Efeitos imediatos da terapia manipulativa vertebral específica ou inespecífica em pacientes com dor lombar crônica: um estudo controlado aleatorizado

• Autor(a) principal: Oliveira, Ronaldo Fernando de
• Data de Publicação: 2012
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/1138
• topic: Manipulação osteopática; Manipulação da coluna; Limiar de dor pressórico.; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL

Background: Little is known about the immediate effects of spinal manipulative therapy in the treatment of chronic low back pain and whether these manipulations need to be specifically performed or not (i.e. applied to painful vertebral levels). Objectives: To analyze the immediate effects of a single, specific spinal manipulation defined during the clinical examination versus a single non-specific spinal manipulation (applied on a upper thoracic vertebrae) in patients with chronic non-specific low back pain for the outcomes pain intensity (measured by the Pain Numerical Rating Scale) and pressure pain threshold (measured with a pressure algometer). Participants: This study included patients with chronic non-specific low back pain (with pain duration of at least 12 weeks), without contraindications to spinal manipulative therapy and with a pain intensity of at least three points on the 11-point Pain Numerical Rating Scale. Interventions: A single high-velocity manipulation was administered to the upper thoracic region of the patients allocated to the “non-specific manipulation” group and to the painful lumbar levels of the patients allocated to the “specific manipulation” group. Randomization: The randomization schedule was generated by an independent statistician and was concealed by using consecutive numbered sealed opaque envelopes. Blinding: The assessor who collected all the data was blind to the group allocation. It was not possible to blind the therapist and patients. Results: A total of 148 patients participated in the study (74 in each group). There was no loss of follow up. No between-group differences were observed for all outcomes. The between-group difference for the primary outcome (pain intensity) was 0.50 points (95% CI -0.10 to 1.10; p=0.10). Adverse Reactions: No adverse reactions were observed. Conclusion: We have not detected between-group differences in both pain intensity and pressure pain threshold. This means that patients with chronic low back pain could benefit from single manipulations to the painful spinal regions as well as manipulations to the spinal points distal to the painful regions. These results can only be generalized if taking into account the immediate effects of these techniques.