Eficácia da manipulação visceral osteopática em pacientes com constipação funcional e dor lombar crônica inespecífica: ensaio clínico placebo-controlado aleatorizado

Abstract

Objetives: The purpose of this study was to verify the effectiveness of osteopathic visceral manipulation in patients with functional constipation and non-specific chronic low back pain. Methods: The study was a prospectively registered, randomized controlled trial with a blinded assessor and it was conducted in the physical therapy clinic in Rondonópolis/MT. The study participants were 76 patients with functional constipation and non-specific chronic low back pain. They went randomized in two groups: OVM (osteopathic visceral manipulation) and placebo (osteopathic visceral manipulation sham). The 6-week treatment program (one session/week) was done in both groups. Primary outcome measures were pain intensity through Pain Numerical Rate Scale (NRS) and lumbar disability (Oswestry Disability Index (ODI) at the final of the treatment (6-week) and the follow-up 3 months after the randomization. Secondary outcome measures were T12-L1 paraspinal electromyographic signal, trunk flexibility during the full flexion motion and FABQ questionnaire (Fear Avoidance Beliefs Questionnaire) at the final of the treatment (6-week) and the follow-up 3 months after the randomization. A blinded assessor collected the data. Results: All the patients were treated in the groups that were allocated. The primary outcome was observed a statistically significant to the pain intensity and functional disability in the OVM group after the 6-weeks treatment and the 3-month follow-up. The secondary outcome was found only a statistically significant in the electromyography signal in dynamic phase (flexion and extension) of the cycle flexion-extension after 6-week treatment. No difference was found in the static phase (full flexion/rest) in the electromyographic signals. Regarding the fingertip-to-floor test and FABQ no statistically significant differences were found at any time. Conclusions: The patients in the OVM group reduced the pain intensity and improve the disability after 6-week treatment and 3-months follow-up. A statistically significant difference was found in the electromyographic signal during the flexion-extension motion after 6-week treatment. No statistically significant differences were found in the fingertip-to-floor test and FABQ.