Análise clínica comparativa da terapia sinérgica de ultrassom e laser e terapias isoladas para tratamento da fibromialgia

Abstract

Fibromyalgia is a diffuse and chronic musculoskeletal pain syndrome that affects mainly women. In Brazil, it is present in 2.5% of the population and, in addition to the generalized painful sensation, other disorders are associated with non-restorative sleep, fatigue, cognitive changes, anxiety and depression, among others. Today, there are no specific exams for diagnosis due to lack of knowledge of its etiology, treatments are guided by symptoms. Treatments can be pharmacological and/or non-pharmacological. However, physiotherapy is present in the area of health sciences to reduce painful and inflammatory episodes and to recover and maintain physical integrity. The use of equipment such as therapeutic ultrasound is the most used resource in physical therapy for inflammatory disorders of the musculoskeletal system. Another piece of equipment, which has been gaining attention in rehabilitation, is the low-intensity laser, which has multiple effects and indications in a punctual and even systemic way. In this sense, a researcher from the IFSC / USP joined together as two treatment techniques in a single equipment, offering patients a synergistic ultrasound and laser therapy. With the technological advance of the device and analyzing the study by Albrecht et al (2013), which identified the increase in nerve endings around blood vessels in the palms of the hands, specifically in the hypothenar region, it was what motivated us to start the study with fibromyalgia patients applying the treatment on the palms of the hands. Thus, the aim of this study was to analyze the effects on pain, quality of life and sleep quality, depression, anxiety and physical activity in these patients, separating the study into three treatment groups: Laser Group, Ultrasound Group and Ultrasound + Laser Group, being taken in the immediate pre- and post-treatment, and 30 days after the end of the treatment. The application was carried out with the prototype that allows the use only of laser or ultrasound, or combining the two techniques. The intervention protocol was carried out with 10 sessions in total, at a frequency of 3 times a week on alternate days, and the application time was 3 minutes in each palm, in all groups. The results exceeded expectations. The isolated therapy groups, laser and ultrasound, had similar results, less than 70%, in the immediate post-treatment, but the group that received synergistic therapy had a result of 92.32% in pain reduction. Quality of life in the synergistic therapy group optimized 72.37% and isolated therapies below 59%. Thus, the Ultrasound + Laser Group, 30 days after the end of treatment, showed 100% and 98.23% efficacy of the final results, in relation to pain and quality of life, respectively. It is concluded that the synergistic effect of ultrasound and laser on the palms of patients with fibromyalgia have satisfactory results corresponding to improvement in pain and quality of life in the immediate and medium-term post-treatment. Furthermore, these results directly influence the reduction of anxiety and depression, and consequently, improve the quality of sleep and the ability to perform physical activity.