Crioterapia combinada a Estimulação Elétrica Nervosa Transcutânea de baixa frequência (burst) em pacientes com dor lombar crônica não específica: ensaio clínico randomizado e cego

Abstract

Background: Chronic non-specific low back pain (CLBP) is defined by persistent pain that remains for more than 3 months and does not present anatomopathological or radiological changes. Among the non-pharmacological resources for the treatment of this condition we have the Cryotherapy and Transcutaneous Electric Nerve Stimulation (TENS) in Burst mode that have been used in clinical practice in isolated or combined form. Objective: To analyze the effects of the combined use of Cryotherapy and TENS Burst on the pain sensation, functional capacity and quality of life of patients with nonspecific CLBP. Methods: This is a clinical trial of 44 individuals of both gender, randomly distributed into four groups: control-placebo group (gCP), cryotherapy group (gCrio), TENS-Burst group (gTENSb) and cryotherapy + TENS Burst (gCrioTENSb). All subjects were submitted to the evaluation measures of: Functional capacity by the Roland-Morris (RM) questionnaire and the sit-to-tand test; Quality of life through SF-36 questionnaire; Pain through the Visual Analogue Scale (VAS) and pain threshold by pressure by the Algometer. Functional capacity and quality of life were assessed before and 48h after protocol. The pain was also assessed after the first, second and third week of the protocol. The intervention protocol was 40 minutes, with 30 minutes of intervention: TENS shaw, cryotherapy, TENS Burst, or combination of resources and 10 minutes of education on the disease for all groups. The data were analyzed through the statistical software SPSS 20.0, assigning the level of significance of 5%. Results: There was an improvement on VAS scores, pressure pain threshold, Roland-Morris and SF-36 questionnaires and sit-tostand test after the intervention protocol in all groups (p<0.05). However, there were no statistical differences between groups (p>0.05). Conclusion: This study showed that there wasn’t difference between cryotherapy and TENSBurst alone, combined or shaw in improving pain, functional capacity and some domains of quality of life in patients with non-specific DLC.