Efecto de un programa estructurado de fisioterapia sobre el dolor, la discapacidad y la movilidad en el dolor lumbar crónico inespecífico
Resumen
Este estudio tuvo como objetivo evaluar la efectividad de un programa estructurado de fisioterapia en la reducción de la intensidad del dolor (PI) y en la mejora de la discapacidad funcional (FD) y la movilidad funcional (FM) en individuos con dolor lumbar crónico inespecífico (CNSLBP). Se llevó a cabo un estudio de cohorte prospectivo con diseño intervencional, que incluyó a 47 pacientes ambulatorios con CNSLBP, con edades comprendidas entre 18 y 64 años (media±DE: 48,0±12,6), de los cuales 15 eran hombres y 32 mujeres. El programa estructurado de fisioterapia tuvo una duración de seis semanas e incluyó un régimen supervisado de fisioterapia de dos semanas (5 sesiones/semana), seguido de un programa de ejercicios en casa (HBE) de cuatro semanas que comprendía ejercicios de estiramiento, resistencia, fortalecimiento y aeróbicos. La PI, la FD y la FM se evaluaron mediante una escala numérica de valoración (NRS), el Índice de Discapacidad de Oswestry (ODI) y la prueba de levantarse de la silla en 30 segundos (30STS), respectivamente. Los puntajes de NRS mostraron una disminución significativa desde la línea base (5,93±2,95) hasta las seis semanas (2,68±1,68) tras la intervención de fisioterapia (p<0,05). Los puntajes de ODI disminuyeron significativamente de 16,36±5,70 a 7,39±5,02 (p<0,05), lo que indica una mejora en la FD. La prueba 30STS reveló una mejora significativa tras la intervención supervisada de dos semanas (t=3,225, p=0,002). Nuestro estudio mostró una reducción significativa de la PI y una mejora en la FD y la FM después de la intervención de fisioterapia de dos semanas. Además, el programa de HBE de cuatro semanas contribuyó a una mejora continua en la PI y la FD, destacando su efectividad en apoyar y potenciar los beneficios de la fase supervisada.
Descargas
-
Resumen183
-
PDF 104
Citas
Fairbank, J. C., & Pynsent, P. B. (2000). Oswestry Disability Index. Spine, 25(22), 2940–2953. https://doi.org/10.1097/00007632-200011150-00017
Fairbank, J. C., Couper, J., Davies, J. B., & O'Brien, J. P. (1980). Oswestry low back pain disability questionnaire. Physiotherapy, 66(8), 271–273.
Fernández-Rodríguez, R., Álvarez-Bueno, C., Cavero-Redondo, I., Torres-Costoso, A., Pozuelo-Carrascosa, D. P., Reina-Gutiérrez, S., Pascual-Morena, C., & Martínez-Vizcaíno, V. (2022). The best exercise options to reduce pain and disability in adults with chronic low back pain: pilates, strength, core-based, and mind-body. Network meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 52(8), 505–521. https://doi.org/10.2519/jospt.2022.10671
Ferreira, M. L., De Luca, K., Haile, L. M., Steinmetz, J. D., Culbreth, G. T., Cross, M., Kopec, J. A., Ferreira, P. H., Blyth, F. M., Buchbinder, R., Hartvigsen, J., Wu, A. M., Safiri, S., Woolf, A. D., Collins, G. S., Ong, K. L., Vollset, S. E., Smith, A. E., Cruz, J. A., ... March, L. M (2023). Global, regional, and national low back pain burden, 1990–2020, attributable risk factors, and projections to 2050: A systematic analysis of the 2021 Global Disease Burden Study. Lancet Rheumatology, 5(6), 316–329. https://doi.org/10.1016/S2665-9913(23)00098-X
Fisher, L. R., Alvar, B. A., Maher, S. F., & Cleland, J. A. (2020). Short-term effects of thoracic spinal impulse manipulation, exercise, and education in individuals with low back pain: a randomized controlled trial. Journal of Orthopaedic & Sports Physical Therapy, 50(1), 24–32. https://doi.org/10.2519/jospt.2020.8928
Hayden, J. A., Cartwright, J., Van Tulder, M. W., & Malmivaara, A. (2012). Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews, 1(1), 1-10. https://doi.org/10.1002/14651858.CD009790
Hayden, J. A., Ellis, J., Ogilvie, R., Stewart, S. A., Bagg, M. K., Stanojevic, S., Yamato, T. P., & Saragiotto, B. T. (2021). Some types of exercise are more effective than others in people with chronic low back pain: A meta-analysis of the tissues. Journal of Physiotherapy, 67(4), 252–262. https://doi.org/10.1016/j.jphys.2021.09.004
Kang, H. (2021). Sample size determination and power analysis using G*Power software. Journal of Educational Evaluation for the Health Profession, 18, 1-12. https://doi.org/10.3352/jeehp.2021.18.17
Koppenaal, T., Arensman, R. M., Van Dongen, J. M., Ostelo, R. W., J. G., Veenhof, C., Kloek, CJJ, & Pisters, M. F. (2020). Effectiveness and cost-effectiveness of stratified mixed physiotherapy in patients with non-specific low back pain: Cluster randomized controlled trial study protocol. BMC Musculoskeletal Disorders, 21(1), 1-24. https://doi.org/10.1186/s12891-020-3174-z
Koppenaal, T., Pisters, M. F., Kloek, C. J., Arensman, R. M., Ostelo, R. W., & Veenhof, C. (2022). Effectiveness of 3-month multi-stratified mixed physiotherapy intervention in patients with nonspecific low back pain: a cluster randomized controlled trial. Journal of Medical Internet Research, 24(2), 1-18. https://doi.org/10.2196/31675
Matarán-Peñarrocha, G. A., Lara Palomo, I. C., Antequera Soler, E., Gil-Martínez, E., Fernández-Sánchez, M., Aguilar-Ferrándiz, M. A., & Castro-Sánchez, A. M. (2020). Comparison of the efficacy of supervised versus unsupervised physical therapy exercise programs on pain, functionality and quality of life of patients with non-specific chronic low back pain: A randomized controlled trial. Clinical Rehabilitation, 34(7), 948–959. https://doi.org/10.1177/0269215520927076
Miftari, S., Rrecaj-Malaj, S., Murtezani, A., Aliu, M. (2024). Comparative analysis of two different physiotherapy intervention programs in individuals with chronic low back pain. Romanian Journal of Medical Practice, 19(2), 112–117. https://doi.org/10.37897/RJMP.2024.2.8
Mutubuki, E. N., Beljon, Y., Maas, E. T., Huygen, F. J. P. M., Ostelo, R. W. J. G., Van Tulder, M. W., & Van Dongen, J. M. (2020). Longitudinal relationship between pain severity and disability versus quality of life and health-related costs among patients with chronic low back pain. Quality of Life Research, 29(1), 275–287. https://doi.org/10.1007/s11136-019-02302-w
Nayyab, I., Ghous, M., Shakil Ur Rehman, S., & Yaqoob, I. (2021). The effects of an exercise programme for core muscle strengthening in patients with low back pain after Caesarian-section: A single blind randomized controlled trial. JPMA. The Journal of the Pakistan Medical Association, 71(5), 1319–1325. https://doi.org/10.47391/JPMA.596
Nieminen, L K, Pyysalo, L M, & Kankaanpää, M. J. (2021). Prognostic factors for pain chronicity in low back pain: A systematic review. PAIN Report, 6(1), 1-17. https://doi.org/10.1097/PR9.0000000000000919
O'Keeffe, M., O'Sullivan, P., Purtill, H., Bargary, N., & O'Sullivan, K. (2020). Cognitive functional therapy compared with group-based exercise and education interventions for chronic low back pain: Multicenter randomised controlled trials (RCTs). British Journal of Sports Medicine, 54(13), 782–789. https://doi.org/10.1136/bjsports-2019-100780
Owen, P. J., Miller, C. T., Mundell, N. L., Verswijveren, S. J., Tagliaferri, S. D., Brisby, H., Bowe, S. J., & Belavy, D. L. (2020). Which specific sports training mode is most effective for treating low back pain? Meta-analysis of the network. British Journal of Sports Medicine, 54(21), 1279–1287. https://doi.org/10.1136/bjsports-2019-100886
Özden, F., Sarı, Z., Karaman, Ö. N., & Aydoğmuş, H. (2022). The effect of video-based telerehabilitation on clinical outcomes, expectations, satisfaction, and motivation in patients with chronic low back pain. Irish Journal of Medical Sciences, 191(3), 1229–1239. https://doi.org/10.1007/s11845-021-02727-8
Ozen, S., Guzel, S., Senlikci, H. B., Cosar, S. N. S., & Selcuk, E. (2023). Efficacy of ultrasound versus shortwave diathermy in the treatment of chronic low back pain in patients with lumbar disc herniation: A prospective randomized controlled study. Sports Science, Medicine and BMC Rehabilitation, 15(1), 1-8. https://doi.org/10.1186/s13102-023-00769-2
Park, S. C., Kang, M. S., Yang, J. H., & Kim, T. H. (2023). Nonsurgical assessment and management of low back pain: A narrative review. Korean Journal of Internal Medicine, 38(1), 16–26. https://doi.org/10.3904/kjim.2022.250
Parks, K. H., & Song, M. R. (2022). Comparative Analysis of Pain, Muscle Strength, Disability, and Quality of Life in Middle-Aged and Older Adults After Lower Back Exercises Web Video. Computers, Informatics, Nursing, 40(3), 170–177. https://doi.org/10.1097/CIN.0000000000000801
Poredos, P., Zlajpah, U., Poredos, P., Mangaroska, A. S., & Jezovnik, M. K. (2021). The use of a walking disorder questionnaire as a measure of functional assessment. Vasa, 50(4), 286–293. https://doi.org/10.1024/0301-1526/a000941
Quentin, C., Bagheri, R., Ugbolue, C. C., Coudeyre, E., Pélissier, C., Descatha, A., Menini, T., Bouillon-Minois, J. B., & Dutheil, F. (2021). Effects of Home Exercise Training on Patients with Nonspecific Low Back Pain: A Systematic Review and Meta-Analysis. International Journal of Environmental and Public Health Research, 18(16), 1-24. https://doi.org/10.3390/ijerph18168430
Rampazo, E. P., Júnior, M. A. L., Corrêa, J. B., De Oliveira, N. T. B., Santos, I. D., Liebano, R. E., & Costa, L. O. P. (2023). Effectiveness of interferential currents in patients with nonspecific chronic low back pain: A systematic review with a meta-analysis. Brazilian Journal of Physical Therapy, 27(5), 1-17. https://doi.org/10.1016/j.bjpt.2023.100549
Salehi, S., Sobhani, V., Mir, S. M., Keivanfar, N., Shamsoddini, A., & Hashemi, S. E. (2024). Exercise-specific efficacy in the general population with non-specific low back pain: A systematic review and meta-analysis of randomized controlled trials. Journal of Body and Movement Therapy, 39, 673–705. https://doi.org/10.1016/j.jbmt.2024.03.049
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). Effects of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), 1-9. https://doi.org/10.1097/MD.0000000000016173
Tella, B. A., Oghumu, S. N., & Gbiri, CAO (2022). Efficacy of transcutaneous electrical nerve stimulation and interferential currents on tactile acuity of individuals with non-specific chronic low back pain. Neuromodulation: Technologies at Neural Interfaces, 25(8), 1403–1409. https://doi.org/10.1111/ner.13522
Tikhile, P., & Patil, D. S. (2024). Unveiling the Efficacy of Physiotherapy Strategies in Alleviating Low Back Pain: A Comprehensive Review of Interventions and Outcomes. Cureus, 16(3), 1-11. https://doi.org/10.7759/cureus.56013
Travers, M. J., O'Connell, N. E., Tugwell, P., Eccleston, C., & Gibson, W. (2020). Transcutaneous electrical nerve stimulation (TENS) for chronic pain: An opportunity to start over. Cochrane Database of Systematic Reviews, 2020, 1-3. https://doi.org/10.1002/14651858.ED000139
Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2008). Statement on Strengthening Observational Study Reporting in Epidemiology (STROBE): Guidelines for reporting observational studies. Journal of Clinical Epidemiology, 61(4), 344–349. https://doi.org/10.1016/j.jclinepi.2007.11.008
Wirth, B., & Schweinhardt, P. (2024). Personalized assessment and management for non-specific low back pain. European Journal of Pain, 28(2), 181–198. https://doi.org/10.1002/ejp.2190
World Health Organization. (2023). WHO guidelines for non-surgical management of chronic primary low back pain in adults in primary care and community settings. https://www.ncbi.nlm.nih.gov/books/NBK599212
Zhu, F., Zhang, M., Wang, D., Hong, Q., Zeng, C., & Chen, W. (2020). Yoga compared with non-exercise exercise or physical therapy on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PLOS SATU, 15(9), 1-21. https://doi.org/10.1371/journal.pone.0238544
Zuo, C., Zheng, Z., Ma, X., Wei, F., Wang, Y., Yin, Y., Liu, S., Cui, X., & Ye, C. (2024). Efficacy of Core Muscle Training Combined with Interferential Therapy in Relieving Chronic Low Back Pain in High-Performance Fighter Pilots: A Randomized Controlled Trial. BMC Public Health, 24(1), 1-12. https://doi.org/10.1186/s12889-024-18177-7
Las obras que se publican en esta revista están sujetas a los siguientes términos:
1. El Servicio de Publicaciones de la Universidad de Murcia (la editorial) conserva los derechos patrimoniales (copyright) de las obras publicadas, y favorece y permite la reutilización de las mismas bajo la licencia de uso indicada en el punto 2.
© Servicio de Publicaciones, Universidad de Murcia, 2013
2. Las obras se publican en la edición electrónica de la revista bajo una licencia Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España (texto legal). Se pueden copiar, usar, difundir, transmitir y exponer públicamente, siempre que: i) se cite la autoría y la fuente original de su publicación (revista, editorial y URL de la obra); ii) no se usen para fines comerciales; iii) se mencione la existencia y especificaciones de esta licencia de uso.
3. Condiciones de auto-archivo. Se permite y se anima a los autores a difundir electrónicamente las versiones pre-print (versión antes de ser evaluada) y/o post-print (versión evaluada y aceptada para su publicación) de sus obras antes de su publicación, ya que favorece su circulación y difusión más temprana y con ello un posible aumento en su citación y alcance entre la comunidad académica.
