Eficacia de la terapia manual en el manejo del dolor y la funcionalidad en pacientes con dolor torácico de origen músculo-esquelético : revisión sistemática
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Fecha
2019
Profesor/a Guía
Facultad/escuela
Idioma
es
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Universidad Andrés Bello
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Licencia CC
Licencia CC
Resumen
Objetivo Determinar la eficacia de la terapia manual en pacientes con dolor torácico de origen músculo-esquelético a través de un proceso de búsqueda sistemática y análisis de la literatura disponible sobre el tema. Materiales y Método En esta revisión dos evaluadores realizaron una búsqueda computarizada exhaustiva de estudios clínicos aleatorizados, en las bases de datos bibliográficas (CINHAL, Scopus, Web of science, PEDro y Pubmed). Se seleccionaron aquellos estudios publicados entre 1 de enero del 1996 al 1 de febrero del 2017, y que cumplieron con los criterios de inclusión y exclusión definidos. El proceso de búsqueda fue complementado con una búsqueda manual y también con la consulta de la literatura gris. Para determinar el nivel de calidad metodológica de los artículos, se utilizaron las escalas PEDro y Risk of bias (Rob). Resultados: Se incluyeron 7 artículos, todos ellos ensayos controlados aleatorizados (n= 1266). Cuatro estudios presentaron diferencias estadísticas significativas para la disminución del dolor posterior a la aplicación de la terapia manual. Las variables, sensibilidad muscular, calidad de vida y funcionalidad no se vieron afectadas significativamente tras la aplicación de la terapia manual. Ningún artículo reporto la variable significancia clínica en sus resultados. Para los estudios seleccionados, el puntaje de la escala de PEDro mostró una alta calidad metodológica. Al ser los estudios evaluados con la escala PEDro todos se categorizaron con un alto riesgo de sesgo. Conclusiones: En base al análisis de la contradictoria evidencia, no es posible
confirmar de manera concluyente un efecto positivo de la terapia manual en el manejo de los síntomas de pacientes con dolor torácico de origen músculo esquelético. Mayor número de estudios aleatorizados con protocolos más consistentes y replicables son necesarios para concluir definitivamente sobre el
aporte de la terapia manual en esta condición clínica
Objective: The aim of this study was to determine the efficacy of manual therapy in patients with thoracic pain of musculoskeletal origin through a process of systematic search and analysis of the available literature. Materials and Methods: In this review two evaluators conducted an exhaustivecomputerized search of randomized clinical studies in the following bibliographic databases; CINHAL, Scopus, Web of science, PEDro and Pubmed. Studies published between January 1, 1996 and February 1, 2017, that met the defined elegibility criteria were selected. The search process was supplemented by handsearching and also by consultation of the grey literature. The PEDro and Risk of bias (Rob) sea les were used to determine the level of methodological quality of the articles. Results: Seven articles were included (n=1266). Four studies showed statistically significant differences in pain reduction following manual therapy. Variables, muscle sensitivity, quality of life and function were not significantly affected after the application of manual therapy. No article reported clinical significance variable in its results. According to PEDro scale, the studies were deemed to be of high methodological quality. For the RoB scale the studies were categorized as high risk of bias. Conclusions: Based on the analysis of the conflicting current literature, there is not possible to possible to confirm a positive effect of manual therapy in the management of symptoms of patients with chest pain of musculoskeletal origin. More randomized studies with more consistent and replicable protocols are needed to con elude definitively on the contribution of manual therapy in this clinical condition.
Objective: The aim of this study was to determine the efficacy of manual therapy in patients with thoracic pain of musculoskeletal origin through a process of systematic search and analysis of the available literature. Materials and Methods: In this review two evaluators conducted an exhaustivecomputerized search of randomized clinical studies in the following bibliographic databases; CINHAL, Scopus, Web of science, PEDro and Pubmed. Studies published between January 1, 1996 and February 1, 2017, that met the defined elegibility criteria were selected. The search process was supplemented by handsearching and also by consultation of the grey literature. The PEDro and Risk of bias (Rob) sea les were used to determine the level of methodological quality of the articles. Results: Seven articles were included (n=1266). Four studies showed statistically significant differences in pain reduction following manual therapy. Variables, muscle sensitivity, quality of life and function were not significantly affected after the application of manual therapy. No article reported clinical significance variable in its results. According to PEDro scale, the studies were deemed to be of high methodological quality. For the RoB scale the studies were categorized as high risk of bias. Conclusions: Based on the analysis of the conflicting current literature, there is not possible to possible to confirm a positive effect of manual therapy in the management of symptoms of patients with chest pain of musculoskeletal origin. More randomized studies with more consistent and replicable protocols are needed to con elude definitively on the contribution of manual therapy in this clinical condition.
Notas
Informe (Magíster en Terapia Manual Ortopédica)
Palabras clave
Dolor, Terapia Manuales, Sistema Musculoesquelético, Revisión Sistemática