RESUMO

INTRODUCTION: Pain is the second most frequent symptom reported in patients with cancer among the main reasons for consultation. The incorporation of educational modalities in pain intervention processes has been suggested. This study aims to examine the efficacy of neuroscience pain education (PNE) in relation to pain, biopsychosocial variables and functional capacity in comparison with conventional treatment. It is hypothesised that an intervention based on PNE achieves better outcomes than conventional management, in terms of pain, biopsychosocial variables and functional capacity in adults with oncological pain. METHODS AND ANALYSIS: This will be a single-blind, controlled clinical trial in which two groups will be compared using changes in pain as the primary measure. The first group will receive conventional treatment in addition to PNE, and participants will undergo an intervention of nine sessions (one session per week, for a total of 9 weeks), each lasting 30-40 min. Specifically, these sessions will teach biophysiological elements using metaphors that allow the adoption of these concepts related to pain. The second group will receive conventional treatment (pharmacological treatment). For this study, a sample size calculation was made based on the background, where 80 adults with oncological pain were required. An initial evaluation will be made to establish the baseline characteristics, and then, according to the randomisation, the assignment to the PNE group or the control group will be made and the two groups will be summoned again. Ten weeks later, for the intervention evaluation, the statistical analysis plan will be established by protocol and by intention-to-treat. ETHICS AND DISSEMINATION: This protocol complies with all ethical considerations. The authors commit to presenting the study's results. This study was approved by the ethics committees of the Universidad Santiago de Cali, Clínica de Occidente/Angiografía de Occidente. The authors commit to presenting the study's results. TRIAL REGISTRATION NUMBER: NCT05581784.

Assuntos

RESUMO

In the absence of medical contraindications, physical activity (PA) can offer health maternal and fetal health outcomes during pregnancy. However, most pregnant women may not consider PA to be feasible, suitable and safe. Hence, it is essential to determine the prevalence of pregnant women who meet the PA recommendations and the possible factors associated with that meeting, since it might be important from the perspective of pregnant women's health. The aim of the present study was to establish the prevalence of meeting the World Health Organization PA recommendations for Colombian pregnant women, as well as possible factors that may be associated with meeting that recommendations. A cross-sectional study including representative data from the National Nutritional Situation Survey (2015) in Colombia was performed. Data were collected in 2015-2016. From an initial sample of 1140 Colombian pregnant women, 702 participants with complete data were included in the final analysis. PA was assessed by self-reported information through the long version of the International Physical Activity Questionnaire. Several potential factors were analysed according to four levels of the socioecological model: the individual, interpersonal, organizational and community levels. The prevalence of Colombian pregnant women who met with the PA recommendations was 7.5%. Indigenous and Mestizo pregnant women showed lower probabilities of meeting the PA recommendations [Indigenous: OR 0.05, 95% CI (0.01-0.18); Mestizo: OR 0.12, 95% CI (0.06-0.22)] than Afro-Colombian participants. Additionally, participants who lived near green and safe spaces for PA were more likely to meet the PA recommendations [OR 2.30, 95% CI (1.06-4.79)] than those who did not live near green areas. In conclusion, a low percentage of Colombian pregnant women met the new PA recommendations. The associations found according to race/ethnicity and living near green and safe areas underline the presence of fundamental disparities associated with meeting PA recommendations.

Assuntos

RESUMO

Osteoarthritis (OA) is the most common joint condition. It affects more than 300 million people worldwide, who suffer from pain and physical disability. OBJECTIVE: To determine the results of cognitive educational interventions for pain management and psychosocial variables in adults with OA. METHOD: A systematic review was conducted based on searches in MEDLINE, OVID, LILACS, Scopus, PEDro, OTseeker, The Cochrane Library, EBSCO, and Google Scholar. The search strategy included the main terms neuroscience education and osteoarthritis, without any re-strictions with regard to dates or study type (PROSPERO register CRD42021222763). RESULTS: We included four articles that implemented the intervention in 1-6 sessions, addressing concepts related to goal orientation and providing strategies for understanding pain. The results suggest that there is an improvement between the groups (PNE) when compared, but this cannot necessarily be attributed to pain neuroscience education (PNE), as small effect sizes for variables such as pain catastrophizing and kinesiophobia were observed. The response in the modulation of acute pain following the surgical procedure may produce a variation in the responses and this may be mediated by medications. CONCLUSION: The study revealed an improvement in favor of the groups managed with PNE, although more studies documenting the topic are warranted.

Assuntos

RESUMO

ABSTRACT Objective: To identify the relationship between hemineglect and pain. Methods: We conducted a systematic review with meta-analysis, examining the relationship between hemineglect and pain. The PRISMA criteria and the Covidence platform were used to select articles and extract data. Methodological quality was evaluated, a comparison was made using pain as an outcome measure, assessed with the visual analog scale (VAS). Results: Out of a total of 340 studies, 4 were selected, 2 of which made it possible to unify pain measured through VAS; the effects were summarized using standardized mean differences (SMD), yielding -0.65, with values of [-1.02, -0.29], with statistical significance. Conclusions: There is moderate evidence of the relationship between negligence and pain. Despite the fact that from the clinical care processes it is presented regularly, and even the little scientific information available, it was established that there are specific pathologies that carry negligence and pain.

RESUMEN Objetivo: Identificar la relación entre heminegligencia y dolor. Métodos: Realizamos una revisión sistemática con metanálisis que examina la relación entre heminegligencia y dolor. Se utilizaron los criterios PRISMA y la plataforma Covidence para seleccionar artículos y extraer datos. Se evaluó la calidad metodológica, se realizó una comparación utilizando el dolor como medida de resultado, evaluado con la escala visual analógica (EVA). Resultados: De un total de 340 estudios, se seleccionaron 4, de los cuales 2 permitieron unificar el dolor medido mediante EVA; los efectos se resumieron utilizando diferencias de medias estandarizadas (DME), obteniendo -0,65 con valores de [-1,02, -0,29] con significancia estadística. Conclusiones: Existe evidencia moderada de la relación entre negligencia y dolor. A pesar de que a partir de los procesos de atención clínica se presenta con regularidad y aún con la poca información científica disponible, se estableció que existen patologías específicas que conllevan negligencia y dolor.

RESUMO

Abstract Objective: To evaluate the impact of two therapeutic interventions in patients with non-specific low back pain. Materials and methods: Prospective study, in which in 20 subjects from both genders assigned through consecutive sampling of the two interventions: Group 1:10 sessions of conventional physiotherapy treatment (CPT) (Ultrasound, TENS: Transcutaneous Electrical Nervous Stimulation y HWC: Hot Wet Compresses) and Group 2:10 sessions of Motor Control Exercises (MCE). A numerical Pain Scale (NPS) was applied before and after each intervention. Results: In the first group, it was found a 20% decrease the pain scores after 10 sessions compared with the baseline measurements (before the intervention) (p=0.03). Similarly, in the second group, pain score dimished 42% respect to baseline values at the end of the 10 therapeutic sessions (p = 0.03). When comparing the two interventions, the MCE were more effective than the CPT, even from the first treatment session (p <0.05). Discussion: a significant reduction of pain was found in both groups, although this reduction was significantly in the group treated with MCE.

Resumen Objetivo: Evaluar el impacto de dos intervenciones terapéuticas en pacientes con dolor lumbar inespecífico. Materiales y métodos: Estudio prospectivo, en 20 sujetos de ambos sexos asignados a través de muestreo consecutivo a una de las dos intervenciones: Grupo 1:10 sesiones de tratamiento de fisioterapia convencional (TFC) (Ultrasonido TENS: eléctrica transcutánea nerviosa Estimulación y CHC: Compresa húmedo-calientes) y Grupo 2: 10 sesiones de ejercicios de control motor (ECM). Se aplicó la Escala numérica del dolor (NPS) antes y después de cada intervención. Resultados: En el primer grupo, se encontró una disminución del 20% de las puntuaciones de dolor después de 10 sesiones en comparación con las mediciones de referencia (antes de la intervención) (p = 0,03). De forma similar, en el segundo grupo, la puntuación del dolor disminuyó un 42% con respecto a los valores basales al final de las 10 sesiones terapéuticas (p = 0,03). Al comparar las dos intervenciones, los ECM fueron más efectivos que el TFC, incluso desde la primera sesión de tratamiento (p <0.05). Discusión: Se encontró una reducción significativa del dolor en ambos grupos, aunque esta reducción fue significativamente en el grupo tratado con ECM.

RESUMO

Las modalidades físicas son todas aquellas herramientas que posee el fisioterapeuta para intervenir con fines curativos) sin embargo, el aumento de las publicaciones científicas ha llevado a la necesidad de conocer la efectividad de estas modalidades en relación con el tratamiento del dolor. El objetivo de esta revisión fue entregar al lector conocimientos actualizados, referencia-dos y evidenciados sobre el dolor y la aplicación clínica de las modalidades físicas para su tratamiento. Se realizó una búsqueda de la mejor evidencia disponible para intentar responder la pregunta de investigación, la cual se sustenta en el paradigma que trae consigo la aplicación de las modalidades físicas más utilizadas (Crioterapia y Termoterapia, Ultrasonido Terapéutico, Laserterapia y Electroterapia). Hasta ahora el número de ensayos clínicos y revisiones sistemáticas que avalan el uso de las modalidades físicas para el manejo del dolor es muy limitado, sumado a la baja calidad metodológica de los ensayos clínicos disponibles. Muchos de los sustentos del uso de las modalidades físicas vienen acompañados de difusos fundamentos fisiológicos y sustento científico con demostraciones in vitro, mas no in vivo. A esto se le suma una limitada cantidad de información sobre los parámetros que se aplican para el manejo del dolor, por lo cual no es posible establecer conclusiones sobre la recomendación de la aplicación clínica de todas las modalidades físicas analizadas para el manejo del dolor.

Physical modalities are all the tools that the therapist has to intervene with curative intent; however, the increase of scientific publications has led to a need to know the effectiveness of these modalities for the treatment of pain. The purpose of this review was to provide the reader updated, referenced and evidenced on pain knowledge and clinical application of physical modalities for treatment. A search for the best available evidence was conducted to try to answer the research question, which is based on the paradigm that entails the application of physical modalities most used (Cryotherapy and Thermotherapy, Therapeutic Ultrasound, Laser therapy and electrotherapy). So far the number of clinical trials and systematic reviews to support the use of physical modalities for pain management is very limited, plus the low methodological quality of the available trials. Many of the underpinnings of the use of physical modalities are accompanied by diffuse physiological basis and scientific support demonstrations in vitro but not in vivo. To this is added a limited amount of information about the parameters that apply to pain management so it is not possible to draw conclusions on the recommendation of the clinical application of all physical modalities tested for pain management.

RESUMO

El objetivo del presente trabajo es hacer una revisión bibliográfica sobre los estudios y publicaciones más relevantes sobre la Osteoartritis (OA) de Cadera, su implicancia a nivel nacional, sus tratamientos Kinésicos convencionales, la Terapia Manual Ortopédica (TMO), y proponer esta última como complemento terapéutico para el tratamiento de todos nuestros pacientes con OA de cadera. La incidencia de esta patología es generalmente mayor en las mujeres, siendo la máxima incidencia entre los 65 y 74 años con una prevalencia aproximada de 13,5 casos por cada 1.000 personas por año, que va en aumento constante con la edad. A nivel nacional, un 3.8 por ciento de la población adulta refiere padecer de OA, observándose una frecuencia más alta en mujeres, tendencia que aumenta con la edad. Cabe destacar que la OA de cadera es la segunda enfermedad reumática más frecuente e invalidante después de la OA de rodilla, por lo tanto, el tratamiento precoz es la estrategia más importante para mejorar la calidad de vida del afectado y evitar su rápido deterioro que inminentemente conlleva a la discapacidad y finalmente a la cirugía artroplástica. La TMO, es una herramienta terapéutica no invasiva que incluye un conjunto de técnicas que se basan en la evaluación y tratamiento de las disfunciones articulares y de tejidos blandos, teniendo como principal método de ejecución la movilización articular.

The objetive of this study is to make a bibliographic review on the most relevant studies and publications about Osteoarthritis of the hip (OA), its relevance on national level, its conventional Physical Therapy treatments and Orthopaedic Manual Therapy (OMT), and to suggest this last one as therapeutic complement to the treatment of all our patients with Osteoarthrtis of the hip. The impact in this pathology was generalyy bigger on women, the higher impac was between 65 and 74 years with an estimated frequency of 13,5 cases each 1.000 people by year, with a constant increase related to age. On national level, a 3,8 percent of the adult population suffer from OA, with a higher frequency on women, that increases with age. It is important to emphasize that OA of the hip is the second rheumatic illness after OA of the knee. Therefore, an early treatment is the most important strategy to improve people's life quality andt to avoid its quick damage that leads to disability and finally to an arthroplastic surgery. OMT, it is a therapeutic non invasive tool that includes a group of techniques that are based on evaluation and treatment of joint dysfunction and soft tissues, having as a main purpose method the joint movement.

Assuntos