RESUMO
BACKGROUND: Low-back pain (LBP) may be directly or indirectly related to impairments from the hip joint. OBJECTIVE: To evaluate the effectiveness of hip interventions on pain and disability in patients with LBP in the short-, medium-, and long-term. METHODS: PubMed, Cochrane Library, PEDro, Web of Science, and SCOPUS databases were searched in November 2022. Randomized controlled trials involving hip-targeted interventions compared to specific low back interventions in patients with LBP were selected. The outcomes were pain intensity and disability. The quality of the studies was assessed with the risk of bias tool. GRADE was used to rate the certainty of evidence. Meta-analyses were conducted using random effects models. RESULTS: A total of 2581 studies were screened. Eight were included in the meta-analysis involving 508 patients with LBP. The results provided very low certainty that both hip strengthening and hip stretching improved pain (MD = -0.66; 95% CI -0.86, -0.48; I2:0%) (MD = -0.55; 95% CI -1.02, -0.08) and disability (SMD = -0.81; 95% CI -1.53, -0.10; I2: 80%) (SMD = -1.03; 95% CI -1.82, -0.25) in the short-term, respectively. No benefits were found in the medium- or long-term. The risk of bias, heterogeneity, and imprecision of the results downgraded the level of evidence. CONCLUSIONS: Very low certainty evidence suggest a positive effect of hip strengthening in isolation or combined with specific low back exercise and hip stretching combined with specific low back exercise for decreasing pain intensity and disability in the short-term, in patients with LBP. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022303173.
Assuntos
Dor Crônica , Pessoas com Deficiência , Dor Lombar , Humanos , Terapia por Exercício/métodos , Medição da DorRESUMO
The objective of this study was to determine the effects of corrective, therapeutic exercise techniques on subjects with adolescent idiopathic scoliosis. A systematic review was conducted by searching the Cochrane Library Plus, Pubmed, PEDro, and SCOPUS databases. Studies in patients diagnosed with adolescent idiopathic scoliosis that considered corrective, therapeutic exercise as an independent outcome measure and symptoms, functional capacity, Cobb's angle and/or other angles or body asymmetries as dependent outcome measures were included. A total of 9 controlled clinical trials that carried out corrective, therapeutic exercise were included. Corrective, therapeutic exercise appears to have positive effects by reducing symptoms and improving function, as well as various angles and body asymmetries. However, further studies with better methodological quality are required to confirm these outcomes and determine the best therapeutic exercise intervention.
El objetivo del estudio fue determinar los efectos de las técnicas de ejercicio terapéutico correctivo en sujetos con escoliosis idiopática del adolescente. Se realizó una revisión sistemática realizando búsquedas en Biblioteca Cochrane Plus, Pubmed, PEDro y SCOPUS. Se incluyeron estudios de pacientes con diagnóstico de escoliosis idiopática del adolescente, que consideraron, como variable independiente, ejercicio terapéutico correctivo y, como variables dependientes, síntomas, capacidad funcional, ángulo de Cobb y/u otros ángulos o asimetrías corporales. Se incluyeron un total de 9 ensayos clínicos controlados que utilizaron ejercicio terapéutico correctivo. El ejercicio terapéutico correctivo parece tener efectos positivos en la disminución de síntomas, mejora de la función y mejora de diferentes ángulos y asimetrías corporales. Sin embargo, son necesarios estudios con mejor calidad metodológica para confirmar estos resultados y determinar la mejor intervención mediante ejercicio terapéutico.