Eficácia de um programa de exercícios multimodais em circuito na dor crônica musculoesquelética em pessoas idosas comunitárias: um ensaio clínico randomizado

Abstract

Introduction: Previous studies have shown that musculoskeletal pain is one of the most prevalent health conditions affecting many individuals worldwide. In relation to the elderly, persistent pain is a widely prevalent and limitation condition of multiple contributing factors, such as physical, mental and social. Objective: To analyze the effectiveness of a multimodal exercise program in circuit form when compared with stretching exercises and health education (multidisciplinary lectures on health), in chronic musculoskeletal pain of older people aged 60 years or over in the city of Palmas. Method: This is a randomized parallel study (two arms), with blind results evaluations. The recruitment of the participants was made by a non- probabilistic sample resulting from invitations to the Basic Health Units of the municipality of Palmas (Tocantins, Brazil). Of this research, 113 older people who were allocated through a randomization process participated in one of two groups for 12 weeks: Experimental Group (multimodal circuit exercise) or Control Group (cycle of multidisciplinary lectures on pain and stretching exercise). The result of the primary outcomes was the intensity of chronic pain and overall perception of change. Secondary outcomes were: cardiorespiratory capacity, lower strength and resistance, and functional mobility. The analyses were processed with prism 9 software (version 9.0.0), with significance level of 1% for all variables (intra and inter-groups). Results: There was a statistically significant difference for pain intensity reported through the Numerical Classification Scale - NRS between the groups at the post-intervention moment, where the Experimental Group - EG presented median (Md) = 2 (IQR=2), resulting in a statistically significant reduction in pain (*p <0.0001.), when compared with the Control Group - CG (Md=3 [IQR=1]). The overall perception of change was performed at the post-intervention moment through the Global Perception of Change Scale (PGIS) and difference showed significant statistics for the perception of the treatment received from the EG group (Md= 6 [IQR=1] compared to the CG group (Md=5 [IQR=0.25]) (*p <0.0001). For secondary outcomes, cardiorespiratory capacity measured through the 6-minute walk test, lower limbs strength and resistance through the Sitting and Lifting in chair test (30) presented significantly significant statistics between the EG and CG groups (*p <0,0001). Functional mobility did not present statistically significant differences between the groups (p = 0.9623), using the Time Up and Go (TUG) test. All outcome variables were homogeneous at the pre-intervention moment. Conclusion: In view of the results presented, we can conclude that the multimodal exercise program in the form of a circuit presented has efficacy for the treatment of chronic musculoskeletal pain in community-like community old people attending the UBS in the city of Palmas-TO.