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BACKGROUND: There is no systematic review assessing the effectiveness of interferential current (IC) in patients with low back pain. OBJECTIVE: To investigate the effectiveness of IC in patients with chronic non-specific low back pain. METHODS: The databases PUBMED, EMBASE, PEDro, Cochrane Library, CINAHL, and SCIELO were searched. Randomized controlled trials reporting pain intensity and disability in patients with chronic non-specific low back pain, in which IC was applied were included. Methodological quality was assessed using the PEDro scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of evidence. RESULTS: Thirteen RCTs were considered eligible for this systematic review (pooled n = 1367). Main results showed moderate-quality evidence and moderate effect sizes that IC probably reduces pain intensity and disability compared to placebo immediately post-treatment (Pain: MD = -1.57 points; 95% CI -2.17, -0.98; Disability: MD = -1.51 points; 95% CI -2.57, -0.46), but not at intermediate-term follow-up. Low-quality evidence with small effect size showed that IC may reduce pain intensity (SMD = -0.32; 95% CI -0.61, -0.03, p = 0.03) compared to TENS immediately post-treatment, but not for disability. There is very low-quality evidence that IC combined with other interventions (massage or exercises) may not further reduce pain intensity and disability compared to the other interventions provided in isolation immediately post-treatment. CONCLUSION: Moderate-quality evidence shows that IC is probably better than placebo for reducing pain intensity and disability immediately post-treatment in patients with chronic non-specific low back pain.
Assuntos
Dor Crônica , Pessoas com Deficiência , Dor Lombar , Humanos , Dor Lombar/terapia , Terapia por Exercício/métodos , Medição da Dor , Dor Crônica/terapiaRESUMO
BACKGROUND: The evidence of the influence of Kinesio Taping® in changing electromyographic signal intensity of the lumbar musculature in patients with chronic non-specific low back pain (LBP) is very sparse. OBJECTIVES: To evaluate if Kinesio Taping® changes the electromyographic signal intensity of the longissimus and iliocostalis muscles in patients with chronic non-specific LBP. METHODS: Prospectively registered, three-arm randomized controlled trial with a blinded assessor. Patients were randomly allocated to the following interventions: 1) Kinesio Taping® Group (n=21), where patients received the tape according to the manufacturer's manual; 2) Placebo Group (i.e. normal surgical tape) (n=21); and 3) Non-treatment control Group (n=21). Assessments were performed at baseline, immediately after, and 30min after the intervention. The primary outcome was muscle activity of the iliocostalis and longissimus muscles as measured by surface electromyography. The secondary outcome was pain intensity (measured with a 0-10 Numerical Rating Scale). The effects of treatment were calculated using linear mixed models. RESULTS: A total of 63 patients were recruited. Follow up rate was high (98.4%). Patients were mostly women with moderate levels of pain and disability. Kinesio Taping® was better than the control and placebo groups in only 4 of 96 statistical comparisons, likely reflective of type I error due to multiple comparisons. No statistically significant differences were identified for the immediate reduction in pain intensity between groups. CONCLUSION: Kinesio Taping® did not change the electromyographic signal intensity of the longissimus and iliocostalis muscles or reduce pain intensity in patients with chronic low back pain. Clinicaltrials.gov: NCT02759757 (https://clinicaltrials.gov/ct2/show/NCT02759757).
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Fita Atlética , Dor Lombar/terapia , Músculo Esquelético/fisiologia , Eletromiografia/métodos , Feminino , Humanos , Região LombossacralRESUMO
BACKGROUND: Chronic musculoskeletal pain affects the quality of life of older adults by interfering in their ability to perform activities of daily living. Aerobic exercise programs have been used in the treatment of various health conditions, including musculoskeletal disorders. However, there is still little evidence on the effects of aerobic exercise for the treatment of older adults with chronic musculoskeletal pain. Thus, the objective of this study is to assess the effects of aerobic exercise in improving pain and function of older adults with chronic pain as a consequence of different chronic musculoskeletal conditions. METHODS: The databases to be used in the search are PubMed, EMBASE, CINAHL, PEDro, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomized controlled trials that used aerobic exercise in the treatment of older adults with chronic musculoskeletal pain will be included. Primary outcomes will be pain and function. We will use the PEDro scale to evaluate the methodological quality and statistical description of each included study, and the strength of the recommendations will be summarized using GRADE. DISCUSSION: The results of this systematic review will provide a synthesis of the current evidence on the effects of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain. In addition, this information can help health professionals in decision-making about the use of aerobic exercise in the treatment of older adults with chronic musculoskeletal pain. ETHICS AND DISSEMINATION: This systematic review was recorded prospectively, and the results will be part of a doctoral thesis to be published in a peer-reviewed international journal and possibly presented at international conferences. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42019118903.
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Dor Crônica , Exercício Físico , Dor Musculoesquelética , Atividades Cotidianas , Idoso , Humanos , Dor Musculoesquelética/prevenção & controle , Dor Musculoesquelética/terapia , Qualidade de Vida/psicologia , Revisões Sistemáticas como AssuntoRESUMO
INTRODUCTION: Aerobic exercise programs have been used for various health conditions, including musculoskeletal disorders. However, the literature is still limited regarding the effect of aerobic exercise on pain and disability in patients with chronic non-specific low back pain. METHODS: Search strategies will be performed in the following databases: PubMed, EMBASE ( https://www.embase.com ), CINAHL, PEDro, Lilacs, and Cochrane Central Register of Controlled Trials (CENTRAL). We will include randomized controlled trials in any language or date of publication. The primary outcomes will be pain and disability. The methodological quality and statistical reporting of each eligible trial will be evaluated using the 11-item PEDro scale. The strength of the recommendations will be summarized using the using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. DISCUSSION: This systematic review will provide a synthesis of current evidence on the effects of aerobic exercise in patients with chronic low back pain on pain and disability outcomes. This information can help healthcare professionals in decision-making related to the use of aerobic exercise in patients with low back pain. Following the guidelines, this systematic review protocol was registered on the Prospective International Register of Systematic Reviews (PROSPERO) number CRD42017071945.
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Pessoas com Deficiência , Exercício Físico , Dor Lombar/terapia , Medição da Dor , Humanos , Doenças Musculoesqueléticas , Resultado do Tratamento , Revisões Sistemáticas como AssuntoRESUMO
The purpose of the study was to test the hypothesis on whether individuals with patellofemoral pain syndrome (PFPS) try to avoid knee position during upward squatting so as not to aggravate this syndrome. Also, we tested whether PFPS would generate changes in the kinetic and electromyographic (EMG) strategies used to perform this task. Eight healthy subjects and 8 subjects with PFPS, but without a history of pain for at least 30 days, took part in the experiment. They were asked to perform upward squatting with knees initially flexed at 60° (very flexed) until reaching an upright position. Angle, velocity, and acceleration (kinematic) were reconstructed for knee and ankle joints. The torques at these joints were calculated using inverse dynamics, taking into account anthropometric and inertial characteristics of each subject, including records from force data. Only activities of major muscles were recorded. The kinetic and EMG profiles were quantified during acceleration and deceleration phases of the upward squatting. Both healthy and PFPS subjects used the same kinetic and EMG strategies to perform the upward squatting, even though the magnitude of the muscle activities were decreased for the latter group. Compared to the control group, the PFPS subjects presented larger joint ankle torques and smaller knee joint torques. However, the subjects avoided keeping their knees very flexed at the initial position. Group differences in the kinetic and EMG strategies can be explained by differences in the initial position, suggesting a protective strategy used by subjects with PFPS. Therefore, for these subjects, coaches and therapists should avoid using this exercise when the knee is required to move above 40° flexion.
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Teste de Esforço/métodos , Síndrome da Dor Patelofemoral/fisiopatologia , Postura , Amplitude de Movimento Articular/fisiologia , Adulto , Articulação do Tornozelo/fisiologia , Fenômenos Biomecânicos , Estudos de Casos e Controles , Eletromiografia/métodos , Feminino , Humanos , Articulação do Joelho/fisiologia , Masculino , Medição da Dor , Propriocepção/fisiologia , Valores de Referência , Adulto JovemRESUMO
Introdução: A lombalgia crônica é um problema de saúde pública, com implicações sociais e financeiras. Escola de postura, recurso terapêutico que emprega uma metodologia preventiva e educativa, constitui-se numa alternativa eficaz de tratamento aos portadores de lombalgia crônica. Objetivo: Avaliar os efeitos do programa de escola de postura na melhoria da qualidade de vida dos indivíduos com lombalgia crônica na clínica de fisioterapia da FACIMED. Métodos: A amostra foi composta por voluntários com lombalgia crônica com idade média de 41 anos (± 5,35). Para coleta de dados, aplicou-se o questionário SF-36 e Escala Analógica de Dor, em dois momentos distintos. A análise estatística utilizou o programa Microsoft Excel Office XP e BIOESTAT 5.0. Resultados: Após o processamento dos dados, obteve-se melhora satisfatória com relação à dor e qualidade de vida. Conclusão: O programa Escola de Postura contribui para melhora da qualidade de vida de indivíduos com lombalgia crônica.
Introducion: Low back pain is a chronic public health problem with social and financial implications. School of posture, therapeutic resource that employs a preventive and educational methodology, it constitutes an effective alternative treatment for patients with chronic low back pain. Objective: To evaluate the effects of school program of posture on improving the quality of life of individuals with chronic low back pain in the physiotherapy of FACIMED. Methods: The sample consisted of volunteers with chronic LBP with average age of 41 years (± 5.35). To collect data, we applied the SF-36 and Analogue Scale of Pain, in two separate stages. The analysis used Microsoft Excel and Office XP BIOESTAT 5.0. Results: After processing the data, we obtained a satisfactory improvement with regard to pain and quality of life. Conclusion: School Program The program contributes to improved quality of life of individuals with chronic low back pain.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Dor Lombar/reabilitação , Equilíbrio Postural , Manejo da Dor/métodosRESUMO
Introdução: Muitos esforços têm sido realizados para estimar as forças que atuam em um corpo em movimento e como essas forças são controladas pelo sistema nervoso central (SNC) para gerar movimentos rápidos e precisos. O entendimento dessas forças e como elas são controladas são de fundamental importância para aqueles que trabalham com o movimento humano. Objetivo: Este estudo tem como objetivo esclarecer, de forma didática, conceitos importantes da cinemática e da cinética, conduzindo o leitor da compreensão de princípios simples a aplicação dos mesmos nas equações de movimento. Metodologia: Este trabalho foi elaborado a partir de uma revisão da literatura nas principais bases de dados da área no período de 1967 a 2009. Resultados: Através da dinâmica inversa é possível calcular os torques musculares e de interação gerados nas articulações. Conclusão: A dinâmica inversa, como uma ferramenta da cinética tem dado uma contribuição importante para as áreas de Controle Motor, Fisioterapia e Reabilitação no sentido de descrever o padrão de geração e coordenação das forças que movem as articulações. Essa descrição tem sido feita para uma grande variedade de tarefas motoras e sua aplicabilidade tem sido estendida para pacientes com disfunção motora.
Introduction: Several studies have been done to determine the forces acting at body during movements and how these forces are controlled by central nervous system (CNS) to generate fast and accurate movements. The knowledge of these forces and how they are controlled are important to professionals that work with human movement. Objective: The goal of this study was to explain, in a didactic way, important concepts related to kinematics and kinetics, conducting the reader from the understanding of simple principles to application of these principles in the motion equations. Methods: This study is a literature review including articles published since 1967 on the main databases from the area. Results: Using the dynamics inverse is possible to calculate the muscle and interaction torques generated at joints. Conclusion: The Inverse Dynamics, has a kinetics tool, has contributed with Motor Control, Physical Therapy, and Rehabilitation areas, helping to describe the generation and coordination pattern of the forces which move the joints. This description has been done to several motor tasks and your application has been extended to handicapped patients.