RESUMO
BACKGROUND: One of the main problems faced by physiotherapists in primary care is low back pain with or without radiation to lower limbs. There are many different treatment approaches for the management of low back pain. Despite the large amount of published studies, the evidence remains contradictory. OBJECTIVE: To evaluate the influence of the osteopathic manipulation of the sacroiliac joint on low back pain with or without radiation to lower limbs. METHOD: Single-blind randomized clinical controlled trial. Participants with low back pain with or without lower limb radiation were randomized to osteopathic manipulation of the sacroiliac joint group (intervention, 6 sessions) or to an electrotherapy group (control, 15 sessions) for 3 weeks. Measures were taken at baseline (week 0) and post-intervention (week 4). The primary outcome measures were pain (Visual Analogue Scale), functional disability (Oswestry disability index and Roland Morris questionnaire). The secondary outcome measure was pain threshold at muscular tender points in the quadratus lumborum, pyramidal, mayor gluteus, and hamstrings. RESULTS: In all, 37 participants completed the study. The results of the intragroup comparisons showed statistically significant improvements in both groups in the visual analogue scale (Osteopathic manipulation group, P= 0.000; Electrotherapy group, P= 0.005) and Oswestry disability index (Osteopathic manipulation group, P= 0.000; Electrotherapy group- P= 0.026) but not in the Roland Morris questionnaire (P= 0.121), which only improved in the intervention group (P= 0.01). The osteopathic manipulation was much more effective than electrotherapy improving to pain and functional disability. CONCLUSION: Osteopathic manipulation of the sacroiliac joint improves pain and disability in patients with sacroiliac dysfunction after three weeks of treatment.
Assuntos
Terapia por Estimulação Elétrica , Dor Lombar , Osteopatia , Humanos , Osteopatia/métodos , Dor Lombar/terapia , Articulação Sacroilíaca , Projetos Piloto , Método Simples-Cego , Resultado do TratamentoRESUMO
BACKGROUND: In international cooperation projects that are carried out in less developed and developing countries, a large number of children with disabilities present cerebral palsy (CP). Orthopaedic disorders are frequent complications associated with this disorder. Their prevention and early intervention are essential to achieve an appropriate therapeutic approach for children with PC and to improve their quality of life. OBJECTIVE: To describe the treatment approach that is currently used in international cooperation projects for the rehabilitation management of the orthopaedic disorders in children with cerebral palsy. METHODS: This is an observational, descriptive, cross-sectional study, carried out by means of an online questionnaire to professionals in the field of Physiotherapy and Rehabilitation working in international cooperation projects. The inclusion criteria were professionals working in the rehabilitation field in development aid, humanitarian action or emergency projects that provided rehabilitation services, working with children with cerebral palsy from 0 to 18 years old. RESULTS: Ninety-eight questionnaires were analysed. The average age of the participants was 33.2 years, they were mainly working in development cooperation projects (83.33%) that were implemented in rehabilitation centres and through community-based rehabilitation services (60%). The projects were located in countries all over the world but mainly on the Asian continent (71.4%). Physiotherapists and orthopaedic technicians (72.22%) were the main professionals working in these projects, followed by occupational therapists and social workers (55.56%). The results indicated that the orthopaedic disorders were very frequent in the sample (66.67%), with hip subluxation (50%), scoliosis (77.78%), kyphosis (61.1%), clubfoot (88.7%) and varus foot (61.11%) standing out. The most commonly used treatment approaches were positioning (88.89%) and the Bobath concept (83.33%). The technical aids that were used by the professionals were ankle foot orthosis (AFO) (94.44%), bracing (66.67%), standing frames (83.33%), moulded seats (100%), corner seats (93.75%) and adapted seats (92.85%). CONCLUSIONS: In international cooperation projects, the rehabilitation treatment of children with cerebral palsy is based on a holistic approach. This is reflected in the interventions that are carried out to treat their orthopaedic disorders and in locally produced devices, awareness raising and community education. However, the professionals surveyed considered that the aids or orthoses used are insufficient in the treatment and prevention of orthopaedic disorders in cerebral palsy.
Assuntos
Paralisia Cerebral , Órtoses do Pé , Doenças Musculoesqueléticas , Adolescente , Adulto , Paralisia Cerebral/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Recém-Nascido , Cooperação Internacional , Doenças Musculoesqueléticas/epidemiologia , Qualidade de VidaRESUMO
Objetivo. Analizar los efectos de la terapia con peloides sobre el dolor percibido, la calidad de vida relacionada con la salud (CVRS) y el consumo de medicamentos en sujetos diagnosticados de artrosis de rodilla. Material y métodos. Ensayo clínico prospectivo y controlado. La muestra (n=147) fue dividida en un grupo experimental (GE) de 61 sujetos (69,13±5,60 años), que recibió 11 sesiones consecutivas de peloides en la rodilla afectada según el procedimiento terapéutico descrito, y un grupo control (GC) de 60 sujetos (73,08±8,90 años), que continuó con su tratamiento farmacológico rutinario. La muestra fue valorada antes y después de la intervención mediante el cuestionario SF-36, la escala visual analógica y la evolución en el consumo de medicamentos, estableciendo el nivel de significación para p≤0,05. Resultados. Tras finalizar la intervención, existieron diferencias estadísticamente significativas (p<0,05) en todas las variables analizadas entre el GE y GC, reduciéndose el consumo de medicamentos en el GE frente a la ausencia de cambios en el GC. Las dimensiones salud general, dolor corporal y el dolor percibido son las que muestran mayores cambios entre ambos grupos. Conclusiones. La peloterapia en pacientes diagnosticados de artrosis de rodilla obtiene efectos inmediatos sobre el dolor percibido y la CVRS, reduciendo el consumo de medicamentos específicos. Son necesarios estudios evalúen desde la evidencia científica los efectos de dicha intervención(AU)
Objective: To analyze the effects of mud therapy on perceived pain, Health Related Quality of Life (HRQL) and drug use in patients diagnosed with knee osteoarthritis. Material and methods: A prospective, controlled clinical trial. The sample (n = 147) was divided into an experimental group (EG) of 61 subjects (69.13 ± 5,60 years) who received 11 consecutive sessions of peloids in the knee/s affected by the process described and a control group (CG) of 60 subjects (73.08 ± 8,90 years) who continued routine drug treatment. The sample was assessed before and after intervention using the SF-36, Visual Analogue Scale and changes in drug use, setting a significance level of P<=.05. Results: After the intervention, there were statistically significant differences (P<.05) in all parameters analyzed between EG and CG, reduced drug use in the EG versus no change in the CG. The general health, bodily pain and perceived pain are those that show major changes between the two groups. Conclusions: Mud therapy in patients diagnosed with knee osteoarthritis attains immediate effects on perceived pain and HRQOL, reducing the consumption of specific drugs. Studies are needed to evaluate the scientific evidence from the effects of such intervention(AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/terapia , Peloterapia/instrumentação , Peloterapia/métodos , Qualidade de Vida , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/fisiopatologia , Estudos Prospectivos , Inquéritos e Questionários , Peloterapia/normas , Peloterapia , Atenção Primária à SaúdeRESUMO
OBJECTIVE: To analyze the effects of mud therapy on perceived pain, Health Related Quality of Life (HRQL) and drug use in patients diagnosed with knee osteoarthritis. MATERIAL AND METHODS: A prospective, controlled clinical trial. The sample (n=147) was divided into an experimental group (EG) of 61 subjects (69.13 ± 5,60 years) who received 11 consecutive sessions of peloids in the knee/s affected by the process described and a control group (CG) of 60 subjects (73.08 ± 8,90 years) who continued routine drug treatment. The sample was assessed before and after intervention using the SF-36, Visual Analogue Scale and changes in drug use, setting a significance level of P ≤ .05. RESULTS: After the intervention, there were statistically significant differences (P<.05) in all parameters analyzed between EG and CG, reduced drug use in the EG versus no change in the CG. The general health, bodily pain and perceived pain are those that show major changes between the two groups. CONCLUSIONS: Mud therapy in patients diagnosed with knee osteoarthritis attains immediate effects on perceived pain and HRQOL, reducing the consumption of specific drugs. Studies are needed to evaluate the scientific evidence from the effects of such intervention.
Assuntos
Peloterapia , Osteoartrite do Joelho/terapia , Percepção da Dor , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Analgésicos/uso terapêutico , Antirreumáticos/uso terapêutico , Terapia Combinada , Feminino , Humanos , Masculino , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/psicologia , Medição da Dor , Resultado do TratamentoRESUMO
OBJECTIVE: The main objective of this study was to systematically review all the scientific studies that analyse the effectiveness of mud pack therapy on patients diagnosed with knee OA. METHODS: One hundred and fifteen publications were identified through an electronic and manual search and 20 of those studies were chosen based on the inclusion criteria: randomized clinical trials, systematic reviews or meta-analyses whose objective was to analyse the effect of mud pack therapy on perceived pain, function and quality of life, with a sample size of ≥20 subjects, published since 2000 and showing conclusive results. RESULTS: In the studies that met the inclusion criteria, 12 analyse functionality, 17 perceived pain, 5 quality of life and all showed a significant improvement in the three analysed variables. The methodological quality of the studies had a moderate risk of bias. CONCLUSION: Mud pack therapy is considered an alternative and effective therapy in the clinical management of knee OA. Studies with better methodology are needed to prove its scope.