Eficacia de un tratamiento combinado de terapia manual con realidad mixta en variables motoras y en la modulación del dolor en sujetos con dolor crónico cervical. Ensayo clínico piloto
Resumen
Introducción: El dolor crónico de cuello puede generar una disminución en la fuerza resistencia de los músculos flexores cervicales profundos, así como un déficit de control motor. Además, algunos factores psicosociales y cambios neuroplásticos también pueden tener un papel importante en el dolor musculoesquelético crónico. En los últimos años, la realidad virtual se ha utilizado en rehabilitación clínica, logrando mejoras en el dolor, en el rango articular y en la discapacidad.
Metodología: Estudio piloto, analítico y experimental con simple ciego del evaluador en el cual participaron 14 sujetos con dolor cervical crónico inespecífico. Ambos grupos recibieron un tratamiento de 8 sesiones durante 4 semanas. Al grupo experimental (n=7) se le realizó un protocolo de terapia manual combinado con realidad virtual mixta como método de ejercicio mientras que al grupo control (n=7) se le llevó a cabo el protocolo de terapia manual y ejercicios convencionales. Se realizó una evaluación al inicio y al final de este. Las variables evaluadas fueron: resistencia (TRFC), propiocepción (JPE), dolor, satisfacción, umbrales térmicos, discapacidad y kinesiofobia.
Resultados: Los resultados fueron estadísticamente significativos en las variables motoras para ambos grupos. En el grupo experimental se encontraron mejoras en la resistencia de los flexores profundos (p=0,030, d=-1,01) y la propiocepción para el movimiento de extensión (p=0,005; d=1,66). Este grupo mostró altos niveles de satisfacción con el tratamiento. En el grupo control, se encontraron cambios significativos en la resistencia de los flexores profundos (p=0,008, d=-1,08), el dolor (p=0,002; d=3,10), la discapacidad (p=0,002; d=1,96) y los umbrales térmicos calientes en el codo y la pierna izquierdos (p=0,02; p=0,04, respectivamente). En ningún grupo se encontraron diferencias significativas en la kinesiofobia.
Conclusión: El uso de realidad mixta puede ser útil para obtener mejoras en variables motoras y de satisfacción con la terapia en sujetos con dolor cervical crónico. Se necesitan futuros estudios que incluyan un tamaño muestral adecuado y periodo de seguimiento.
Cómo citar
Referencias
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