El efecto de la educación sobre el dolor y la funcionalidad en pacientes con trastornos musculoesqueléticos de miembro superior: una revisión sistemática

Doval, Danielle; Martins, Maiara da Silva; Araujo, Francisco Xavier de

Brasil

Español English

REVISÃO SISTEMÁTICA • Fisioter. Pesqui. 29 (3) • Jul-Sep 2022 • https://doi.org/10.1590/1809-2950/21018929032022PT copiar

El efecto de la educación sobre el dolor y la funcionalidad en pacientes con trastornos musculoesqueléticos de miembro superior: una revisión sistemática

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Este estudio tuvo como objetivo verificar los efectos de la educación del paciente (EP) en individuos con trastornos musculoesqueléticos del miembro superior (MS) sobre los resultados de dolor y/o funcionalidad. Dos revisores realizaron búsquedas de forma independiente en las bases de datos PubMed, Cochrane, PEDro, SciELO y LILACS, desde el comienzo de las publicaciones en estas bases hasta abril de 2021. Se incluyeron ensayos clínicos aleatorizados con seres humanos con trastornos musculoesqueléticos en el MS; que han sido intervenidos con EP; y con resultados de dolor y/o funcionalidad. Los revisores determinaron de forma independiente la elegibilidad del estudio, extrajeron los datos y evaluaron la calidad metodológica mediante la escala PEDro. En esta revisión se incluyeron ocho estudios con un total de 603 participantes. La EP tuvo resultados superiores en tres de los estudios en cuanto al alivio del dolor o la mejora de la función en el grupo comparativo. Aparentemente, la EF es más efectiva cuando se combina con ejercicio.

Palabras clave
Educación del Paciente; Extremidad Superior; Dolor; Funcionalidad; Fisioterapia

Autor (Ano)	Amostra (N; NFem; idade média)	Diagnóstico	Intervenção de EP	Grupo comparativo	Desfechos	Instrumento	Follow-up	Resultados	Escore PEDro
Núñez-Cortés et al. (2019) ⁽¹³13. Núñez-Cortés R, Espinoza-Ordóñez C, Pommer PP, Horment-Lara G, Pérez-Alenda S, Cruz-Montecinos C. A single preoperative pain neuroscience education: is it an effective strategy for patients with carpal tunnel syndrome? Med Hypotheses. 2019;126:46-50. doi: 10.1016/j.mehy.2019.03.013. https://doi.org/10.1016/j.mehy.2019.03.0...	30; 30; 53,8 anos	STC	Uma sessão de PNE audiovisual, sobre neurofisiologia, aspectos biopsicossociais + exercícios PO	Receberam uma sessão de EP padrão audiovisual, sobre aspectos médicos e anatômicos + exercícios PO	Dor e função MS	Dor: EVA	Semanas 4 e 12 após a cirurgia	Semana 4:	7
						Função MS: QuickDASH		Dor: GE=GC
								Função: GE=GC
								Semana 12:
								Dor: GE=GC
								Função: GE=GC
Clark, Bassett e Siegert (2019) ⁽¹⁴14. Clark H, Bassett S, Siegert R. The effectiveness of web-based patient education and action and coping plans as an adjunct to patient treatment in physiotherapy: a randomized controlled trial. Physiother Theory Pract. 2019;35(10):930-9. doi: 10.1080/09593985.2018.1467521. https://doi.org/10.1080/09593985.2018.14...	108; 54; 50,55 anos	Lesões no ombro	EP audiovisual sobre anatomia, tratamento, demonstração de exercícios e diário	Tiveram acesso ao módulo 1 do programa de intervenção e ao diário	Dor e função MS	Dor: Escala P4	Semana 8 após o início do estudo	Dor: GE=GC	6
	108; 54; 50,55 anos	Lesões no ombro			Dor e função MS	Função MS: DASH		Função: GE=GC	6
Manning et al. (2014) ⁽¹⁵15. Manning VL, Hurley MV, Scott DL, Coker B, Choy E, Bearne LM. Education, self-management, and upper extremity exercise training in people with rheumatoid arthritis: a randomized controlled trial. Arthritis Care Res (Hoboken). 2014;66(2):217-27. doi: 10.1002/acr.22102. https://doi.org/10.1002/acr.22102...	108; 82; 55,15 anos	AR	EP em grupo com seminários interativos sobre AR e exercícios + cuidados habituais	Receberam apenas cuidados habituais	Função MS, capacidade funciona da mão e dor	Função MS: DASH Capacidade funcional da mão: GAT	Semana 12 e 36 após o início do estudo	Semana 12:	8
						Dor: EVA		Função, capacidade funcional da mão e dor: GE>GC
								Semana 36:
								Função, capacidade funcional da mão: GE=GC
								Dor: GE>GC
Hall et al. (2013) ⁽¹⁶16. Hall B, Lee HC, Fitzgerald H, Byrne B, Barton A, Lee AH. Investigating the effectiveness of full-time wrist splinting and education in the treatment of carpal tunnel syndrome: a randomized controlled trial. Am J Occup Ther. 2013;67(4):448-59. doi: 10.5014/ajot.2013.006031. https://doi.org/10.5014/ajot.2013.006031...	54; 41; 54,35 anos	STC	EP abordou anatomia, informações sobre STC + apostilas + órtese de punho	Não receberam nenhuma intervenção	Dor e função MS	Dor: EVA	Semana 8 após o fim da intervenção	Dor: GE=GC	5
	54; 41; 54,35 anos	STC		Não receberam nenhuma intervenção	Dor e função MS	Função: BQFSS		Função: GE=GC	5
Lin et al. (2010) ⁽¹⁷17. Lin SY, Neoh CA, Huang YT, Wang KY, Ng HF, Shi HY. Educational program for myofascial pain syndrome. J Altern Complement Med. 2010;16(6):633-40. doi: 10.1089/acm.2009.0378. https://doi.org/10.1089/acm.2009.0378...	62; 42; 49,37 anos	SDM	EP audiovisual e apostilas com informações sobre SDM e alongamento + AS	Receberam resumo sobre intervenção geral + AS	Dor	Dor: BPI-T	Semana 4 após o fim da intervenção	Dor: GE>GC	6
Hansson et al. (2010) ⁽¹⁸18. Hansson EE, Jönsson-Lundgren M, Ronnheden AM, Sörensson E, Bjärnung A, Dahlberg LE. Effect of an education programme for patients with osteoarthritis in primary care - a randomized controlled trial. BMC Musculoskelet Disord. 2010;11:244. doi: 10.1186/1471-2474-11-244. https://doi.org/10.1186/1471-2474-11-244...	114; não descrito; 49,37 anos	OA	EP sobre anatomia, fisiologia, dor, OA, exercícios e tratamento	Continuaram vivendo normalmente	Dor e função da mão	Função da mão: GAT	6 meses após a intervenção	Função: GE=GC	8
	114; não descrito; 49,37 anos	OA		Continuaram vivendo normalmente	Dor e função da mão	Dor: EQ-5D		Dor: GE>GC	8
Hammond e Freeman (2004) ⁽¹⁹19. Hammond A, Freeman K. The long-term outcomes from a randomized controlled trial of an educational-behavioural joint protection programme for people with rheumatoid arthritis. Clin Rehabil. 2004;18(5):520-8. doi: 10.1191/0269215504cr766oa. https://doi.org/10.1191/0269215504cr766o...	127; 97; 50,52 anos	AR	EP padrão sobre AR, tratamento, exercícios e dor + folhetos informativos + proteção das articulações	Receberam educação comportamental sobre proteção das articulações + apostila com informações	Dor e função MS	Dor: EVA	4 anos após o fim da intervenção	Dor: GE=GC	6
	127; 97; 50,52 anos	AR			Dor e função MS	Função MS: AIMS2		Função: GE=GC	6
Hammond e Freeman (2001) ⁽²⁰20. Hammond A, Freeman K. One-year outcomes of a randomized controlled trial of an educational-behavioural joint protection programme for people with rheumatoid arthritis. Rheumatology (Oxford). 2001;40(9):1044-51. doi: 10.1093/reumatologia/40.9.1044. https://doi.org/10.1093/reumatologia/40....	127; 97; 50,52 anos	AR	EP padrão sobre AR, tratamento, exercícios e dor + folhetos informativos + proteção das articulações	Receberam educação comportamental sobre proteção das articulações + apostila com informações	Dor e função MS	Dor: EVA	6 e 12 meses após o fim da intervenção	6 meses:	6
						Função MS: AIMS2		Dor: GE=GC
								Função: GE=GC
								12 meses:
								Dor: GE<GC
								Função: GE<GC

Autor (ano)	Follow-up	Dor	Funcionalidade
Núñez-Cortés et al. (2019) ⁽¹³13. Núñez-Cortés R, Espinoza-Ordóñez C, Pommer PP, Horment-Lara G, Pérez-Alenda S, Cruz-Montecinos C. A single preoperative pain neuroscience education: is it an effective strategy for patients with carpal tunnel syndrome? Med Hypotheses. 2019;126:46-50. doi: 10.1016/j.mehy.2019.03.013. https://doi.org/10.1016/j.mehy.2019.03.0...	Semana 4 e 12	GE=GC	GE=GC
Clark, Bassett e Siegert (2019) ⁽¹⁴14. Clark H, Bassett S, Siegert R. The effectiveness of web-based patient education and action and coping plans as an adjunct to patient treatment in physiotherapy: a randomized controlled trial. Physiother Theory Pract. 2019;35(10):930-9. doi: 10.1080/09593985.2018.1467521. https://doi.org/10.1080/09593985.2018.14...	Semana 8	GE=GC	GE=GC
Manning et al. (2014) ⁽¹⁵15. Manning VL, Hurley MV, Scott DL, Coker B, Choy E, Bearne LM. Education, self-management, and upper extremity exercise training in people with rheumatoid arthritis: a randomized controlled trial. Arthritis Care Res (Hoboken). 2014;66(2):217-27. doi: 10.1002/acr.22102. https://doi.org/10.1002/acr.22102...	Semana 12	GE>GC	GE>GC
	Semana 36	GE>GC	GE=GC
Hall et al. (2013) ⁽¹⁶16. Hall B, Lee HC, Fitzgerald H, Byrne B, Barton A, Lee AH. Investigating the effectiveness of full-time wrist splinting and education in the treatment of carpal tunnel syndrome: a randomized controlled trial. Am J Occup Ther. 2013;67(4):448-59. doi: 10.5014/ajot.2013.006031. https://doi.org/10.5014/ajot.2013.006031...	Semana 8	GE=GC	GE=GC
Lin et al. (2010) ⁽¹⁷17. Lin SY, Neoh CA, Huang YT, Wang KY, Ng HF, Shi HY. Educational program for myofascial pain syndrome. J Altern Complement Med. 2010;16(6):633-40. doi: 10.1089/acm.2009.0378. https://doi.org/10.1089/acm.2009.0378...	Semana 4	GE>GC	NA
Hansson et al. (2010) ⁽¹⁸18. Hansson EE, Jönsson-Lundgren M, Ronnheden AM, Sörensson E, Bjärnung A, Dahlberg LE. Effect of an education programme for patients with osteoarthritis in primary care - a randomized controlled trial. BMC Musculoskelet Disord. 2010;11:244. doi: 10.1186/1471-2474-11-244. https://doi.org/10.1186/1471-2474-11-244...	6 meses	GE>GC	GE=GC
Hammond e Freeman (2004) ⁽¹⁹19. Hammond A, Freeman K. The long-term outcomes from a randomized controlled trial of an educational-behavioural joint protection programme for people with rheumatoid arthritis. Clin Rehabil. 2004;18(5):520-8. doi: 10.1191/0269215504cr766oa. https://doi.org/10.1191/0269215504cr766o...	4 anos	GE=GC	GE=GC
Hammond e Freeman (2001) ⁽²⁰20. Hammond A, Freeman K. One-year outcomes of a randomized controlled trial of an educational-behavioural joint protection programme for people with rheumatoid arthritis. Rheumatology (Oxford). 2001;40(9):1044-51. doi: 10.1093/reumatologia/40.9.1044. https://doi.org/10.1093/reumatologia/40....	6 meses	GE=GC	GE=GC
	12 meses	GE<GC	GE<GC

Diagnóstico	Autor (ano)	Follow-up	Dor	Funcionalidade
AR	Manning et al. (2014) ⁽¹⁵15. Manning VL, Hurley MV, Scott DL, Coker B, Choy E, Bearne LM. Education, self-management, and upper extremity exercise training in people with rheumatoid arthritis: a randomized controlled trial. Arthritis Care Res (Hoboken). 2014;66(2):217-27. doi: 10.1002/acr.22102. https://doi.org/10.1002/acr.22102...	Semana 12	GE>GC	GE>GC
		Semana 36	GE>GC	GE=GC
	Hammond e Freeman (2004) ⁽¹⁹19. Hammond A, Freeman K. The long-term outcomes from a randomized controlled trial of an educational-behavioural joint protection programme for people with rheumatoid arthritis. Clin Rehabil. 2004;18(5):520-8. doi: 10.1191/0269215504cr766oa. https://doi.org/10.1191/0269215504cr766o...	4 anos	GE=GC	GE=GC
	Hammond e Freeman (2001) ⁽²⁰20. Hammond A, Freeman K. One-year outcomes of a randomized controlled trial of an educational-behavioural joint protection programme for people with rheumatoid arthritis. Rheumatology (Oxford). 2001;40(9):1044-51. doi: 10.1093/reumatologia/40.9.1044. https://doi.org/10.1093/reumatologia/40....	6 meses	GE=GC	GE=GC
		12 meses	GE<GC	GE<GC
STC	Núñez-Cortés (2019) ⁽¹³13. Núñez-Cortés R, Espinoza-Ordóñez C, Pommer PP, Horment-Lara G, Pérez-Alenda S, Cruz-Montecinos C. A single preoperative pain neuroscience education: is it an effective strategy for patients with carpal tunnel syndrome? Med Hypotheses. 2019;126:46-50. doi: 10.1016/j.mehy.2019.03.013. https://doi.org/10.1016/j.mehy.2019.03.0...	Semana 4 e 12	GE=GC	GE=GC
STC	Hall et al. (2013) ⁽¹⁶16. Hall B, Lee HC, Fitzgerald H, Byrne B, Barton A, Lee AH. Investigating the effectiveness of full-time wrist splinting and education in the treatment of carpal tunnel syndrome: a randomized controlled trial. Am J Occup Ther. 2013;67(4):448-59. doi: 10.5014/ajot.2013.006031. https://doi.org/10.5014/ajot.2013.006031...	Semana 8	GE=GC	GE=GC
OA	Hansson et al. (2010) ⁽¹⁸18. Hansson EE, Jönsson-Lundgren M, Ronnheden AM, Sörensson E, Bjärnung A, Dahlberg LE. Effect of an education programme for patients with osteoarthritis in primary care - a randomized controlled trial. BMC Musculoskelet Disord. 2010;11:244. doi: 10.1186/1471-2474-11-244. https://doi.org/10.1186/1471-2474-11-244...	6 meses	GE>GC	GE=GC
SDM	Lin et al. (2010) ⁽¹⁷17. Lin SY, Neoh CA, Huang YT, Wang KY, Ng HF, Shi HY. Educational program for myofascial pain syndrome. J Altern Complement Med. 2010;16(6):633-40. doi: 10.1089/acm.2009.0378. https://doi.org/10.1089/acm.2009.0378...	Semana 4	GE>GC	NA
Lesões do ombro	Clark, Bassett e Siegert (2019) ⁽¹⁴14. Clark H, Bassett S, Siegert R. The effectiveness of web-based patient education and action and coping plans as an adjunct to patient treatment in physiotherapy: a randomized controlled trial. Physiother Theory Pract. 2019;35(10):930-9. doi: 10.1080/09593985.2018.1467521. https://doi.org/10.1080/09593985.2018.14...	Semana 8	GE=GC	GE=GC

Acompanhamento	Autor (ano)	Follow-up	Dor	Funcionalidade
Curto prazo	Núñez-Cortés (2019) ⁽¹³13. Núñez-Cortés R, Espinoza-Ordóñez C, Pommer PP, Horment-Lara G, Pérez-Alenda S, Cruz-Montecinos C. A single preoperative pain neuroscience education: is it an effective strategy for patients with carpal tunnel syndrome? Med Hypotheses. 2019;126:46-50. doi: 10.1016/j.mehy.2019.03.013. https://doi.org/10.1016/j.mehy.2019.03.0...	4 semanas	GE=GC	GE=GC
Curto prazo	Lin et al. (2010) ⁽¹⁷17. Lin SY, Neoh CA, Huang YT, Wang KY, Ng HF, Shi HY. Educational program for myofascial pain syndrome. J Altern Complement Med. 2010;16(6):633-40. doi: 10.1089/acm.2009.0378. https://doi.org/10.1089/acm.2009.0378...	4 semanas	GE>GC	NA
Médio prazo	Núñez-Cortés (2019) ⁽¹³13. Núñez-Cortés R, Espinoza-Ordóñez C, Pommer PP, Horment-Lara G, Pérez-Alenda S, Cruz-Montecinos C. A single preoperative pain neuroscience education: is it an effective strategy for patients with carpal tunnel syndrome? Med Hypotheses. 2019;126:46-50. doi: 10.1016/j.mehy.2019.03.013. https://doi.org/10.1016/j.mehy.2019.03.0...	12 semanas	GE=GC	GE=GC
	Clark, Bassett e Siegert (2019) ⁽¹⁴14. Clark H, Bassett S, Siegert R. The effectiveness of web-based patient education and action and coping plans as an adjunct to patient treatment in physiotherapy: a randomized controlled trial. Physiother Theory Pract. 2019;35(10):930-9. doi: 10.1080/09593985.2018.1467521. https://doi.org/10.1080/09593985.2018.14...	8 semanas	GE=GC	GE=GC
	Manning et al. (2014) ⁽¹⁵15. Manning VL, Hurley MV, Scott DL, Coker B, Choy E, Bearne LM. Education, self-management, and upper extremity exercise training in people with rheumatoid arthritis: a randomized controlled trial. Arthritis Care Res (Hoboken). 2014;66(2):217-27. doi: 10.1002/acr.22102. https://doi.org/10.1002/acr.22102...	12 semanas	GE>GC	GE>GC
	Hall et al. (2013) ⁽¹⁶16. Hall B, Lee HC, Fitzgerald H, Byrne B, Barton A, Lee AH. Investigating the effectiveness of full-time wrist splinting and education in the treatment of carpal tunnel syndrome: a randomized controlled trial. Am J Occup Ther. 2013;67(4):448-59. doi: 10.5014/ajot.2013.006031. https://doi.org/10.5014/ajot.2013.006031...	8 semanas	GE=GC	GE=GC
Longo prazo	Manning et al. (2014) ⁽¹⁵15. Manning VL, Hurley MV, Scott DL, Coker B, Choy E, Bearne LM. Education, self-management, and upper extremity exercise training in people with rheumatoid arthritis: a randomized controlled trial. Arthritis Care Res (Hoboken). 2014;66(2):217-27. doi: 10.1002/acr.22102. https://doi.org/10.1002/acr.22102...	36 semanas	GE>GC	GE=GC
	Hansson et al. (2010) ⁽¹⁸18. Hansson EE, Jönsson-Lundgren M, Ronnheden AM, Sörensson E, Bjärnung A, Dahlberg LE. Effect of an education programme for patients with osteoarthritis in primary care - a randomized controlled trial. BMC Musculoskelet Disord. 2010;11:244. doi: 10.1186/1471-2474-11-244. https://doi.org/10.1186/1471-2474-11-244...	6 meses	GE>GC	GE=GC
	Hammond e Freeman (2004) ⁽¹⁹19. Hammond A, Freeman K. The long-term outcomes from a randomized controlled trial of an educational-behavioural joint protection programme for people with rheumatoid arthritis. Clin Rehabil. 2004;18(5):520-8. doi: 10.1191/0269215504cr766oa. https://doi.org/10.1191/0269215504cr766o...	4 anos	GE=GC	GE=GC
	Hammond e Freeman (2001) ⁽²⁰20. Hammond A, Freeman K. One-year outcomes of a randomized controlled trial of an educational-behavioural joint protection programme for people with rheumatoid arthritis. Rheumatology (Oxford). 2001;40(9):1044-51. doi: 10.1093/reumatologia/40.9.1044. https://doi.org/10.1093/reumatologia/40....	6 meses	GE=GC	GE=GC
		12 meses	GE<GC	GE<GC

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