Immediate effect of quick massage on muscle tension and pressure pain threshold / Efeito imediato da quick massage sobre a tensão muscular e o limiar de tolerância de dor à pressão

ABSTRACT BACKGROUND AND OBJECTIVES: Massage is described as an effective complementary therapy for relieving muscle tension and pain. The aim of this study was to verify the benefits of quick massage on muscle tension and pressure pain tolerance threshold (PPT). METHODS: A randomized clinical study in which 40 professors participated and were randomly divided into control (CG) and experimental (EG) groups. They were assessed for the level of muscle tension in the shoulder and neck regions using the visual analogue scale (VAS). PPT was assessed through algometry at the upper trapezius and sternocleidomastoid muscles and at the following anatomical areas: base of the occipital, scapular spine, thoracic (T6-T7) and lumbar (L4-L5) regions. The EG received a single session of quick massage for 20 minutes on the shoulders, neck and spine. RESULTS: Regarding pain, a significant difference was observed only at the base of the occipital, the EG presented greater tolerance to pressure pain both before and after the intervention when compared to the CG. Regarding muscle tension, after the intervention, there was a reduction in the perception in the EG compared to the CG group. CONCLUSION: Quick massage was efficient to decrease the perception of muscle tension assessed by VAS, however, PPT did not increase after the intervention.

RESUMO JUSTIFICATIVA E OBJETIVOS: A massagem é descrita como terapia complementar efetiva no alívio de dor e tensão muscular. O objetivo deste estudo foi verificar os benefícios da Quick Massage sobre a tensão muscular e o limiar de tolerância de dor à pressão (LTDP). MÉTODOS: Estudo clínico randomizado que incluiu 40 docentes divididos aleatoriamente em grupo controle (GC) e grupo experimental (GE). Eles foram avaliados quanto ao nível de tensão muscular na região dos ombros e pescoço por meio da escala analógica visual (EAV). O LTDP foi avaliado por algometria sobre os músculos trapézio superior e esternocleidomastóideo e nos seguintes pontos anatômicos: base do occipital, espinha da escápula, região torácica (T6-T7) e região lombar (L4-L5). O GE recebeu uma única sessão de Quick Massage por 20 minutos na região dos ombros, pescoço e coluna vertebral. RESULTADOS: Em relação à dor, somente na base do occipital foi verificada diferença significante, o GE apresentou maior tolerância de dor à pressão tanto antes quanto após a intervenção em relação ao GC. Em relação à tensão muscular, após a intervenção, houve redução da percepção no GE em relação ao grupo GC. CONCLUSÃO: A Quick Massage foi eficiente para diminuir a percepção da tensão muscular, contudo, o limiar de tolerância de dor à pressão não aumentou após a intervenção.

Geotherapy combined with kinesiotherapy is efficient in reducing pain in patients with osteoarthritis.

INTRODUCTION: Patients with osteoarthritis (OA) suffer from a degenerative disease that causes several physical disabilities and pain. Despite the few studies involving exercise combined with geotherapy (a therapy using poultices made from earth materials such as clay or mud) for patients with OA, this subject is still under debate, as effect of the earth material remains unclear. The aim of this study was to compare pain, joint stiffness and disability in patients who underwent kinesiotherapy (K) or geotherapy combined with kinesiotherapy (GK). METHOD: This was a clinical randomized single-blinded prospective study, in which 48 individuals participated. Volunteers were evaluated for pain perception, pressure pain tolerance thresholds, and responded to questionnaires about pain, joint stiffness and physical disability (WOMAC) and about symptoms and disability (Lequesne Algofunctional Index). Patients in K group underwent 15 twice-weekly sessions of kinesiotherapy consisting of stretching and strengthening exercises for lower limbs. GK patients received a poultice of powder dolomite mixed with hot water on the knees for 25 min before each of the 15 sessions of the same kinesiotherapy program. RESULTS: Both interventions were effective in reducing pain, joint stiffness and physical disability (p < 0.001), and in increasing pressure pain thresholds (p < 0.05); however, patients who underwent GK presented a more pronounced reduction in pain perception (p = 0.006) than those in K group. They also exhibited more tolerance to pain in all sites evaluated. CONCLUSION: Both interventions were effective in reducing pain, joint stiffness and physical disability, but GK produced significantly better results in pain perception.

Superficial temperature and pain tolerance in patients with chronic low back pain.

INTRODUCTION: Low back pain is a common and very prevalent disease and can impose limitations that negatively impact patients. The objective of this study was to verify and compare the association between lumbar superficial temperature and pressure pain tolerance thresholds in individuals with chronic nonspecific low back pain and healthy controls. METHODS: This was a cross-sectional observational study involving 38 individuals with nonspecific chronic low back pain and 19 healthy controls. Volunteers underwent thermographic (infrared sensor), pain perception (visual analog scale), and pressure pain tolerance thresholds (algometry) evaluations in the right and left paravertebral muscles and L4-L5 ligament. RESULTS: A lower tolerance to pressure pain was found in patients compared to controls at all evaluated sites (p ≤ 0.003). Superficial temperature was significantly higher in the sites evaluated in the low back pain group (p < 0.001). In patients with low back pain, pain perception was weakly and inversely correlated with pressure pain tolerance (r = -0.31; p = 0.05) and moderately correlated to the temperature of the evaluated sites (r = 0.51 to 0.59, p ≤ 0.001). Also, an inverse and weak to moderate association was observed between pressure pain tolerance thresholds and temperature in patients only (r = -0.36 to -0.49; p ≤ 0.02). CONCLUSION: Individuals with low back pain have lower pressure pain tolerance thresholds and higher superficial temperature in the lumbar region when compared to healthy individuals. The associations observed show that the higher the pain perception, the lower the pain tolerance and the higher the superficial temperature in the lumbar region. Also, the higher the temperature, the lower the pain tolerance.

Influência de estímulos cutâneos plantares sobre a sensibilidade e controle postural em idosos / Influence of plantar cutaneous stimuli on sensitivity and postural control in the elderly / Influencia de los estímulos cutáneos plantares en la sensibilidad y el control postural en ancianos

A diminuição da sensibilidade cutânea plantar pode resultar na redução do controle postural em idosos, tornando-os mais suscetíveis a quedas. O objetivo deste estudo foi verificar a influência de um programa de estimulação cutânea plantar, sobre o limiar de sensibilidade e controle postural em indivíduos idosos. Este foi um estudo clínico prospectivo, randomizado e simples-cego, no qual participaram 36 indivíduos idosos acima de 60 anos de idade de ambos os sexos, submetidos ao teste Timed Up and Go (TUG), para mensurar a mobilidade funcional, teste de apoio unipodal para avaliar o equilíbrio estático, e avaliação da sensibilidade plantar por estesiometria com monofilamentos de nylon. Os idosos foram divididos em dois grupos. O grupo-controle não passou por nenhuma intervenção e foi orientado a não mudar o estilo de vida. Já o grupo-experimental foi orientado a realizar intervenções domiciliares por 3 semanas. Após esse período, todos os participantes foram reavaliados. Os resultados revelaram que ambos os grupos apresentaram maior sensibilidade cutânea plantar após 3 semanas; porém, não foram observadas alterações no controle postural. Ambos os grupos demonstraram melhora em relação à sensibilidade cutânea plantar, e não houve diferença entre eles.

Decreased plantar skin sensitivity may result in reduced postural control in the elderly, making them more susceptible to falls. The objective of this study was to verify the influence of a plantar cutaneous stimulation program on the sensitivity threshold and postural control in elderly individuals. This was a prospective, randomized, single-blind clinical study involving 36 elderly individuals older than 60 years of age of both sexes, submitted to the Timed Up and Go (TUG) test to measure functional mobility, unipedal stance test to evaluate static balance, and evaluation of plantar sensitivity by sensation threshold test with nylon monofilaments. Elderly were divided into two groups. The control group did not undergo any intervention and was instructed not to change their lifestyle. The experimental group was oriented to perform home interventions for 3 weeks. After this period, all participants were reassessed. Results revealed that both groups showed higher plantar skin sensibility after 3 weeks, but no changes were observed in postural control. Both groups showed improvement in plantar cutaneous sensitivity, and there was no difference between them.

La disminución de la sensibilidad cutánea plantar puede resultar en la reducción del control postural en ancianos, haciéndolos más susceptibles a caídas. El objetivo de este estudio fue verificar la influencia de un programa de estimulación cutánea plantar sobre el umbral de sensibilidad y control postural en individuos ancianos. Este fue un estudio clínico prospectivo, aleatorizado y simple ciego en el que participaron 36 individuos mayores de 60 años de ambos sexos, sometidos a la prueba Timed Up and Go (TUG), para medir la movilidad funcional, prueba de apoyo unipodal para evaluar el equilibrio estático, y evaluar la sensibilidad plantar por estosiometría con monofilamentos de nylon. Los ancianos se dividieron en dos grupos. El grupo control no pasó por ninguna intervención y fue orientado a no cambiar el estilo de vida. El grupo experimental fue orientado a realizar intervenciones domiciliares por 3 semanas. Después de ese período, todos los participantes fueron reevaluados. Los resultados revelaron que ambos grupos presentaron mayor sensibilidad cutánea plantar después de 3 semanas, pero no se observaron alteraciones en el control postural. Ambos grupos demostraron una mejora en relación a la sensibilidad cutánea plantar, y no hubo diferencia entre ellos.

The influence of physical fitness on pressure pain threshold of elderly women.

Several factors may influence pressure pain threshold (PPT), including physical fitness. However, only a few authors have studied this relationship. The aim of this study was to investigate the relationships between muscle strength, functional capacity (ability to perform physical work and activities of daily living) and PPT in elderly women. This observational cross-sectional study involved 75 healthy women aged between 60 and 75 years. Volunteers underwent an evaluation consisting of anthropometry, functional capacity, muscle strength and PPT assessment by algometry in the following muscles: biceps brachii, flexor carpi ulnaris, flexor carpi radialis, vastus medialis, vastus lateralis and gluteus maximus. Mean age of the 75 volunteers was 66.8 ± 4.6 years old. No significant correlations were found between handgrip or elbow flexion strength and PPT in the upper limb muscles evaluated. The same was observed regarding functional capacity, lower limbs strength and PPT in lower limb muscles. Functional capacity and muscle strength did not correlate with PPT in healthy elderly women.

Efeitos da geoterapia e fitoterapia associadas à cinesioterapia na osteoartrite de joelho: estudo randomizado duplo cego / Effects of geotherapy and phytotherapy associated with kinesiotherapy in the knee osteoarthritis: randomized double blind study

A geoterapia é o uso terapêutico de argilas, que são definidas como materiais naturais terrosos que possuem em sua composição diferentes tipos de minerais. Objetivo: Este trabalho teve como objetivo comparar a dor, mobilidade, descarga de peso e prejuízos funcionais em indivíduos com osteoartrite de joelho, submetidos a dois tipos de tratamentos fisioterapêutico: grupo de geoterapia associada a cinesioterapia (GGC) e grupo de geoterapia associada a fitoterapia e cinesioterapia (GGFC). Método: O estudo foi um ensaio clínico randomizado duplo-cego no qual participaram 25 indivíduos de ambos os sexos com idade acima de 43 anos. Ambos submetidos a 10 sessões com duração de 45 minutos. Os indivíduos realizaram as avaliações para verificação da dor pela Escala visual analógica (EVA), para avaliar a mobilidade funcional o teste Timed Up and Go (TUG), para avaliar a incapacidade e sintomas o Questionário Algo funcional de Lequesne, e para medir a descarga de peso entre os membros o Nintendo Wii Fit®. Resultados: Mostraram que apenas o GGFC obteve melhora da mobilidade funcional. Ambos os grupos melhoraram a intensidade da dor e sintomas após a intervenção sendo que a melhora do GGFC foi superior ao GGC em relação aos sintomas da OA. Ambos os grupos não mostraram melhoras quanto à descarga de peso. Conclusão: A geoterapia e fitoterapia associada à cinesioterapia podem ser benéficas quanto à redução da dor e prejuízos funcionais associados à OA de joelho.

Geotherapy is the therapeutic use of clay materials which are defined as natural earths that have different minerals in their composition. Objective: This work aimed to compare the pain, mobility, weight-bearing, and functional impairment in individuals with Knee Osteoarthritis who had undergone two types of physiotherapy treatments: the first group associated Geotherapy with Kinesiotherapy (GGK) and second group associated Geotherapy and Phytotherapy with Kinesiotherapy (GGFK). Method: This study was a randomized double-blind clinical trial, which was attended by 25 individuals of both sexes aged over 43 years; they underwent 10 sessions lasting 45 minutes each. The individuals performed the assessments to check for pain by using a visual analogue scale (VAS); to assess functional mobility, the test Timed Up and Go (TUG) test; to assess disability and symptoms, the Lequesne Algo functional questionnaire; and finally the Nintendo Wii Fit®, to measure weight-bearing between members. Results: The results showed that only the GGFK had improved functional mobility. Both groups improved the intensity of pain and symptoms after the intervention and that improvement in GGFK was superior for symptoms in relation to GGK. Both groups showed a reduction in the intensity of pain and symptoms after the intervention, and the GGFK improvement was greater than the GGK for symptoms of Osteoarthritis (OA). Neither group showed any improvement in weight-bearing. Conclusion: It was concluded that geotherapy and phytotherapy associated with kinesiotherapy can be beneficial in reducing the pain and functional impairment associated with knee OA.