RESUMO
Introducción: El dolor lumbar crónico es una de las principales causas de incapacidad laboral en el mundo. Requiere un abordaje interdisciplinario para la evolución del paciente. Hasta el momento, no existe consenso en el manejo del dolor lumbar crónico, lo que generó la inquietud de esta revisión sistemática. Objetivo: Identificar la efectividad de los protocolos de fisioterapia en el manejo del dolor lumbar crónico. Metodología: Se realizó una búsqueda sistemática en las bases de datos Pubmed, ScienceDirect, Scopus, Oxford, Wiley, Cochrane Library Plus, PEDro, Epistemonikos, Hinari y LILACS, Google Scholar, Teseo y PROSPERO, desde el inicio de las bases hasta agosto de 2021. Los criterios de selección se definieron según la intervención y el tema del artículo. Resultados: Se incluyeron 26 estudios en la síntesis cualitativa, se excluyeron artículos que no cumplieran con los criterios de inclusión. Se encontró efecto en el control del dolor y la disminución de la discapacidad y las principales intervenciones son: fortalecimiento muscular del Core y miembros inferiores, estiramiento de miembros inferiores, movilidad lumbopélvica y educación o escuela de espalda. La frecuencia en el tratamiento osciló entre 2 y 3 veces por semana durante 5 semanas. Conclusiones: Se encontró mayor efectividad en el tiempo de control del dolor y la disminución de la discapacidad, relacionados principalmente con el fortalecimiento muscular del Core y las estrategias educativas.(AU)
Introduction: Chronic low back pain is one of the main causes of incapacity for work in the world. It requires an interdisciplinary approach for the evolution of the patient. Until now, there is no consensus on the management of chronic low back pain, which generated the concern of this systematic review. Aim: To identify the effectiveness of physiotherapy protocols in the management of chronic low back pain. Methodology: A systematic search was carried out in the Pubmed, ScienceDirect, Scopus, Oxford, Wiley, Cochrane Library Plus, PEDro, Epistemonikos, Hinari and LILACS, Google Scholar, Teseo and PROSPERO databases, from the beginning of the databases until August, 2021. The selection criteria were defined according to the intervention and topic of the article. Results: Twenty-six studies were included in the qualitative synthesis, articles that did not meet the inclusion criteria were excluded. An effect was found in the control of pain and the reduction of disability and the main interventions are: muscular strengthening of the core and lower limbs, stretching of the lower limbs, lumbopelvic mobility and education or back school. The treatment frequency ranged from 2 to 3 times per week for 5 weeks. Conclusions: Greater effectiveness was found in pain control time and disability reduction, mainly related to core muscle strengthening and educational strategies.(AU)
Assuntos
Humanos , Masculino , Feminino , Protocolos Clínicos , Dor Lombar/tratamento farmacológico , Dor Lombar/reabilitação , Modalidades de Fisioterapia/normas , Dor Crônica/reabilitaçãoRESUMO
En la actualidad diversos estudios han identificado una baja adherencia al tratamiento de rehabilitación pulmonar en pacientes con EPOC, a pesar de los efectos positivos que se obtienen con el tratamiento; factores como la ausencia de soporte familiar, las múltiples comorbilidades, la dificultad respiratoria, la ansiedad y la depresión afectan la adherencia de los pacientes a la rehabilitación pulmonar. Dado que no existe evidencia concluyente acerca de cuáles de estos factores son más determinantes en la adherencia a la rehabilitación pulmonar de los pacientes con EPOC, se decidió realizar esta revisión exploratoria (scoping review) con el objetivo de revisar y analizar la evidencia disponible sobre los factores que influyen en la adherencia de los pacientes con EPOC a los programas de rehabilitación pulmonar. Se realizó una búsqueda de literatura en las bases de datos Medline, Ovid, Science Direct, EMBASE, EBSCO, ISI-web of science y se definieron previamente criterios de selección que consideraran los factores que se relacionan con la asistencia y la adherencia en pacientes con EPOC en PRP. Como marco conceptual para el análisis de los resultados se utilizó el modelo de adherencia propuesto por la OMS. Como resultado significativo se encontró que los factores en la dimensión enfermedad (40%) y paciente (30%) son los que se mencionan con mayor frecuencia en los estudios, permitiendo identificar que el diseño de un programa de rehabilitación pulmonar debe tener en cuenta las necesidades específicas del paciente y su condición clínica. Se requiere un estudio que permita establecer las barreras y facilitadores de la adherencia en el medio colombiano (AU)
Currently, several studies have identified low adherence to pulmonary rehabilitation in patients with COPD, despite the positive effects of the treatment. Patient adherence to pulmonary rehabilitation is affected by factors such as the absence of family support, and the presence of multiple comorbidities, respiratory distress, anxiety and depression. Given that there is no conclusive evidence about which of these factors are most influential in determining adherence to pulmonary rehabilitation in patients with COPD, we conducted this scoping review to analyse the available evidence on the factors influencing the adherence of patients with COPD to pulmonary rehabilitation programs (PRP). A wide literature search was carried out in Medline, Ovid, Science Direct, EMBASE, EBSCO and ISI-web of science, with prior definition of the selection criteria that included the factors associated with healthcare and adherence in patients with COPD in PRP. We used the adherence model proposed by the WHO as a conceptual framework. As a significant result, we found that factors in the dimension of illness (40%) and patient (30%) were the most frequently found dimensions in the studies, revealing that the design of pulmonary rehabilitation programs must take into account the specific needs of the patient. Further studies are needed to establish barriers and facilitators of adherence among COPD patients to PRP in the Colombian setting (AU)
Assuntos
Humanos , Doença Pulmonar Obstrutiva Crônica/reabilitação , Cooperação e Adesão ao Tratamento , Cooperação do Paciente , Comorbidade , DispneiaRESUMO
Currently, several studies have identified low adherence to pulmonary rehabilitation in patients with COPD, despite the positive effects of the treatment. Patient adherence to pulmonary rehabilitation is affected by factors such as the absence of family support, and the presence of multiple comorbidities, respiratory distress, anxiety and depression. Given that there is no conclusive evidence about which of these factors are most influential in determining adherence to pulmonary rehabilitation in patients with COPD, we conducted this scoping review to analyse the available evidence on the factors influencing the adherence of patients with COPD to pulmonary rehabilitation programs (PRP). A wide literature search was carried out in Medline, Ovid, Science Direct, EMBASE, EBSCO and ISI-web of science, with prior definition of the selection criteria that included the factors associated with healthcare and adherence in patients with COPD in PRP. We used the adherence model proposed by the WHO as a conceptual framework. As a significant result, we found that factors in the dimension of illness (40%) and patient (30%) were the most frequently found dimensions in the studies, revealing that the design of pulmonary rehabilitation programs must take into account the specific needs of the patient. Further studies are needed to establish barriers and facilitators of adherence among COPD patients to PRP in the Colombian setting.
