dic
17
2011

Últimos artículos sobre Intervenciones Terapéuticas en la Lumbalgia

Imagen LumgalgiaEn los últimos meses se han publicado numerosos artículos sobre la efectividad de diversas terapias en la lumbalgia, los he recopilado en un único post, pero en ésta ocasión os dejo las reseñas en inglés (en verdad, me han desbordado las publicaciones).
Me encanta que cada vez sean más los ensayos clínicos que versen sobre las distintas intervenciones que aplicamos en el día a día, creo que es un buen indicativo del interés que se ha despertado por una rehabilitación y fisioterapia cada vez más “evidente” y menos basada en costumbres heredadas o modas pasajeras. Ahora está en nuestra mano traducirlo y aplicarlo a la asistencia clínica real.

1) Ejercicio aeróbico + fisioterapia convencional en la lumbalgia crónica:

Arch Phys Med Rehabil. 2011 Oct;92(10):1681-5. Aerobic exercise training in addition to conventional physiotherapy for chronic low back pain: a randomized controlled trial. Chan CW, Mok NW, Yeung EW.

  • RESULTS: Both groups demonstrated a significant reduction in pain (P<.001) and an improvement in disability (P<.001) at 8 weeks and 12 months; however, no differences were observed between groups. There was no significant difference in LBP relapse at 12 months between the 2 groups (χ(2)=2.30, P=.13). 
  • CONCLUSIONS: The addition of aerobic training to conventional physiotherapy treatment did not enhance either short- or long-term improvement of pain and disability in patients with chronic LBP.

2) Efectos del estiramiento muscular, terapia manual y las inyecciones de esteroides junto con “mantenerse activo” en la calidad de vida en lumbalgia aguda o subaguda

Clin Rehabil. 2011 Nov;25(11):999-1010. A randomized controlled trial of the effects of muscle stretching, manual therapy and steroid injections in addition to ‘stay active’ care on health-related quality of life in acute or subacute low back pain. Grunnesjö MI, Bogefeldt JP, Blomberg SI, Strender LE, Svärdsudd KF.

  • RESULTS: In a multivariate analysis adjusted for possible outcome affecting variables other than the treatment given Well-being score was 68.4 (12.5), 72.1 (12.4), 72,3 (12.4) and 72.7 (12.5) in groups 1-4, respectively (P for trend <0.05). There were significant trends for the well-being components patience (P < 0.005), energy (P < 0.05), mood (P < 0.05) and family situation (P < 0.05). The remaining two components and Complaint score showed a non-significant trend towards improvement. 
  • CONCLUSION: The effects on health-related quality of life were greater the larger the number of treatment modalities available. The ‘stay active’ treatment group, with the most restricted number of modalities, had the most modest health-related quality of life improvement, while group 4 with the most generous choice of treatment modalities, had the greatest improvement.
3) Tratamiento de la lumbalgia crónica: Programa de Rehablitación multidisciplinar + Tto farmacológico Vs Tto farmacológico en monoterapia.


Clin J Pain. 2011 Nov-Dec;27(9):811-8. Treatment of chronic low back pain: a randomized clinical trial comparing multidisciplinary group-based rehabilitation program and oral drug treatment with oral drug treatment alone.Tavafian SS, Jamshidi AR, Mohammad K.
  • RESULTS: The 2 groups were comparable regarding all baseline characteristics (P>0.05). There were significant differences within each group by time in terms of all subscales of 36-item Short-form (P<0.01) except for mental health (P=0.7). Furthermore, there were significant differences between groups in terms of all domains of SF-36 scale except for general health (P=0.06), social function (P=0.08) and role emotional (P=0.7). Furthermore, according to the scores of Ronald-Morris Disability Questionnaire and Quebec Disability Scale, the disability of patients in the intervention group was improved over time significantly (P=0.01 and P<0.0001, respectively). 
  • DISCUSSION: The findings revealed that the group-based multidisciplinary program could improve most domains of quality of life in chronic low back pain patients in the 6-month period. However, there were no significant differences between two groups in sub scales such as general health, social function and role emotional.
4) Tai Chi en la lumbalgia crónica

Arthritis Care Res (Hoboken). 2011 Nov;63(11):1576-83. doi: 10.1002/acr.20594. Tai chi exercise for treatment of pain and disability in people with persistent low back pain: a randomized controlled trial.Hall AM, Maher CG, Lam P, Ferreira M, Latimer J.

  • RESULTS: Tai chi exercise reduced bothersomeness of back symptoms by 1.7 points on a 0-10 scale, reduced pain intensity by 1.3 points on a 0-10 scale, and improved self-report disability by 2.6 points on the 0-24 Roland-Morris Disability Questionnaire scale. The followup rate was >90% for all outcomes. These results were considered a worthwhile treatment effect by researchers and participants. 
  • CONCLUSION: This is the first pragmatic randomized controlled trial of tai chi exercise for people with low back pain. It showed that a 10-week tai chi program improved pain and disability outcomes and can be considered a safe and effective intervention for those experiencing long-term low back pain symptoms

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