Papel de diferentes domínios de atividade física no curso clínico da dor lombar crônica não-específica
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Data
2018-03-20
Autores
Hisamatsu, Thalysi Mayumi [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Investigar a capacidade dos diferentes domínios de atividade física, mensurados por meio de instrumentos objetivo e subjetivo, em predizer desfechos clínicos em pacientes com dor lombar crônica não específica. Materiais e métodos: O delineamento do estudo foi de coorte longitudinal com um seguimento de 6 meses. A amostra consistiu de 179 participantes com dor lombar crônica não específica. Na avaliação inicial, os seguintes dados foram coletados: dados antropométricos/ demográficos; duração e intensidade da dor (Escala Numérica de Dor); incapacidade funcional (Questionário de Incapacidade de Roland Morris); medo do movimento (Escala Tampa de Cinesiofobia); depressão (Inventário de Depressão de Beck) e nível de atividade física mensurado por meio do acelerômetro (período de tempo em atividades físicas leves e em atividade física moderada/vigorosa mensurados em minutos por dia, passos por dia e counts por minutos) e por meio do questionário de Atividade Física Habitual de Baecke (atividade física ocupacional, atividade física de lazer e locomoção e exercício físico). Após 6 meses os pacientes foram avaliados em relação a intensidade da dor e incapacidade funcional. Análise de regressão linear multivariada foi utilizada para investigar a associação dos domínios de atividade física com os desfechos clínicos de dor e incapacidade. Resultados: Um total de 179 participantes com dor lombar crônica não específica foram avaliados inicialmente, sendo que 150 participantes utilizaram o acelerômetro corretamente na avaliação inicial. Os resultados mostraram que a atividade física ocupacional, mensurado pelo questionário de Atividade Física Habitual de Baecke, apresentou associação significativa com a incapacidade mesmo ajustando a ánalise para a presença de covariáveis. Sendo que indivíduos que reportaram maior nível de atividade física ocupacional apresentaram maior nível de incapacidade (β: 2,94; 95% CI 1,08; 4,79). O modelo de regressão final incluiu ainda as covariáveis idade, duração dos sintomas, depressão e incapacidade inicial, explicando 23,2% da variação de incapacidade após 6 meses. Conclusão: Dentre os domínios de atividade física investigados no presente estudo, atividade física ocupacional mostrou ser o único domínio capaz de predizer piora da incapacidade após 6 meses.
To investigate the ability of different physical activity domains, measured by objective and subjective instruments, in predicting clinical outcomes in chronic non-specific low back pain. Material and methods: Study design was a longitudinal cohort with 6 months follow-up. Sample size was of 179 participants with chronic non-specific low back pain. In the first evaluation, the following data were collected: anthropometric/demographic data; pain duration and intensity (Numerical Rating Scale); functional disability (Roland Morris Disability Questionnaire); fear of movement (Tampa Scale for Kinesiophobia); depression (Beck Depression Inventory) and physical activity levels measured by accelerometer (time spend in light, moderate/ vigorous physical activity, steps per day, Counts per minutes) and by Baecke questionnaire for the evaluation of habitual physical activity (occupational physical activities, leisure and locomotion physical activities and physical exercise). After 6 months patients were evaluated according to pain intensity and functional disability. Multivariate regression analysis was used to investigate the physical activity domains association with pain and disability outcomes. Results: A total of 179 participants with chronic non-specific low back pain were initially evaluated, of those, 150 participants wore accelerometer correctly in the initial evaluation. Results showed occupational physical activity, measured by Baecke questionnaire for the evaluation of habitual physical activity, had significant association with disability even though analysis had been adjusted for covariates presence. Which means that individuals who reported higher occupational physical activity levels showed higher disability levels (β: 2.94; 95% CI 1.08; 4.79). The final regression model even included the age, pain duration, depression and initial disability, explained 23.2% of disability 6 months follow-up variance. Conclusion: Among physical activity domains investigated in the present study, occupational physical activity showed to be the only domain able to predict worsening disability after 6 months.
To investigate the ability of different physical activity domains, measured by objective and subjective instruments, in predicting clinical outcomes in chronic non-specific low back pain. Material and methods: Study design was a longitudinal cohort with 6 months follow-up. Sample size was of 179 participants with chronic non-specific low back pain. In the first evaluation, the following data were collected: anthropometric/demographic data; pain duration and intensity (Numerical Rating Scale); functional disability (Roland Morris Disability Questionnaire); fear of movement (Tampa Scale for Kinesiophobia); depression (Beck Depression Inventory) and physical activity levels measured by accelerometer (time spend in light, moderate/ vigorous physical activity, steps per day, Counts per minutes) and by Baecke questionnaire for the evaluation of habitual physical activity (occupational physical activities, leisure and locomotion physical activities and physical exercise). After 6 months patients were evaluated according to pain intensity and functional disability. Multivariate regression analysis was used to investigate the physical activity domains association with pain and disability outcomes. Results: A total of 179 participants with chronic non-specific low back pain were initially evaluated, of those, 150 participants wore accelerometer correctly in the initial evaluation. Results showed occupational physical activity, measured by Baecke questionnaire for the evaluation of habitual physical activity, had significant association with disability even though analysis had been adjusted for covariates presence. Which means that individuals who reported higher occupational physical activity levels showed higher disability levels (β: 2.94; 95% CI 1.08; 4.79). The final regression model even included the age, pain duration, depression and initial disability, explained 23.2% of disability 6 months follow-up variance. Conclusion: Among physical activity domains investigated in the present study, occupational physical activity showed to be the only domain able to predict worsening disability after 6 months.
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Palavras-chave
Dor lombar, Atividade física, Prognóstico, Low back pain, Physical activity, Prognosis