Efeito dos exercícios ativos associados à educação em dor versus exercícios ativos na melhora da dor e funcionalidade de pacientes com dor lombar: uma revisão da literatura

Abstract

Introduction:Low back pain is a prevalent condition that affects millions of people around the world, representing one of the main public health challenges. It is characterized by discomfort or pain in the lower back region, significantly impacting individuals' quality of life. Active exercise and pain education has been associated with improving the psychosocial aspects of pain, and may help increase neuromuscular facilitation and core stability of the paraspinal muscles, which are important for managing low back pain. Objective: To analyze the effects of combining active exercise with pain education compared to the isolated active exercise approach on improving pain and functionality in patients with chronic low back pain. Methods: A narrative review of the literature was carried out, with the selection of articles carried out between May and October 2023 in the Pubmed and PEDro databases. Inclusion criteria involved randomized clinical trials focused on treating chronic low back pain through exercise combined with pain education. The articles were selected based on titles, abstracts and complete reading, being evaluated using the PEDro scale. Results: The electronic search resulted in a total of 146 studies. After selection, 10 studies that used pain education and active exercises, with outcomes in pain and disability, were analyzed. The interventions lasted between 4 and 12 weeks, with 2 to 3 sessions per week. All included studies demonstrated that exercise therapy combined with pain education promotes improvement in chronic low back pain, and 9 of these studies highlighted improvement in disability. Furthermore, it was observed that individuals who received pain education showed improvement in kinesiophobia and fear avoidance beliefs. Conclusion: The combined approach of pain education and active exercise has been shown to be effective in reducing pain and improving functionality in patients with chronic low back pain. These findings suggest that interventions that address physical and psychosocial aspects can provide better clinical outcomes and greater quality of life for patients.