AGENTES FISICOS EN REHABILITACION CAMERON EPUB

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However, there remains a group that reports no pain relief [ 23 ].

Electrotherapy is considered among the noninvasive pain treatment techniques, in both its low- and medium-voltage applications [ 17 , 18 ]. Deep oscillation therapy is an effective technique for pain relief and has the advantage of being deep-acting and achieved with minimal mechanical impact, meaning it is useful in acute pain processes [ 24 , 25 ]. Medium-voltage electrotherapy, like interferential current therapy, combined with ultrasound with zeroed out parameters, together known as pain tracking, is applied in order to diagnose or locate the trigger points.

It has therapeutic and prognostic value, enabling detection of significant changes from one session to the next, and has demonstrated positive results in the immediate relief of acute radicular and neurogenic pain, as well as somatic pain [ 17 , 18 ]. Therefore, in this work we intend to evaluate the usefulness of the pain tracking technique in acute mechanical low back pain, as well as the evolution of pain using a visual analogue scale, disability based on the Waddell test before and after treatment, and the onset of clinical changes in this group of patients.

Method We performed an experimental prospective longitudinal explanatory study between January and September The universe was made up of all those patients referred to the Physical Medicine and Rehabilitation Clinic at the Clinical Research Center with clinically diagnosed acute mechanical low back pain.

The sample was made up of 90 patients who expressed a desire to participate in the study and whose low back pain had begun no more than 7 days ago, presenting neither radiation to the lower body parts nor decompensation. Defectual psychiatric and psychotic patients were excluded from the study as were those whose state of health prevented them from participating or where medical treatment was indicated.

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All patients were interviewed and physically examined by palpation of the paravertebral region, checking for contracture and pain in the spinous processes of the lumbar vertebrae in order to diagnose minor intervertebral derangement MID.

A medical history was taken, including sociodemographic and epidemiological characteristics, and the visual analogue scale VAS and Foral Waddell test were applied before and after treatment with physical agents. The sample was divided into 2 groups, where Group I, or the study group, corresponded to even numbers and Group II, or the control group, to odd numbers. By way of treatment plan, patients received daily treatment over 7 sessions.

The study group was treated using the pain tracking technique with interferential current applied to the lumbosacral spine region, with amplitude modulation frequency AMF of Hz, spectrum of 0 Hz, carrier frequency of Hz, and ultrasound with zeroed out parameters. The positive electrode was used as the indifferent electrode and positioned on the metamera itself or nearby target area, while the negative electrode was substituted for the ultrasound applicator and moved slowly over the target area.

Treatment began at the lowest intensity, increasing progressively until reaching the limit of tolerance. The patient was put in ventral decubitus prone position with a pillow under the abdomen. Group II, or the control group, received treatment with interferential current and cryotherapy.

The patient was put in the lateral or ventral decubitus prone position with a pillow under the abdomen to correct lumbar lordosis.

After the electrotherapy, in both groups we applied 10 minutes of cryotherapy with a clockwise massage over the 7 treatment sessions.

Both groups were issued with postural hygiene recommendations at home. In terms of the professions of our patients, 27 are labourers, 17 are professionals, 11 are housewives, and 10 are drivers.

The remainder are office workers or students. In the study, pain was triggered by prolonged static posture in the workplace for 31 patients, intense physical labour for 26 patients, bending and twisting and forward trunk bending for 15 and 12, respectively, and 6 through carrying out work with vibrations.

We found that patients worsened sitting in 23 cases, with trunk movements in 22 and standing in In terms of postures that provided relief, the lateral decubitus position was reported by 54 patients as being effective, the Williams position by 29 patients, and the ventral decubitus prone position by 7 patients. Some Evaluation Criteria.

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A medical history was taken for each patient. A database was created to process these medical histories using descriptive techniques median. The results are expressed in tables. To establish a comparison between the pain variables, the Wilcoxon signed-rank test and the disability test were applied to both groups before and after treatment, and the Mann Whitney test was used to compare the onset of analgesia also in both groups. The tests were performed with a predetermined significance level of.

Results Table 1 shows the evolution of pain based on VAS before and after treatment in both groups. The median score at start of treatment in both groups was 7. At the end of treatment, the median VAS score was 0. Table 1: Evolution of pain based on VAS in both groups at the start and end of treatment. When we compared the pain based on its clinical evolution from start to end of treatment, we observed highly significant differences in the two groups with.

Table 2 presents patient evolution based on the Waddell test.

In the study group, the median was 5. When we compared the test at the start and end of treatment by groups, we observed highly significant differences in the two groups with.

Table 2: Waddell test on both groups at start and end of treatment. We applied the Mann Whitney test to compare the onset of analgesia between the groups.

The median score in the study group was 2. Scores ranged between 1 and 6 in both groups, observing highly significant differences with , where pain relief was faster among the patients who were treated using the pain tracking technique see Table 3.

Table 3: Onset of analgesia in both groups.

Discussion Currently peripheral electrical analgesia is considered the least risky therapy for pain treatment. To stimulate this mechanism, a frequency higher than Hz must be used at a low intensity below the pain threshold [ 17 , 18 ]. In the case of pain tracking, the effect of the ultrasound is added to the locating of pain points and production of an intense sensitive stimulus with a fixed modulated frequency of Hz, providing immediate pain relief. This is why the author believes that, given the demonstrated analgesic effect of medium-voltage electrotherapy, pain relief was achieved in both groups and in the pain tracking group the effect of the ultrasound meant the improvements were faster than when just interferential current was applied.

It is important to remark that we used interferential current for this study because of its advantages over low-voltage currents: stimulation is not aggressive, galvanic effects are eliminated, it is more deep-acting, and there is no unpleasant sensation when the circuit is opened [ 17 , 18 ].

Waddell reports an increase within the Canadian population from 2.

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Uy tlendael reports an increase within the Belgian population from 0. It is observed that while the rate of low back pain has risen arithmetically, the rate of disability resulting from back pain has risen geometrically [ 2 , 26 ].

Low back pain renders the patient unable to carry out certain activities. However, this disability is significantly modified when the pain is relieved, and the patient is able to resume those activities they had had to stop with the onset of the pain.

Conclusions Both the pain tracking and interferential current techniques combined with cryotherapy are useful treatments for acute mechanical low back pain. Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this paper.

References A. Manek and A.

AGENTES FISICOS EN REHABILITACION MICHELLE CAMERON DOWNLOAD

View at Google Scholar M. Contreras and M. Barbadillo, C.

View at Google Scholar L. Machado, S. Kamper, R.After the electrotherapy, in both groups we applied 10 minutes of cryotherapy with a clockwise massage over the 7 treatment sessions.

To establish a comparison between the pain variables, the Wilcoxon signed-rank test and the disability test were applied to both groups before and after treatment, and the Mann Whitney test was used to compare the onset of analgesia also in both groups.

View at Google Scholar R. Among those that can be prescribed is heat therapy [ 19 — 21 ]. Email to friends Share on Facebook — opens in a new window or tab Rheabilitacion on Twitter — opens in a new window or tab Share on Pinterest — opens in a new window or tab. You may reading Like Mother,. View or edit your browsing history. It is also the reason why the majority of instances of low back pain of this kind fall into the category of nonspecific low back pain [ 1 ].

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