A adição de modalidades eletroanalgésicas a um programa multimodal de intervenção terapêutica melhora os resultados clínicos em indivíduos com dor cervical crônica inespecífica? Um ensaio clínico randomizado

Abstract

Introduction: Chronic nonspecific neck pain (CNP) is a common and complex condition. Although many studies have evaluated the effectiveness of transcutaneous electrical nerve stimulation (TENS), interferential current (IFC), therapeutic exercises (TE), and manual therapy (MT) individually, this study aimed to determine whether adding IFC and/or TENS to a Multimodal Therapeutic Intervention Program (MTIP) would produce better outcomes than MTIP alone in terms of functional capacity, pain intensity, pain catastrophizing, kinesiophobia, and perceived global effect in individuals with CNP. The MTIP included therapeutic exercises and manual therapy delivered in supervised sessions, based on principles of motor control and functional progression. All participants received a single 60-minute pain education session during the baseline assessment. Methods: 75 individuals with CNP were randomly assigned to three groups: MTIP, MTIP + IFC, or MTIP + TENS. Interventions were carried out over eight weeks. Outcomes were measured at baseline, after the intervention, and at a 1- month follow-up. The primary outcome was the Neck Disability Index (NDI). Secondary outcomes included the Numerical Pain Rating Scale (NPRS) at rest and during movement, the Pain Catastrophizing Scale (PCS), the Tampa Scale for Kinesiophobia (TSK), the Copenhagen Neck Functional Disability Scale (CNFDS), the World Health Organization Disability Assessment Schedule (WHODAS 2.0), and the Global Perceived Effect Scale (GPE). Results: No significant differences were found between groups for the primary outcome. Regarding secondary outcomes, the MTIP group demonstrated better results on NPRS- m and CNFDS. Additionally, MTIP performed better than MTIP + IFC on NPRS – r immediately post- intervention, while MTIP + TENS outperformed both groups at follow-up. No significant differences were observed for GPE, and none of the differences were clinically meaningful. Conclusion: Adding IFC and/or TENS to an MTIP did not produce better clinical outcomes for individuals with chronic nonspecific neck pain.