RESUMEN
ABSTRACT BACKGROUND AND OBJECTIVES: Chronic pain has a high demand for health care due to its multifactorial cause. The COVID-19 pandemic represented a scenario of social stress, in which there was a reduction in care for chronic non-communicable diseases, including cases of chronic pain. The aim of this study was to understand the impacts of the pandemic on this population, considering the perception of pain, experience with care and mental health. METHODS: This is an exploratory case study using a qualitative methodology. An intentional sample of six patients diagnosed with chronic musculoskeletal pain, of both genders and aged between 30 and 70 was used. The individuals underwent a semi-structured interview, in which the data was analyzed by thematic analysis and coding. RESULTS: After the analysis, three themes emerged: 1) Multidimensional impact of pain and coping strategies; 2) Characteristics of the health service and individual-centered care; 3) Influence of pain on quality of life and perspective of future life. The impact of health care was a factor of anxiety and uncertainty about pain. It had repercussions on new coping strategies, such as telehealth. In this context, Primary Health Care was a scenario capable of managing the short- and long-term quality of life of individuals with chronic pain. CONCLUSION: This study contributed to understanding the impact of the COVID-19 pandemic on individuals with chronic pain, which represents a challenge to current care.
RESUMO JUSTIFICATIVA E OBJETIVOS: A dor crônica apresenta alta demanda de assistência à saúde, devido a sua causa multifatorial. A pandemia da COVID-19 representou um cenário de estresse social, em que houve redução de atendimentos às doenças crônicas não transmissíveis, incluindo os casos de dores crônicas. O objetivo deste estudo foi compreender os impactos da pandemia para este público, considerando a percepção da dor, experiência com assistência e saúde mental. MÉTODOS: Trata-se de um estudo de caso exploratório de metodologia qualitativa. Foi utilizada uma amostra intencional de seis pacientes com diagnóstico de dor musculoesquelética crônica, de ambos os sexos e com idade entre 30 e 70 anos. Os indivíduos passaram por uma entrevista semiestruturada, na qual os dados foram analisados por análise temática e codificação. RESULTADOS: Após a análise, emergiram três temas: 1) Impacto multidimensional da dor e estratégias de enfrentamento; 2) Características do serviço de saúde e atenção centrada no indivíduo; 3) Influência da dor na qualidade de vida e na perspectiva de vida futura. O impacto na assistência à saúde foi um fator de ansiedade e incertezas sobre a dor. Isso repercutiu em novas estratégias de enfrentamento, como os teleatendimentos. Nesse contexto, a Atenção Primária à Saúde foi o cenário capaz de gerenciar a qualidade de vida a curto e a longo prazo dos indivíduos com dor crônica. CONCLUSÃO: Este estudo contribuiu para a compreensão do impacto da pandemia da COVID-19 em indivíduos com dor crônica, o qual representa desafios à assistência atual.
RESUMEN
This study analyzed the electromyographic and strength responses of the flexor muscles of the wrist following stimulation of acupuncture points. A total of 52 participants were randomly divided into four groups: local (heart 3, HT3), distant (heart 4, HT4), control (bladder 60, BL60), and naïve control groups. To obtain the root mean square electromyographic activity, we placed surface electrodes over the wrist flexors. To obtain kilogram force (kgf) values, we attached a force transducer to the floor and to the hands of participants. Both values were recorded over three repetitions of maximal isometric wrist flexion contractions. Data were analyzed using one-way analyses of variance, followed by Dunnett's post-hoc tests. We found reductions in electromyographic activity contralateral to the stimulated point in the distant group 10 minutes after removal of the needles (F(3,48) = 3.25; p < 0.05). Regarding muscle strength, ipsilateral and contralateral stimulation in the distant group produced kgf levels prior to and 10 minute and 20 minutes after withdrawal of the acupuncture needle that were lower than that obtained prior to insertion of the needle (F(3,48) = 5.82; p < 0.05). Thus, stimulation of the acupuncture points distant from the wrist flexors reduced ipsilateral and contralateral muscle strength and decreased the root mean square values contralateral to the site of stimulation.