CRYOTHERAPY COMBINED TRANSCUTANEOUS ELECTRIC NERVE STIMULATION OF LOW FREQUENCY (BURST) IN PATIENTS WITH NONSPECIFIC CHRONIC LOW BACK PAIN:
CONTROLLED, RANDOMIZED AND BLIND CLINICAL TRIAL
nonspecific Chronic Back Pain, Cryotherapy, Transcutaneous Electrical Nerve Stimulation and Analgesia.
Introduction: Chronic low back pain (DLC) is defined by persistent pain occurring on most days and staying for more than 3 months. Many pathological conditions may lead to the onset of this pain, but the vast majority of DLC cases do not present anatomopathological or radiological alterations. Among the non-pharmacological resources for the treatment of this disorder are electrophysiological resources, such as Cryotherapy and Transcutaneous Electrical Nerve Stimulation (TENS) in Burst mode. Objective: To observe the influence of the combination: Cryotherapy and TENS Burst on the pain sensation, functional capacity and quality of life of patients with chronic nonspecific low back pain. Materials and methods: This is a randomized, blinded, controlled clinical trial conducted at Hospital Universitário Onofre Lopes. Fourty-four individuals of both sexes were randomly divided into four groups: control-placebo group (gCP), cryotherapy group (gCrio), TENS-Burst group (gTENSb) and cryotherapy + TENS Burst (gCrioTENSb). All the subjects were submitted to the measures of evaluation of: Pain through the Visual Analogue Scale (EVA) and pain threshold by pressure by the Algometer; Functional ability by the questionnaire Roland-Morris and the sit-up test; Quality of life through questionnaire SF 36; besides the feeling of pleasure / displeasure of the intervention by Felling Scale. Pain was assessed before and immediately after the first session, after week 1, week 2, week 3 and after 48 h of week 3 of the protocol. The functional capacity and quality of life were evaluated before and 48h after the end of the protocol, on the last day of evaluation the pleasure / displeasure sensation was also evaluated. The intervention protocol was 40 minutes, being 10 minutes of education about the disease and 30 minutes of intervention: Cryotherapy, TENS, placebo or Burst, or the combination of resources depending on the group allocated. Data were analyzed using the statistical software SPSS 20.0, assigned the level of significance of 5% and presented in mean and standard deviation. The Kolmogorov-Smirnov test was used to test the normality of the data. As the data presented a normal distribution, the one-way ANOVA test was used to evaluate baseline between groups (initial data) and feeling scale, mixed ANOVA among the four groups studied ANOVA (gCP, gCrio, gTENSb and gCrioTENSb) in both evaluations. The ANOVA of repeated measures for pain sensation, skin temperature and intensity of electrical stimulation. Results: There was no statistical difference between the groups on VAS, pressure pain threshold, MRI, sit-up test, SF-26 and Felling Scale (p> 0.05). Conclusion: This study showed that all groups achieved improvement: pain immediately after the first session and post treatment protocol, functional capacity, quality of life domains and felling scale post treatment protocol without difference between groups in patients with non-specific.