Qual o efeito da cinesioterapia comparada a nenhuma ou outras intervenções para melhora da dor e funcionalidade em pacientes com osteoartrite de quadril?

Abstract

Introduction: Hip osteoarthritis (OA) is a rheumatological disease that can cause pain, stiffness and joint dysfunction, being an important cause of disability among the elderly. Kinesiotherapy is an important type of physiotherapeutic intervention used in the treatment of hip OA, but It is necessary to study and compare with other types of interventions to understand their effectiveness and facilitate a patient's treatment plan. Objective: The objective of this literature review is to show the effect of kinesiotherapy compared to no or other interventions to improve pain and function in patients with hip OA. Methods: This work consists of a narrative literature review. A search was carried out in the PUBMED database from May to July 2023. Inclusion criteria: randomized controlled clinical trials, from 2010 to 2023, in English and Portuguese; patients with hip OA, studies whose outcome contains pain and/or function; studies in which the intervention group performs kinesiotherapy or kinesiotherapy associated with other interventions. Exclusion criteria: patients who had already undergone hip arthroplasty (THA). Review studies, cross-sectional studies, case control, cohort, case studies and pre-post studies without a comparison group. Results: 99 articles were found. After passing the inclusion and exclusion criteria, seven studies were included. Next, a manual search was carried out, resulting in the inclusion of three more studies, resulting in 10 studies included. The sample ranged from 31 to 210 people, with a total of 1252 participants. Regarding interventions in the studies, participants performed kinesiotherapy with pain education compared to just pain education, kinesiotherapy compared to manual therapy associated with kinesiotherapy, kinesiotherapy associated with manual therapy and education compared to no intervention, kinesiotherapy compared to no intervention, kinesiotherapy compared Nordic walking and home kinesiotherapy. Intervention time 10 ranged from 9 to 36 weeks. The outcomes evaluated were ROM, pain and function using the WOMAC or HOOS subscale, gait speed, gait kinematics, muscle strength and hip joint stiffness. Regarding the results, in the pre- and post-intervention comparison, eight of the ten studies demonstrated some effect on pain or function. However, when comparing groups, only four studies showed positive results for pain and function. For the kinematic outcome of gait evaluated in two studies, kinesiotherapy did not generate a positive effect. Conclusion: This review showed that kinesiotherapy carried out for a period of 9 to 36 weeks improved some pain and function outcomes in eight of the ten included studies. This improvement occurred in the outcomes of pain, stiffness and/or function assessed by WOMAC. Furthermore, when comparing kinesiotherapy with other interventions, this literature review brought inconclusive results, as only four of the ten studies showed a significant difference between the groups.