Análise da efetividade de tratamentos não farmacológicos para dor neuropática, entre exercícios cinético-funcionais × outros métodos de tratamento: uma revisão sistemática

Abstract

Introduction: Neuropathic pain is defined by the International Association for the Study of Pain as: "pain that arises as a result of an injury or disease that affects the somatosensory system" and has a prevalence of 7 to 8% in the general population. Non-pharmacological treatments include: interventional therapies such as central neurostimulation, psychological therapies and physical therapy, the latter including exercises. Based on the findings on the use of exercise as a therapy for neuropathic pain, this study aims to compare the effectiveness of physical exercise in relation to other non-pharmacological treatment methods for neuropathic pain. Methodology: The search was performed by two reviewers independently. Five databases were used, with a limitation of 10 years and Portuguese and English languages. Studies with adult patients 18 years and older, non-pharmacological therapeutic modalities, and clinical trials only were included. Data were extracted by two reviewers using standardized forms. Results: 8 studies were added, from 8 different countries, with the population ranging from 12 to 355 participants. Interventions included, resistance exercise, balance exercise, aerobic, stretching, and mobility exercise, while controls were usual care, educational activities, and one that dealt with simulated tDCS and exercise. Five studies had statistically significant results in reducing pain in their exercise group compared to the control. Tooth et al (2014) had significant results for both groups (exercise and education), but the exercise group was superior. Only 3 studies evaluated the participants' quality of life, where only one observed improvement in the intervention group and one evaluated the negative correlation between neuropathic pain and functional status. Conclusion: There are still few studies comparing exercise to other nonpharmacological therapeutic modalities. We reiterate the effectiveness of exercises to reduce neuropathic pain in patients with different causes for it, being superior to the other compared modalities.