Pilates method in the treatment of patients with Chikungunya fever: a randomized controlled trial.

OBJECTIVE: The aim of this study was to evaluate the effects of the Pilates method on the reduction of pain, improvement of joint function, and quality of life of patients with chronic Chikungunya fever. DESIGN: This is a randomized, controlled, blind trial for the evaluators. SETTING: The study was conducted at the Advanced Laboratory in Physical Education and Health at Federal University of Pernambuco, Brazil. SUBJECTS: A total of 51 patients were allocated randomly and divided into 2 groups: a Pilates group (26 patients) and a control group (25 patients). After 12 weeks, 4 patients in the Pilates group and 5 in the control group were lost to follow-up. INTERVENTION: The Pilates group performed 24 Pilates method intervention sessions; the control group continued to receive standard clinical treatment at the outpatient clinic. MAIN MEASURES: The main measures were as follows: visual analogue scale (VAS) for pain, functional capacity evaluated by Health Assessment Questionaire (HAQ), quality of life measured by the 12-Item Short-Form Health Survey (SF-12), and range of joint motion by goniometry. RESULTS: After 12 weeks, patients in the Pilates group presented lower VAS (P < 0.001), lower HAQ scores (P < 0.001), and higher quality-of-life scores (P < 0.001) compared with the control group. We found statistically significant results for the Pilates group in the range of movement for shoulder, knee, ankle, and lumbar spine (P < 0.001). In the intragroup analysis, there was a significant improvement in all outcomes evaluated. CONCLUSION: In this study, patients undertaking Pilates method for 12 weeks had less pain, better function and quality of life, and increased range of joint movement.

Estudio de caso: efecto de la intervención fisioterapéutica en un paciente con secuelas de chikungunya / Case study: Effect of a physiotherapy intervention in a patient with chikungunya sequelae

Antecedentes: La fiebre del chikungunya es una enfermedad vírica transmitida por mosquitos del género Aedes aegypti. Cursa con una fase aguda, en la que se presenta fiebre, exantemas y artralgias, y una fase crónica, en la que hay persistencia de artralgias incapacitantes, con un patrón poliarticular y distal; el tratamiento de la enfermedad es principalmente farmacológico y hay una baja evidencia sobre el tratamiento de las secuelas de la enfermedad. Objetivo: Evaluar el efecto de la intervención fisioterapéutica en un paciente con secuelas de chikungunya. Paciente: De género masculino, con 36 años, infectado con el virus en el 2015 y en el que persiste la artralgia, la disminución de la movilidad articular y el edema. Método: Se realiza una intervención fisioterapéutica durante 8 semanas con actividad física, modalidades terapéuticas e hidroterapia; al final de la intervención se evalúan los cambios. Conclusión: El programa propuesto permite disminuir el dolor y mejorar la movilidad articular y la capacidad funcional

Background: Chikungunya fever is a viral disease transmitted by mosquitoes of the genus Aedes aegypti. It has an acute phase in which there is fever, rashes and arthralgia, and a chronic phase in which there is a persistent disabling arthralgia, with a polyarticular and distal pattern. The treatment of the disease is mainly pharmacological, and there is little evidence about the treatment of the sequelae of the disease. Objective: To evaluate the effect of a physiotherapy intervention in a patient with chikungunya sequelae. Patient: Male, 36 years old, infected with the virus in 2015 and who has persistent arthralgia, decreased joint mobility, and oedema. Method: A physiotherapy intervention was performed for 8 weeks with physical activity, therapeutic modalities, and hydrotherapy. At the end of the intervention the changes were evaluated. Conclusion: The proposed program helped to reduce pain and improve joint mobility and functional capacity

Recommendations of the Brazilian Society of Rheumatology for the diagnosis and treatment of chikungunya fever. Part 2 - Treatment.

Chikungunya fever has become an important public health problem in countries where epidemics occur because half of the cases progress to chronic, persistent and debilitating arthritis. Literature data on specific therapies at the various phases of arthropathy caused by chikungunya virus (CHIKV) infection are limited, lacking quality randomized trials assessing the efficacies of different therapies. There are a few studies on the treatment of musculoskeletal manifestations of chikungunya fever, but these studies have important methodological limitations. The data currently available preclude conclusions favorable or contrary to specific therapies, or an adequate comparison between the different drugs used. The objective of this study was to develop recommendations for the treatment of chikungunya fever in Brazil. A literature review was performed via evidence-based selection of articles in the databases Medline, SciELO, PubMed and Embase and conference proceedings abstracts, in addition to expert opinions to support decision-making in defining recommendations. The Delphi method was used to define the degrees of agreement in 2 face-to-face meetings and several online voting rounds. This study is part 2 of the Recommendations of the Brazilian Society of Rheumatology (Sociedade Brasileira de Reumatologia - SBR) for the Diagnosis and Treatment of chikungunya fever and specifically addresses treatment.

Recommendations of the Brazilian Society of Rheumatology for the diagnosis and treatment of chikungunya fever. Part 2 - Treatment / Recomendações da Sociedade Brasileira de Reumatologia para diagnóstico e tratamento da febre chikungunya. Parte 2 - Tratamento

Abstract Chikungunya fever has become an important public health problem in countries where epidemics occur because half of the cases progress to chronic, persistent and debilitating arthritis. Literature data on specific therapies at the various phases of arthropathy caused by chikungunya virus (CHIKV) infection are limited, lacking quality randomized trials assessing the efficacies of different therapies. There are a few studies on the treatment of musculoskeletal manifestations of chikungunya fever, but these studies have important methodological limitations. The data currently available preclude conclusions favorable or contrary to specific therapies, or an adequate comparison between the different drugs used. The objective of this study was to develop recommendations for the treatment of chikungunya fever in Brazil. A literature review was performed via evidence-based selection of articles in the databases Medline, SciELO, PubMed and Embase and conference proceedings abstracts, in addition to expert opinions to support decision-making in defining recommendations. The Delphi method was used to define the degrees of agreement in 2 face-to-face meetings and several online voting rounds. This study is part 2 of the Recommendations of the Brazilian Society of Rheumatology (Sociedade Brasileira de Reumatologia - SBR) for the Diagnosis and Treatment of chikungunya fever and specifically addresses treatment.

Resumo A febre chikungunya tem se tornado um importante problema de saúde pública nos países onde ocorrem as epidemias, visto que metade dos casos evolui com artrite crônica, persistente e incapacitante. Os dados na literatura sobre terapêuticas específicas nas diversas fases da artropatia ocasionada pela infecção pelo vírus chikungunya (CHIKV) são limitados, não existem estudos randomizados de qualidade que avaliem a eficácia das diferentes terapias. Há algumas poucas publicações sobre o tratamento das manifestações musculoesqueléticas da febre chikungunya, porém com importantes limitações metodológicas. Os dados atualmente disponíveis não permitem conclusões favoráveis ou contrárias a terapêuticas específicas, bem como uma adequada avaliação quanto à superioridade entre as diferentes medicações empregadas. O objetivo deste trabalho foi elaborar recomendações para o tratamento da febre chikungunya no Brasil. Foi feita uma revisão da literatura com seleção de artigos baseados em evidência, nas bases de dados Medline, SciELO, PubMed e Embase e de resumos de anais de congressos, além da opinião dos especialistas para dar apoio às decisões tomadas para definir as recomendações. Para a definição do grau de concordância foi feita uma metodologia Delphi, em duas reuniões presenciais e várias rodadas de votação on line. Este artigo refere-se à parte 2 das Recomendações da Sociedade Brasileira de Reumatologia para Diagnóstico e Tratamento da Febre Chikungunya, que trata especificamente do tratamento.