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Intervenção combinada baseada em terapia manual, exercício terapêutico e educação em utentes com dor lombar com envolvimento da articulação sacroilíaca: estudo de série de casos
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Advisor(s)
Abstract(s)
Introdução: A dor lombar (DL) é a condição músculo-esquelética com maior
prevalência em Portugal, bem como a principal causa de anos vividos com
incapacidade em todo o mundo. Existe uma grande variabilidade de intervenções
em fisioterapia, no entanto existe uma tendência na literatura a desvalorizar os
fatores físicos, entre eles o envolvimento da articulação sacroilíaca (SI). O objetivo
deste estudo foi descrever um programa de educação, terapia manual e exercício
terapêutico e os seus benefícios ao nível da dor e incapacidade funcional em
utentes com DL associada ao envolvimento da articulação SI.
Materiais e Métodos: Foi realizado um estudo observacional do tipo série de
casos, com intervenção numa amostra de utentes com DL unilateral com
envolvimento da articulação SI, submetidos a um programa de terapia manual,
exercício e educação, com avaliação na baseline (T0), às 4 (T1) e 8 semanas (T2)
e acompanhamento pós-intervenção aos 3 meses (T3). Foram utilizados como
instrumentos de medida o questionário sociodemográfico, a escala numérica da dor
(END), a versão portuguesa da Quebec Back Pain Disability Scale (QBPDS-PT) e
a versão portuguesa da Global Perceived Effect Scale (GPES-PT), bem como a
medição do Straight Leg Raise (SLR), o Single Limb Stance (SLS) e o Unilateral
Pelvic Lift (UPL).
Resultados: Foram incluídos 12 participantes neste estudo. A maioria dos utentes
beneficiou da intervenção em Fisioterapia, observando-se melhorias clinicamente
importantes ao nível da dor e incapacidade funcional em 8 e 7 participantes após a
intervenção, respetivamente. No entanto apenas 6 percecionaram melhoria no seu
estado global de saúde. Estas melhorias foram acompanhadas do aumento das
amplitudes medidas de SLR e da coordenação muscular funcional em pelo menos
2 testes.
Conclusões: Os resultados deste estudo demonstram um exemplo de como uma
intervenção em fisioterapia considerando o envolvimento da articulação SI poderá
ser considerada em utentes com DL. De modo a otimizar a robustez de resultados,
serão necessários mais estudos.
Introduction: Low back pain (LBP) is the most prevalent musculoskeletal condition in Portugal, as well as the main cause of years lived with disability worldwide. There is a great variability of interventions in physiotherapy, however there is a tendency in the literature to devalue physical factors, including the involvement of the sacroiliac (SI) joint. The objective of this study was to describe a program of education, manual therapy and therapeutic exercise and its benefits in terms of pain and functional disability in users with LBP associated with involvement of the SI joint. Materials and Methods: An observational case series study was carried out, with intervention on a sample of patients with unilateral LBP with involvement of the SI joint, undergoing a program of manual therapy, exercise and education, with assessment at baseline (T0), at 4 (T1) and 8 weeks (T2) and post-intervention follow-up at 3 months (T3). The sociodemographic questionnaire, the numerical pain scale (END), the portuguese version of the Quebec Back Pain Disability Scale (QBPDS-PT) and the portuguese version of the Global Perceived Effect Scale (GPES-PT) were used as measuring instruments, as well as measuring the Straight Leg Raise (SLR), the Single Limb Stance (SLS) and the Unilateral Pelvic Lift (UPL). Sample recruitment for the present study was carried out at Hospital Garcia de Orta. Results: 12 participants were included in this study. Most patients benefited from the Physiotherapy intervention, with clinically important improvements being observed in terms of pain and functional disability in 8 and 7 participants after the intervention, respectively. However, only 6 noticed an improvement in their overall health status. These improvements were accompanied by increases in measured SLR amplitudes and functional muscle coordination in at least 2 tests. Conclusions: The results of this study demonstrate an example of how a physiotherapy intervention considering the involvement of the SI joint can be considered in users with LBP. To optimize the robustness of results, more studies will be needed.
Introduction: Low back pain (LBP) is the most prevalent musculoskeletal condition in Portugal, as well as the main cause of years lived with disability worldwide. There is a great variability of interventions in physiotherapy, however there is a tendency in the literature to devalue physical factors, including the involvement of the sacroiliac (SI) joint. The objective of this study was to describe a program of education, manual therapy and therapeutic exercise and its benefits in terms of pain and functional disability in users with LBP associated with involvement of the SI joint. Materials and Methods: An observational case series study was carried out, with intervention on a sample of patients with unilateral LBP with involvement of the SI joint, undergoing a program of manual therapy, exercise and education, with assessment at baseline (T0), at 4 (T1) and 8 weeks (T2) and post-intervention follow-up at 3 months (T3). The sociodemographic questionnaire, the numerical pain scale (END), the portuguese version of the Quebec Back Pain Disability Scale (QBPDS-PT) and the portuguese version of the Global Perceived Effect Scale (GPES-PT) were used as measuring instruments, as well as measuring the Straight Leg Raise (SLR), the Single Limb Stance (SLS) and the Unilateral Pelvic Lift (UPL). Sample recruitment for the present study was carried out at Hospital Garcia de Orta. Results: 12 participants were included in this study. Most patients benefited from the Physiotherapy intervention, with clinically important improvements being observed in terms of pain and functional disability in 8 and 7 participants after the intervention, respectively. However, only 6 noticed an improvement in their overall health status. These improvements were accompanied by increases in measured SLR amplitudes and functional muscle coordination in at least 2 tests. Conclusions: The results of this study demonstrate an example of how a physiotherapy intervention considering the involvement of the SI joint can be considered in users with LBP. To optimize the robustness of results, more studies will be needed.
Description
Keywords
Dor lombar Articulação sacroilíaca Intervenção em fisioterapia Low back pain Sacroiliac joint Physiotherapy intervention