Eficácia da terapia manual na redução da dor e melhora da função em indivíduos com lombalgia subaguda e crônica: uma revisão sistemática

Abstract

The aim of this study was to make a literature systematic review of the past 10 years to verify if manual therapy is effective in reducing pain and improving the function of individuals with subacute and chronic low back pain. To that end, we made a systematic review of studies published between 2005 and December 2015 in the the electronic databases Pubmed, PEDro, Bireme and Cochrane Library using the key words, join mobilization or manual therapy, pain, function and low back pain or chronic low back. Studies whose sample were not exclusively of individual with subacute or chronic low back pain, whose objective of intervention was not the reduction of pain and which intervention didnt provide a method of manual therapy were excluded. In accordance with the exclusion criteria, of the 26 articles found on the database PEDro, only 1 was included for analysis; of the 233 articles found on Pubmed, only 10 were selected, once 1 study had already been selected on PEDro. Of the 49 studies found on Bireme, 2 had already been previously selected on PEDro and Pubmed. 17 articles were found on Cochrane, of which only 1 fitted the criteria but had already been selected on PEDro. Four types of manual therapy were shown. 1) joint manipulation alone, 2) joint mobilization alone, 3) massages, 4) association of joint mobilization and manipulation. The results of this study suggest that manual therapy was effective in reducing pain and improvising function in individuals with subacute and chronic lower back pain in the short and long term. However, the majority of the studies did not describe the clinical characteristics of the individuals that can interfere in chronic pain and that responded better to manual therapy. Furthermore, one of the limitations of the studies was the fact of not testing a manual therapy technique on its own, affecting the transparency of the results. The effectiveness of manual therapy depends on applicator experience, the form of the used intervention, duration of intervention and how the patient perceives their disease. Further studies are necessary to better define the methodology of the application of manual therapy in pain reduction and improvement in functional capacity in patients with acute and chronic low back pain.