RESUMEN
INTRODUCTION: The objectives of this study were to determine the effects of the Mézières Method (MM) on pain and disability related to low back pain (LBP), compared to a program of heat, massage and exercise, and to understand the meaning of the bodily experience with the MM. PATIENTS AND METHODS: Mixed methods convergent parallel design, combining an equivalent randomized clinical trial with a qualitative phenomenological approach. Sixty-one participants aged 18-65 years with chronic non-specific LBP lasting more than 3 months. Patients were randomized into two groups: the MM group (n = 29) and the comparison group (CG) who received heat, massage plus flexibility and strengthening exercises (n = 31). MM and CG participants underwent 10 one-hour physical therapy sessions over a 5-week period and were evaluated three times: pre-intervention, post-intervention and follow-up at 6 weeks after the end of treatment. RESULTS: Both groups reported positive effects on LBP . MM group showed superior effects in pain relief in the short term (Cohen's D 0.80; p = 0.004). Participants interpreted the interaction with the MM as a teaching-learning process that allowed body awareness. CONCLUSION: Both treatment were similarly beneficial but MM had superior effects on pain in the short term. MM is perceived by the participants as a teaching-learning process focused on body awareness that facilitate effective management of LBP.
Asunto(s)
Dolor de la Región Lumbar , Humanos , Dolor de la Región Lumbar/terapia , Terapia por Ejercicio/métodos , Ejercicio FísicoRESUMEN
Abstract Introduction: Low back pain (LBP) is a frequent reason for consultation, and one of the main causes of permanent work disability. Stratifying the risk of disability due to LBP allows the development of specific therapeutic interventions; however, such stratification requires valid and reliable instruments. Objective: To determine the internal consistency, as well as the convergent, discriminant, and criterion validity of the Start Back Screening Tool (SBST) questionnaire in a Colombian sample. Materials and methods: Quantitative scale validation study conducted in 68 adult patients with LBP who underwent a physical therapy intervention (10 sessions) between 2019 and 2020 in a clinic located in Chía, Colombia. Participants completed the SBST, the Numerical Pain Rating Scale (NPRS), and the Roland-Morris Disability Questionnaire (RMDQ) at three times: pre-intervention, post-intervention, and after 6 weeks of follow-up (without treatment). The internal consistency of the SBST was determined using Cronbach's alpha, omega, lambda-6, and greatest lower bound (GLB) coefficients. Regarding criterion and construct validity, correlations between the SBST and the NPRS and the RMDQ were assessed using the Pearson's correlation coefficient. Finally, a repeated measures ANOVA was performed between the SBST mean scores obtained at the three moments in order to estimate its discriminant validity. Results: The internal consistency of the instrument, according to the different coefficients, ranged from acceptable to high (alpha=0.634; omega=0.648; lambda-6=0.664; GLB=0.780). Positive correlations were found between the SBST mean score (mean=3.824; SD=1.892) and the NPRS (r=0.257; p=0.035) and RMDQ (r=0.475; p<0.0010) mean scores, as well as significant differences between pre-intervention, post-intervention, and follow-up SBST mean scores (ANOVA: F=33.722; p<0.001). Conclusion: SBST is a valid and reliable instrument to classify the level of risk of poor prognosis in Colombian patients with LBP.
Resumen Introducción. El dolor lumbar (DL) es una causa frecuente de consulta y una de las principales causas de incapacidad laboral permanente. La estratificación del riesgo de discapacidad por DL permite desarrollar intervenciones terapéuticas específicas; sin embargo, dicha estratificación requiere instrumentos válidos y confiables. Objetivo. Determinar la consistencia interna y la validez convergente, discriminante y de criterio del cuestionario Start Back Screening Tool (SBST) en una muestra colombiana. Materiales y métodos. Estudio cuantitativo de validación de pruebas realizado en 68 pacientes adultos con DL que recibieron una intervención fisioterapéutica (10 sesiones) entre 2019 y 2020 en una clínica de Chía, Colombia. Los participantes diligenciaron el SBST, la escala numérica de clasificación del dolor (ENCD) y el cuestionario Roland Morris Disability (RMD) en tres momentos: pre-intervención, post-intervención y luego de 6 semanas de seguimiento (sin tratamiento). La consistencia interna del SBST se determinó mediante los coeficientes alfa de Cronbach, Omega, lambda-6 y greatest lower bound (GLB). En cuanto a la validez de criterio y de constructo, se evaluaron las correlaciones entre el instrumento y la ENCD y el RMD mediante el coeficiente de correlación de Pearson. Finalmente, se realizó un ANOVA de medidas repetidas entre las medias de puntaje del SBST obtenidas en los tres momentos para estimar su validez discriminante. Resultados. La consistencia interna del instrumento, según los diferentes coeficientes, varió entre aceptable y alta (alfa=0.634; omega=0.648; lambda-6=0.664; GLB=0.780). Se observaron correlaciones positivas entre el puntaje promedio en el SBST y los puntajes promedio en la ENCD (r=0.257; p=0.035) y la RMD (r=0.475; p<0.0010), así como diferencias significativas entre los puntajes promedio del SBST pre-intervención, post-intervención y seguimiento (ANOVA: F=33.722; p<0.001). Conclusión. El SBST es un instrumento válido y confiable para clasificar el nivel de riesgo de mal pronóstico en pacientes colombianos con DL.