Efeitos de diferentes programas de treinamento sobre a força muscular, percepção de dor, incapacidade funcional, nível de estresse e marcadores bioquímicos em adultos com dor lombar: um estudo clínico randomizado.

Abstract

Low back pain has been considered as the number one cause of physical disability worldwide. This can lead to the search for health services and contribute to early retirement, much more than any other health condition. Therefore, this dissertation was made up of five studies: 1) Study of systematic review and meta-analysis; 2) Case study; 3 and 4) Correlation studies; 5) Randomized clinical trial, which aimed to analyze the effects of different training programs on muscle strength, pain perception, functional disability, stress level and biochemical markers in adults with low back pain. Participants were randomly divided into three groups: resistance training group (RG); resistance training group associated with core training (RCG) and control group (CG). Baseline serum levels of cortisol were analyzed using the chemiluminescence method and the enzymatic method was applied for the analysis of cretine kinase (CK). The perceptions of pain, functional lumbar disability and stress were determined using the visual analogue scale (VAS), the Roland-Morris questionnaire (RMQ) and the perceived stress scale, respectively. Muscle strength was assessed by tests of spine extensors and flexors. Interventions were performed for eight weeks (3 × / week, 50 min / session). In the RG and RCG groups, significant intergroup reductions were observed between pre and post-intervention in pain, perceived stress level, CK level, lumbar functional disability and increased strength of trunk flexors and extensors. Pain reduction in RG and RCG (p <0.001) and CG (p = 0.012), lumbar functional disability RG and RCG (p <0.001), perceived stress RG p = 0.008 and RCG (p <0.001), only in RCG there was a reduction in CK (p = 0.041) Significant increases in strength of RG flexors (p <0.00) 1 and RCG (p = 0.005) and RG trunk extensors (p = 0.001) were identified; RCG (p = 0.002). In the intergroup comparison in the post-intervention there was a significant reduction in waist circumference between the RCG and CG RCG groups (p = 0.040). The results of pain between RG, RCG and CG, in the post-intervention, (p = 0.018) and (p = 0.025) respectively, can be understood by the reduction of pain in the RG and RCG groups; CK in the post-intervention, between RCG and CG (p = 0.008), which can be explained by the significant reduction of the RG and RCG groups during the intervention. It is possible to conclude that the resistance training practice proposed in the study, with or without the existence of core training exercise, can reduce low back pain levels, functional disability, stress levels, CK levels and increase strength.