Efeitos do método Pilates sobre marcadores bioquímicos, percepção de dor, incapacidade funcional lombar e força muscular em mulheres na pós-menopausa com dor lombar

Abstract

Low back pain is the main cause of years lived with disabilities, causing functional and work disabilities. The reduction in the hormone levels can be a risk factor for the degeneration of intervertebral discs of the lumbar spine, especially in postmenopausal women. Therefore, this thesis aimed to analyze the effects of the Pilates method on biochemical markers, pain perception, low back functional disability, kinesiophobia, and muscle strength in postmenopausal women with chronic low back pain. To this end, three types of research were developed. Study 1 is a systematic review that investigated the effects of exercise on serum insulin-like growth factor-1 (IGF-1) levels in older women. The results pointed to the need for studies with greater methodological rigor and the use of different types of exercises as an intervention, especially when the woman is in the postmenopausal phase. Study 2 evaluated the correlation between cortisol, creatine kinase (CK), estradiol, pain perception, low back functional disability, and abdominal and lumbar muscle strength. The sample consisted of 11 postmenopausal women with low back pain. Basal serum cortisol and estradiol levels were analyzed by the chemiluminescence method and the enzymatic method was applied for CK analysis. The pain perceptions and the low back functional disability were determined using the visual analog scale (VAS) and the Roland-Morris questionnaire (RMQ), respectively. Abdominal strength and strength of the extensor muscles of the spine were analyzed by an isometric test. It was observed that postmenopausal women with greater age tend to present higher cortisol levels and lower lumbar strength levels. Also, higher cortisol levels were related to lower lumbar strength levels. Lower estradiol levels represented a higher perception of low back pain. Study 3 aimed to analyze the effects of the Pilates method on biochemical markers, pain perception, low back functional disability, kinesiophobia, and muscle strength in postmenopausal women with chronic low back pain. The sample was randomly divided into a Pilates group without accessories (PG; n=11) and another with accessories (PAG; n=11). Both groups performed the training program for eight weeks (2×/week, 50-60 min/session). After the interventions, both groups had lower levels of low back pain perception and low back functional disability, and greater lumbar strength (p<0.05). In PAG, there were significant increases in IGF-1, IGFBP-3, IGF-1/IGFBP-3 ratio, and abdominal strength (p<0.05), and a significant reduction in CK (p<0.05) after the training period. Higher IGF-1/IGFBP-3 ratio and lower CK levels were observed in PAG when compared to PG in the post-test (p<0.05). There were no significant differences in kinesiophobia and cortisol levels after the interventions