Loading...
Publication
Efetividade de um programa de exercício estruturado e personalizado (Programa MyBack) na melhoria da aptidão fisica em indivíduos que recuperaram de um episódio de lombalgia: um ensaio clínico aleatorizado
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 3.14 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Introdução: Mundialmente, cerca de 1,71 mil milhões de pessoas têm uma
condição musculoesquelética, sendo a lombalgia (LG) o sintoma mais frequente
com uma incidência de 223.5 milhões e prevalência de 568.4 milhões. A maioria
dos episódios de LG tem um prognóstico favorável e é de curta duração, todavia
10 a 20% dos utentes desenvolvem um curso de dor persistente e incapacitante
que perdura para além de três meses e cerca de 40% a 69% dos indivíduos têm
recorrências num prazo de 12 meses após a recuperação. Embora o exercício e
a educação sejam recomendados, os resultados das revisões sistemáticas com
meta-análise realizadas são inconsistentes, sendo que a maioria das
intervenções existentes incluem diferentes tipos de exercícios, e não têm em
consideração os princípios da prescrição de exercício nem as aptidões físicas
dos participantes. A investigação acerca dos efeitos de programas de exercício
estruturados e individualizados às componentes de aptidão em déficit, que
envolvam indivíduos em risco de recorrência de lombalgia, é escassa ou
inexistente. Objetivos: Comparar a efetividade da adição de um programa de
exercício estruturado e personalizado (programa MyBack) à prática usual,
relativamente à prática usual isolada, em pessoas que recuperaram de um
episódio recente de lombalgia ao nível de: 1) força de resistência do tronco e
membros inferiores; 2) capacidade aeróbia; 3) flexibilidade; 4) controlo motor.
Secundariamente, pretende-se identificar se o programa é seguro e viável, em
termos de adesão e retenção, quando aplicado em contexto real. Métodos: Foi
realizado um ensaio clínico aleatorizado, que incluiu uma amostra de 61
indivíduos que recuperaram de um episódio de LG. Os indivíduos elegíveis,
foram submetidos a uma avaliação inicial através de um conjunto de testes de
aptidão física e posteriormente distribuídos pelos dois grupos em estudo, grupo
de “prática usual” e grupo “MyBack”. Este último realizou um programa de
exercícios e educação durante 12 semanas, selecionado a partir das
competências da aptidão física em déficit na avaliação inicial (capacidade
cardiorrespiratória, força de resistência dos músculos do tronco e membros
inferiores, controlo motor e flexibilidade). Foi realizada uma avaliação final após
os 3 meses do programa. Resultados: Foram encontradas diferenças
estatisticamente significativas, favorecendo o grupo MyBack, nos domínios da
aptidão física, “capacidade cardiorrespiratória”, “força de resistência dos
músculos do tronco”, “força de resistência dos músculos dos membros inferiores”
e “flexibilidade” (<0,001). Apenas 3 participantes desistiram do programa por
motivo de outras doenças, sendo a taxa de retenção de 81,3%. A percentagem
de adesão às sessões foi elevada tanto nas sessões presenciais (90,5%), como
nas sessões autónomas (88,06%). Discussão e conclusão: O programa MyBack é um programa seguro, viável e efetivo na melhoria das aptidões físicas em défice para a amostra em estudo fornecendo novos dados acerca da prescrição de exercício em indivíduos que recuperaram de pelo menos um
episódio de LG. Explorando o potencial impacto da condição física na recorrência
LG, através da avaliação e identificação das componentes da aptidão física que
cada individuo necessita de melhorar, leva-nos a programas de exercícios mais
específicos, orientados para os objetivos de cada pessoa o que pode ser uma
janela de oportunidade para desenvolver programas de prevenção secundária
nesta população com resultados robustos e fiáveis.
Introduction: Worldwide, about 1.71 billion people have a musculoskeletal condition, with low back pain (LG) being the most frequent symptom with an incidence of 223.5 million and prevalence of 568.4 million. Most episodes of LG have a favorable prognosis and short duration, however 10 to 20% of clients develop a course of persistent and disabling pain that lasts beyond three months and about 40% to 69% of individuals have recurrences within 12 months of recovery. Although exercise and education are recommended, the results of systematic reviews with meta-analysis carried out are inconsistent, and most existing interventions include different types of exercise, and do not take into account the principles of exercise prescription or the physical fitness of the participants. Research on the effects of structured and individualized exercise programs on the deficient fitness components, involving individuals at risk of recurrence of low back pain, is scarce or non-existent Objective: This study aims to compare the effectiveness of adding a structured and personalized exercise program (MyBack program) to usual practice, compared to usual practice alone, in people who have recovered from a recent episode of low back pain at the level of: 1) trunk and lower limb resistance strength; 2) aerobic capacity; 3) flexibility; 4) Motor control. Secondarily, it is intended to identify whether the program is safe and viable, in terms of adherence and retention, when applied in a real context. Methods: A randomized clinical trial was conducted, which included a sample of 61 individuals who recovered from one episode of LG. Eligible individuals were submitted to an initial assessment through a set of physical fitness tests and later distributed among the two groups under study, the "usual practice" and the "MyBack" group. The latter undertook a 12-week exercise and education program, selected on the basis of the physical fitness skills in deficit in the initial assessment (cardiorespiratory capacity, resistance strength of the trunk and lower limb muscles, motor control and flexibility). A final evaluation was carried out after the 3 months of the program. Results: Statistically significant differences were found, favoring the MyBack group, in the domains of physical fitness, "cardiorespiratory capacity", "trunk muscle endurance strength", "lower limb muscle endurance strength" and "flexibility" (<0.001). Only 3 participants dropped out of the program due to other diseases, with a retention rate of 81.3%. The percentage of adherence to the sessions was high both in face-to-face sessions (90.5%) and in autonomous sessions (88.06%). Discussion and conclusion: The MyBack program is a safe, feasible and effective program in improving physical fitness deficit for the study sample and providing new data on exercise prescription in individuals who have recovered from at least one episode of LG. Exploring the potential impact of physical condition on LG recurrence, through the assessment and identification of the components of physical fitness that each individual needs to improve, leads us to more specific exercise programs, oriented to the goals of each person, which can be a window of opportunity to develop secondary prevention programs in this population with robust and reliable results.
Introduction: Worldwide, about 1.71 billion people have a musculoskeletal condition, with low back pain (LG) being the most frequent symptom with an incidence of 223.5 million and prevalence of 568.4 million. Most episodes of LG have a favorable prognosis and short duration, however 10 to 20% of clients develop a course of persistent and disabling pain that lasts beyond three months and about 40% to 69% of individuals have recurrences within 12 months of recovery. Although exercise and education are recommended, the results of systematic reviews with meta-analysis carried out are inconsistent, and most existing interventions include different types of exercise, and do not take into account the principles of exercise prescription or the physical fitness of the participants. Research on the effects of structured and individualized exercise programs on the deficient fitness components, involving individuals at risk of recurrence of low back pain, is scarce or non-existent Objective: This study aims to compare the effectiveness of adding a structured and personalized exercise program (MyBack program) to usual practice, compared to usual practice alone, in people who have recovered from a recent episode of low back pain at the level of: 1) trunk and lower limb resistance strength; 2) aerobic capacity; 3) flexibility; 4) Motor control. Secondarily, it is intended to identify whether the program is safe and viable, in terms of adherence and retention, when applied in a real context. Methods: A randomized clinical trial was conducted, which included a sample of 61 individuals who recovered from one episode of LG. Eligible individuals were submitted to an initial assessment through a set of physical fitness tests and later distributed among the two groups under study, the "usual practice" and the "MyBack" group. The latter undertook a 12-week exercise and education program, selected on the basis of the physical fitness skills in deficit in the initial assessment (cardiorespiratory capacity, resistance strength of the trunk and lower limb muscles, motor control and flexibility). A final evaluation was carried out after the 3 months of the program. Results: Statistically significant differences were found, favoring the MyBack group, in the domains of physical fitness, "cardiorespiratory capacity", "trunk muscle endurance strength", "lower limb muscle endurance strength" and "flexibility" (<0.001). Only 3 participants dropped out of the program due to other diseases, with a retention rate of 81.3%. The percentage of adherence to the sessions was high both in face-to-face sessions (90.5%) and in autonomous sessions (88.06%). Discussion and conclusion: The MyBack program is a safe, feasible and effective program in improving physical fitness deficit for the study sample and providing new data on exercise prescription in individuals who have recovered from at least one episode of LG. Exploring the potential impact of physical condition on LG recurrence, through the assessment and identification of the components of physical fitness that each individual needs to improve, leads us to more specific exercise programs, oriented to the goals of each person, which can be a window of opportunity to develop secondary prevention programs in this population with robust and reliable results.
Description
Keywords
Lombalgia Aptidão Física Exercício Prevenção secundária Educação Low back pain Recurrence Secondary Prevention Exercise Educational intervention