Comparação dos efeitos da estimulação elétrica nervosa transcutânea em pacientes com lombalgia crônica não específica: ensaio clínico randomizado
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Data
2007
Autores
Facci, Ligia Maria [UNIFESP]
Orientadores
Trevisani, Virgínia Fernandes Moça [UNIFESP]
Tipo
Tese de doutorado
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Introdução: Os equipamentos de eletroterapia mais utilizados no tratamento da lombalgia crônica não-específica são a Estimulação Elétrica Nervosa Transcutânea (TENS) e a Corrente Interferencial (CI). Ainda são escassas, porém, as evidências que justifiquem a sua utilização na prática clínica. Objetivos: O objetivo deste estudo foi comparar os efeitos da Estimulação Elétrica Transcutânea (TENS) com os da Corrente Interferencial (CI) em pacientes com lombalgia crônica não-específica. Métodos: Cento e cinqüenta pacientes com lombalgia crônica não-específica foram randomicamente divididos em três grupos: 1)TENS; 2) Corrente Interferencial e 3) Controle. Os pacientes designados à eletroterapia receberam 10 sessões de 30 minutos, em dias consecutivos, enquanto os pacientes do grupo controle permaneceram sem tratamento pelo mesmo período.Todos os pacientes foram avaliados, antes e depois do protocolo de tratamento, quanto à intensidade de dor através da EVA e do Questionário McGill; capacidade funcional, pelo questionário Roland-Morris; e utilização de medicamentos adicionais ao tratamento. Resultados: Cento e trinta e sete pacientes completaram o protocolo de tratamento, sendo 72,7 por cento do sexo feminino e 27,3 por cento do masculino, com média de idade de 47,16 ± 15,93 anos. Com relação à intensidade de dor, houve redução média na EVA de 44,86 mm (IC:- 52,4; -35,6) no grupo 2, de 39,18 mm (IC: -48,7; -29,7) no grupo 1, e de 8,53 mm (IC:-15,7; -01,3) no grupo 3, e no questionário McGill a redução do PPI no grupo 1 foi mais evidente, e do PRI e do NWC no grupo 2. No questionário Roland Morris, o grupo 2 teve redução média de 7,20, o grupo 1 de 6,59 e o grupo 3 de 0,70 pontos. É importante destacar que 84 por cento dos pacientes do grupo 1, 75 por cento do grupo 2 e 34 por cento do grupo 3 deixaram de tomar o medicamento após tratamento. Em todos os desfechos investigados, o grupo Controle apresentou diferença estatisticamente significante com relação aos demais grupos (p<0,0001), mas, apesar dos pacientes que receberam CI terem obtido melhores resultados na redução da dor e na melhora da capacidade funcional, estes não foram estatisticamente significantes quando comparados ao grupo de TENS (p>0,05). Conclusão: No tratamento da lombalgia crônica não-específica, tanto a TENS como Corrente Interferencial melhoram a capacidade funcional, reduzem a dor e diminuem a utilização de medicamentos quando comparados ao controle. Não há diferença, entretanto, entre os efeitos dos dois equipamentos de eletroterapia..
Background: The electrotherapy equipments more used in non specific chronic low back pain are Transcutaneous Electrical Nerve Stimulation (TENS) and Interferential Current (IFC). However, the evidences that support their use in clinical background are still scarce. Objectives: The purpose of this study was to compare the effects of the TENS and IFC in patients with non specific chronic low back pain. Methods: A hundred and fifty patients with non specific chronic low back pain were randomly divided into three groups: 1) TENS; 2) IFC; e 3) Control. The patients designed to electrotherapy received 10 sessions lasting 30 minutes each one in consecutive days, while the patients of the Control group stayed without any treatment in the same period. All the patients were evaluated before and after the protocol of the treatment, according to the intensity of the pain through the Visual Analogue Scale (VAS) and McGill Pain Questionnaire; specific functional disability by Roland Morris Disability Questionnaire (RMDQ); and the use of adding medicines to the treatment. Results: A hundred and thirty seven patients finished the protocol of the treatment being 72,7% females and 27,3% males, with an age average from 47,167 ± 15,939 years old. Related to pain intensity, there was an average reduction on the VAS of the second group of 44,86 mm (CI:-52,4; -35,6), of 39,18 mm (CI:-48,7; -29,7) on the first group and 08,53 mm (CI:-15,7; -01,3) on the third one, as on the McGill Pain Questionnaire the PPI decreasing was clearer on the first group and of PRI and NWC of group 2. On RMDQ, group 2 had an average reduction of 7,20, group 1 of 6,59 and group 3 of 0,70 points. It is important to testify that 84% of the patients from the first group, 75% of the second group and 34% of the third group left the medicines after the treatment. In all the accomplishments examined, the Control group presented a statistically significant difference related to the other groups (p<0,0001), but, despite the patients that received IFC had better results when related to the reduction of the pain and a functional improvement capability, these were not statistically significant differences when compared to group of TENS (p>0,05). Conclusion: In non specific chronic low back pain treatment as TENS as IFC improve the functional capability, reduce the pain and the use of medicines when compared to Control. There is no difference, however, between the effects of the two other equipments.
Background: The electrotherapy equipments more used in non specific chronic low back pain are Transcutaneous Electrical Nerve Stimulation (TENS) and Interferential Current (IFC). However, the evidences that support their use in clinical background are still scarce. Objectives: The purpose of this study was to compare the effects of the TENS and IFC in patients with non specific chronic low back pain. Methods: A hundred and fifty patients with non specific chronic low back pain were randomly divided into three groups: 1) TENS; 2) IFC; e 3) Control. The patients designed to electrotherapy received 10 sessions lasting 30 minutes each one in consecutive days, while the patients of the Control group stayed without any treatment in the same period. All the patients were evaluated before and after the protocol of the treatment, according to the intensity of the pain through the Visual Analogue Scale (VAS) and McGill Pain Questionnaire; specific functional disability by Roland Morris Disability Questionnaire (RMDQ); and the use of adding medicines to the treatment. Results: A hundred and thirty seven patients finished the protocol of the treatment being 72,7% females and 27,3% males, with an age average from 47,167 ± 15,939 years old. Related to pain intensity, there was an average reduction on the VAS of the second group of 44,86 mm (CI:-52,4; -35,6), of 39,18 mm (CI:-48,7; -29,7) on the first group and 08,53 mm (CI:-15,7; -01,3) on the third one, as on the McGill Pain Questionnaire the PPI decreasing was clearer on the first group and of PRI and NWC of group 2. On RMDQ, group 2 had an average reduction of 7,20, group 1 of 6,59 and group 3 of 0,70 points. It is important to testify that 84% of the patients from the first group, 75% of the second group and 34% of the third group left the medicines after the treatment. In all the accomplishments examined, the Control group presented a statistically significant difference related to the other groups (p<0,0001), but, despite the patients that received IFC had better results when related to the reduction of the pain and a functional improvement capability, these were not statistically significant differences when compared to group of TENS (p>0,05). Conclusion: In non specific chronic low back pain treatment as TENS as IFC improve the functional capability, reduce the pain and the use of medicines when compared to Control. There is no difference, however, between the effects of the two other equipments.
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Citação
FACCI, Ligia Maria. Comparação dos efeitos da estimulação Elétrica Nervosa Transcutânea com os da Corrente Interferencial em pacientes com lombalgia crônica não específica: ensaio clínico randomizado. 2007. 139 f. Tese (Doutorado em Ciências) – Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2007