Efeitos de um programa educacional de autocuidado de coluna em idosos com dor lombar crônica: um estudo quasi-experimental

Abstract

ARTIGO ORIGINAL | ORIGINAL ARTICLE RESUMOO estudo teve por objetivo verificar os efeitos de um programa educacional de autocuidado de coluna, no controle da dor e na incapacidade em idosos ativos com dor lombar crônica (DL) não específica. Os idosos foram divididos em grupo experimental (GE n = 17) e controle (GC n = 13). A intervenção consistiu na entrega de uma cartilha educativa e um workshop. Foram variáveis dependentes: 1. intensidade da dor (EVN), 2. capacidade funcional relacionada à DL (RMQ), 3. quantidade de pontos de dor, 4. uso de medicação para DL e 5. frequência de uso de medicação para DL. Houve avaliação pré e após 1 mês da primeira avaliação. Na avaliação intragrupo foi observada no GE diminuição significativa de todos os parâmetros avaliados (todos p < 0,05) fato não observado no GC. Quanto à análise entre os grupos houve melhora significativa com tamanhos de efeitos moderados a grandes no GE para EVN (p=0.003, TE=0.53), no RMQ (p=0.037, TE=0.38) e nos pontos de dor (p=0.006, TE=0.49). Os resultados demonstraram que a cartilha pode ser uma ferramenta útil, capaz de gerar independência no cuidado e tratamento da DL crônica em idosos ativos.Palavras-chave: Lombalgia, idoso, autocuidado, educação ABSTRACT The purpose of this paper was to investigate the effects of an educational self-care program of spine in the control of pain and disability in actives older adults with chronic non-specific low back pain (LBP). They were divided in an experimental group (EG n = 17) and a control group (CG n = 13). The intervention consisted of delivering an educational booklet and also attending a workshop. Dependent variables were: 1. pain intensity (EVN), 2. functional capacity related to LBP (RMQ), 3. amount of pain points, 4. medication for LBP, 5. frequency of medication for LBP. There was evaluation pre and after 1 month of the first evaluation. The intragroup evaluation was observed in EG significant reduction of all parameters (all p < 0.05) was not observed in CG. Regarding the analysis between groups showed significant improvement with moderate to large effect sizes in EG to EVN (p=0.003, TE=0.53), RMQ (p=0.037, TE=0.38) and pain points (p=0.006, TE=0.49). The results highlight the booklet as a useful tool, capable of generating independence in the self-care for active older adults with chronic LBP.

Chronic Pain Self-Management Strategies for Older Adults: An Integrative Review

“…Most studies investigated more than one dependent variable, and most of them presented positive outcomes, yielding improvement of many symptoms after the practice of the chosen pain self-management strategy ( Table 2 ). The most evidenced positive outcome was related to pain itself (51.72%) [ 20 , 25 , 28 , 29 , 30 , 32 , 33 , 35 , 36 , 38 , 40 , 43 , 44 , 45 , 47 , 48 , 49 , 53 , 54 , 55 , 58 , 59 , 61 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 74 , 75 , 78 , 79 ]. Self-strategies investigated resulted in the reduction of pain intensity and/or the number of spots presenting pain.…”

“…To adopt physical exercise as a self-management strategy, the older adult must know how to practice unsupervised exercise in a safe manner, avoiding accidents, and to attempt self-care in posture and movement [ 31 , 47 , 74 ]. Although many authors have given posture advice, there is no consensus in the literature about causal relationships between physical posture adopted and pain incidence [ 87 ].…”

“…Education and cognitive behavioral therapy (CTB) were both in third place among the self-management strategies used. Studies investigating patient education on pain reported reduction of pain and medication use, improvement of functional capacity [ 47 , 74 ], decrease in daily pain catastrophizing, morning disability, fatigue and anxiety, improvement of pain-related perceived control [ 64 ] and not seeking additional care [ 41 ], beyond those results reported under self-management courses/programs, which also included educational strategies. To cope with complexity in pain patient care, we must abandon linear models, accept unpredictability, respect (and use) autonomy and creativity, and respond flexibly to emerging patterns and opportunities [ 88 ].…”

Physiotherapeutic intervention on chronic lumbar pain impact in the elderly

“…Initially, education of the elderly with CLBP by means of spinal self-care programs is a useful tool for treatment. In addition to allowing better pain control, it decreases incapacity and costs generated by the disease 12 . When this approach is associated to strengthening lumbar region with stabilizing exercises 14 , since the elderly affected by low back pain have further spinal instability 19 , treatment becomes more effective and promising.…”

Saúde Do Idoso: Percepções Dos Profissionais De Enfermagem Perante O Manejo Clínico Da Dor

“…Neste âmbito, Rios e colaboradores 6 afirmam que em casos de saúde fragilizada, o quadro da dor pode agravar esta situação, refletindo negativamente no autocuidado e, consequentemente, à perda progressiva da qualidade de vida do indivíduo.…”