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Efetividade de um Programa de Exercício na Dor e Qualidade de Vida em Indivíduos com Dor Lombar Crónica
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Advisor(s)
Abstract(s)
Introdução: A dor lombar (DL), considerada como a principal causa de anos perdidos por
incapacidade, é uma das condições dolorosas mais experienciadas pelos indivíduos. Atualmente, a
Fisioterapia, principalmente o exercício e as estratégias de educação/ auto-gestão são as
intervenções mais recomendadas para a dor lombar crónica de origem não específica (DLCne).
Contudo, a literatura não é clara quanto aos detalhes deste tipo de intervenção (tipologia, frequência,
intensidade e duração) em indivíduos com esta condição. Objetivo: Comparar os efeitos de um
programa de exercício estruturado versus a fisioterapia multimodal em indivíduos com DLCne, ao
nível da intensidade da dor, catastrofização, qualidade de vida da dor e perceção global de melhoria.
Metodologia: Foi realizado um estudo quase experimental em indivíduos com DLC. Os participantes
do grupo de exercício estruturado (GEE) (n=15) realizaram o programa Rehmove durante 6 semanas,
constituído por 12 sessões. O grupo de Fisioterapia multimodal (GFM) (n=15) realizou diversas
modalidades terapêuticas, combinadas de formas distintas, durante 6 semanas. Os intervenientes
foram avaliados antes da intervenção (baseline), 3 semanas após o início da mesma, no final da
intervenção (6 semanas) e no follow-up (3 meses após a conclusão desta). Os instrumentos utilizados
foram a Escala Numérica da Dor (END), EuroQol- 5D-3L (EQ-5D-3L-PT), Pain Catastrophizing Scale
(PCS-PT) e Global Perceived Effect Scale (GPES-PT). Na baseline, também foi avaliado o
mecanismo de dor predominante através do Pain Detect Questionnaire (PDQ-PT). Resultados: No
outcome intensidade da dor, no GEE, houve diferenças significativas entre o início e o final da
intervenção. Quanto ao GFM verificaram-se melhorias estatisticamente significativas entre a
avaliação feita na baseline, 3 semanas após o início da intervenção, final da intervenção e o followup. Relativamente às variáveis catastrofização e qualidade de vida, o GFM melhorou
significativamente quer na análise intergrupo, como na intragrupo. No que diz respeito à perceção
global de melhoria, o GFM apresentou melhorias clínicas no follow-up (80%), enquanto o GEE
manteve os valores do fim da intervenção (40%). Conclusão: O GFM apresentou melhorias
significativas nos outcomes intensidade da dor e catastrofização, nas restantes variáveis (qualidade
de vida e perceção global de melhoria) não se verificaram diferenças significativas entre grupos
Introduction: Low back pain (LBP), considered as the main cause of years lost due to disability, is one of the most painful conditions experienced by individuals. Currently, Physiotherapy, mainly exercise and education / self-management strategies are the most recommended interventions for chronic low back pain of non-specific origin (CLBPnso). However, the literature is not clear as to the details of this type of intervention (typology, frequency, intensity, and duration) in individuals with this condition. Objective: To compare the effects of a structured exercise program versus multimodal physiotherapy in individuals with CLBPnso, in terms of pain intensity, catastrophization, quality of life of pain and overall perception of improvement. Methodology: A quasi-experimental study was conducted on individuals with DLC. Participants in the structured exercise group (SEG) (n = 15) performed the Rehmove program for 6 weeks, consisting of 12 sessions. The Multimodal Physiotherapy group (MPG) (n = 15) performed several therapeutic modalities, combined in different ways, for 6 weeks. The participants were evaluated before the intervention (baseline), 3 weeks after the beginning of the intervention, at the end of the intervention (6 weeks) and at the follow-up (3 months after its completion). The instruments used were the Numerical Pain Scale (NPS), EuroQol-5D-3L (EQ-5D-3L-PT), Pain Catastrophizing Scale (PCS-PT) and Global Perceived Effect Scale (GPES-PT). In the baseline, the predominant pain mechanism was also assessed through the Pain Detect Questionnaire (PDQ-PT). Results: In the outcome of pain intensity, in the SEG, there were significant differences between the beginning and the end of the intervention. As for the MPG, there were statistically significant improvements between the evaluation made on the baseline, 3 weeks after the beginning of the intervention, end of the intervention and the follow-up. Regarding the catastrophizing and quality of life variables, the MPG improved significantly both in the intergroup and in the intragroup analysis. Regarding the global perception of improvement, the MPG showed clinical improvements in the follow-up (80%), while the SEG maintained the values at the end of the intervention (40%). Conclusions: The MPG showed significant improvements in the outcomes of pain intensity and catastrophizing, but in the remaining variables (quality of life and global perception of improvement) there were no significant differences between groups.
Introduction: Low back pain (LBP), considered as the main cause of years lost due to disability, is one of the most painful conditions experienced by individuals. Currently, Physiotherapy, mainly exercise and education / self-management strategies are the most recommended interventions for chronic low back pain of non-specific origin (CLBPnso). However, the literature is not clear as to the details of this type of intervention (typology, frequency, intensity, and duration) in individuals with this condition. Objective: To compare the effects of a structured exercise program versus multimodal physiotherapy in individuals with CLBPnso, in terms of pain intensity, catastrophization, quality of life of pain and overall perception of improvement. Methodology: A quasi-experimental study was conducted on individuals with DLC. Participants in the structured exercise group (SEG) (n = 15) performed the Rehmove program for 6 weeks, consisting of 12 sessions. The Multimodal Physiotherapy group (MPG) (n = 15) performed several therapeutic modalities, combined in different ways, for 6 weeks. The participants were evaluated before the intervention (baseline), 3 weeks after the beginning of the intervention, at the end of the intervention (6 weeks) and at the follow-up (3 months after its completion). The instruments used were the Numerical Pain Scale (NPS), EuroQol-5D-3L (EQ-5D-3L-PT), Pain Catastrophizing Scale (PCS-PT) and Global Perceived Effect Scale (GPES-PT). In the baseline, the predominant pain mechanism was also assessed through the Pain Detect Questionnaire (PDQ-PT). Results: In the outcome of pain intensity, in the SEG, there were significant differences between the beginning and the end of the intervention. As for the MPG, there were statistically significant improvements between the evaluation made on the baseline, 3 weeks after the beginning of the intervention, end of the intervention and the follow-up. Regarding the catastrophizing and quality of life variables, the MPG improved significantly both in the intergroup and in the intragroup analysis. Regarding the global perception of improvement, the MPG showed clinical improvements in the follow-up (80%), while the SEG maintained the values at the end of the intervention (40%). Conclusions: The MPG showed significant improvements in the outcomes of pain intensity and catastrophizing, but in the remaining variables (quality of life and global perception of improvement) there were no significant differences between groups.
Description
Keywords
Dor Lombar Crónica Mecanismos de Produção de Dor Catastrofização da Dor Qualidade de Vida Exercício Estruturado Fisioterapia Multimoda Chronic Low Back Pain Underlying Pain Mechanisms Pain Catastrophizing Quality of Life Structured Exercise Multimodal Physiotherapy