Eficácia da terapia por fotobiomodulação associada a um programa multimodal de intervenção terapêutica em indivíduos com dor cervical crônica inespecífica: ensaio clínico randomizado

Abstract

Chronic nonspecific neck pain (CNSNP) is a relevant public health problem associated with high disability rates, functional impairment, and substantial socioeconomic costs. Therapeutic exercise has proven effective in managing this condition, while the evidence supporting photobiomodulation therapy (PBMT) as an adjunct to multimodal programs remains limited. This study aimed to compare the effectiveness of PBMT combined with a Multimodal Therapeutic Intervention Program (MTIP) in individuals with CNSNP. A parallel, superiority randomized controlled trial was conducted with 62 participants assigned to two groups: MTIP alone or MTIP plus PBMT. Both groups engaged in an eight-week MTIP program, with only the experimental group receiving extra PBMT. The primary outcome measured was functional disability (Neck Disability Index). Secondary outcomes included pain intensity at rest and during movement (Numerical Pain Rating Scale), catastrophizing (Pain-Related Catastrophizing Thoughts Scale), kinesiophobia (Tampa Scale for Kinesiophobia), additional functional disability (Copenhagen Neck Functional Disability Scale), and overall perceived effect. Results demonstrated statistically significant differences between groups favoring MTIP for functional disability and pain at rest after the intervention (NDI = 4.06; 95% CI: 2.83–5.28; NPRS-r = 0.54; 95% CI: 0.14–0.95) and at one-month follow-up (NDI = 3.23; 95% CI: 1.97–4.48; NPRS-r = 0.79; 95% CI: 0.37–1.21). However, none of these differences reached the minimal clinically important change (MCIC) thresholds. Within-group differences were also statistically significant for both MTIP and MTIP+PBMT groups after the intervention and at follow-up. In conclusion, isolated multimodal exercise demonstrated greater efficacy in managing CNSNP, reinforcing its recommendation as the first-line therapeutic approach.