Eficácia do fortalecimento muscular no pós-operatório precoce de artroplastia total de joelho: revisão sistemática com meta-análise
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Data
2024-01-02
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Universidade Estadual Paulista (Unesp)
Resumo
A artroplastia total do joelho (ATJ) trata-se de uma intervenção cirúrgica, na qual
ocorre a substituição da articulação afetada por uma prótese. A fisioterapia é
fundamental na reabilitação após ATJ, podendo diminuir o tempo de internação
hospitalar, reduzir os sintomas e possibilitar a melhora da função do joelho. O
objetivo foi analisar os efeitos do fortalecimento muscular na força, funcionalidade e
dor de indivíduos com ATJ no período pós-operatório precoce. Os estudos foram
selecionados por meio de seis bases de dados (Pubmed, PEDro, LILACS, EMBASE,
CINAHL e Cochrane Library), utilizando os termos e palavras chave com
Arthroplasties, Knee Replacement, Physiotherapy, Exercise, Rehabilitation e
Postoperative. Todos os estudos incluídos foram avaliados quanto à qualidade
metodológica, utilizando a Escala PEDro. Somente ensaios clínicos randomizados
que envolveram ATJ unilateral primária no pós-operatório precoce foram incluídos
nesta revisão. Todas as meta-análises foram conduzidas por meio do software
Review Manager – RevMan e descritos como diferenças médias padronizadas
(standardized mean difference - SMD) com intervalos de confiança de 95% (IC).
Nove estudos foram escolhidos para revisão do texto completo. Os principais
achados deste estudo demonstraram que o fortalecimento muscular, quando
confrontado com as condições de comparação, foi eficaz apenas para a variável
força muscular demonstrando melhora na função geral (dois estudos, n=155;
MD=-1,39, 95% IC [-2,58, -0,19]; p=0,02; I²=96%). Já para as demais análises não
foram observadas diferenças significantes. Os achados do presente estudo
demonstram que o fortalecimento muscular, quando iniciado principalmente no PO
precoce de ATJ, é melhor que as condições de comparação na força muscular do
joelho.
Arthroplasties, Knee Replacement (TKA) is a surgical intervention, in which the affected joint is replaced by a prosthesis. Physiotherapy is essential in rehabilitation after TKA, which can decrease the length of hospital stay, reduce symptoms and enable improvement in knee function. Objective to analyze the effects of muscle strengthening on the functionality of individuals with TKA in the early postoperative period. The studies were selected using six databases (Pubmed, PEDro, LILACS, EMBASE, CINAHL and Cochrane Library), using the terms and keywords with Arthroplasties, Knee Replacement, Physiotherapy, Exercise, Rehabilitation and Postoperative. All included studies were assessed for methodological quality, using the PEDro Scale. Only randomized controlled trials involving primary unilateral TKA in the early postoperative period were included in this review. All meta-analyzes were conducted using the Review Manager - RevMane software described as standardized mean difference (standardized mean difference - SMD) with 95% confidence intervals (CI). Nine studies were chosen to review the full text. The main findings of this study demonstrated that muscle strenghening, when confronted with the conditions of comparison, was effective only for the muscle strength (two studies, n=155; MD=-1,39, 95% IC [-2,58, -0,19]; p=0,02; I²=96%). For the other analyzes, however, no significant differences were observed. The findings of the present study demonstrate that muscle strengthening, when initiated mainly in the early PO of TKA, is better than the comparison conditions in knee functionality.
Arthroplasties, Knee Replacement (TKA) is a surgical intervention, in which the affected joint is replaced by a prosthesis. Physiotherapy is essential in rehabilitation after TKA, which can decrease the length of hospital stay, reduce symptoms and enable improvement in knee function. Objective to analyze the effects of muscle strengthening on the functionality of individuals with TKA in the early postoperative period. The studies were selected using six databases (Pubmed, PEDro, LILACS, EMBASE, CINAHL and Cochrane Library), using the terms and keywords with Arthroplasties, Knee Replacement, Physiotherapy, Exercise, Rehabilitation and Postoperative. All included studies were assessed for methodological quality, using the PEDro Scale. Only randomized controlled trials involving primary unilateral TKA in the early postoperative period were included in this review. All meta-analyzes were conducted using the Review Manager - RevMane software described as standardized mean difference (standardized mean difference - SMD) with 95% confidence intervals (CI). Nine studies were chosen to review the full text. The main findings of this study demonstrated that muscle strenghening, when confronted with the conditions of comparison, was effective only for the muscle strength (two studies, n=155; MD=-1,39, 95% IC [-2,58, -0,19]; p=0,02; I²=96%). For the other analyzes, however, no significant differences were observed. The findings of the present study demonstrate that muscle strengthening, when initiated mainly in the early PO of TKA, is better than the comparison conditions in knee functionality.
Descrição
Palavras-chave
Artroplastia total do joelho, Exercício, Fisioterapia, Pós-operatório, Reabilitação, Osteoartrite, Arthroplasties, Knee replacement, Exercise, Physiotherapy, Postoperative, Rehabilitation, Osteoarthritis
Como citar
LEITE, Alany Gabrielli. Eficácia do fortalecimento muscular no pós-operatório precoce de artroplastia total de joelho: revisão sistemática com meta-análise. Orientador: Allysiê Priscilla de Souza Cavina. 2024. 49 f. Trabalho de Conclusão (Residência em Fisioterapia) - Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista, Presidente Prudente, 2024.