Comparando os efeitos da educação em dor versus exercício na modificação das crenças em pacientes com dor lombar crônica inespecífica: uma revisão bibliográfica

Abstract

Introduction: non-specific low back pain is a complex condition, characterized by the interaction of physical, psychological and social factors. Due to its great repercussion, effective treatment options must cover a biopsychosocial context, justifying an in-depth exploration of the cognitions and pain behavior of these patients, such as assessment of beliefs. Inadequate beliefs lead to a catastrophic response and behaviors of avoiding movements and activities considered as a source of pain, leading to the process of disuse. Individuals who present a modification of this model are more active in the process of coping with pain and present more favorable outcomes. Objectives: to carry out a bibliographical review of the literature to compare the effects of pain education versus exercise in modifying beliefs in patients with chronic non-specific low back pain. Methodology: the search was carried out between July and August 2023, using the descriptors “beliefs”, “education”, “exercise” and “low back pain”, with no defined publication date, in the electronic databases PEDro and Pubmed, in the English language. We only included a randomized clinical trial. Articles were excluded if whose sample was not exclusively of individuals with chronic low back pain; the objective of the intervention is not to modify patients' beliefs; the intervention does not present a modality of therapeutic exercises and pain education as a form of treatment. Results: 5 articles were selected and all presented scores ≥ 5 on the PEDro scale, considered high quality. There was variability in relation to the type of intervention used and the outcomes analyzed, with a total of five different types of interventions being verified, being: exercise, yoga, physiotherapy, walking and education Conclusion: both physical exercises and pain education techniques were effective in modifying fear avoidance beliefs in individuals with non-specific chronic low back pain, with superiority of a given intervention depending on the type of approach used. More studies are needed to better define the methodology on the effects of exercise and, mainly, to standardize the best approach aimed at pain education in modifying beliefs in individuals with chronic low back pain.