Avaliação do conhecimento de fisioterapeutas sobre a neurociência da dor em Palmas/TO
Palavras-chave:
fisioterapia, neurociência da dor, educação
Resumo
Introdução: A dor crônica é multifatorial, influenciada por fatores biológicos, psicológicos/emocionais e sociais. Por isso, é importante o conhecimento da neurociência da dor e a atuação de acordo com o modelo biopsicossocial. Objetivo: O presente estudo visa avaliar o conhecimento que os fisioterapeutas de Palmas têm sobre os mecanismos neurofisiológicos da dor crônica, através do Questionário da Neurofisiologia da Dor (QND) Metodologia: O estudo trata-se de uma pesquisa descritiva, observacional e transversal, realizada no período de julho/2022 a julho/2023. A amostra foi composta por fisioterapeutas, que trabalham no município de Palmas – TO. Resultados: 22 fisioterapeutas participaram do estudo. A média de acertos no QND foi de 8,04 questões dentre as 12, representando 66,67% de acertos em média. No entanto, considerando a análise individual de cada participante, 63,64% tiveram mais de 65% de acertos. Conclusão: Os conhecimentos que os fisioterapeutas têm em relação à moderna neurofisiologia da dor são insatisfatórios. Sendo assim, é de extrema importância a capacitação dos fisioterapeutas acerca da temática.
Referências
1. Booth J, Moseley GL, Schiltenwolf M, Cashin A, Davies M, Hubscher M. Exercise for chronic musculoskeletal pain: A biopsychosocial approach. 2017 Dec;15(4):413-421. doi: 10.1002/msc.1191. Epub 2017 Mar 30.
2. Brinjikji PH, Luetmer BC. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. AJNR Neuroradiol. 2015;36(4):811–6.
3. Buchbinder, R., Blyth, F. M., March, L. M., Brooks, P., Woolf, A. D., & Hoy, D. G. (2013). Placing the global burden of low back pain in context. Best Practice & Research. Clinical Rheumatology, 27, 575–589.
4. Catley MJ, O’Connell NE, Mosely GL. How good is the Neurophysiology of Pain Questionnaire? A Rasch analysis of psychometric properties. Journal of Pain, 2013; 14(8): 818-827.
5. Ceroni FS. Avaliação do conhecimento sobre neurofisiologia da dor em graduandos em fisioterapia e fisioterapeutas. 2021. 45p. Disponível em: https://repositorio.ufsc.br/handle/123456789/230507. Acesso no dia 07 de agosto de 2023.
6. Clark S, Horton R. Low back pain: a major global challenge. Lancet. 2018;391(10137):2302.
7. Clauw, Daniel J. et al. Reframing chronic pain as a disease, not a symptom: rationale and implications for pain management. Postgraduate Medicine, v. 131, n. 3, p.185-198, 2019.
8. DeSantana JM, Perissinotti DMN, Junior JOO, Correia LMF, Oliveira CM, DaFonseca PRB. Definição de dor revisada após quatro décadas. Editorial. BrJp 3(3). Jul-Sep 2020.
9. Dolphens M, Nijs J, Cagnie B, et al.. Efficacy of a modern neuroscience approach versus usual care evidence-based physiotherapy on pain, disability and brain characteristics in chronic spinal pain patients: protocol of a randomized clinical trial. BMC Musculoskelet Disord. 2014;8(15):149.
10. Foster NE, Anema JR, Cherkin D, et al.. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368–83.
11. Goldberg, Daniel S., Mcgee, Summer J. Pain as a global public health priority. BMC public health, v. 11, n. 1, p.770, 2011.
12. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356–67.
13. Hashmi JA, Baliki MN, Huang L, et al. Dor que muda de forma: a cronificação da dor nas costas muda a representação cerebral dos circuitos nociceptivos para os emocionais. Cérebro. 2013;136 (Pt 9): 2751-2768. doi: 10.1093/brains/awt211.
14. Hua T, Chen B, Lu D, Sakurai K, Shengli Z, Han BX, Kim J, Luping Y, Chen Y, Lu J, Wang F. General anesthetics activate a potent central pain-suppression circuit in the amygdala. Nature Neurosciencie 23, pages 854–868 (2020).
15. Javdaneh N, Saeterbakken AH, Shams A, Barati AH. Pain Neuroscience Education Combined with Therapeutic Exercises Provides Added Benefit in the Treatment of Chronic Nec Pain. 2021. Disponível em: https://pubmed.ncbi.nlm.nih.gov/34444594/. Acessado no dia 17 de julho. 2023.
16. Konkiewitz EC. Toda dor é uma percepção cerebral e toda dor crônica envolve a neuropsiquiatria. 2023. Disponível em: https://cienciasecognicao.org/neuroemdebate/arquivos/4503. Acessado no dia 07 de agosto. 2023.
17. Kuner R, Flor H. Plasticidade estrutural e reorganização na dor crõnica. Nat Rev Neurosci. 2016;18 (1): 20-30. doi: 10.1038/nrn.2016.162.
18. Loeser JD, Treede RD. The Kyoto protocol of IASP Basic Pain Terminology. 2008 Jul 31;137(3):473-477. doi: 10.1016/j.pain.2008.04.025. Epub 2008 Jun 25.
19. Louw A, Zimney K, Puentedura EJ, Diener I. The efficacy of pain neuroscience education on musculoskeletal pain: a systematic review of the literature. Physiotherapy Theory and Practice, 1-24, 2016.
20. Marques ES, Xarles T, Antunes TM, Silva KKD, Reis FJJ, Oliveira LAS, Nogueira LAC. Avaliação do conhecimento fisiológico da dor de estudantes de fisioterapia. Rev Dor. São Paulo 2016; 17(1): 29-33.
21. Medeiros LF, Caumo W, Dussán-Sarria J, Deitos A, Brietzke A, Laste G, Campos-Carraro C, Souza A, Scarabelot VL, Cioato SG, Vercelino R, Castro AL, Araújo AS, Belló-Klein A, Fregni F, Torres ILS. Effect of deep intramuscular stimulation and transcranial magnetic stimulation on neurophysiological biomarkers in chronic myofascial pain syndrome. Pain Med. 2016; 17: 122–35.
22. Middleton, Steven J. et al. Studying human nociceptors: from fundamentals to clinic. Brain, v. 144, n. 5, p. 1312-1335, 2021.
23. Moseley GL, Butler DS. Critical Review: Fifteen Years of Explaining Pain: The Past, Present, and Future. The Journal of Pain 2015; 16(9): 807-813.
24. Moseley GL. A pain neuromatrix approach to patients with chronic pain. 2003 Aug;8(3):130-40. doi: 10.1016/s1356-689x(03)00051-1.
25. Nijs J, Apeldoorn A, Hallegraeff H, Clark J, Smeets R, Malfliet A, Girbés EL, Kooning M, Ickmans K. Low Back Pain: Guidelines for the Clinical Classification of Predominant Neuropathic, Nociceptive, or Central Sensitization Pain. Pain Physician. 2015; 18:333-46.
26. Nijs J, Jacqui C, Malfliet A, Ickmans K,Voogt L, Don S, DenBandt H, Goubert D, Kregel J, Coppieters I, Dankaerts W. In the spine or in the brain? Recent advances in pain neuroscience applied in the intervention for low back pain. 2017 Sep-Oct;35 Suppl 107(5):108-115. Epub 2017 Sep 29.
27. Nogueira LAC, Chaves AO, Oliveira N, et al. Cross-cultural adaptation of the revised neurophysiology of pain questionnaire into brazilian portuguese language. J Bras Psiquiatr. 2018;67(4):273–7.
28. Puentedura EJ, Louw A. A neuroscience approach to managing athletes with low back pain. Phys Ther Sport. 2012 Aug;13(3):123-33. doi: 10.1016/j.ptsp.2011.12.001. Epub 2011 Dec 27.
29. Roy M, Shohamy D, Daw N, Jepma M, Wimmer GE, Wagner TD. Representação de erros preditivos aversivos na substância cinzenta periaquedutal humana. Nat Neurosci. 2014;17 (11):1607-1612. doi:10.1038/nn.3832.
30. Sanzarello I, Merlini L, Rosa MA, et al. Central sensitization in chronic low back pain: A narrative review. J Back Musculoskelet Rehabil. 2016;29(4):625–33.
31. Siddal PJ, Cousins MJ. Persistent pain as a disease entity: implications for clinical management. Anesth Analg. 2004 Aug;99(2):510-20, table of contents. doi: 10.1213/01.ANE.0000133383.17666.3A.
32. Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-7.
33. Wijma AJ, VanWilgen CP, Meeus M, Nijs J. Clinical biopsychosocial physiotherapy assessment of patients with chronic pain: The first step in pain neuroscience education. Physiother Theory Pract. 2016 Jul;32(5):368-84. doi: 10.1080/09593985. 2016. 1194651. Epub 2016 Jun 28.
34. Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar;152(3 Suppl):S2-S15. doi: 10.1016/j.pain.2010.09.030. Epub 2010 Oct 18.
35. Yamada AS, Antunes FTT, Ferraz C, Souza AH, Simon D.The genetic influence of the brain-derived neurotrophic factor Val66Met polymorphism in chronic low back pain. Advances in Rheumatology. 2021; 61:24. https://doi.org/10.1186/s42358-021-00183-7.
36. Yamada AS, Simon D, Souza AH. Aspectos biológicos e implicações clínicas na dor lombar crônica: uma revisão narrativa. Revista Saúde e Desenvolvimento humano. 2022; 10(1). http://dx.doi.org/10.18316/sdh.v10i1.8208.
37. Yudofzky SC. Neuropsiquiatria e Neurociência na prática clínica. Artmed; 4ª edição 3 outubro 2005.
2. Brinjikji PH, Luetmer BC. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. AJNR Neuroradiol. 2015;36(4):811–6.
3. Buchbinder, R., Blyth, F. M., March, L. M., Brooks, P., Woolf, A. D., & Hoy, D. G. (2013). Placing the global burden of low back pain in context. Best Practice & Research. Clinical Rheumatology, 27, 575–589.
4. Catley MJ, O’Connell NE, Mosely GL. How good is the Neurophysiology of Pain Questionnaire? A Rasch analysis of psychometric properties. Journal of Pain, 2013; 14(8): 818-827.
5. Ceroni FS. Avaliação do conhecimento sobre neurofisiologia da dor em graduandos em fisioterapia e fisioterapeutas. 2021. 45p. Disponível em: https://repositorio.ufsc.br/handle/123456789/230507. Acesso no dia 07 de agosto de 2023.
6. Clark S, Horton R. Low back pain: a major global challenge. Lancet. 2018;391(10137):2302.
7. Clauw, Daniel J. et al. Reframing chronic pain as a disease, not a symptom: rationale and implications for pain management. Postgraduate Medicine, v. 131, n. 3, p.185-198, 2019.
8. DeSantana JM, Perissinotti DMN, Junior JOO, Correia LMF, Oliveira CM, DaFonseca PRB. Definição de dor revisada após quatro décadas. Editorial. BrJp 3(3). Jul-Sep 2020.
9. Dolphens M, Nijs J, Cagnie B, et al.. Efficacy of a modern neuroscience approach versus usual care evidence-based physiotherapy on pain, disability and brain characteristics in chronic spinal pain patients: protocol of a randomized clinical trial. BMC Musculoskelet Disord. 2014;8(15):149.
10. Foster NE, Anema JR, Cherkin D, et al.. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368–83.
11. Goldberg, Daniel S., Mcgee, Summer J. Pain as a global public health priority. BMC public health, v. 11, n. 1, p.770, 2011.
12. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356–67.
13. Hashmi JA, Baliki MN, Huang L, et al. Dor que muda de forma: a cronificação da dor nas costas muda a representação cerebral dos circuitos nociceptivos para os emocionais. Cérebro. 2013;136 (Pt 9): 2751-2768. doi: 10.1093/brains/awt211.
14. Hua T, Chen B, Lu D, Sakurai K, Shengli Z, Han BX, Kim J, Luping Y, Chen Y, Lu J, Wang F. General anesthetics activate a potent central pain-suppression circuit in the amygdala. Nature Neurosciencie 23, pages 854–868 (2020).
15. Javdaneh N, Saeterbakken AH, Shams A, Barati AH. Pain Neuroscience Education Combined with Therapeutic Exercises Provides Added Benefit in the Treatment of Chronic Nec Pain. 2021. Disponível em: https://pubmed.ncbi.nlm.nih.gov/34444594/. Acessado no dia 17 de julho. 2023.
16. Konkiewitz EC. Toda dor é uma percepção cerebral e toda dor crônica envolve a neuropsiquiatria. 2023. Disponível em: https://cienciasecognicao.org/neuroemdebate/arquivos/4503. Acessado no dia 07 de agosto. 2023.
17. Kuner R, Flor H. Plasticidade estrutural e reorganização na dor crõnica. Nat Rev Neurosci. 2016;18 (1): 20-30. doi: 10.1038/nrn.2016.162.
18. Loeser JD, Treede RD. The Kyoto protocol of IASP Basic Pain Terminology. 2008 Jul 31;137(3):473-477. doi: 10.1016/j.pain.2008.04.025. Epub 2008 Jun 25.
19. Louw A, Zimney K, Puentedura EJ, Diener I. The efficacy of pain neuroscience education on musculoskeletal pain: a systematic review of the literature. Physiotherapy Theory and Practice, 1-24, 2016.
20. Marques ES, Xarles T, Antunes TM, Silva KKD, Reis FJJ, Oliveira LAS, Nogueira LAC. Avaliação do conhecimento fisiológico da dor de estudantes de fisioterapia. Rev Dor. São Paulo 2016; 17(1): 29-33.
21. Medeiros LF, Caumo W, Dussán-Sarria J, Deitos A, Brietzke A, Laste G, Campos-Carraro C, Souza A, Scarabelot VL, Cioato SG, Vercelino R, Castro AL, Araújo AS, Belló-Klein A, Fregni F, Torres ILS. Effect of deep intramuscular stimulation and transcranial magnetic stimulation on neurophysiological biomarkers in chronic myofascial pain syndrome. Pain Med. 2016; 17: 122–35.
22. Middleton, Steven J. et al. Studying human nociceptors: from fundamentals to clinic. Brain, v. 144, n. 5, p. 1312-1335, 2021.
23. Moseley GL, Butler DS. Critical Review: Fifteen Years of Explaining Pain: The Past, Present, and Future. The Journal of Pain 2015; 16(9): 807-813.
24. Moseley GL. A pain neuromatrix approach to patients with chronic pain. 2003 Aug;8(3):130-40. doi: 10.1016/s1356-689x(03)00051-1.
25. Nijs J, Apeldoorn A, Hallegraeff H, Clark J, Smeets R, Malfliet A, Girbés EL, Kooning M, Ickmans K. Low Back Pain: Guidelines for the Clinical Classification of Predominant Neuropathic, Nociceptive, or Central Sensitization Pain. Pain Physician. 2015; 18:333-46.
26. Nijs J, Jacqui C, Malfliet A, Ickmans K,Voogt L, Don S, DenBandt H, Goubert D, Kregel J, Coppieters I, Dankaerts W. In the spine or in the brain? Recent advances in pain neuroscience applied in the intervention for low back pain. 2017 Sep-Oct;35 Suppl 107(5):108-115. Epub 2017 Sep 29.
27. Nogueira LAC, Chaves AO, Oliveira N, et al. Cross-cultural adaptation of the revised neurophysiology of pain questionnaire into brazilian portuguese language. J Bras Psiquiatr. 2018;67(4):273–7.
28. Puentedura EJ, Louw A. A neuroscience approach to managing athletes with low back pain. Phys Ther Sport. 2012 Aug;13(3):123-33. doi: 10.1016/j.ptsp.2011.12.001. Epub 2011 Dec 27.
29. Roy M, Shohamy D, Daw N, Jepma M, Wimmer GE, Wagner TD. Representação de erros preditivos aversivos na substância cinzenta periaquedutal humana. Nat Neurosci. 2014;17 (11):1607-1612. doi:10.1038/nn.3832.
30. Sanzarello I, Merlini L, Rosa MA, et al. Central sensitization in chronic low back pain: A narrative review. J Back Musculoskelet Rehabil. 2016;29(4):625–33.
31. Siddal PJ, Cousins MJ. Persistent pain as a disease entity: implications for clinical management. Anesth Analg. 2004 Aug;99(2):510-20, table of contents. doi: 10.1213/01.ANE.0000133383.17666.3A.
32. Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-7.
33. Wijma AJ, VanWilgen CP, Meeus M, Nijs J. Clinical biopsychosocial physiotherapy assessment of patients with chronic pain: The first step in pain neuroscience education. Physiother Theory Pract. 2016 Jul;32(5):368-84. doi: 10.1080/09593985. 2016. 1194651. Epub 2016 Jun 28.
34. Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar;152(3 Suppl):S2-S15. doi: 10.1016/j.pain.2010.09.030. Epub 2010 Oct 18.
35. Yamada AS, Antunes FTT, Ferraz C, Souza AH, Simon D.The genetic influence of the brain-derived neurotrophic factor Val66Met polymorphism in chronic low back pain. Advances in Rheumatology. 2021; 61:24. https://doi.org/10.1186/s42358-021-00183-7.
36. Yamada AS, Simon D, Souza AH. Aspectos biológicos e implicações clínicas na dor lombar crônica: uma revisão narrativa. Revista Saúde e Desenvolvimento humano. 2022; 10(1). http://dx.doi.org/10.18316/sdh.v10i1.8208.
37. Yudofzky SC. Neuropsiquiatria e Neurociência na prática clínica. Artmed; 4ª edição 3 outubro 2005.
Publicado
2023-10-16
Edição
Seção
Artigos
Os artigos podem ser reproduzidos total ou parcialmente, desde que a fonte seja devidamente citada e seu uso seja para fins acadêmicos.
