Effect of the association of continuous shortwave diathermy and Pilates-based exercises on pain, depression, and anxiety in chronic non-specific low back pain: a randomized clinical trial

Chronic nonspecific low back pain (CNLBP) is the most common musculoskeletal condition, which can be influenced by nociceptive, psychosocial, cognitive, and affective aspects, causing vulnerabilities and impairing the individual's ability to manage pain. The association of continuous shortwave diathermy (CSWD) with Pilates-based exercises may contribute to reduce pain, depression, and anxiety in patients with CNLBP. A single-blind randomized clinical trial was performed in which 36 patients with CNLBP were divided into a control group that received placebo CSWD and an intervention group that received active CSWD. Both groups received 12 sessions of Pilates-based exercises. Pain, depression, and anxiety variables were evaluated using the McGill questionnaire, the Beck Depression Inventory, and the Visual Analog Anxiety Scale. Assessments were performed at baseline, after three and six weeks of treatment, and at the three-month follow-up. The Shapiro-Wilk test, Student's t-test, Mann-Whitney U test, chi-squared test, and repeated measures ANOVA, with α=0.05, were used to compare the outcomes, and indicated that active CSWD did not present additional improvement in the assessed variables in CNLBP patients compared to the placebo group. Both groups improved pain and depression at follow-up and reduced anxiety only during Pilates-based exercises. Therefore, only Pilates-based exercises seemed sufficient to manage patients with CNLBP.

¿Es más efectivo el tratamiento combinado de electroestimulación transcutánea del nervio tibial y electroestimulación vaginal que el tratamiento en monoterapia de electroestimulación del nervio tibial para la vejiga hiperactiva? Un ensayo controlado aleatorizado / Is the addition of vaginal electrical stimulation to transcutaneous tibial nerve electrical stimulation more effective for overactive bladder treatment? A randomized controlled trial

INTRODUCCIÓN Y OBJETIVOS: La vejiga hiperactiva (VH) es un trastorno frecuente que aumenta con la edad y afecta a la calidad de vida de los pacientes. Las guías recomiendan los programas de modificación de la conducta como tratamiento de primera línea, aunque la fisioterapia también se ha utilizado con éxito, seguridad y bajo coste. La fisioterapia clínica está utilizando la electroestimulación transcutánea del nervio tibial (ETNT) y la electroestimulación vaginal (EV). Este estudio tuvo como objetivo evaluar si la combinación de EV con ETNT es más exitosa que la monoterapia con ETNT para el tratamiento de las mujeres con VH. PACIENTES Y MÉTODOS: En total, 106 mujeres mayores de 18 años diagnosticadas con VH o incontinencia urinaria mixta con síntomas típicos de VH se dividieron aleatoriamente en 2 grupos: grupo 1: ETNT (n = 52); grupo 2: ETNT + EV (n = 54). El diario miccional de 3 días, la fuerza muscular del suelo pélvico (escala de Ortiz), el cuestionario de salud de King y el cuestionario de VH se evaluaron antes y después del tratamiento. La variable principal fue la frecuencia urinaria y una reducción de ≥ 3 micciones/día se consideró como clínicamente relevante. Se usaron modelos lineales mixtos para la comparación de los 2 grupos. RESULTADOS: Inicialmente, los grupos fueron similares en edad, índice de masa corporal, número de embarazos, tiempo de aparición de VH y prevalencia de síntomas de VH. Después del tratamiento se observó una reducción en la frecuencia urinaria de 1,5 micciones en el grupo 2; a pesar de ser estadísticamente significativa, esta no fue clínicamente relevante. CONCLUSIONES: La combinación de EV con ETNT no hizo que el tratamiento para la VH fuese más efectivo que la monoterapia con ETNT

INTRODUCTION AND OBJECTIVES: Overactive bladder (OAB) is a prevalent disorder that increases with age and impairs patients' quality of life. Guidelines recommend behavior modifications as the first-line treatment; however, physiotherapy has also been used with success, safety, and low cost. Transcutaneous tibial nerve electrical stimulation (TTNS) and vaginal electrical stimulation (VS) are being used in clinical physiotherapy practice. This study aimed to verify whether the addition of VS to TTNS is more beneficial than TTNS alone for women with OAB. PATIENTS AND METHODS: In all, 106 women aged >18 years diagnosed with OAB or mixed urinary incontinence with prevalent OAB symptoms were randomly divided into 2 groups: Group 1: TTNS (n = 52); Group 2: TTNS + VS (n = 54). The 3 day voiding diary, pelvic floor muscle strength (Ortiz Scale), King's Health Questionnaire, and Overactive Bladder Questionnaire were assessed before and after treatment. Urinary frequency was considered the primary outcome, and a reduction of ≥ 3 micturitions/day was considered clinically relevant. Mixed linear models were used to compare the 2 groups. RESULTS: Initially, the groups were similar in age, body mass index, number of pregnancies, time of OAB onset, and prevalence of OAB symptoms. After treatment, a reduction in urinary frequency of 1.5 micturitions was observed in Group 2, which was not clinically relevant despite being statistically significant. CONCLUSIONS: The addition of VS to TTNS for the treatment of OAB was not more effective than TTNS as a single therapy