Exercícios de controle motor versus exercícios gerais na síndrome dolorosa do trocânter maior: ensaio controlado aleatorizado
Carregando...
Data
2023-04-17
Autores
Nava, Guilherme Thomaz de Aquino [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A síndrome dolorosa do trocanter maior (SDTM) refere-se à dor na região do trocânter maior do fêmur. A SDTM está associada à fraqueza e ao controle deficitário da pelve. Sabe-se que as pessoas com SDTM se beneficiam de exercício físico, mas não há estudos que tenham comparado um treinamento com foco no controle motor e exercícios gerais. O objetivo deste estudo foi comparar um protocolo de controle motor e um protocolo de exercícios gerais com relação a dor média, antes e após 8 e 60 semanas de tratamento. Métodos: O estudo foi aprovado pelo Comitê de Ética em Pesquisa (CAAE: 87372318.1.0000.5406) e registrado prospectivamente no Registro Brasileiro de Ensaios Clínicos (RBR-37gw2x). Sessenta mulheres foram randomizadas em dois grupos, o grupo controle motor (GCM) e o grupo exercícios gerais (GEG). O desfecho primário foi a intensidade média da dor. Os desfechos secundários foram efeito global percebido (EGP), força muscular, catastrofização da dor, cinesiofobia, sensibilização central e qualidade de vida. Resultados: Nenhuma interação significativa de tempo x grupo foi observada em relação à intensidade média da dor em 8 semanas (MD: -0,06; IC 95% -1,41 a 1,29; p = 0,92, tamanho do efeito = 0,02) ou 60 semanas ( MD: -0,75; IC 95% -2,35 a 0,83; p=0,34, tamanho do efeito= 0,24). Com relação aos desfechos secundários, somente o desfecho força muscular apresentou diferença estatisticamente significativa na comparação entre os grupos, especificamente na reavaliação dos músculos extensores do quadril no lado sem dor (MD: 0,1; IC 95% 0,0004 a 0,2; p=0,04; tamanho do efeito = 0,54). Conclusão: O protocolo de controle motor não foi superior ao protocolo de exercícios gerais na melhora da intensidade média da dor em 8 e 60 semanas de acompanhamento em mulheres com SDTM.
Introduction: Greater trochanter pain syndrome (GTPS) refers to pain in the greater trochanter region of the femur. GTPS is associated with weakness and poor control of the pelvis. It is known that people with GTPS benefit from physical exercise, but there are no studies that have compared training focused on motor control and general exercises. The aim of this study was to compare a motor control protocol and a general exercise protocol with respect to average pain, before and after 8 and 60 weeks of treatment. Methods: The study was approved by the Research Ethics Committee (CAAE: 87372318.1.0000.5406) and prospectively registered in the Brazilian Registry of Clinical Trials (RBR-37gw2x). Sixty women were randomized into two groups, the motor control group (MCG) and the general exercise group (GEG). The primary outcome was mean pain intensity. Secondary outcomes were perceived global effect (GPE), muscle strength, pain catastrophizing, kinesiophobia, central sensitization, and quality of life. Results: No significant time x group interactions were observed regarding mean pain intensity at 8 weeks (MD: -0.06; 95% CI -1.41 to 1.29; p = 0.92, effect size = 0.02) or 60 weeks (MD: -0.75; 95% CI -2.35 to 0.83; p=0.34, effect size=0.24). Regarding the secondary outcomes, only the muscle strength outcome showed a statistically significant difference when comparing the groups, specifically in the reassessment of the hip extensor muscles on the side without pain (MD: 0.1; 95% CI 0.0004 to 0.2 ; p=0.04; effect size = 0.54). Conclusion: The motor control protocol was not superior to the general exercise protocol in improving mean pain intensity at 8 and 60 weeks of follow-up in women with GTPS.
Introduction: Greater trochanter pain syndrome (GTPS) refers to pain in the greater trochanter region of the femur. GTPS is associated with weakness and poor control of the pelvis. It is known that people with GTPS benefit from physical exercise, but there are no studies that have compared training focused on motor control and general exercises. The aim of this study was to compare a motor control protocol and a general exercise protocol with respect to average pain, before and after 8 and 60 weeks of treatment. Methods: The study was approved by the Research Ethics Committee (CAAE: 87372318.1.0000.5406) and prospectively registered in the Brazilian Registry of Clinical Trials (RBR-37gw2x). Sixty women were randomized into two groups, the motor control group (MCG) and the general exercise group (GEG). The primary outcome was mean pain intensity. Secondary outcomes were perceived global effect (GPE), muscle strength, pain catastrophizing, kinesiophobia, central sensitization, and quality of life. Results: No significant time x group interactions were observed regarding mean pain intensity at 8 weeks (MD: -0.06; 95% CI -1.41 to 1.29; p = 0.92, effect size = 0.02) or 60 weeks (MD: -0.75; 95% CI -2.35 to 0.83; p=0.34, effect size=0.24). Regarding the secondary outcomes, only the muscle strength outcome showed a statistically significant difference when comparing the groups, specifically in the reassessment of the hip extensor muscles on the side without pain (MD: 0.1; 95% CI 0.0004 to 0.2 ; p=0.04; effect size = 0.54). Conclusion: The motor control protocol was not superior to the general exercise protocol in improving mean pain intensity at 8 and 60 weeks of follow-up in women with GTPS.
Descrição
Palavras-chave
Síndrome dolorosa do trocanter maior, Exercício, Tendinopatia glútea, Dor, Reabilitação, Greater trochanteric pain syndrome, Exercise, Gluteal tendinopathy, Pain, Rehabilitation