Background:Low back pain is an important health condition with major socioeconomic consequences and is associated with high costs for the health system, absenteeism at work and reduced functional performance. It is one of the most relevant health problems in the elderly, with point prevalence estimates higher than other musculoskeletal conditions.Objectives:To verify the effect of segmental stabilization versus the Pilates method in the elderly with chronic low back pain.Methods:The study included 9 elderly women with chronic low back pain randomized into two groups: Segmental Stabilization Group (SG n = 5; age 65.2 ± 4.32; Body Mass Index - BMI 29.99 ± 4.65) and Pilates Group (PG n = 4; age 67.75 ± 7.13; BMI 26.49 ± 4.06). Both groups underwent 16 individual sessions of 60 minutes twice a week and avaliated before and after 8 weeks. Pain was assessed using the Visual Analogue Pain Scale; functional disability, by Oswestry’s disability index; excessive fear of movement and physical activity, using the Tampa Kinesiophobia Scale; level of confidence in the balance for specific activities, on the Activity-Specific Balance Confidence (ABC) scale and; activation of the transverse muscle of the abdomen, by the pressure biofeedback unit Stabilizer of the Chatanooga brand. The allocation and evaluations of the participants were performed by a blind examiner. The data were analyzed using the Student’s t-test with the level of significance (p≤0.05).Results:The data show significant differences in the reduction of pain intensity (p= 0.022) and functional disability (p=0.023) only in SG and improvement in kinesiophobia (p=0.007) only in PG. The level of confidence in the balance for specific activities was better in the SG when compared to the PG (p=0.059). There was no difference in the activation of the transversus abdominis in both groups.Conclusion:The results indicate that the segmental stabilization was effective to improve pain and functional disability, Pilates to improve the degree of kinesiophobia and the SG obtained a better result when compared to the PG regarding the level of confidence in the balance for specific activities. Both techniques had a great effect on improving functional capacity and on the level of confidence in the balance for specific activities. It is suggested to carry out studies with a larger number of participants and follow-up evaluation to assess the long-term effects.References:[1]Boonstra AM, Preuper HRS, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. IJSR 2008; 3(2):165-9.[2]Marques AP, Mendes YC, Taddei U, Pereira CAB, Assumpção A. Brazilian-Portuguese translation and cross cultural adaptation of the activities-specific balance confidence ABC) scale. Braz J Phys Ther 2013; 17(2): 170-8.[3]Siqueira FB, Teixeira-Salmela LF, Magalhães LC. Análise das propriedades psicométricas da versão brasileira da escala tampa de cinesiofobia. Acta Orto Bras 2007; 15(1): 19-24.[4]Viggato R, Alexandre NMC, Correa Filho HR. Development of a Braziliam Portuguese version of the Oswestry Disability Index: cross-cultural adaptation, reliability, and validity. Spine 2007; 32(4):481-6.Acknowledgments:Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Disclosure of Interests:None declared

INTRODUÇÃO: Dismenorreia é a condição dolorosa mais frequente em adolescentes e mulheres jovens causando absenteísmo e presenteísmo no trabalho e na escola. É caracterizada por um quadro álgico leve, moderado ou severo na região pélvica anterior do tipo cólica, o qual pode acontecer antes, durante ou depois do fluxo menstrual. OBJETIVO: Verificar a influência da Estimulação Elétrica Nervosa Transcutânea (TENS) na dor pélvica causada pela dismenorreia primária. MÉTODOS: 50 universitárias foram aleatoriamente distribuídas em dois grupos de 25 voluntárias: Grupo Região Pélvica Anterior (GA) e Grupo Região Pélvica Posterior (GP), que foram submetidas a TENS durante 30 minutos tendo a intensidade aumentada a cada 10 minutos e avaliadas pela Escala Visual Analógica de Dor antes, depois e duas horas após o término do tratamento. RESULTADOS: Houve uma diminuição do quadro álgico nos momentos antes e após o tratamento (GA e GP: p<0,0001) e antes e duas horas após o tratamento (GA e GP p<0,0001). Nos momentos depois do tratamento e duas horas após o seu término foi possível observar um aumento do quadro álgico no GA (p=1,0000) e diminuição no GP, porém, os valores não foram estatisticamente significativos (p=0,8443). CONCLUSÃO: O uso da TENS contribuiu para a redução do quadro álgico das mulheres de ambos os grupos. Registro Brasileiro de Ensaios Clínicos: RBR-67cjv5.

Objetivo: Comparar dois tipos de Estimulação Elétrica Nervosa Transcutânea (TENS), convencional e acupuntura, no tratamento da dismenorreia primária. Métodos: Participaram do estudo 24 voluntárias com quadro clínico de dismenorreia primária, com idade entre 18 e 35 anos, divididas aleatoriamente em: grupo convencional (GC n=12), tratado com TENS convencional e grupo acupuntura (GA n=12), tratado com TENS acupuntura. As participantes foram avaliadas antes, imediatamente depois e duas horas após a terapêutica através da Escala Visual Analógica de dor (EVA). Resultados: Ao analisar os dados referentes ao GC e GA, verificou-se redução significativa do quadro álgico ao se comparar os tempos antes e depois do tratamento (p?0,01), assim como depois e duas horas após o seu término (p?0,01), sem diferença entre os grupos. Conclusões: A TENS reduziu a dor pélvica causada pela síndrome da dismenorreia primária das participantes da pesquisa, porém, sem diferença estatística entre os grupos.

BackgroundManaging chronic pain is challenging due to the long-term safety profile of most drugs. The treatment of chronic Low Back Pain (CLBP) represents a significant medical and financial burden and aims at relieving pain, improving functional ability, and preventing recurrence and chronicity. It is therefore important to gain insight into how CLBP is managed in the population.ObjectivesTo characterize the intake profile of analgesic and other pain relief drugs in the Portuguese adult population with CLBP, taking the World Health Organization (WHO) analgesic ladder and pain intensity into account. To assess the relationship between having CLBP and the intake of analgesic and other pain relief drugs.MethodsEpiReumaPt was a cross-sectional Portuguese population-based study (10,661 subjects). Self-reported active CLBP (ACLBP) was considered: LBP on the day of enrollment and for ≥90 days. Prevalence and profile of analgesic intake was characterized among those self-reporting ACLBP, taking into account the intensity of pain and the WHO analgesic ladder. To understand whether the presence of ACLBP was a factor associated with drug intake, multivariable logistic regressions were conducted for each of the analgesic/pain relief therapeutic groups (in separate models), adjusted for confounders.ResultsAmong 1,487 subjects with ACLBP, 18.7% were using analgesic/pain relief drugs. Estimated prevalences were: anxiolytics, 14.1%; NSAIDs, 12.3%; antidepressants, 10.1%; analgesic antipyretic, 6.6%; anticonvulsants, 3,4%; central muscle relaxants, 2.6%; opioids, 1.6%. Most subjects with severe pain were in the 1st step of the WHO analgesic ladder: NSAIDs plus anxiolytics, sedatives & hypnotics (4.6%); NSAIDs plus antidepressants (3.2%); NSAIDs plus central muscle relaxants (2.5%). The presence of ACLBP was significantly associated with the intake of all therapeutic groups (table):Table 1.Association of the presence of ACLBP with the intake of each class of analgesic/pain relief drugs (separate multivariable models)Dependent variables*Active CLBP (yes/no)OR (95% CI)p-valueAnxiolytics, sedatives & hypnotics§8.86 (6.08–12.90)<0.001†NSAIDs±8.56 (5.84–12.53)<0.001†Antidepressants§12.56 (7.96–19.81)<0.001†Analgesics, Antipyretics¶7.68 (3.38–17.48)<0.001†Anticonvulsants9.27 (4.16–20.69)<0.001†Analgesic Opioids8.13 (2.78–23.77)<0.001†Central Muscle Relaxants12.01 (5.88–24.51)<0.001†*All the analyses were adjusted for: age, gender, geographic area, education level, number of self-reported comorbidities, and self-report of rheumatic and musculoskeletal diseases. §Additionally adjusted for: anxiety and depressive symptoms; ¶Additionally adjusted for: heart disease and gastrointestinal diseases.ConclusionsACLPB was associated with the intake of drugs belonging to all analgesic drug classes. Nevertheless, this drug intake was very low, even for those with severe pain. The WHO analgesic ladder was carefully followed with an extremely conservative use of analgesic opioids even for those with severe pain. There is clearly an unmet need in what ...

BackgroundLow back pain is the second most common health condition in Brazilian elderly, after arterial hypertension, and can be defined as any pain between the last ribs and the lower gluteal folds, with or without pain in the lower limbs, manifesting itself acutely, subacutely or chronically.ObjectivesTo analyze the effect of segmental stabilization in comparison with the Pilates method in elderly patients with chronic non-specific low back pain.Methods9 elderly people with chronic low back pain participated in the study, randomized into two groups: Segmental Stabilization Group (SG n=9; age 66.11±4.78; Body Mass Index - BMI 28.21±4.05) and Pilates Group (PG n=13; age 67.46 ±4.89; BMI 28.18±3.48). Both groups performed 16 individual 60-minute sessions twice a week and evaluated before and at the end of treatment. Pain was assessed using the Visual Numerical Pain Scale; functional disability, by the Oswestry disability index; excessive fear of movement and physical activity, by the Tampa Kinesiophobia Scale; level of confidence in balance for specific activities, by the Activities-specific Balance Confidence (ABC) scale and; activation of the transversus abdominis muscle, by the pressure biofeedback unit Stabilizer of the brand Chatanooga. The allocation and assessments of participants were performed by a blinded examiner. Data were analyzed using Student’s t test with the level of significance (p≤0.05).ResultsPain intensity had a greater reduction in the SG when compared to the PG (p=0.0015), as well as a reduction in functional disability (p=0.0043). The activation of the transversus abdominis was greater in the PG (p=0.0213). There was no difference in kinesiophobia and the level of confidence in balance for specific activities.ConclusionSegmental stabilization and Pilates were effective in improving pain and functional disability, with SG showing a better effect for these variables. The PG obtained better results when compared to the SG regarding the activation of the transversus abdominis muscle. It is suggested to carry out studies with a greater number of participants, a longer treatment and follow-up time to complement these findings.References[1]Boonstra AM, Preuper HRS, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. IJSR 2008; 3(2):165-9.[2]Marques AP, Mendes YC, Taddei U, Pereira CAB, Assumpção A. Brazilian-Portuguese translation and cross cultural adaptation of the activities-specific balance confidence ABC) scale. Braz J Phys Ther 2013; 17(2): 170-8.[3]Siqueira FB, Teixeira-Salmela LF, Magalhães LC. Análise das propriedades psicométricas da versão brasileira da escala tampa de cinesiofobia. Acta Orto Bras 2007; 15(1): 19-24.[4]Viggato R, Alexandre NMC, Correa Filho HR. Development of a Braziliam Portuguese version of the Oswestry Disability Index: cross-cultural adaptation, reliability, and validity. Spine 2007; 32(4):481-6.AcknowledgementsCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Disclosure of InterestsNone declared