Comparación entre las técnicas de abdominal Bracing y RPG, pacientes con lumbago crónico, que acuden al centro de salud SIME USFQ de la ciudad de Quito en el período de Julio-Diciembre 2013
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2014
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es
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Universidad Andrés Bello
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Resumen
La investigación realizada tuvo como objetivo comparar la eficacia de un programa de Reeducación Postural Global (RPG) vs. un programa de abdominal bracing en sujetos con dolor lumbar.
Las personas que se incluyeron fueron sujetos con dolor lumbar que asistieron al servicio de rehabilitación física de la clínica de la Universidad San Francisco de Quito, quienes firmaron su consentimiento de participar en el estudio, en los meses de julio a diciembre del 2013, y se excluyeron a los pacientes con artrosis, osteoporosis, escoliosis, hernias discales, personas con cirugías lumbares.
Se tomó una muestra poblacional de 100 pacientes, de los cuales 50 fueron asignados al grupo de GPR y 50 al grupo abdominal bracing. Las medidas de resultado primarias el Índice de Discapacidad de Oswestry (ODI) (anexo 2) y el test Core de Me Gill (Anexo 3). Los datos se recogieron al inicio y a la finalización de la aplicación del programa de ejercicios, se aplicó el programa de ejercicios 3 veces por semana durante 8 semanas. Posteriormente, 2 semanas de seguimiento a los participantes.
Al inicio del estudio, los dos grupos no presentaron diferencias significativas y al comparar las diferencias entre los grupos, el grupo de Abdominal bracing obtuvo mejores resultados en dolor lumbar por hiperlordosis lumbar. Pero el grupo al que se le aplicó RPG obtuvo mejores resultados en rectificación lumbar.
Estos resultados deben ser confirmados por otros estudios con los estándares metodológicos superiores, incluyendo la asignación al azar, muestras de mayor tamaño, mayor tiempo de seguimiento.
La aplicación del abdominal bracing en hiperlordosis lumbar presenta una mejoría superior en tiempos de resistencia (34%) en el test de Me Gill comparada con la técnica de RPG (18%). En el test de Owestry el 24% de pacientes con hiperlordosis lumbar que fueron aplicados abdominal bracing presentan mayor mejoría, al tener una limitación funcional mínima del 0%- 20%, que la muestra tratada con RPG que presenta una limitación leve al finalizar la aplicación del 20%- 40%, el 22%. En rectificación lumbar total presenta una mejoría mínima comparada en tiempos de resistencia (221-260 segundos) del test de Mc Gill, el RPG (20%) vs. Abdominal bracing (18%). En el test de Owestry el 34% de pacientes con rectificación lumbar total que fueron aplicados RPG presentan una mayor mejoría, al tener una limitación funcional mínima del O- 20%, que la muestra tratada con Abdominal que presenta una limitación al finalizar la aplicación del 0-20%, que corresponde al 20%.
The investigation made to compare the effectiveness of a Global Postural Reeducation (RPG) vs. abdominal bracing program in subjects with LBP. Those included were subjects with low back pain who attended the physical therapy clinic at the Universidad San Francisco de Quito, in the months of July to December 2013, and excluded patients with osteoarthritis, osteoporosis, escoliosis, hemiated discs, lumbar surgeries people. A sample population of 100 patients, of whom 50 were assigned to the GPR group and 50 to the abdominal bracing group was noted. The primary outcomes were the Oswestry Oisability Index (001) and the Core test McGill. The data at baseline and at the completion of the implementation of the exercise program were collected, the exercise program was applied 3 times a week for 8 weeks. Subsequently, the participants had followed for 2 weeks. At baseline, the two groups did not differ significantly and to compare differences between groups, the group of Abdominal bracing outperformed lumbar pain by lumbar lordosis. But the group that was applied in RPG outperformed lumbar rectification. These results should be confirmed by other studies with higher methodological standards, including randomization, larger sample sizes, Ionger follow-up. Applying the abdominal bracing in lumbar hyperlordosis exhibits better resistance times (34%) in the test McGill than RPG technique (18%). Patients with lumbar lordosis that were applied abdominal bracing (24%) had better results in the Owestry's test (minimal functional limitations, 0% - 20%) than the patients (22%) treated with RPG (slight functional limitation 20%- 40%) Patients with lumbar rectification have minimal improvement compared to resistance times (221-260 seconds) McGill Test, the RPG (20%) vs. abdominal bracing (18%). In the test Owestry 34% of patients with lumbar rectification were applied RPG exhibit greater improvement, to have a mínimum functional limitation. O- 20%, than the sample treated with Abdominal presented a constraint to termínate the application of 0-20% which corresponds to 20%.
The investigation made to compare the effectiveness of a Global Postural Reeducation (RPG) vs. abdominal bracing program in subjects with LBP. Those included were subjects with low back pain who attended the physical therapy clinic at the Universidad San Francisco de Quito, in the months of July to December 2013, and excluded patients with osteoarthritis, osteoporosis, escoliosis, hemiated discs, lumbar surgeries people. A sample population of 100 patients, of whom 50 were assigned to the GPR group and 50 to the abdominal bracing group was noted. The primary outcomes were the Oswestry Oisability Index (001) and the Core test McGill. The data at baseline and at the completion of the implementation of the exercise program were collected, the exercise program was applied 3 times a week for 8 weeks. Subsequently, the participants had followed for 2 weeks. At baseline, the two groups did not differ significantly and to compare differences between groups, the group of Abdominal bracing outperformed lumbar pain by lumbar lordosis. But the group that was applied in RPG outperformed lumbar rectification. These results should be confirmed by other studies with higher methodological standards, including randomization, larger sample sizes, Ionger follow-up. Applying the abdominal bracing in lumbar hyperlordosis exhibits better resistance times (34%) in the test McGill than RPG technique (18%). Patients with lumbar lordosis that were applied abdominal bracing (24%) had better results in the Owestry's test (minimal functional limitations, 0% - 20%) than the patients (22%) treated with RPG (slight functional limitation 20%- 40%) Patients with lumbar rectification have minimal improvement compared to resistance times (221-260 seconds) McGill Test, the RPG (20%) vs. abdominal bracing (18%). In the test Owestry 34% of patients with lumbar rectification were applied RPG exhibit greater improvement, to have a mínimum functional limitation. O- 20%, than the sample treated with Abdominal presented a constraint to termínate the application of 0-20% which corresponds to 20%.
Notas
Tesis (Magíster en Terapia Manual Ortopédica)
Palabras clave
Dolor de la Región Lumbar, Investigaciones, Ecuador, Terapia Ocupacional Ortopédica, Quito