Navegando por Assunto "Dor lombar"

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Acesso aberto (Open Access)
Ajustes posturais antecipatórios e compensatórios em idosos com e sem lombalgia
(Universidade Federal do Pará, 2021-03) GARCEZ, Daniela Rosa; CALLEGARI, Bianca; http://lattes.cnpq.br/0881363487176703; https://orcid.org/0000-0001-9151-3896; YAMADA, Elizabeth Sumi; http://lattes.cnpq.br/7240314827308306
Chronic low back pain (DLC) is associated with changes in postural control and is highly prevalent in the elderly. Research shows that aging and DLC are described as important factors that affect postural control. The postural control impairments increase the risk of falls. Researches evaluating the postural control in elderly people with DLC are still necessary for greater effectiveness in balance rehabilitation programs to prevention falls in this population. The objective of this study is to verify whether anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) are affected by DLC in elderly people by assessing their postural control during a self-initiated perturbation paradigm induced by rapid upper arm movement when pointing to a target. Elderly people were divided into: Group with DLC (GDLC) (n = 15) and Control Group (CG) (n = 15). The participants’ lower limb muscle onset and center of pressure (COP) displacements were assessed prior to perturbation and throughout the entire movement. T0 moment (i.e., the beginning of the movement) was defined as the anterior deltoid (DEL) onset, and all parameters were calculated with respect to it. The rectus femoris (RT), semitendinosus (ST), and soleous (SOL) showed delayed onset in the GDLC group compared with the control group: RF (control: -0.094 ± 0.017 s; GDLC: -0.026 ± 0.012 s, t = 12, p < 0.0001); ST (control: - 0.093 ± 0.013 s; GDL: -0.018 ± 0.019 s, t = 12, p < 0.0001); and SOL (control: -0.086± 0.018 s; GDL: -0.029 ± 0.015 s, t = 8.98, p < 0.0001). In addition, COP displacement was delayed in the GDLC group (control: -0.035 ± 0.021 s; GDL: -0.015 ± 0.009 s, t = 3; p = 0.003) and presented a smaller amplitude during APA COPAPA [control: 0.444 cm (0.187; 0.648); GDLC: 0.228 cm (0.096; 0.310), U = 53, p = 0.012]. The GDLC group required a longer time to reach the maximum displacement after the perturbation (control: 0.211 ± 0.047 s; GDLC 0.296 ± 0.078 s, t = 3.582, p = 0.0013). This indicates that GDLC elderly patients have impairments to recover their postural control and less efficient anticipatory adjustments during the compensatory phase. Our results suggest that people with GDL have altered feedforward hip and ankle muscle control, as shown from the SOL, ST, and RT muscle onset. This study is the first study in the field of aging that investigates the postural adjustments of an elderly population with GDLC. Clinical assessment of this population should consider postural stability as part of a rehabilitation program.
Acesso aberto (Open Access)
Associação entre características clínicas, funcionais e psicossociais com o risco de cronicidade dos sintomas em pacientes com dor lombar crônica não específica
(Universidade Federal do Pará, 2024-10-20) SILVA, Lucas Yuri Azevedo da; MAGALHÃES, Maurício Oliveira; http://lattes.cnpq.br/7766377002832983; https://orcid.org/0000-0002-7857-021X
Background: Low back pain is considered the leading cause of disability worldwide. Central sensitization is one of the mechanisms that explains how dysregulation in the central nervous system can modulate the chronicity of low back pain; however, it is unclear how clinical, functional, and psychosocial variables are associated with the risk stratification of low back pain chronification. Objective: To verify the association between low and high risk of symptom chronicity and clinical, functional, and psychosocial findings in patients with non specific chronic low back pain. Methods: This is a cross-sectional study applied to individuals with non-specific chronic low back pain, following the recommendations of The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), conducted between April 2023 and June 2024. The Numerical Pain Rating Scale (NPRS) and the INSTRUTHERM DD2000 20K pressure algometer were used to assess pain intensity and threshold; the Roland-Morris Disability Questionnaire (QRM) to assess functional disability; the Start Back Screening Tool (SBST) for chronicity risk stratification; the Pain Catastrophizing Scale (PCS), the Tampa Scale for Kinesiophobia (TSK), and the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics were performed, and correlation tests were conducted between SBST stratifications of chronicity and the scores from the evaluation instruments. Additionally, multinomial regression analyses were employed. Results: A total of 150 participants were included in the analysis. The correlation between low chronicity risk and clinical, functional, and psychosocial parameters showed statistically significant and moderate negative correlations for the QRM (r = -0.40) and PCS (r = -0.48). Significant, positive, and moderate correlations with high chronicity risk were observed for the QRM (r = 0.40) and PCS (r = 0.48), while positive and weak correlations were found for TSK (r = 0.39) and HADS (r = 0.27). Moreover, the multinomial regression analysis between high and low chronicity risk identified functional disability as a significant predictor for the elevated chronicity risk. For each one-unit increase in the disability questionnaire, the odds of being in the high-risk group increased by 8.8% (OR = 1.088, 95% CI: 1.003 - 1.181, p = 0.043). Additionally, catastrophizing was also a significant predictor. Each additional unit in the catastrophizing score increased the odds of being classified in the high-risk chronicity group by 10.0% (OR = 1.100, 95% CI: 1.049 - 1.154, p < 0.001). The model presented a significant intercept (β = -4.621, p < 0.001), indicating that, in the absence of predictor factors, the probability of being in the high-risk chronicity group is extremely low (OR = 0.009, 95% CI: 0.002 - 0.043). Conclusion: These findings suggest that the probability of being at high risk of chronicity compared to low risk was 36.8%, explained by functional disability and pain catastrophizing.