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Efetividade do programa MyBack na prevenção de recorrências de lombalgia: um ensaio clínico aleatorizado
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Abstract(s)
Introdução e Objetivos: A lombalgia é uma condição de saúde comum e a principal
causa global de anos vividos com incapacidade. As recorrências são frequentes e geram
impactos significativos ao nível individual e social. Intervenções baseadas em exercício
e educação parecem reduzir a recorrência, mas a sua efetividade tende a diminuir a longo
prazo. Para manter a efetividade destas, é fundamental promover a prática contínua de
exercício físico, utilizando para tal, intervenções multimodais que integrem estratégias de
mudança comportamental e abordem fatores específicos que incentivem a adoção a longo
prazo. O objetivo deste estudo foi avaliar a efetividade do programa MyBack na
prevenção secundária de lombalgia, na redução do risco associado à mesma e na avaliação
do tempo decorrente até ao seu surgimento, num período de 6 meses. Adicionalmente,
avaliou-se a efetividade das estratégias de mudança comportamental na adoção de prática
regular de exercício/ atividade física, 6 meses após aleatorização. Metodologia: Sessenta
e um participantes recuperados de um episódio recente de lombalgia foram aleatorizados
nos grupos MyBack (n=28) e controlo (n=33). O grupo MyBack participou num
programa de 12 sessões presenciais de exercício-físico, seguidas por 12 sessões
autónomas ao longo de 6 semanas, incluindo uma componente educacional focada na
mudança comportamental. O grupo controlo recebeu uma intervenção mínima focada na
gestão dos sintomas e na promoção da atividade física A medida de avaliação principal
do estudo foi o tempo decorrido entre a avaliação inicial até ao surgimento da primeira
recorrência de lombalgia, durante um período de 6 meses. Secundariamente, avaliou-se o
efeito das intervenções na recorrência de lombalgia aos 3 e 6 meses após aleatorização e
a adoção regular de exercício/atividade física (6 meses após a aleatorização). Resultados:
Relativamente ao resultado primário, constata-se que o programa MyBack demonstrou
prolongar significativamente o tempo decorrente até à ocorrência da primeira recorrência
de lombalgia em comparação com o grupo de controlo (χ²(2) = 3,960, p = 0,047). Aos 3
meses, o risco de recorrência foi 3,4 vezes maior no grupo de controlo, com uma redução
relativa do risco de 70,5% (IC95%: 0,06 a 0,91). Aos 6 meses, o risco foi 1,94 vezes
maior no grupo de controlo, com uma redução relativa do risco de 48% (IC95%: 0,07 a
0,75). No que respeita aos resultados relacionados com a última medida de resultado,
observou-se uma associação estatisticamente significativa entre os participantes do grupo
MyBack e a prática atual de exercício/ atividade física, χ2(1) =9,582, p =0,002, bem
como, diferenças estatisticamente significativas entre as medianas dos dois grupos (U =
353, z =2,931, p = 0,003), indicando que os participantes do grupo MyBack praticam
exercício/ atividade física mais dias por semana. Conclusões: O programa MyBack
parece efetivo na prevenção secundária de lombalgia. Estes resultados reforçam a sua
efetividade na redução de recorrências e na promoção da prática regular de exercício
físico como parte do cotidiano, contribuindo para a prevenção da recorrência a longo
prazo.
Introduction and Objectives: Low back pain (LBP) is a common health condition and the leading cause of years lived with disability worldwide. Recurrences are frequent and have significant individual and social impacts. Exercise and education-based interventions seem to reduce recurrence, but their effectiveness tends to diminish over time. Sustaining their benefits requires promoting the continuous practice of physical exercise through multimodal interventions that incorporate behavior change strategies and address specific factors encouraging long-term adherence. This study aimed to assess the effectiveness of the MyBack program in the secondary prevention of LBP, its impact on recurrence risk reduction, and the time until recurrence over six months. Additionally, the study evaluated the effectiveness of behavior change strategies in promoting regular exercise or physical activity six months post-randomization. Methodology: Sixty-one participants recovering from a recent episode of LBP were randomly allocated to the MyBack group (n=28) or a control group (n=33). The MyBack group participated in 12 supervised exercise sessions, followed by 12 autonomous sessions over six weeks, complemented by an educational component focused on behavior change. The control group received minimal intervention focused on symptom management and promoting physical activity. The primary outcome was the time from baseline to the first recurrence of LBP within six months. Secondary outcomes included recurrence rates at three- and six-months post-randomization and regular exercise adherence at six months. Results: The MyBack program significantly prolonged the time until the first recurrence of LBP compared to the control group (χ²(2) = 3.960, p = 0.047). At three months, the recurrence risk was 3.4 times higher in the control group, with a relative risk reduction of 70.5% (95% CI: 0.06 to 0.91). At six months, the recurrence risk was 1.94 times higher in the control group, with a relative risk reduction of 48% (95% CI: 0.07 to 0.75). Additionally, a significant association was observed between the MyBack group and regular exercise practice (χ²(1) = 9.582, p = 0.002), with significant differences in weekly exercise frequency between the groups (U = 353, z = 2.931, p = 0.003), indicating that MyBack participants engaged in more weekly exercise. Conclusions: The MyBack program appears effective in the secondary prevention of low back pain. These results highlight its effectiveness in reducing recurrences and promoting regular physical exercise as part of daily life, contributing to long-term recurrence prevention
Introduction and Objectives: Low back pain (LBP) is a common health condition and the leading cause of years lived with disability worldwide. Recurrences are frequent and have significant individual and social impacts. Exercise and education-based interventions seem to reduce recurrence, but their effectiveness tends to diminish over time. Sustaining their benefits requires promoting the continuous practice of physical exercise through multimodal interventions that incorporate behavior change strategies and address specific factors encouraging long-term adherence. This study aimed to assess the effectiveness of the MyBack program in the secondary prevention of LBP, its impact on recurrence risk reduction, and the time until recurrence over six months. Additionally, the study evaluated the effectiveness of behavior change strategies in promoting regular exercise or physical activity six months post-randomization. Methodology: Sixty-one participants recovering from a recent episode of LBP were randomly allocated to the MyBack group (n=28) or a control group (n=33). The MyBack group participated in 12 supervised exercise sessions, followed by 12 autonomous sessions over six weeks, complemented by an educational component focused on behavior change. The control group received minimal intervention focused on symptom management and promoting physical activity. The primary outcome was the time from baseline to the first recurrence of LBP within six months. Secondary outcomes included recurrence rates at three- and six-months post-randomization and regular exercise adherence at six months. Results: The MyBack program significantly prolonged the time until the first recurrence of LBP compared to the control group (χ²(2) = 3.960, p = 0.047). At three months, the recurrence risk was 3.4 times higher in the control group, with a relative risk reduction of 70.5% (95% CI: 0.06 to 0.91). At six months, the recurrence risk was 1.94 times higher in the control group, with a relative risk reduction of 48% (95% CI: 0.07 to 0.75). Additionally, a significant association was observed between the MyBack group and regular exercise practice (χ²(1) = 9.582, p = 0.002), with significant differences in weekly exercise frequency between the groups (U = 353, z = 2.931, p = 0.003), indicating that MyBack participants engaged in more weekly exercise. Conclusions: The MyBack program appears effective in the secondary prevention of low back pain. These results highlight its effectiveness in reducing recurrences and promoting regular physical exercise as part of daily life, contributing to long-term recurrence prevention
Description
Keywords
Lombalgia Recorrências Exercício Físico Mudança Comportamental Ensaio Clínico Aleatorizado Low back pain Recurrence Physical Exercise Behavior Change Randomized Controlled Trial