Avaliação da efetividade do método pilates no tratamento de indivíduos com cervicalgia mecânico-postural crônica
Arquivos
Data
2014-04-12
Autores
Cazotti, Luciana de Araujo 
Orientadores
Natour, Jamil Natour
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A dor cervical é uma ocorrência comum e afeta cerca de 70% dos indivíduos em algum momento de suas vidas, sendo considerado um problema frequente de incapacidade e uma razão fundamental para a busca de atenção médica. O método Pilates é um programa de atividade física que propõe a consciência corporal em busca da harmonia entre o corpo e a mente tem sido amplamente utilizada para melhorar o condicionamento físico e reabilitação em geral. Embora os sintomas de dor cervical sejam frequentes na população, faltam evidências na literatura referentes à efetividade do método Pilates, no tratamento de pacientes com cervicalgia mecânico-postural. Objetivo: O objetivo deste estudo foi avaliar a efetividade do método Pilates na melhora da dor, função, qualidade de vida e do consumo de analgésicos em indivíduos com dor cervical mecânico-postural crônica. Material e métodos: Foram selecionados sessenta e quatro pacientes com diagnóstico de dor cervical mecânico-postural crônica. Os critérios de inclusão foram os seguintes: portadores de dor cervical por mais de três meses, ambos os gêneros, idade entre 18 e 65 anos. Foram excluídos pacientes com diagnóstico de fibromialgia, grávidas, lesões traumáticas da coluna vertebral, infecções e inflamações na coluna cervical, dor cervical irradiada para os membros superiores, aqueles que iniciaram ou alteraram a prática de atividade física nos últimos três meses, deficiência visual não corrigida por óculos e doenças do sistema nervoso central (SNC). Os pacientes foram randomizados em dois grupos: Pilates e controle. O primeiro (GP) realizou duas sessões de Pilates por semana, durante 12 semanas. O grupo-controle (GC) permaneceu em lista de espera para o Pilates. Ambos foram instruídos a utilizar paracetamol 750 mg a cada seis horas, em caso de dor, e o consumo do medicamento foi controlado. Os dois grupos foram avaliados para a dor (Escala numérica de dor - END), função (Neck Disability Index - NDI) e qualidade de vida (SF-36). As avaliações foram realizadas por um avaliador cego no baseline (T0), 45 dias (T45), 90 dias (T90) e 180 (T180) dias após o inicio do estudo. Resultados: Trinta e dois pacientes foram randomizados para cada grupo. Eles foram inicialmente homogêneos em relação às características clínicas e demográficas. Somente o índice de massa corpórea (IMC) não foi homogêneo entre eles, com o GP apresentando maior IMC que o GC. Em relação à avaliação entre os grupos ao longo do tempo (ANOVA), encontramos diferença estatística para dor (p<0,001), função (p<0,001) e para os domínios do SF-36 capacidade funcional (p=0,019), dor (p<0,001), estado geral de saúde (p=0,022), vitalidade (p<0,001), saúde mental (p=0,012), sempre com melhores resultados para o GP. Em relação à medicação, o GP consumiu menos analgésicos que o GC (p=0,037). Conclusão: Podemos concluir que o método Pilates é efetivo no tratamento da cervicalgia mecânico-postural crônica, apresentando melhora dos aspectos relacionados à dor, função, qualidade de vida (capacidade funcional, dor, estado geral de saúde, vitalidade e saúde mental) e redução do consumo de analgésicos.
Background: Neck pain is a common occurrence and affects about 70% of individuals at some point in their lives. It is a frequent source of disability and a key reason for seeking medical attention. The Pilates method, a physical activity program that aims for body awareness through the harmonization of body and mind, has been widely used to improve physical fitness and rehabilitation in general. Although the symptoms of neck pain are common in the population, there is very little literature on the effectiveness of the Pilates method as treatment for mechanical-postural neck pain. Objective: The goal of this study was to assess the efficacy of the Pilates method on lessening the pain and improving function and quality of life, as well as reducing the consumption of painkillers in patients with mechanical-postural neck pain. Material and methods: Sixty-four patients diagnosed with mechanical-postural neck pain were selected. The selection criteria were the following: Individuals complaining of neck pain for a period over three months, both genders, ages between 18 and 65. All individuals diagnosed with the following were excluded: fibromyalgia, pregnants, traumatic spinal injuries, infections and inflammation of the cervical spine, cervical pain radiating to the upper limbs, those who initiated or changed their physical activity regimen in the three months prior to the study, individuals with visual deficiency not corrected by the use of glasses and those who presented diseases of the central nervous system (CNS). Patients were randomized into two groups: Pilates and control. The first one (PG) attended two sessions of Pilates per week, for 12 weeks. The control group (CG) remained on the waiting list for Pilates. Both were instructed to use acetaminophen 750 mg every six hours for the pain, and the consumption of the drug was controlled. Both groups were assessed for pain (numerical pain scale - NPS, function (Neck Disability Index - NDI) and quality of life (SF-36). This was a single blind evaluation at baseline (T0), 45 days (T45), 90 days (T90) and 180 (T180) days after the start of the study. Results: Thirty-two patients were randomized in each group. Initially they were homogeneous in relation to demographics and clinical characteristics. The only exception being body mass index (BMI), with the PG showing higher BMI than the CG. Regarding the assessment between groups over time (ANOVA), statistical differences were identified for pain (p <0.001), function (p <0.001) and the SF-36 functional capacity (p = 0.019), pain (p <0.001), general health (p = 0.022), vitality (p <0.001), mental health (p = 0.012), with the PG constantly achieving the best results. The consumption of pain medication was lower among those in the PG than in the CG (p = 0.037). Conclusion: The Pilates method is effective in the treatment of chronic mechanical-postural neck pain, presenting improvement in the levels of pain, function, quality of life (functional capacity, pain, general health, vitality and mental health) and reducing the consumption of analgesics.
Background: Neck pain is a common occurrence and affects about 70% of individuals at some point in their lives. It is a frequent source of disability and a key reason for seeking medical attention. The Pilates method, a physical activity program that aims for body awareness through the harmonization of body and mind, has been widely used to improve physical fitness and rehabilitation in general. Although the symptoms of neck pain are common in the population, there is very little literature on the effectiveness of the Pilates method as treatment for mechanical-postural neck pain. Objective: The goal of this study was to assess the efficacy of the Pilates method on lessening the pain and improving function and quality of life, as well as reducing the consumption of painkillers in patients with mechanical-postural neck pain. Material and methods: Sixty-four patients diagnosed with mechanical-postural neck pain were selected. The selection criteria were the following: Individuals complaining of neck pain for a period over three months, both genders, ages between 18 and 65. All individuals diagnosed with the following were excluded: fibromyalgia, pregnants, traumatic spinal injuries, infections and inflammation of the cervical spine, cervical pain radiating to the upper limbs, those who initiated or changed their physical activity regimen in the three months prior to the study, individuals with visual deficiency not corrected by the use of glasses and those who presented diseases of the central nervous system (CNS). Patients were randomized into two groups: Pilates and control. The first one (PG) attended two sessions of Pilates per week, for 12 weeks. The control group (CG) remained on the waiting list for Pilates. Both were instructed to use acetaminophen 750 mg every six hours for the pain, and the consumption of the drug was controlled. Both groups were assessed for pain (numerical pain scale - NPS, function (Neck Disability Index - NDI) and quality of life (SF-36). This was a single blind evaluation at baseline (T0), 45 days (T45), 90 days (T90) and 180 (T180) days after the start of the study. Results: Thirty-two patients were randomized in each group. Initially they were homogeneous in relation to demographics and clinical characteristics. The only exception being body mass index (BMI), with the PG showing higher BMI than the CG. Regarding the assessment between groups over time (ANOVA), statistical differences were identified for pain (p <0.001), function (p <0.001) and the SF-36 functional capacity (p = 0.019), pain (p <0.001), general health (p = 0.022), vitality (p <0.001), mental health (p = 0.012), with the PG constantly achieving the best results. The consumption of pain medication was lower among those in the PG than in the CG (p = 0.037). Conclusion: The Pilates method is effective in the treatment of chronic mechanical-postural neck pain, presenting improvement in the levels of pain, function, quality of life (functional capacity, pain, general health, vitality and mental health) and reducing the consumption of analgesics.
Descrição
Citação
CAZOTTI, Luciana de Araujo. Avaliação da efetividade do método pilates no tratamento de indivíduos com cervicalgia mecânico-postural crônica. 2014. 83 f. Dissertação (Mestrado) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2014.