Aplicabilidade clínica das técnicas de liberação manual diafragmática: uma revisão sistemática

2020 ◽  
Vol 18 (3) ◽  
pp. 111-116
Author(s):  
Dulce Marieli Danieli ◽  
Fabíola De Almeida Gomes ◽  
Bruna Eibel ◽  
William Dhein
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Gastroesophageal Reflux ◽  
Randomized Clinical Trials ◽  
Experimental Studies ◽  
Scar Tissue ◽  
Low Back ◽  
Musculoskeletal Manipulations ◽  
Clinical Applicability ◽  
Quasi Experimental

INTRODUÇÃO: O diafragma é o principal músculo respiratório e desempenha um papel importante na respiração e na regulação fisiológica. Uma terapia que visa melhorar essas condições referentes ao diafragma, é a técnica de liberação manual diafragmática. OBJETIVO: O objetivo deste estudo foi verificar a aplicabilidade clínica das técnicas manuais de liberação diafragmática e identificar as principais técnicas, populações investigadas, variáveis avaliadas e seus desfechos. MÉTODOS: Foram pesquisadas as seguintes bases de dados: PubMed, Scielo e Science Direct, com os descritores “Diaphragm [Mesh]” e “Musculoskeletal Manipulations [Mesh]” com seus correspondentes no mesmo idioma. Foram incluídos ensaios clínicos randomizados, não randomizados, estudos semi, quase-experimentais e estudos pilotos ou de caso, que abordaram técnicas de liberação manuais diafragmáticas.RESULTADOS: Há variadas técnicas de liberação diafragmática, sendo as mais mencionadas: normalização dos pilares do diafragma, alongamento e estiramento do diafragma, relaxamento dos pilares do diafragma. Além disso, as técnicas de liberação diafragmática vêm sendo associadas a protocolos de terapia manipulativa osteopática (TMO). As principais populações estudadas foram de pacientes saudáveis, com lombalgia, cervicalgia, osteoartrite, asmáticos, doença pulmonar obstrutiva crônica, constipados, cardiopatas e com refluxo gastroesofágico. Os principais desfechos avaliados são variáveis musculoesqueléticas (dor, flexibilidade, amplitude, espessura diafragmática), variáveis cardiorrespiratórias (pressão inspiratória/expiratória máxima (PImax e Pemax), mobilidade torácica, frequência cardíaca e respiratória), qualidade de vida e disfunções gastrointestinais/gastroesofágicas. CONCLUSÃO: A aplicabilidade clínica das técnicas de liberação diagramática está sendo investigada associado com outras técnicas osteopáticas, em protocolos de TMO em pacientes saudáveis, pneumopatas, cardiopatas, gestantes, em cicatriz pós-cirúrgica, constipados, com refluxo gastroesofágico, osteoartrite, cervicalgia e com lombalgia. Evidencia-se: diminuição ou eliminação das dores musculoesqueléticas, aumento da flexibilidade, ADM, Pimáx e Pemáx, aumento da mobilidade torácica, aumento da qualidade de vida, diminuição do inchaço e dor abdominal e sem efeito em cardiopatas.ABSTRACT. Clinical applicability of manual diaphragmatic release techniques: a systematic review.BACKGROUND: The diaphragm is the main respiratory muscle and plays an important role in breathing and physiological regulation. A therapy that aims to improve these conditions regarding the diaphragm, is the manual diaphragmatic release technique.OBJECTIVE: The aim of this study was to verify the clinical applicability of manual diaphragmatic release techniques and searching the main techniques, population, evaluated variables, and outcomes. METHODS: The following electronic databases were searched: PubMed, Scielo, and Science Direct, with the descriptors “Diaphragm [Mesh]” and “Musculoskeletal Manipulations [Mesh]” with their correspondents in the same language. There were included randomized clinical trial, non-randomized clinical trials, semi, and quasi-experimental studies, and pilot or case studies, which addressed manual diaphragmatic release techniques.RESULTS: There are various diaphragmatic release techniques, the most mentioned are: normalization of the diaphragm pillars, stretching of the diaphragm, relaxation of the diaphragm pillars, and protocols for osteopathic manipulative therapy (OMT) for the diaphragm. The main populations studied were healthy patients, with low back pain, asthmatics, chronic pulmonary obstructive disease, constipated, cardiac patients, and gastroesophageal reflux. The main outcomes assessed are musculoskeletal variables (pain, flexibility, range of motion, diaphragmatic thickness), cardiorespiratory variables (maximal inspiratory/expiratory pressure (MIP and MEP), chest mobility, heart, and respiratory rate), quality of life, and gastrointestinal/ gastroesophageal disorders.CONCLUSION: The clinical applicability of diagrammatic release techniques is being investigated in association with other osteopathic techniques, in protocols of OMT in healthy subjects, patients with lung diseases, heart disease, pregnant women, scar tissue, constipated, with gastroesophageal reflux, osteoarthritis, cervicalgia and with low back pain. There is evidence of reduction and elimination of musculoskeletal pain, increased MIP, increased chest mobility, an increase in health quality, a decrease of bloating and abdominal pain related to constipation, and a decrease of reflux symptoms.

scholarly journals Influence of Pilates Method on Nonspecific Lumbar Pain

2020 ◽  
Vol 39 (04) ◽  
pp. 300-305
Author(s):  
Ana Carla Schimidt ◽  
Paula de Oliveira Herzinger ◽  
Danielle Pacheco Matias ◽  
Leonardo C. Welling
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Perception ◽  
Randomized Clinical Trials ◽  
Lumbar Pain ◽  
Low Back ◽  
Reduction Of Pain ◽  
Pilates Method

AbstractLow back pain is defined as pain located between the lower rib cage and the gluteal folds, and its etiology is multifactorial, considerably affecting quality of life. The aim of this literature review was to analyze the influence of the Pilates method on the symptoms of patients with nonspecific low back pain, which is considered a promising treatment for this type of pathology. A narrative review of the literature was carried out using the PubMed, Pedro, Scopus and Scielo databases. To perform the search, Pilates AND Low back nonspecific AND Pain were used as keywords. Articles published in the last 5 years, randomized clinical trials that verified the influence of the Pilates method in adult individuals with unspecified low back pain and full text in English were included. Of the 77 articles identified, 7 articles met the inclusion criteria, 7 analyzed the primary outcomes of pain intensity and disability, 5 articles compared Pilates with other rehabilitation techniques and 2 studies compared the effectiveness of Pilates solo with Pilates apparatus. It was concluded that all the techniques that were compared with Pilates are effective, being difficult to affirm the superiority of Pilates over them in relation to the reduction of pain and disability and improvement of quality of life. However, the Pilates method has shown good results in pain perception and intensity, functional capacity, fear of movement and the idea that movement can worsen your condition, muscle strength, range of motion and flexibility.

scholarly journals Effects of Exercises On Pregnancy Related Low Back Pain: A Quasi Experimental Study

2018 ◽  
Vol 08 (03) ◽  
pp. 163-167
Author(s):  
Abida Arif ◽  
Ghousia Shahid ◽  
Muhammad Arif Siddique ◽  
Khalid Aziz ◽  
Muhammad Faisal Fahim
Keyword(s):  
Experimental Study ◽  
Low Back Pain ◽  
Back Pain ◽  
Exercise Therapy ◽  
Post Treatment ◽  
Control Group ◽  
Low Back ◽  
Moderate Pain ◽  
Quasi Experimental ◽  
Experimental Group

Objective: To evaluate the effect of therapeutic exercises on pregnancy related low back pain in a tertiary care hospital of Karachi. Material & Methods: This was a quasi-experimental study with non-probability convenience sampling technique. Study was carried out at Liaquat National Hospital Karachi. Patients were divided into two groups (Experimental and Control). Inclusion criteria were age <30 years, 2nd and 3rd trimester, stable medical status and those who gave the informed consent. Exclusion were pregnancy induced hypertension (>140/90mmHg), Cardiac disease, diabetes mellitus, persistent vaginal bleeding, history of miscarriages, decreased foetal movement. Data was collected through assessment Modified Oswestry Low back pain disability questionnaire. SPSS version 23.0 was used to analyze the data. Results: A total of 30 samples were selected for the study. There were 15 respondents in experimental while 15 in control group. Disability levels were found to be significantly decreased after post treatment in experimental group with P-value= 0.002. It was seen that number of patients was increased from 1(6.7%) to 6(40%) in minimal disability group whereas crippled back pain group in pre-treatment group was totally shifted towards minimal or moderate pain 3(20.0%) and no case was seen in post-treatment. Conclusion: Low back pain in pregnancy can disturb daily life routine but exercise therapy and proper counselling will lead stress free life to female in gestation. After post treatment in experimental group showed decrease in pain as compare to control group who were not provided any exercise therapy. Working women in experimental group also showed decrease by crippled back pain to moderate pain after exercise. So in the end researcher suggest that physiotherapy exercises play a vital role in reducing Low Back Pelvic Pain (LBPP) during pregnancy.

scholarly journals EXTRACORPOREAL SHOCK WAVE THERAPY (ESWT) IN CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS

2020 ◽  
Vol 13 (4) ◽  
pp. 1-16
Author(s):  
Karolina Walewicz
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Randomized Clinical Trials ◽  
Extracorporeal Shock Wave Therapy ◽  
Low Back ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

Background: Extracorporeal Shock Wave Therapy (ESWT) has become a popular tool to treat musculoskeletal disorders and chronic low back pain. Aim of the study: To review the current scientific literature and assess the utility of ESWT in treating chronic low back pain. Methods: This systematic review was conducted from November 2019 to January 2020. Its purpose was to determine what the effectiveness is of the various forms of ESWT for the treatment of chronic low back pain. The critical review of the literature on the use of ESWT in chronic low back was made using the scientifically recognized medical databases PubMed, MEDLINE, Physiotherapy Evidence Database (PEDro) and Web of Science Core Collection. There was no restriction by date. Exclusion criteria were experimental, in vitro, animal, review, case reports, non-randomized clinical trials or studies with healthy participants. All articles written in languages other than English have also been excluded. Results: Six studies were included in the final analysis. According to the applied PEDro classification, the average scoring for the studies was 4.83, which indicates overall low quality of the presented reports. However, this result appeared closer to the moderate (acceptable) quality range (6-8 points) than to the unacceptable range (0-2 points). Conclusion: Based on the findings in the analyzed articles, ESWT promises to be an efficient and useful procedure in chronic low back pain treatment. Unfortunately, the level of evidence is relatively weak because there are a limited number of published studies related to ESWT and the final score in the PEDro classification was low. Together, these results indicate the need for further high quality randomized clinical trials.

scholarly journals Effectiveness of ozone therapy compared to other therapies for low back pain: a systematic review with meta-analysis of randomized clinical trials

2019 ◽  
Vol 69 (5) ◽  
pp. 493-501 ◽  
Author(s):  
Raul Ribeiro de Andrade ◽  
Olavo Barbosa de Oliveira-Neto ◽  
Luciano Timbó Barbosa ◽  
Isabelle Oliveira Santos ◽  
Célio Fernando de Sousa-Rodrigues ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Low Back Pain ◽  
Back Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Low Back ◽  
Ozone Therapy

scholarly journals Assessment of effectiveness of spinal exercises and body mechanics on low back pain among post menopausal women

2015 ◽  
Vol 1 (4) ◽  
pp. 191 ◽  
Author(s):  
Angel Rajakumari G ◽  
Soli T. K. ◽  
Malathy D
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Control Group ◽  
Low Back ◽  
Menopausal Women ◽  
Significant Difference ◽  
Post Test ◽  
Quasi Experimental ◽  
Equivalent Control ◽  
Post Menopausal

Aim: To assessment of effectiveness of spinal exercises and body mechanics on low back pain among post menopausal women.Participants and setting: A quasi experimental non equivalent control group pretest post test design was adapted. The study was conducted in the urban area of suryapet. 40 post menopausal women who fulfilled the inclusion criteria were selected by nonprobability purposive sampling technique.Intervention: The intervention such as spinal exercises and body mechanics were performed to overcome the level of low back pain among post menopausal women. The pre and post assessment was done by using a combined numerical and categorical pain scale.Measurement and findings: The women completed the demographic and obstetrical information and pain was measured by 0- 10 Modified combined numerical categorical pain intensity scale. This study revealed that there was high significant difference found in low back pain at p<0.001level between study group.Conclusion: The overall findings in the present study revealed that the spinal exercises and body mechanics was effectives and had brought about significant change in the reduction of low back pain among post menopausal women compared to pre test level of low back pain.

A comparative study of the therapeutic efficacy of vertical oscillatory pressure and transverse oscillatory pressure in the management of Chronic Low Back Pain

2018 ◽  
Vol 8 (2) ◽  
pp. 216-222
Author(s):  
Oluwadare Akanni Ogundipe ◽  
Olufemi Opeyemi Ogundiran
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Significant Difference ◽  
Before And After ◽  
Treatment Data ◽  
Quasi Experimental ◽  
Oscillatory Pressure

BACKGROUND: The use of physical modalities in treatment of Chronic Low Back Pain (CLBP) is potentially beneficial, but the general evidence still leaves questions about its security application. OBJECTIVE: This study sought to investigate and compare the relative efficacy of Vertical Oscillatory Pressure (VOP) and Transverse Oscillatory Pressure (TOP) in the management chronic low back pain (CLBP) of mechanical origin. METHODS: A two-group, quasi-experimental design was utilized, involving a total of forty-two participants purposively recruited with due consideration of the specific inclusion and exclusion criteria. Five research questions were raised with corresponding hypotheses formulated for them, which were tested at 0.05 level of significance. The participants were randomly assigned to the VOP and TOP groups, and were subsequently managed thrice weekly for a duration of six weeks. The pain intensity rating, straight leg raising, and spinal range of motion were the outcome measures selected, which were assessed before and after treatment. Data were collected, organized, and analyzed using descriptive and T-Student test analytical statistics. RESULTS: The results of the study showed a significant difference in each of the outcome measures for both groups (p<0,05). CONCLUSION: This suggested that both VOP and VOP were relatively effective in managing CLBP.

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