A influência da Fisioterapia na redução da intensidade da dor e no efeito global percebido de pacientes com dores musculoesqueléticas

Aline Oliveira Chaves, Renato Santos Almeida, Leticia Amaral Corrêa, Felipe José Jandre dos Reis, Ney Armando Mello Meziat-Filho, Leandro Alberto Calazans Nogueira


A melhora clínica do paciente com dores musculoesqueléticas (DME) deve ser monitorada em conjunto com a percepção do paciente sobre o efeito do tratamento, apesar da falta de informação sobre esse tema. Objetivo: Analisar a influência do tratamento fisioterápico na redução da intensidade da dor e no efeito global percebido de pacientes com DME. Métodos: Foi realizado um estudo observacional analítico retrospectivo em 61 pacientes com DME que responderam uma questão relacionada à intensidade de dor e outra questão sobre o efeito global percebido do tratamento fisioterápico. A intensidade de dor medida após 10 meses de acompanhamento foi comparada aos valores iniciais. Resultados: Os participantes eram predominantemente mulheres (83,3%) adultas (média de idade de 59,6 anos). A média de intensidade da dor na avaliação inicial foi de 6,4 (± 2,7), com média de tempo de dor de 20,3 meses. A média de intensidade de dor após o contato telefônico foi de 4,37 (± 3,9). A análise do efeito global percebido evidenciou melhora na maioria dos participantes (16,7% completamente recuperados; 39,7% melhoraram muito, 26,7% melhoraram pouco). Conclusão: Pacientes com DME apresentaram redução da intensidade da dor e melhora no efeito global percebido após um programa de Fisioterapia.

Palavras-chave: fisioterapia, dor crônica, dor musculoesquelética, intensidade de dor, efeito global percebido.

Texto completo:



Rocha APC, Kraychete DC, Lemonica L, Carvalho LRd, Barros GAMd, Garcia JBdS et al. Dor: aspectos atuais da sensibilização periférica e central. Rev Bras Anestesiol 2007;57(1):94-105.

Yu H, Cote P, Southerst D, Wong JJ, Varatharajan S, Shearer HM et al. Does structured patient education improve the recovery and clinical outcomes of patients with neck pain? A systematic review from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J 2016;16(12):1524-40. https://doi.org/10.1016/j.spinee.2014.03.039.

Piper S, Shearer HM, Côté P, Wong JJ, Yu H, Varatharajan S et al. The effectiveness of soft-tissue therapy for the management of musculoskeletal disorders and injuries of the upper and lower extremities: A systematic review by the Ontario Protocol for Traffic Injury management (OPTIMa) collaboration. Man Ther 2016;21:18-34. https://doi.org/10.1016/j.math.2015.08.011

Nogueira LAC, Chaves ADO, Wendt ADS, Souza RLSD, Reis FJJ, Andrade FGD. Central sensitization patients present different characteristics compared with other musculoskeletal patients: A case–control study. Eur J Physiother 2016;18(3):147-53. https://doi.org/10.3109/21679169.2016.1150509

Oliveira FAC, Almeida RS, Santos WT, Nogueira LAC. Pain intensity and functional limitation are not related with medical image findings in patients with shoulder pain. Revista Dor 2014;15(3). https://doi.org/10.5935/1806-0013.20140044

Babatunde OO, Jordan JL, Van der Windt DA, Hill JC, Foster NE, Protheroe J. Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence. Plos One 2017;12(6). https://doi.org/10.1371/journal.pone.0178621.

Patti A, Bianco A, Paoli A, Messina G, Montalto MA, Bellafiore M, et al. Effects of pilates exercise programs in people with chronic low back pain: a systematic review. Medicine 2015;94(4):e383. https://doi.org/10.1097/MD.0000000000000383.

van Koulil S, Effting M, Kraaimaat FW, van Lankveld W, van Helmond T, Cats H et al. Cognitive-behavioural therapies and exercise programmes for patients with fibromyalgia: state of the art and future directions. Ann Rheum Dis 2007;66(5):571-81. https://doi.org/ 10.1136/ard.2006.054692

Daenen L, Varkey E, Kellmann M, Nijs J. Exercise, not to exercise, or how to exercise in patients with chronic pain? Applying science to practice. Clin J Pain 2015;31(2):108-14. https://doi.org/10.1097/AJP.0000000000000099.

Murphy S, Blake C, Power CK, Fullen BM. Outcomes of a group education/exercise intervention in a population of patients with non-specific low back pain: a 3-year review. Irish J Med Sci 2014;183(3):341-50. https://doi.org/10.1007/s11845-013-1013-z.

Voogt L, de Vries J, Meeus M, Struyf F, Meuffels D, Nijs J. Analgesic effects of manual therapy in patients with musculoskeletal pain: a systematic review. Man Ther 2015;20(2):250-6. https://doi.org/10.1016/j.math.2014.09.001

Tsertsvadze A, Clar C, Court R, Clarke A, Mistry H, Sutcliffe P. Cost-effectiveness of manual therapy for the management of musculoskeletal conditions: a systematic review and narrative synthesis of evidence from randomized controlled trials. J Manipulative Physiol Ther 2014;37(6):343-62. https://doi.org/10.1016/j.jmpt.2014.05.001

Clar C, Tsertsvadze A, Court R, Hundt GL, Clarke A, Sutcliffe P. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report. Chiropr Man Therap 2014;22(1):12. https://doi.org/10.1186/2045-709X-22-12.

Brédart A, Marrel A, Abetz-Webb L, Lasch K, Acquadro C. Interviewing to develop Patient-Reported Outcome (PRO) measures for clinical research: eliciting patients' experience. Health Qual Life Outcomes 2014;12:15. https://doi.org/10.1186/1477-7525-12-15

Institute of Medicine. Institute of Medicine (IOM). Committee on quality of health care in America. Crossing the quality chasm: a new health system for the 21st century. Washington: National Academy Press; 2001.

Almeida RS, Bourliataux-Lajoinie S, Martins M. Instrumentos para mensuração da satisfação dos usuários de serviços de saúde: revisão sistemática. Cad Saúde Pública 2015;31:11-25. http://doi.org/10.1590/0102-311X00027014.

Rosenzveig A, Kuspinar A, Daskalopoulou SS, Mayo NE. Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Medicine (Baltimore) 2014;93(22):e120. https://doi.org./10.1097/MD.0000000000000120.

SURCA/SMSDC-Rio. Sistema de informação ambulatorial ou hospitalar. SURCA/SMSD-Rio; 2014.

Smart KM, Blake C, Staines A, Doody C. Clinical indicators of 'nociceptive', 'peripheral neuropathic' and 'central' mechanisms of musculoskeletal pain. A Delphi survey of expert clinicians. Man Ther 2010;15(1):80-7. https://doi.org/10.1016/j.math.2009.07.005.

Li KK, Harris K, Hadi S, Chow E. What should be the optimal cut points for mild, moderate, and severe pain? J Palliat Med 2007;10(6):1338-46. https://doi.org/10.1089/jpm.2007.0087

Kamper SJ, Ostelo RW, Knol DL, Maher CG, de Vet HC, Hancock MJ. Global Perceived Effect scales provided reliable assessments of health transition in people with musculoskeletal disorders, but ratings are strongly influenced by current status. J Clin Epidemiol 2010;63(7):760-6.e1. https://doi.org/10.1016/j.jclinepi.2009.09.009

Schoenfelder T, Klewer J, Kugler J. Determinants of patient satisfaction: a study among 39 hospitals in an in-patient setting in Germany. Int J Qual Health Care 2011;23(5):503-9. https://doi.org/10.1093/intqhc/mzr038.

Kregel J, Coppieters I, DePauw R, Malfliet A, Danneels L, Nijs J et al. Does conservative treatment change the brain in patients with chronic musculoskeletal pain? A Systematic Review. Pain Physician 2017;20(3):139-54.

Smart KM, Blake C, Staines A, Doody C. Self-reported pain severity, quality of life, disability, anxiety and depression in patients classified with 'nociceptive', 'peripheral neuropathic' and 'central sensitisation' pain. The discriminant validity of mechanisms-based classifications of low back (±leg) pain. Man Ther 2012;17(2):119-25. https://doi.org/10.1016/j.math.2011.10.002.

Kaiser U, Kopkow C, Deckert S, Neustadt K, Jacobi L, Cameron P et al. Developing a core outcome-domain set to assessing effectiveness of interdisciplinary multimodal pain therapy: the VAPAIN consensus statement on core outcome-domains. Pain 2017. https://doi.org./10.1097/j.pain.0000000000001129.

Baker TL, Cronin JJ, Hopkins CD. The impact of involvement on key service relationships. J Serv Mark 2009;23:115-24. https://doi.org/10.1108/08876040910946378

DOI: http://dx.doi.org/10.33233/fb.v20i2.2226


  • Não há apontamentos.