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Influência da localização da dor nos resultados em Fisioterapia em utentes com condições músculo-esqueléticas: estudo de coorte prospetivo
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Abstract(s)
Introdução: As condições músculo-esqueléticas (CME) são uma das principais
causas de dor e incapacidade, afetando a qualidade de vida e produtividade laboral.
Caracterizadas por dor e limitações funcionais, podem afetar várias localizações do
corpo. Estudos recentes sugerem que uma abordagem centrada exclusivamente
na localização da dor pode ser limitada, sendo importante considerar fatores
comuns às CME com potencial impacto nos resultados em saúde. Contudo, a
influência da localização da dor nos resultados da fisioterapia em pessoas com
CME ainda é incerta.
Objetivo: Este estudo teve como objetivo analisar a associação entre a localização
da dor músculo-esquelética (ME) e a resposta à Fisioterapia na intensidade da dor
e saúde ME.
Metodologia: Conduziu-se um estudo de coorte prospetivo com utentes com
condições ME que iniciaram fisioterapia. As avaliações ocorreram no início e final
da intervenção, recolhendo-se dados sociodemográficos e clínicos, a intensidade
da dor e a saúde ME. Utilizaram-se modelos de regressão logística para analisar a
relação entre a localização da dor e os critérios de sucesso na intensidade da dor
e saúde ME.
Resultados: A amostra incluiu 258 participantes com dor ME, com uma taxa de
desistência de 21,3%. Observou-se apenas uma diferença significativa na redução
percentual da dor entre as participantes com dor no ombro (50,48%) e com dor
generalizada (25,45%) (p = 0,014). A dor no ombro associou-se inicialmente a uma
menor probabilidade de insucesso nos critérios de intensidade da dor, mas essa
associação perdeu significância após ajustes para variáveis de confundimento. Não
foram encontradas outras associações estatisticamente significativas entre a
localização da dor ME e a resposta à Fisioterapia.
Conclusões: Os resultados deste estudo não suportam o impacto da localização
da dor, isoladamente, na resposta à intervenção de fisioterapia em pessoas com
CME. Estes achados reforçam a necessidade de uma abordagem que considere
outras características individuais dos utentes para além da localização da dor,
indicando a relevância de estudos adicionais para desenvolver intervenções mais
personalizadas para a dor ME.
Introduction: Musculoskeletal conditions (MSK) are among the leading causes of pain and disability, impacting quality of life and work productivity. Characterized by pain and functional limitations, they can affect various body locations. Recent studies suggest that an approach focused solely on pain location may be limited, highlighting the importance of considering factors common to MSK conditions with potential impact on health outcomes. However, the influence of pain location on physiotherapy outcomes in people with MSK conditions remains uncertain. Objective: This study aimed to analyze the association between the location of musculoskeletal pain and the response to physiotherapy in terms of pain intensity and musculoskeletal health. Methodology: A prospective cohort study was conducted with patients with MSK conditions who initiated physiotherapy. Assessments took place at the beginning and end of the intervention, collecting sociodemographic and clinical data, pain intensity, and MSK health. Logistic regression models were used to analyze the relationship between pain location and success criteria for pain intensity and MSK health. Results: The sample included 258 participants with MSK pain, with a dropout rate of 21.3%. A significant difference was observed only in the percentage reduction in pain between participants with shoulder pain (50.48%) and generalized pain (25.45%) (p = 0.014). Shoulder pain was initially associated with a lower likelihood of failure in pain intensity criteria, but this association lost significance after adjusting for confounding variables. No other statistically significant associations were found between MSK pain location and physiotherapy response. Conclusions: The results of this study do not support the impact of pain location, on its own, on the response to physiotherapy intervention in individuals with musculoskeletal conditions (MSK). These findings emphasize the need for an approach that considers other individual characteristics of patients beyond pain location, highlighting the importance of additional studies to develop more personalized interventions for MSK pain.
Introduction: Musculoskeletal conditions (MSK) are among the leading causes of pain and disability, impacting quality of life and work productivity. Characterized by pain and functional limitations, they can affect various body locations. Recent studies suggest that an approach focused solely on pain location may be limited, highlighting the importance of considering factors common to MSK conditions with potential impact on health outcomes. However, the influence of pain location on physiotherapy outcomes in people with MSK conditions remains uncertain. Objective: This study aimed to analyze the association between the location of musculoskeletal pain and the response to physiotherapy in terms of pain intensity and musculoskeletal health. Methodology: A prospective cohort study was conducted with patients with MSK conditions who initiated physiotherapy. Assessments took place at the beginning and end of the intervention, collecting sociodemographic and clinical data, pain intensity, and MSK health. Logistic regression models were used to analyze the relationship between pain location and success criteria for pain intensity and MSK health. Results: The sample included 258 participants with MSK pain, with a dropout rate of 21.3%. A significant difference was observed only in the percentage reduction in pain between participants with shoulder pain (50.48%) and generalized pain (25.45%) (p = 0.014). Shoulder pain was initially associated with a lower likelihood of failure in pain intensity criteria, but this association lost significance after adjusting for confounding variables. No other statistically significant associations were found between MSK pain location and physiotherapy response. Conclusions: The results of this study do not support the impact of pain location, on its own, on the response to physiotherapy intervention in individuals with musculoskeletal conditions (MSK). These findings emphasize the need for an approach that considers other individual characteristics of patients beyond pain location, highlighting the importance of additional studies to develop more personalized interventions for MSK pain.
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Keywords
Dor músculo-esquelética Localização da dor Fisioterapia Prognóstico Saúde músculo-esquelética Musculoskeletal pain Pain location Physiotherapy Prognosis Musculoskeletal health