A influência do nível de atividade física no curso clínico da dor lombar aguda
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Data
2019-02-18
Autores
Silva, Fernanda Gonçalves
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A dor lombar aguda não específica pode ser definida como dor sem uma causa específica conhecida com uma duração menor do que seis semanas. Estima-se que cerca de 90% dos pacientes dor lombar aguda retornam ao trabalho dentro de três meses; no entanto, muitos continuam a apresentar recorrência e/ou a persistência dos sintomas. Apesar das evidências atuais não serem capazes de dar suporte à um fator causal específico responsável pela ocorrência dos episódios iniciais de dor lombar, fatores físicos e psicossociais possuem um papel importante no surgimento e persistência desta condição. Portanto, é imprescindível seu entendimento a fim de predizer a sua influência na transição para um quadro crônico. Pouco se sabe sobre a influencia dos níveis de atividade física em desfechos clinicos, como intensidade da dor e incapacidade, em pacientes com dor lombar aguda. Objetivo: Esse estudo teve como objetivo: I) investigar se pacientes com dor lombar aguda alteram dor, incapacidade e nível de atividade física ao longo de 3 e 6 meses; II) analisar a capacidade do nível de atividade física e fatores individuais em predizer os desfechos de dor, incapacidade do paciente após 3 e 6 meses. Métodos: Os pacientes foram recrutados e avaliados a partir de instrumentos de medida objetiva e subjetiva para atividade física, dor, incapacidade em três momentos. Os dados foram análisados por meio de teste de Friedman, Wilcoxon e através de regressões lineares univariadas e multivariadas para análise de predição dos desfechos clínicos. Resultados: Foram avaliados 112 indivíduos, a idade média dos participantes foi 35,91 (±12,01) anos. As medidas de intensidade de dor e incapacidade apresentaram diferença estatisticamente significativa (p<0,00) quando comparadas a avaliação inicial. Não houve diferença entre as avaliações de atividade física para os três momentos. Além disso, a atividade física ocupacional foi o único domínio de atividade física capaz de predizer incapacidade aos seis meses (B= 3.49, IC= 0.65 - 6.34, p<0,01). Conclusão: Nossos achados demonstraram que os níveis de dor e incapacidade, aos três e seis meses, reduziram de maneira significativa quando comparado com a avaliação inicial e que a atividade física ocupacional pode influenciar de maneira negativamente no curso clínico de indivíduos com dor lombar aguda após seis meses do episódio inicial. Não foi verificado associação preditiva para os outros domínios de atividade física.
Introduction: Acute non-specific low back pain can be defined as pain without a specific known cause lasting less than six weeks. It is estimated that about 90% of acute low back pain patients return to work within three months; however, many continue to have recurrence and / or persistence of symptoms. Although current evidence can not support a specific causal factor responsible for the occurrence of early episodes of low back pain, physical and psychosocial factors play an important role in the onset and persistence of this condition. Therefore, their understanding is essential in order to predict their influence in the transition to a chronic condition. Little is known about the influence of physical activity levels on clinical outcomes such as pain intensity and disability in patients with acute low back pain. Objective: This study aimed to: I) investigate whether patients with acute low back pain alter pain, disability and physical activity level after 3 and 6 months; II) to analyze the capacity of the physical activity level and individual factors to predict the pain and disability outcomes, after 3 and 6 months. Methods: Patients were recruited and evaluated from objective and subjective measurement instruments for physical activity, pain, disability in three moments. Data were analyzed using the Friedman, Wilcoxon test and through univariate and multivariate linear regressions for analysis of prediction of clinical outcomes. Results: A total of 112 individuals were evaluated, the mean age of participants was 35.91 (± 12.01) years. The measures of pain intensity and disability showed a statistically significant difference (p <0.00) when compared to the initial evaluation. There was no difference between physical activity assessments for the three moments. In addition, occupational physical activity was the only domain of physical activity capable of predicting disability at six months (B= 3.49, IC= 0.65 - 6.34, p<0,01). Conclusion: Our findings showed that pain and disability levels at three and six months were significantly reduced when compared to the initial evaluation and that occupational physical activity may negatively influence the clinical course of individuals with acute low back pain after six months of the initial episode. No predictive association was verified for the other domains of physical activity.
Introduction: Acute non-specific low back pain can be defined as pain without a specific known cause lasting less than six weeks. It is estimated that about 90% of acute low back pain patients return to work within three months; however, many continue to have recurrence and / or persistence of symptoms. Although current evidence can not support a specific causal factor responsible for the occurrence of early episodes of low back pain, physical and psychosocial factors play an important role in the onset and persistence of this condition. Therefore, their understanding is essential in order to predict their influence in the transition to a chronic condition. Little is known about the influence of physical activity levels on clinical outcomes such as pain intensity and disability in patients with acute low back pain. Objective: This study aimed to: I) investigate whether patients with acute low back pain alter pain, disability and physical activity level after 3 and 6 months; II) to analyze the capacity of the physical activity level and individual factors to predict the pain and disability outcomes, after 3 and 6 months. Methods: Patients were recruited and evaluated from objective and subjective measurement instruments for physical activity, pain, disability in three moments. Data were analyzed using the Friedman, Wilcoxon test and through univariate and multivariate linear regressions for analysis of prediction of clinical outcomes. Results: A total of 112 individuals were evaluated, the mean age of participants was 35.91 (± 12.01) years. The measures of pain intensity and disability showed a statistically significant difference (p <0.00) when compared to the initial evaluation. There was no difference between physical activity assessments for the three moments. In addition, occupational physical activity was the only domain of physical activity capable of predicting disability at six months (B= 3.49, IC= 0.65 - 6.34, p<0,01). Conclusion: Our findings showed that pain and disability levels at three and six months were significantly reduced when compared to the initial evaluation and that occupational physical activity may negatively influence the clinical course of individuals with acute low back pain after six months of the initial episode. No predictive association was verified for the other domains of physical activity.
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Palavras-chave
Atividade física, Dor lombar aguda, Dor, Incapacidade, Physical activity, Acute low back pain, Pain, Disability