ABSTRACT
Abstract Introduction: Despite recent advances in the treatment of osteoarthritis (OA), few studies have evaluated the longitudinal effect of physical modalities in functional capacity in patients with knee OA. Thereby, since the physical components and pain can affect the functional performance of daily activities, the effect of these treatment's form is still to be established. Objective: Evaluate the effectiveness of therapeutic ultrasound, electrical stimulation and phototherapy in the functional performance, in patients with knee osteoarthritis. Methods: Articles present in the PubMed, Lilacs, SciELO and PEDro's databases were evaluated. The used keywords were "pulsed ultrasound therapy", "ultrasound therapy", "electric stimulation" and "low level laser therapy" in combination with "knee osteoarthritis". Were included in this presented review, randomized clinical studies using ultrasound, electrical and laser stimulation in subjects with knee osteoarthritis. To evaluate the methodological quality of the selected studies, was used the PEDro's scale. The dependent variables of the study were: pain, physical function, joint stiffness, life quality and functional performance. Results: 268 studies were found, of these, 41 studies met eligibility criteria and were classified for analysis in full. The used methodology in the studies varied widely, however, in most cases there was improvement in functional performance of individuals with knee OA, with the use of physical modalities, for the pulsed ultrasound, continuous ultrasound, electrical stimulation and laser resourses. Conclusion: The physical modalities used in the studies demonstrated improvement in functional performance of individuals with knee OA.
Resumo Introdução: Apesar dos avanços recentes no tratamento da Osteoartrite (OA), poucos estudos avaliaram o efeito longitudinal de modalidades físicas na capacidade funcional em pacientes com OA do joelho. Assim, uma vez que os componentes físicos e dor podem afetar o desempenho funcional de atividades diárias, o efeito dessas formas de tratamento ainda está para ser estabelecido. Objetivo: Avaliar a efetividade do uso do ultrassom terapêutico, estimulação elétrica e fototerapia no desempenho funcional em indivíduos com osteoartrite de joelhos. Métodos: Artigos presentes nas bases de dados PubMed, Lilacs, SciELO e PEDro foram avaliados. As palavras-chave utilizadas foram: "pulsed ultrasound therapeutic", "ultrasound therapeutic", "electric stimulation" e "low level laser therapy" em combinação com "knee osteoarthritis". Foram incluídos na presente revisão, estudos clínicos randomizados que utilizaram ultrassom, estimulação elétrica e laser em indivíduos com OA de joelhos. Para avaliar a qualidade metodológica dos estudos selecionados, utilizou-se a escala PEDro. As variáveis dependentes do estudo foram: dor, função física, rigidez articular, qualidade de vida e desempenho funcional. Resultados: Foram encontrados 268 estudos, desses, 41 estudos atenderam aos critérios de elegibilidade e foram classificados para análise na íntegra. A metodologia utilizada pelos estudos variou amplamente, no entanto, em sua maioria houve melhora no desempenho funcional de indivíduos com OA de joelho com a utilização de modalidades físicas, para os recursos Ultrassom pulsado, ultrassom contínuo, estimulação elétrica e laser. Conclusão: O uso das modalidades físicas utilizadas nos estudos demonstraram melhora no desempenho funcional de indivíduos com OA de joelhos.
Subject(s)
Humans , Osteoarthritis, Knee , Electric Stimulation , Physical Functional Performance , Phototherapy , Activities of Daily Living , Physical Therapy SpecialtyABSTRACT
AIMS: The aim of this study was to verify the influence of Pilates on muscle activation of lumbar multifidus (LM) and transversus abdominis/internal oblique muscles (TrA/IO) in individuals with nonspecific low back pain. METHODS: Twelve individuals of both sexes with non-specific low back pain were evaluated before and after a two-month Pilates program in relation to electromyographic activity of LM and TrA/IO, as well as clinical aspects such as pain, flexibility, muscular endurance, quality of life; and Fear-Avoidance Beliefs Questionnaire (in relation to physical and work-related activities. A statistical analysis was performed using a test for independent samples and significance was established at the level of 0.05. RESULTS: After eight weeks of Pilates training, there was an improvement in the clinical parameters of pain, flexibility, muscular endurance and disability. The individuals presented lower LM activation (p=0.025), higher trunk extension strength (p=0.005) and an increase in time from onset to peak muscle activation (p=0.02). CONCLUSION: Pilates protocol was effective for clinical improvement and motor behavior in patients with nonspecific low back pain and the parameters assessed showed a large effect size despite the small sample.(AU)