Thermal and non-thermal effects of capacitive-resistive electric transfer application on different structures of the knee: a cadaveric study. Sci Rep, 2020, 10(1): 12345. doi: 10.1038/s41598-020-78612-8.
TASHIRO Y, SUZUKI Y, NAKAYAMA Y, et al. The effect of capacitive and resistive electric transfer on non-specific chronic low back pain. Electromagn Biol Med, 2020, 39(4): 437-444. doi: 10.1080/15368378.2020. 1851255.
BELTRAME R, RONCONI G, FERRARA P E, et al. Capacitive and resistive electric transfer therapy in rehabilitation: a systematic review. Int J Rehabil Res, 2020, 43(4): 291-298. doi: 10.1097/MRR.000000000 0000435.
WANG J, CUI C, CHIM Y N, et al. Vibration and β-hydroxy-β-methylbutyrate treatment suppresses intramuscular fat infiltration and adipogenic differentiation in sarcopenic mice. J Cachexia Sarcopenia Muscle, 2020, 11(2): 564-577. doi: 10.1002/jcsm.12535.
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