Cryotherapy in Knee Arthroplasty: Systematic Review and Meta-Analysis.

Total knee arthroplasty is performed to relieve knee pain and disability related to end-stage osteoarthritis. Cryotherapy is used as an analgesic method, reducing the intraarticular temperature. The objective of this study was to review the literature on the efficacy of cryotherapy in knee arthroplasty. A total of 700 articles were found in databases according to the search criteria for each database and the included descriptors (EndNote Web). After exclusion of duplicate articles, automatically and manually, Phase 1 was performed-reading of titles and abstracts of 375 articles according to the eligibility criteria by two blinded reviewers using the Rayyan QCRI (Qatar Computing Research Institute) program, conflicts were resolved in consensus between the 2 reviewers. Thus, 21 articles were selected for Phase 2-reading in full, leaving 5 articles for this review. The Cochrane instrument Rob 2 was used to assess the quality of bias of the selected studies, and RevMan 5.4.1 was used for meta-analysis. The age of study participants ranged from 51 to 74 years. The sample size ranged from 37 to 389 subjects, with a total of 648 subjects. The risk of bias was almost entirely high and moderate for all endpoints: pain, range of motion (ROM), and function. There was a decrease in pain level and as secondary endpoints ROM and functionality, there were divergences between studies. It can be concluded that although cryotherapy is indicated to reduce pain in the postoperative period of knee arthroplasty, studies have many methodological biases and the meta-analysis performed could not confirm the effects; therefore, more primary studies are needed to better understand the effects.

Avaliação da adaptação da corrente interferencial nas formas bipolar e tetrapolar em mulheres com lombalgia crônica não específica: ensaio clínico cruzado / Evaluation of interferential current adaptation in bipolar and tetrapolar forms in women with chronic non-specific low back pain: cross-over clinical trial

INTRODUÇÃO: A corrente interferencial é uma modalidade bastante utilizada, porém, apresenta como fator limitante a quantidade de acomodações, o que é comum em eletroestimulação. Apesar de possuir alguns recursos que visam reduzir a adaptação fisiológica, não é totalmente eficaz; neste sentido, pode haver diferenças devido à técnica de uso. Assim, o presente estudo pretendeu analisar se há diferenças na adaptação para as formas bipolar ou tetrapolar em indivíduos com dor lombar crônica não específica. MÉTODOS: Ensaio clínico cruzado, composto por 15 voluntárias com dor lombar crônica não específica, as quais receberam terapia bipolar ou tetrapolar em semanas subsequentes. Foi explicado sobre a adaptação à corrente e o que deveria avisar quando ocorresse, e, desta forma, foi computado o número de vezes em que o fenômeno ocorreu, o tempo necessário até ocorrer a primeira adaptação, a intensidade inicial da corrente utilizada e o quanto aumentou-se após a primeira adaptação. RESULTADOS: Para nenhuma das variáveis analisadas, foi observada diferença significativa entre as duas técnicas (p>0,05). CONCLUSÃO: As técnicas analisadas não mostraram diferenças na adaptação em mulheres jovens com dor lombar não específica.

INTRODUCTION: The interferential current is a widely used modality; however, it presents as a limiting factor the amount of accommodation, which is common in electrostimulation. Despite having some resources that aim to reduce physiological adaptation, it is not fully effective in this sense, but there may be differences due to the technique of use. Thus, the present study aimed to analyze whether there are differences in the accommodation for bi- or tetrapolar forms in individuals with chronic nonspecific low back pain. METHODS: Crossover clinical study, consisting of 15 volunteers with chronic nonspecific low back pain, who received bipolar or tetrapolar therapy in subsequent weeks. They were explained about the current accommodation and that they should be told when it occurred, and in this way, the number of times that the phenomenon occurred, the time needed until the first accommodation occurred, the initial intensity of the current used, and how much it increased after the first accommodation were computed. RESULTS: None of the variables analyzed had a significant difference between the two techniques (p>0.05). CONCLUSION: The techniques analyzed showed no differences in accommodation in young women with nonspecific low back pain.