O efeito da técnica de liberação miofascial diafragmática em pacientes com fibromialgia: um protocolo de ensaio clínico randomizado
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Data
2021
Tipo de documento
Artigo Científico
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Ciências da Saúde
Modalidade de acesso
Acesso aberto
Editora
Autores
Back, José Leonardo
Orientador
Oliveira, Ana Cristina Farias de
Coorientador
Rosas, Ralph Fernando
Resumo
INTRODUÇÃO: A fibromialgia (FM), é caracterizada por dor crônica generalizada, associada a quadros de ansiedade, sono não reparador, depressão entre outros sintomas. A sua etiologia permanece incerta, apesar da literatura recente apontar para alterações na via central da dor. O diagnóstico é complexo, tendo seus critérios sido alterados por diversas vezes. Existem várias opções terapêuticas farmacológicas e não farmacológicas, mas poucas apresentam evidência significativa no controle sintomático a longo prazo. A fisioterapia, dispõe de intervenções como: exercícios aeróbico, acupuntura, hidroterapia, cinesioterapia e técnicas manipulativas como a osteopatia, quiropraxia e a terapia manual. Dentre as técnicas de terapia manual existe a Liberação Miofascial Diafragmática (LMD), que tem o objetivo de promover o estiramento do diafragma, resultando em um relaxamento, que pode levar ao aumento das pressões respiratórias, reduzir a tensão gerada pelos pontos de gatilho, normalizar o comprimento da fibra e promover maior eficácia da contração muscular. OBJETIVOS: analisar os efeitos da LMD em pacientes com FM. MÉTODOS: Ensaio clínico randomizado cego. PARTICIPANTES: Serão selecionadas 105 mulheres com diagnóstico clínico de FM. INSTRUMENTOS DE MEDIÇÃO: O presente estudo buscará mensurar os efeitos do tratamento, em relação a dor, gravidade dos sintomas e qualidade de vida, após 04 consultas, por meio dos questionários IDG, EGS e FIQR-Br. INTERVENÇÃO: No grupo Intervenção, serão realizadas 04 sessões de LMD, e no Grupo Controle, serão realizadas 04 sessões de LMD Placebo. ANÁLISE ESTATÍSTICA: os dados coletados serão analisados 9i-090=ANOVA two-way (α=0,05) e será realizada análise por intenção de tratar. RESULTADOS ESPERADOS: alívio da dor, melhora da gravidade dos sintomas e da qualidade de vida. CONCLUSÃO: Os resultados deste estudo fornecerão algumas das primeiras evidências de um ensaio clínico randomizado cego, controlado por placebo, em grande escala, sobre a eficácia da LMD no controle da dor e nas mudanças de qualidade de vida em pacientes com fibromialgia.
INTRODUCTION: Fibromyalgia (FM) is characterized by widespread chronic pain, associated with anxiety, non-restorative sleep, depression and other symptoms. Its etiology remains uncertain, despite recent literature pointing to changes in the central pain pathway. Diagnosis is complex, and its criteria have been changed several times. There are several pharmacological and non-pharmacological therapeutic options, but few have significant evidence for long-term symptomatic control. Physical therapy offers interventions such as: aerobic exercise, acupuncture, hydrotherapy, kinesiotherapy and manipulative techniques such as osteopathy, chiropractic and manual therapy. Among the manual therapy techniques there is Diaphragmatic Myofascial Release (DMR), which aims to promote the stretching of the diaphragm, resulting in relaxation, which can lead to increased respiratory pressures, reduce the tension generated by the trigger points, normalize fiber length and promote greater effectiveness of muscle contraction. OBJECTIVES: to analyze the effects of DMR in patients with FM. METHODS: Randomized blinded clinical trial. PARTICIPANTS: 105 women with clinical diagnosis of FM will be selected. MEASUREMENT INSTRUMENTS: This study will seek to measure the effects of treatment, in relation to pain, symptom severity and quality of life, after 04 consultations, through the IDG, EGS and FIQR-Br questionnaires. INTERVENTION: In the Intervention group, there will be 04 sessions of LMD, and in the Control Group, there will be 04 sessions of LMD Placebo. STATISTICAL ANALYSIS: the collected data will be analyzed quantitatively using the two-way ANOVA test (α=0.05) and an intention-to-treat analysis will be performed. EXPECTED RESULTS: pain relief, improvement in symptom severity and quality of life. CONCLUSION: The results of this study will provide some of the first evidence from a large-scale, blind, placebo-controlled, randomized clinical trial of the efficacy of LMD in pain control and quality of life changes in patients with fibromyalgia.
INTRODUCTION: Fibromyalgia (FM) is characterized by widespread chronic pain, associated with anxiety, non-restorative sleep, depression and other symptoms. Its etiology remains uncertain, despite recent literature pointing to changes in the central pain pathway. Diagnosis is complex, and its criteria have been changed several times. There are several pharmacological and non-pharmacological therapeutic options, but few have significant evidence for long-term symptomatic control. Physical therapy offers interventions such as: aerobic exercise, acupuncture, hydrotherapy, kinesiotherapy and manipulative techniques such as osteopathy, chiropractic and manual therapy. Among the manual therapy techniques there is Diaphragmatic Myofascial Release (DMR), which aims to promote the stretching of the diaphragm, resulting in relaxation, which can lead to increased respiratory pressures, reduce the tension generated by the trigger points, normalize fiber length and promote greater effectiveness of muscle contraction. OBJECTIVES: to analyze the effects of DMR in patients with FM. METHODS: Randomized blinded clinical trial. PARTICIPANTS: 105 women with clinical diagnosis of FM will be selected. MEASUREMENT INSTRUMENTS: This study will seek to measure the effects of treatment, in relation to pain, symptom severity and quality of life, after 04 consultations, through the IDG, EGS and FIQR-Br questionnaires. INTERVENTION: In the Intervention group, there will be 04 sessions of LMD, and in the Control Group, there will be 04 sessions of LMD Placebo. STATISTICAL ANALYSIS: the collected data will be analyzed quantitatively using the two-way ANOVA test (α=0.05) and an intention-to-treat analysis will be performed. EXPECTED RESULTS: pain relief, improvement in symptom severity and quality of life. CONCLUSION: The results of this study will provide some of the first evidence from a large-scale, blind, placebo-controlled, randomized clinical trial of the efficacy of LMD in pain control and quality of life changes in patients with fibromyalgia.
Palavras-chave
Fibromialgia, Liberação Miofascial, Diafragma