A influência do sedentarismo na prevalência de lombalgia

TREATMENT OF NON-SPECIFIC CHRONIC LOW BACK PAIN: RESISTANCE TRAINING WITH OR WITHOUT USING WEIGHTS?

ABSTRACT Introduction: Dysfunction of the core muscles contributes to the persistence of pain in patients with chronic low back pain. Evidence shows that the active approach is beneficial in the rehabilitation of these patients. However, there is uncertainty as to the most effective methods or form of exercise, as the literature offers little guidance in this regard. Objective: To analyze and compare the impact on quality of life, function, flexibility, abdominal strength and abdominal fat rate in patients with non-specific chronic low back pain after a program of resistance training using two different forms of exercise. Methods: Thirty individuals, aged between 18 and 65 years, participated in the study. Twenty performed physical training program twice a week for eight weeks, and ten did not perform any physical exercises, but received guidance and pain relief. The physically active individuals were randomly divided in two groups and received similar resistance training, focusing on the same muscle groups. Ten performed training with dumbbells and bodybuilding machines (TRCP) and ten did not use this equipment (TRSP). All were assessed before and after the intervention, through questionnaires on quality of life and function, and tests for flexibility, abdominal strength and measurement of the abdominal fat rate. Results: In the intra-group comparison (initial vs eight weeks), there were no significant differences in quality of life in any of the groups. However, regarding function, the three groups showed significant improvement, with TRSP showing the best evolution. For flexibility and abdominal strength gain, TRCP showed the best evolution in both instruments. For decrease in abdominal fat rate, only TRCP showed significant differences. In the intergroup comparison, there were no significant differences for any of the evaluated outcomes. Conclusion: The two exercise programs were effective in improving function, flexibility and abdominal strength in patients with chronic, non-specific low back pain. However, there were no statistically significant differences in any of the outcomes in the comparison between groups. Level evidence II, Comparative prospective study.

Pain perception and low back pain functional disability after a 10-week core and mobility training program: A pilot study

BACKGROUND AND OBJECTIVE

The aim of this study was to evaluate the effects of a 10-week core and mobility training program on pain perception and low back disability score in professors, students and employees of a university.

METHODS

Twenty-four individuals of a university who previously reported pain and low back disability were randomly assigned to an experimental group (EG; n= 8) that received 2 weekly sessions of 50 minutes of core and mobility training for 10 weeks; or to a control group (CG; n= 16). Both groups received a guideline to adopt ergonomic postures during work and activities of daily living. The visual analog pain scale (VAS) and the Roland-Morris questionnaire (RMQ) were applied pre- and post intervention.

RESULTS

Significant reductions in the pain intensity perception (p= 0.014) and low back functional disability (p= 0.011) were noted in the EG pre- and post measures. However, no significant difference was observed in the CG. Thus, there was a significant difference between the EG and the CG in the post-intervention measures (p= 0.001).

CONCLUSION

Core and mobility training and home-ergonomic instructions were effective to reduce the pain intensity perception and low back functional disability in the EG.

RELATIONSHIP BETWEEN THE ISCHIOTIBIAL AND PARAVERTEBRAL MUSCLES AND LOW BACK PAIN

ABSTRACT Low back pain or lumbago is a painful condition that affects an increasing number of people around the world and has numerous causal factors. Among these factors, the most distinctive are muscle imbalances, weakness of paravertebral muscles and shortening of ischiotibial muscles. The role of these muscle groups is still controversial and not fully explained in the literature. Thus, a survey was conducted in the SciELO, LILACS, MEDLINE, and PubMed databases in the last decade (2003-2013), using as keywords: hamstrings, low back pain, lumbago, and paravertebral. The works found confirm that, according to the methodology, weakness in paravertebral muscles is of great importance to the development of low back pain as well as the shortening of the ischiotibial muscles, which are directly related to this factor.

Effects of Pilates and Classical Kinesiotherapy on chronic low back pain: a case study

Abstract Introduction : Chronic low back pain (LBP) is characterized by daily lower back pain lasting more than three consecutive months. It may lead to functional disability and can be treated by several physical therapy techniques, including therapeutic exercise. The aim of this study was to investigate the effects of pilates and classical kinesiotherapy on the treatment of pain and functional disability in patients with chronic low back pain. Materials and methods : The study sample consisted of five patients with a diagnosis of chronic low back pain and a mean age of 32.4 ± 15.6 years. A Visual Analogue Scale (VAS) was used for pain assessment, and the Oswestry Disability Index was used to assess functional disability at the beginning and at the end of the intervention. Patients were divided into two groups and received 20 individual sessions of therapeutic exercise at a frequency of two sessions per week. Group A was treated with classical kinesiotherapy and group B was treated with pilates exercises. Statistical analysis was performed using Wilcoxon's test. The significance level was set at 5%. Results : There was a significant reduction in pain (p = 043) and functional disability (p = 042) in both groups. We found no significant differences between the effects of pilates and classical kinesiotherapy on pain and functional disability. Conclusions : We conclude that, in the population studied here, both pilates and classical kinesiotherapy were effective in treating chronic low back pain symptoms, with no significant difference between them.

Heavy physical work and low back pain: the reality in urban cleaning

Low back pain (LBP) is a major public health issue. There is lack of research on this disorder affecting urban cleaning workers. A cross-sectional study was conducted to describe the prevalence of LBP, occupational and extra-occupational characteristics, as well as associated factors in these workers. A census was performed with 624 workers in Salvador, Brazil, using a questionnaire administered by an interviewer in 2010. Cases of LBP were defined by reported symptoms of pain in the previous 12 months, lasting more than a week or with monthly minimum frequency, which led to restrictions at work or to seeking medical attention, or in cases when respondents had a severity score > 3 on a numerical scale from 0 to 5. Physical demands at work were measured on a numerical 6-point scale with 14 variables. Psychosocial demands were measured using the Job Content Questionnaire. Sociodemographic factors, lifestyle habits and domestic work were evaluated. Multiple logistic regression (LR) was used to identify factors associated with LBP, for which the prevalence was 37.0%. Among them, 62.8% of workers felt pain in the last 7 days. LBP was associated with longer working hours, flexion and trunk rotation, psychosocial demands, working directly in collection and low schooling. Dynamic work (walking, running) served as a protective factor. It was concluded that many workers develop their activity at the presence of pain. The results emphasize the need for preventive measures through multifactorial approach encompassing adaptations in physical environment and changes in work organization.

Physical activities in daily life and functional capacity compared to disease activity control in acromegalic patients: impact in self-reported quality of life

OBJECTIVE

To evaluate the quality of life and its association with daily physical activity and disease control in acromegalic patients.

SUBJECTS AND METHODS

A cross-sectional, case series study, composed of 42 patients recruited from the Neuroendocrinology Unit of the University Hospital of Brasilia. Level of physical activity was accessed by the International Physical Activity Questionnaire (IPAQ 6-short-form), which evaluates the weekly time spent on physical activity of moderate to vigorous intensity in different contexts of life. Quality of life was evaluated by The Medical Outcome Study Questionnaire Short Form (SF-36). Data was compared to growth hormone (GH) and insulin-like growth factor (IGF-1) levels. Students' t test and Fisher test were used, p < 0.05, SPSS 17.0.

RESULTS

Twenty-two women, aged 51.33 ± 14.33 and 20 men, aged 46.2 ± 13.18 were evaluated. Arthralgia was present in 83% of cases. In men, the most common sites of pain were the knees (73%), spine (47% lumbar, and 53% thoracic and cervical segments), hands and wrists (40%). Higher scores on SF-36 were observed in patients with intermediate or high levels of physical activity, in the domains social functioning (75 CI 57.3-92.6), general health (75.5 CI 60.4-90.5), mental health (70 CI 57.8-82.1).

CONCLUSIONS

In this study, the presence and severity of physical disability and pain were not associated with initial GH and IGF-1 levels or time of exposure to GH excess. However, the patients considered controlled, with normal a normal age-adjusted IGF-1, presented higher scores in SF-36, in physical and emotional domains, compared with patients with persistent hypersomatotrophism. These findings suggest benefits of metabolic control in self-reported quality of life.

Análise da musculatura estabilizadora lombopélvica em jovens com e sem dor lombar

INTRODUÇÃO: A capacidade de controle da musculatura profunda local em indivíduos com dor lombar tende a estar diminuída. OBJETIVO: Analisar e comparar o comportamento da musculatura estabilizadora lombopélvica em jovens com e sem dor lombar. MATERIAIS E MÉTODOS: A pesquisa do tipo transversal quantitativa teve aplicação de avaliações para estabilidade lombopélvica por meio dos testes de Resistência Estática do Tronco, Resistência das Costas de Sorenson e Teste de Side Bridge (ponte lateral), questionário funcional lombar de Roland-Morris; a escala de dor foi avaliada com uso da escala análoga visual da dor em adultos jovens da Universidade Estadual do Norte do Paraná (UENP), Centro de Ciências da Saúde, Jacarezinho (PR). RESULTADOS: A amostra do trabalho foi composta de 108 indivíduos, 17 do gênero masculino e 91 do gênero feminino, apresentando médias e desvios padrão respectivamente de: idade 19,44 ± 1,73 anos, estatura 167 ± 8 cm, peso 60,48 ± 11 kg e índice de massa corpórea (IMC) 21,70 ± 2,80 kg/m². Dos participantes, 20% apresentaram dor lombar. Na comparação entre grupos de indivíduos com dor lombar e sem dor mediante testes de estabilidade lombopélvica, não se observou diferenças significativas, p > 0,05 para todos os testes, mesmo com divisão por gênero, onde o percentual dos indivíduos com dor foi de 18,68% no grupo feminino e de 29,41% no masculino. CONCLUSÃO: Constatou-se que os adultos jovens com dor lombar não se apresentaram com a musculatura estabilizadora lombopélvica significativamente diferente quando comparados com os sem dor.

Efeitos da ginástica laboral na dor nas costas e nos hábitos posturais adotados no ambiente de trabalho

O objetivo deste estudo foi verificar o efeito da Ginástica Laboral (GL) sobre a dor nas costas e sobre os hábitos posturais de trabalhadores que ficam por longos períodos na posição sentada. Participaram 30 trabalhadores do setor administrativo, divididos em grupo controle (n=15) e grupo experimental (n=15), sendo este submetido a sessões de GL durante três meses. Ambos os grupos foram avaliados por um questionário de dor e postura, sendo as respostas codificadas, tabuladas e submetidas ao teste de Wilcoxon para verificar as diferenças entre pré e pós-experimento (α=0,05). Os resultados demonstraram que a GL proporcionou diminuição da intensidade e frequência da dor referida aos trabalhadores do grupo experimental, e mudança do hábito postural durante o trabalho, melhorando a postura sentada.

Lombalgia na terceira idade: distribuição e prevalência na Clínica Escola de Fisioterapia da Universidade Estadual do Sudoeste da Bahia

Resumo A degeneração da coluna vertebral inerente ao processo de envelhecimento, juntamente com o maior tempo de exposição a sobrecargas ao longo da vida, pode tendenciar o idoso a ser acometido pela lombalgia. Neste sentido, este estudo tem como objetivo determinar a prevalência e a caracterização da lombalgia em idosos atendidos no Setor de Geriatria da Clínica Escola de Fisioterapia da Universidade Estadual do Sudoeste da Bahia. Trata-se de um estudo de caráter descritivo, com corte transversal, realizado por meio de investigação de prontuários. Foram analisados 44 prontuários de pacientes portadores de lombalgia, com idade igual ou superior a 60 anos, de ambos os sexos, a partir de um universo de 131 prontuários de idosos, encontrando-se uma prevalência de 33,6%. Os indivíduos são predominantemente mulheres, com faixa etária entre 60 e 69 anos, e aposentados. Verificou-se que dos 21 (47,73%) dos idosos apresentaram lombalgia de causa desconhecida; 19 (43,18%), dor do tipo crônica; e 26 (59,09%), irradiação para os membros inferiores. A partir deste estudo, constatou-se alta prevalência de lombalgia em idosos, sendo um dado importante para prevenção e intervenção precoce, no intuito de melhorar a qualidade de vida desta população.