Efeitos da manipulação osteopática em trabalhadores feirantes com dor lombar crônica inespecífica: ensaio clínico randomizado

Abstract

Introduction: Low back pain can affect up to 80% of the world population, being the main cause of work leave. Physical therapy uses resources and techniques to treat low back pain, including osteopathy. Belonging to manual therapies, osteopathy can assist in the treatment of nonspecific chronic lumbar thrombosis through spinal manipulation techniques. Objective: To investigate the effects of two manipulative techniques of osteopathy, high speed and low amplitude and muscle energy, in market workers with nonspecific chronic low back pain. Methods: Randomized, double blind clinical trial. The sample consisted of 30 market workers from Manaus-AM, presenting unspecific chronic low back pain, randomly selected for a single day of intervention. Anamnesis, functional disability (Roland-Morris), quality of life (SF-36), fears, and beliefs (FABQ-Phys and FABQ-Work) questionnaires were applied for descriptive analysis. For comparison of pre- and post-intervention effects, the pain intensity scale (NPRS), the Schober mobility test and the isokinetic dynamometer Biodex-3 were applied to evaluate the isometric and isokinetic torque peak at 60 and 120 ° / s for trunk flexors and extenders. After the evaluation, the subjects were randomized into 3 intervention groups: High Speed and Low Amplitude Group (G1); Energy Muscle Group (G2); and Placebo Group (G3). All were immediately reevaluated the intervention for pain, mobility and peak torque variables. Results: Both groups (G1 and G2) presented significant reduction of pain intensity (p <0.01; p = 0.02, respectively) and increased mobility after intervention (p <0.01; p = 0.01, respectively), G1 showed significant improvement when compared with G3 for pain (p = 0.033) and mobility (p <0.01) and with G2 for mobility (p <0.01). The variables related to PT had no significant difference in any of the groups. The flexion-extension ratio (F / E) of the isometric and isokinetic PT at 60 ° / s of the trunk muscles presented values below the references (0.49; 0.63, respectively), resulting in muscle imbalance, with greater force of extensors than flexors. Conclusion: The AVBA technique and the ME technique were able to reduce pain and increase lumbar spine mobility immediately after an intervention in market workers with nonspecific chronic low back pain, the technique has a superior result when compared with the ME technique for the mobility outcome.