The effects of low-level laser in the treatment of myofascial pain syndrome: systematic review / Os efeitos do laser de baixa intensidade no tratamento da síndrome da dor miofascial: revisão sistemática

ABSTRACT BACKGROUND AND OBJECTIVES: Among the approaches inherent to conservative treatment, the low-level laser therapy (LLLT) is one of the most used resources in the treatment of myofascial pain. This research sought to search the literature for the available evidence on the treatment of myofascial pain syndrome with LLLT in order to analyze the reported effects of this intervention. CONTENTS: Medline/PubMed, SCOPUS, Web of Science, Cochrane Central Registry of Controlled Trials (CENTRAL) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) by Ebsco was used to search for articles on randomized clinical trials that related myofascial pain syndrome with LLLT. Studies were systematically selected by two reviewers independently, through title, abstract and, later, full text. Ten articles that met the criteria were included in this integrative review. In six of these articles, the improvement in pain compared to placebo group was presented right after LLLT session, although these results did not remain in the follow-ups of the studies that performed follow ups. CONCLUSION: LLLT seems to be a resource that decreases pain in patients with myofascial pain syndrome. Despite the positive results in reducing pain with the use of LLLT in some studies, this review admits the heterogeneity of studies with conficting results related to the effectiveness of LLLT. Research that defines the parameters and adequate therapeutic dosages are necessary for a better understanding of the real effects of LLLT on this clinical condition.

RESUMO JUSTIFICATIVA E OBJETIVOS: Das abordagens inerentes ao tratamento conservador, o laser de baixa intensidade (LBI) é um dos recursos mais utilizados no tratamento da dor miofascial. Esta pesquisa buscou avaliar na literatura as evidências disponíveis sobre o tratamento da síndrome da dor miofascial com o LBI para analisar os efeitos reportados dessa intervenção. CONTEÚDO: Foram utilizadas as bases de dados Medline/Pubmed, SCOPUS, Web of Science, Registro Central Cochrane de Ensaios Controlados (CENTRAL) e Cumulative Index to Nursing and Allied Health Literature (CINAHL), da Ebsco, para busca de artigos de ensaios clínicos randomizados que relacionassem síndrome da dor miofascial com LBI. Os estudos foram selecionados sistematicamente por dois revisores, independentemente, por meio do título, resumo e, posteriormente, texto completo. Dez artigos que se adequaram aos critérios foram incluídos nessa revisão sistemática. Em seis destes artigos, foi apresentada a melhora da dor comparada ao grupo placebo logo após a sessão de LBI, embora esses resultados não tenham permanecido nos acompanhamentos dos estudos que realizaram follow-ups. CONCLUSÃO: O LBI parece ser um recurso que diminui a dor em pacientes com síndrome da dor miofascial. Apesar dos resultados positivos na diminuição da dor com o uso do LBI em alguns estudos, esta análise admite a heterogeneidade dos estudos com resultados conflitantes relacionados à efetividade do LBI. Pesquisas que definam os parâmetros e dosagens terapêuticas adequadas são necessárias para um melhor entendimento sobre os reais efeitos do LBI sobre essa condição clínica.

Effects of insoles adapted in flip-flop sandals for persistent heel pain: a protocol for a sham-controlled randomised trial.

INTRODUCTION: Persistent heel pain is a prevalent complaint affecting up to 10% of the population. Insoles adapted in flip-flop sandals are an alternative treatment for pain and function of individuals with persistent heel pain, showing improvement within 12 weeks of treatment. Most studies considered foot posture and biomechanics to prescribe insoles for persistent heel pain, but few verified the effects of a 12-week treatment on pain catastrophising. This study will investigate the effects of insoles adapted in flip-flop sandals on pain intensity, function, functional walking capacity and pain catastrophising of individuals with persistent heel pain. METHODS AND ANALYSIS: This is a protocol for a sham-controlled randomised trial. Eighty individuals with persistent heel pain will be assessed and randomised into two intervention groups: insoles adapted in flip-flop sandals and flip-flop sandals with sham (ie, flat) insoles. Assessments will be conducted at baseline (T0), after 6 weeks (T6), 12 weeks postintervention (T12) and after a 4-week follow-up (T16). The primary outcome will be the pain intensity, and secondary outcomes will be foot function, functional walking capacity and pain catastrophising. Analysis of variance with mixed design (if normal distribution) or Friedman's test (if not normal distribution) will verify intergroup and intragroup differences. Bonferroni post hoc tests will be performed in case of significant group or time interaction. Intent-to-treat analysis will be used, and a significance level of 5% and 95% CIs will be considered. ETHICS AND DISSEMINATION: This study was approved by the research ethics committee of the Federal University of Rio Grande do Norte (registry no. 4,018,821). Results will be disseminated to individuals, submitted to a peer-reviewed journal and disclosed in scientific meetings. TRIAL REGISTRATION NUMBER: NCT04784598.

Exercise dependence, body dismorphia, and anxiety in crossfit practitioners: A cross-sectional study.

INTRODUCTION: Physical exercise provides better body image perception and well-being. However, if practiced compulsively, it may lead to compulsion and psychobiological damage. CrossFit is a method aiming at maximum performance, and it is currently attracting many regular practitioners. OBJECTIVE: Evaluate exercise dependence prevalence, muscle dysmorphia, and trait-state anxiety in CrossFit practitioners. METHODS: One hundred fifty regular male CrossFit practitioners were evaluated and subdivided into two groups: with and without risk for exercise dependence. Trait-state anxiety and muscle dysmorphia were also assessed. Unpaired t-test compared groups, Fisher's exact test was used for associations between categorical variables (p < 0.05), while correlations were verified using Pearson's correlation coefficient. RESULTS: 122 participants were identified with no risk for exercise dependence and 28 with risk for exercise dependence. Participants presented mean age of 30.3 ± 7.05 years and had been practicing physical exercise for 8.02 ± 8.1 years, with training frequency of 5.3 ± 1.09 days per week and 107.9 ± 50.5 min per training day. Prevalence risk of exercise dependence was 18.6%, and muscle dysmorphia was significantly different between groups with (10.7%, n = 3) and without risk (6.6%, n = 8) for exercise dependence. Participants with risk for dependence chose CrossFit mainly due to appearance (32%). CONCLUSION: Prevalence risk of exercise dependence was 18.6% and satisfaction with muscle appearance may influence exercise behavior.

Prevalence of musculoskeletal complaints and quality of life among administrative technicians.

BACKGROUND: Work-related musculoskeletal disorders comprise muscle, tendon, synovial, nerve, fascial and ligament injuries alone or combined, with a proven or not relationship with work. They manifest as pain, paresthesia, feeling of heaviness and fatigue, and may cause temporary or permanent incapacity for work. OBJECTIVE: To establish the prevalence of musculoskeletal symptoms and quality of life of administrative technicians at a public institution who used computers at work for 5 years. METHODS: The sample comprised 70 administrative technicians aged 20 to 69 who used computers at work for 5 years. We analyzed the prevalence of musculoskeletal complaints by means of the Nordic Musculoskeletal Questionnaire and quality of life with SF-36. Interviews were performed in the workplace. The data were analyzed with SPSS 20.0 and the significance level was set to 5%. RESULTS: SF-36 domain scores were considered satisfactory for all the participants. Prevalence of pain in the past 7 days (70%) and past 12 months (77.1%) was high. The lower back was the body site most frequently involved (38.6%). CONCLUSION: The prevalence of pain in several body sites was high among the analyzed administrative technicians. Pain might interfere with their work and lead to sick leave spells. Clinical assessments and interventions are needed to minimize this problem.

INTRODUÇÃO: Os distúrbios osteomusculares relacionados ao trabalho (DORT) são afecções de músculos, tendões, sinóvias, nervos, fáscias e ligamentos isoladas ou combinadas associados, comprovadamente ou não, ao trabalho. Caracterizam-se pela ocorrência de sintomas como dor, parestesia, sensação de peso e fadiga e são causa de incapacidades laborais temporárias ou permanentes. OBJETIVO: Investigar a prevalência de sintomas osteomusculares em técnicos administrativos de uma instituição federal que desempenharam atividade informatizada nos últimos cinco anos, bem como a qualidade de vida. METODOLOGIA: Participaram do estudo 70 técnicos administrativos que desempenhavam trabalho informatizado havia pelo menos cinco anos, com idade entre 20 e 69 anos. Buscou-se avaliar a prevalência de sintomas osteomioarticulares, por meio do Questionário Nórdico de Sintomas Osteomusculares, e a qualidade de vida, pelo Short Form Health Survey 36 (SF-36). As entrevistas foram realizadas no local de trabalho, e os dados, analisados no Statistical Package for the Social Sciences (20.0), com nível de significância de 5%. RESULTADOS: Os resultados obtidos mostraram que os sujeitos apresentaram valores conforme o considerado normal para todos os domínios do SF-36 e alta prevalência de dor nos últimos sete dias (70%) e nos últimos 12 meses (77,1%), sendo a coluna lombar a região mais afetada, com 38,6%. CONCLUSÃO: Trabalhadores técnicos administrativos desempenhando trabalho informatizado apresentam altos índices de presença do episódio dor em diferentes regiões corporais, podendo interferir na produção do trabalho e levar ao afastamento da atividade. Logo, faz-se necessário que se realizem avaliações clínicas e futuras intervenções para minimizar essas alterações.

Prevalência de sintomas osteomusculares e qualidade de vida de trabalhadores técnicos administrativos / Prevalence of musculoskeletal complaints and quality of life among administrative technicians

Introdução: Os distúrbios osteomusculares relacionados ao trabalho (DORT) são afecções de músculos, tendões, sinóvias, nervos, fáscias e ligamentos isoladas ou combinadas associados, comprovadamente ou não, ao trabalho. Caracterizam-se pela ocorrência de sintomas como dor, parestesia, sensação de peso e fadiga e são causa de incapacidades laborais temporárias ou permanentes. Objetivo: Investigar a prevalência de sintomas osteomusculares em técnicos administrativos de uma instituição federal que desempenharam atividade informatizada nos últimos cinco anos, bem como a qualidade de vida. Metodologia: Participaram do estudo 70 técnicos administrativos que desempenhavam trabalho informatizado havia pelo menos cinco anos, com idade entre 20 e 69 anos. Buscou-se avaliar a prevalência de sintomas osteomioarticulares, por meio do Questionário Nórdico de Sintomas Osteomusculares, e a qualidade de vida, pelo Short Form Health Survey 36 (SF-36). As entrevistas foram realizadas no local de trabalho, e os dados, analisados no Statistical Package for the Social Sciences (20.0), com nível de significância de 5%. Resultados: Os resultados obtidos mostraram que os sujeitos apresentaram valores conforme o considerado normal para todos os domínios do SF-36 e alta prevalência de dor nos últimos sete dias (70%) e nos últimos 12 meses (77,1%), sendo a coluna lombar a região mais afetada, com 38,6%. Conclusão: Trabalhadores técnicos administrativos desempenhando trabalho informatizado apresentam altos índices de presença do episódio dor em diferentes regiões corporais, podendo interferir na produção do trabalho e levar ao afastamento da atividade. Logo, faz-se necessário que se realizem avaliações clínicas e futuras intervenções para minimizar essas alterações.

Background: Work-related musculoskeletal disorders comprise muscle, tendon, synovial, nerve, fascial and ligament injuries alone or combined, with a proven or not relationship with work. They manifest as pain, paresthesia, feeling of heaviness and fatigue, and may cause temporary or permanent incapacity for work. Objective: To establish the prevalence of musculoskeletal symptoms and quality of life of administrative technicians at a public institution who used computers at work for 5 years. Methods: The sample comprised 70 administrative technicians aged 20 to 69 who used computers at work for 5 years. We analyzed the prevalence of musculoskeletal complaints by means of the Nordic Musculoskeletal Questionnaire and quality of life with SF-36. Interviews were performed in the workplace. The data were analyzed with SPSS 20.0 and the significance level was set to 5%. Results: SF-36 domain scores were considered satisfactory for all the participants. Prevalence of pain in the past 7 days (70%) and past 12 months (77.1%) was high. The lower back was the body site most frequently involved (38.6%). Conclusion: The prevalence of pain in several body sites was high among the analyzed administrative technicians. Pain might interfere with their work and lead to sick leave spells. Clinical assessments and interventions are needed to minimize this problem.