Laser de baixa potência como tratamento coadjuvante da dor miofascial: avaliação eletromiográfica

Autores

  • Angélica Rodrigues de Araújo Atlântica Editora

DOI:

https://doi.org/10.33233/fb.v12i4.926

Resumo

Introdução: A sí­ndrome dolorosa miofascial designa a dor muscular regional causada por trigger points. Esses são caracterizados como pontos de hiperirritabilidade presentes na musculatura, cuja palpação induz í  reprodução de sintomas. Os dispositivos luminosos (LASER"™s e LED"™s) são citados na literatura como uma nova modalidade para o tratamento dessa sí­ndrome. Objetivo: Avaliar os efeitos do laser de baixa intensidade na modulação da dor de indiví­duos portadores de sí­ndrome dolorosa miofascial. Métodos: Dois indiví­duos foram aleatoriamente alocados em dois grupos – laser de baixa intensidade (LBI) e compressão isquêmica (CI). O sinal eletromiográfico dos músculos trapézio superior e médio e a intensidade da dor foram coletados diariamente antes e após as intervenções. Resultados: A intensidade da dor pré e pós-intervenção apresentaram diferenças significativas, em repouso e em movimento, apenas para o grupo LBI. Diferenças significativas não foram observadas na intensidade da dor ao longo das 8 sessões nos grupos avaliados. Não foram encontradas diferenças entre a atividade muscular de nenhum dos músculos em ambos os grupos, a curto e a longo prazo. Conclusão: Ambas as intervenções acarretaram efeitos benéficos distintos sob a sí­ndrome dolorosa miofascial. A combinação das duas técnicas pode ser uma alternativa interessante para o tratamento desta sí­ndrome.

Palavras-chave: sí­ndrome dor miofascial, terapia a laser de baixa intensidade, eletromiografia.

 

Biografia do Autor

Angélica Rodrigues de Araújo, Atlântica Editora

Ft., D.Sc., Profa. do curso de Fisioterapia da PUC Minas

Referências

Cummings M, Baldry P. Regional myofascial pain: diagnosis and management. Best Pract Res Clin Rheumatol 2007;21(2):367-87.

Borg-Stein J, Simons DG. Myofascial pain. Arch Phys Med Rehab 2002;83(1):40-7.

Mense S, Simons DG. Muscle pain, understanding its nature, diagnosis, and treatment. LWW 2001;205-87

Harden RN, Muscle pain syndromes. Am J Phys Med Rehab 2007;86:47-58.

Simons DG, Travell J. Myofascial pain and dysfunction: the trigger point manual. 2 ed. Baltimore: Williams and Wilkins; 1999.

Bennett R. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol 2007;21(3):427-45.

Fernández de-Las-Peñas C, Alonso-Blanco C, Miangolarra JC. Myofascial trigger points in subjects presenting with mechanical neck pain: A blinded, controlled study. Man Ther 2007;12:20-33.

Fricton JR, Kroening R, Haley D, Siegert R. Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients. Oral Surg 1985;60:615-23.

Cooper BC, Alleva M, Cooper DL, Lucente FE. Prevalence of myofascial pain dysfunction: analysis of 476 patients. Laryngoscope 1986;96:1099-106.

Simons DG. Clinical and etiological update of myofascial pain from trigger points. Journal of Musculoskeletal Pain 1996;4:93-121.

Skootsky SA, Jaeger B, Oye RK. Prevalence of myofascial pain in general internal medicine practice. West J Med 1989;151:157-60.

Treaster D, Marras WS, Burr D, Sheedy JE, Hart D. Myofascial trigger point development from visual and postural stressors during computer work. J Electromyogr Kinesiol 2006;16:115-24.

Mense S. Biochemical pathogenesis of myofascial pain. Journal of Musculoskeletal Pain 1996;54:145-62.

Hay EM, Dziedzic K, Sim J. Treatment options for regional musculoskeletal pain: what is the evidence? Bailliere Clin Rheum 1999;13(2):243-59.

Lew HL, Lee EH, Castaneda A, Klima R, Date E. Therapeutic use of botulinum toxin type A in treating neck and upper-back pain of myofascial origin: a pilot study. Arch Phys Med Rehab 2008;89(1):75-80.

Zaralidou AT, Amaniti EN, Maidatsi PG, Gorgias NK, Vasilakos DF. Comparison between newer local anesthetics for myofascial pain syndrome management. Methods Find Exp Clin Pharmacol 2007;29(5):353-7.

Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points. Anesthesiol Clin 2007;25(4):841-51.

Hou CR, Tsai LC, Cheng KF, Chung KC, Hong CZ. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Arch Phys Med Rehab 2002;83:1406-14.

Gazi MCB, Issy AM, Ãvila IP, Sakata RK. Comparison of acupuncture to injection for myofascial trigger point pain. Pain Pract 2010;29:1-7.

Hanten WP, Olson SL, Butts NL, Nowicki AL. Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points. Phys Ther 2000;80(10):997-1003.

Wang YH, Ding XL, Zhang Y, Chen J, Ge HY, Arendt-Nielsen L et al. Ischemic compression block attenuates mechanical hyperalgesia evoked from latent myofascial trigger points. Exp Brain Res 2010;202:265-70.

Fryer G, Hodgson L. The effect of manual pressure release on myofascial trigger points in the upper trapezius muscle. J Bodywork Mov Ther 2005;9(4):248-55.

Schaffer M, Bonel H, Sroka R, Schaffer PM, Busch M, Sittek H et al. Magnetic resonance imaging (MRI) controlled outcome of side effects caused by ionizing radiation, treated with 780 nm-diode laser - preliminary results. J Photoch Photobiol B 2000;59:1-8.

Lucas UC, Gemert MJC, Haan RJ. Efficacy of low-level laser therapy in the management of stage III decubitus ulcers: a prospective, observer-blinded multicentre randomized clinical trial. Lasers Med Sci 2003;18:72-7.

Soriano F, Campana V, Moya M, Gavotto A, Simes J, Soriano M et al. Photobiomodulation of pain and inflammation in microcrystalline arthropathies: experimental and clinical results. Photomed Laser Surg 2006;24(2):140-50.

Bjordal JM, Couppé C, Chow RT, Tunér J, Ljunggren EA. A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. Aust J Physiother 2003;49:107-16.

Gur A, Sarac AJ, Cevick R, Altindag O, Sarac S. Efficacy of 904 nm gallium arsenide low level laser therapy in the management of chronic myofascial pain in the neck: A double- blind and randomize-controlled trial. Lasers Surg Med 2004;35(3):229-35.

Simunovic Z, Ivankovich AD, Depolo A. Wound healing of animal and human body sport and traffic accident injuries using low-level laser therapy treatment: a randomized clinical study of seventy-four patients with control group. J Clin Laser Med Surg 2000;18(2):67-73.

Beckerman H, Bie RA, Bouter, LM, Cuyper HJ, Oostendorp RAB. The efficacy of laser therapy for musculoskeletal and skin disorders: A criteria-based meta-analysis of randomized clinical trials. Phys Ther 1992;72(7):483-91.

Bie RA, Verhagen AP, Lenssen AF, Vet HCW, van den Wildberg FAJM, Kootstra G et al. Efficacy of 904 nm laser therapy in the management of musculoskeletal disorders: a systematic review. Phys Ther Rev 1998;3(2):59-72.

Hakguder A, Birtane M, Gurcan S, Kokino S, Turan FN. Efficacy of low level laser therapy in myofascial pain syndrome: An algometric and thermographic evaluation. Lasers Surg Med 2003;33:339-43.

Thorsen H, Gam AN, Jensen H, Hojamark L, Wahlstrom L. Low energy laser treatment effect in localized fibromyalgia in the neck and shoulder regions. Ugeskr Laeger 1991;153(25):1801-4.

Ilbuldo E, Cakmak A, Disci R, Aydin R. Comparison of laser, dry needling, and placebo laser treatments in myofascial pain syndrome. Photomed Laser Surg 2004;22(4):306-11.

Altan, L, Bingöl U, Aykaç M, Yurtkuran M. Investigation of the effect of GaAs laser therapy on cervical myofascial pain syndrome. Rheumatol Int 2005;25(1):23-7.

Dundar U, Evcik D, Samli F, Pusak H, Kavuncu V. The effect of gallium arsenide aluminum laser therapy in the management of cervical myofascial pain syndrome: a double blind, placebo-controlled study. Clin Rheumatol 2007;26(6):930-34.

Ackelman BH, Lindgren U. Validity and reliability of a modified version of the neck disability index. J Rehabil Med 2002;34(6):284-87.

Santos CC, Pereira LSM, Resende MA, Magno F, Aguiar V. Aplicação da versão brasileira do questionário de dor Mcgill em idosos com dor crônica. Acta Fisiatra 2006;13(2):75-82.

Soderberg GL, Knutson LM. A guide for use and interpretation of kinesiologic electromyographic data. Phys Ther 2000;80:485-98.

SENIAM- Surface Electromyography for the non-invasive assessment of muscles. [citado 2007 Nov 12]. Disponível em URL: http://www.seniam.org.

Olavi A, Pekka R, Pertti K, Pekka P. Effect of the infrared laser therapy at treated and non-treat trigger points. Acunpunct Electrother Res 1989;14(1):9-14.

Brousseau L, Welch V, Wells G, Tugwell P, de Bie R, Gam A et al. Low level laser therapy for osteoarthritis and rheumatoid arthritis: a metanalysis. J Rheumatol 2000;27(8):1961-9.

Ozdemir F, Birtane M, Kokino S. The clinical efficacy of low power laser therapy on pain and function in cervical osteoarthritis. Clin Rheumatol 2001;20(3):181-4.

Hubbard DR, Berkoff GM. Myofascial trigger point show spontaneous needle EMG activity. Spine 1993;18(13):1803-7.

Downloads

Publicado

2017-05-20

Edição

v. 12 n. 4 (2011): Fisioterapia Brasil v12n4

Seção

Artigos originais

Licença

Autores que publicam nesta revista concordam com os seguintes termos:

Autores mantém os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a  Licença Creative Commons Attribution 4.0  que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.

Autores têm autorização para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capí­tulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.