Eficácia do exercício no tratamento da dor e incapacidade associados a dor miofascial: uma revisão sistemática

Abstract

Aim: To investigate the effectiveness of exercise on pain and disability related to myofascial pain (MP). Methods: Systematic review with meta-analysis of randomised controlled trials. Electronic searches were conducted in Medline, EMBASE, PEDro, AMED and Cochrane databases. Adults with muscle pain and trigger points of any duration were considered for inclusion. Exercise versus control and exercises versus other interventions were compared for the outcomes of pain intensity and disability. Results: Thirteen studies involving 474 participants were included. Pooled estimates showed statistically significant effects of exercise when compared to control on pain intensity and disability at short-term follow-up. Weighted mean differences were respectively -1.3 (95% CI -2.1 to -0.5) and -0.68 (95% CI -1.22 to -0.14) points on a 010 scale. These effects were not clinically important. Only one study compared exercise to other intervention on pain intensity and disability and meta-analysis was not possible. Sensitivity analysis showed that blinding might influence effects of exercise. Conclusion: There is low-quality evidence that exercise has significant but not clinically important effects on pain and disability related to MP when compared to control. Although effects were not clinically important, estimates are likely to change with future high-quality studies in the field. For now, exercise is considered an advantageous option for clinical practice in the treatment of MP due to few side effects produced and its good cost-effectiveness.