RESUMEN
BACKGROUND: Chikungunya fever (CF) is a viral disease, transmitted by alphavirus through Aedes aegypti, and albopictus mosquitoes, affecting several people, mainly in tropical countries, when its transmitter is not under control, and the main symptom of the chronic phase of CF is joint pain. OBJECTIVES: The primary objective of this study was to observe the prevalence, most affected joints, and intensity of chronic joint pain in individuals affected by CF, and also identify the factors associated with chronic joint pain in these individuals. METHODS: Cross-sectional study that evaluated one hundred and thirty volunteers, of both sexes, aged between 20-65 years, with a clinical and/or laboratory diagnosis of CF. The presence of joint pain was investigated using the Brazilian version of the Nordic Questionnaire of Musculoskeletal Symptoms and the intensity of pain using the Visual Analogue Scale. RESULTS: Of the 130 volunteers evaluated, n = 112 (86%) reported currently experiencing chronic joint pain, persistent, for approximately 38.6 ± 1.73 months, with the greatest predominance in the morning (58%). The joints most affected by pain were: the ankles (65.5%), interphalangeal joints of the hands (59.2%), and knees (59.2%). The joints that presented the greatest intensity of pain were: the ankles (5.13 ± 0.34), interphalangeal joints of the hands (4.63 ± 0.34), and knees (4.33 ± 0.33). Sedentary behavior (p = 0.037), increasing age (p = 0.000), and overweight/obesity (p = 0.002) were factors associated with chronic joint pain. CONCLUSION: A high prevalence of chronic, persistent joint pain was observed, with a greater prevalence in the morning. The joints most affected by chronic pain and with the greatest pain intensity were the ankles, and interphalangeal joints of the hands and knees. Sedentary behavior, increasing age, and overweight/obesity were the factors associated with chronic joint pain in individuals affected by CF in this study. Key Points ⢠Individuals affected by CF had a high prevalence of chronic joint pain, persistent and more prevalent in the mornings ⢠The ankles and interphalangeal joints of the hands and knees were the joints with the highest prevalence of pain ⢠The ankles and interphalangeal joints of the hands and knees were the joints with the greatest pain intensity ⢠Sedentary behavior, increasing age, and overweight/obesity were factors associated with chronic joint pain in individuals affected by CF.
Asunto(s)
Artralgia , Fiebre Chikungunya , Dolor Crónico , Obesidad , Sobrepeso , Conducta Sedentaria , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Fiebre Chikungunya/complicaciones , Fiebre Chikungunya/epidemiología , Estudios Transversales , Artralgia/epidemiología , Obesidad/complicaciones , Obesidad/epidemiología , Anciano , Adulto Joven , Dolor Crónico/epidemiología , Factores de Edad , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Brasil/epidemiología , Prevalencia , Dimensión del DolorRESUMEN
BACKGROUND: Opting to use aquatic or land-based physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in community-dwelling older adults (CDOAs) is still a questionable clinical decision for physiotherapists. OBJECTIVE: Assess the quality of evidence from randomized or quasi-randomized controlled trials that used aquatic physical therapy exercises to improve balance, gait, quality of life and reduce fall-related outcomes in CDOAs. METHODS: Articles were surveyed in the following databases: MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, CINAHL, SciELO and Google Scholar, published in any language, up to July 31, 2023. Two independent reviewers extracted the data and assessed evidence quality. The risk of bias of the trials was evaluated by the Cochrane tool and evidence quality by GRADE approach. Review Manager software was used to conduct the meta-analyses. RESULTS: 3007 articles were identified in the searches, remaining 33 studies to be read in full, with 11 trials being eligible for this systematic review. The trials included presented low evidence quality for the balance, gait, quality of life and fear of falling. Land-based and aquatic physical therapy exercises improved the outcomes analyzed; however, aquatic physical therapy exercises were more effective in improving balance, gait, quality of life and reducing fear of falling in CDOAs. The meta-analysis showed that engaging in aquatic physical therapy exercises increases the functional reach, through of the anterior displacement of the center of pressure of CDOAs by 6.36cm, compared to land-based physical therapy exercises, assessed by the Functional Reach test: [CI:5.22 to 7.50], (p<0.00001), presenting low quality evidence. CONCLUSIONS: Aquatic physical therapy exercises are more effective than their land-based counterparts in enhancing balance, gait, quality of life and reducing the fear of falling in CDOAs. However, due to methodological limitations of the trials, this clinical decision remains inconclusive. It is suggested that new trials be conducted with greater methodological rigor, in order to provide high-quality evidence on the use of the aquatic physical therapy exercises to improve the outcomes analyzed in CDOAs.
Asunto(s)
Accidentes por Caídas , Calidad de Vida , Accidentes por Caídas/prevención & control , Vida Independiente , Miedo , Modalidades de Fisioterapia , MarchaRESUMEN
PURPOSE: The purpose of this study is to observe the prevalence and intensity of musculoskeletal pain and the quality of life in mothers of children with microcephaly and also to compare the scores of the quality of life domains between mothers who had or did not have musculoskeletal pain. METHODS: This is a cross-sectional study that evaluated mothers of children with a clinical diagnosis of microcephaly, due to congenital Zika virus syndrome, in the state of Pernambuco, northeast region, Brazil. To assess musculoskeletal pain, the Nordic Questionnaire of Musculoskeletal Symptoms was used, pain intensity was assessed by the Visual Analogue Scale and quality of life by the SF-36 Questionnaire. RESULTS: Of the 63 mothers evaluated, 59 (93.7%) reported currently experiencing musculoskeletal pain. The lumbar spine was the body region with the highest prevalence of pain (77.8%), followed by the thoracic spine (57.1%) and cervical spine (50.8%). Pain intensity was higher in the lumbar spine (6.00 ± 0.47), thoracic spine (4.44 ± 0.52) and shoulders (3.81 ± 0.51). The domains that presented the lowest scores in the quality of life assessment were general health status (49.0 ± 3.19), emotional aspects (49.7 ± 5.88) and pain (49.7 ± 2.50). Mothers who had musculoskeletal pain had lower scores in all domains of quality of life assessment compared to mothers who did not have pain, demonstrating significant differences for functional capacity (P = 0.035), physical aspects (P = 0.047) and pain (P = 0.002). CONCLUSION: A high prevalence of musculoskeletal pain was observed in mothers of children with microcephaly, with a higher prevalence and intensity in the lumbar spine. The domains related to physical and emotional health presented the worst scores in the quality of life of the evaluated mothers and the presence of musculoskeletal pain reduced the quality of life of the mothers of children with microcephaly in this study.