Comparación de las mejoras en el dolor y discapacidad en los ejercicios supervisados frente a intervenciones breves en pacientes con WAD subagudo o crónico: revisión sistemática.
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2015-06-16
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Jaén: Universidad de Jaén
Resumen
[ES] Objetivos y Métodos: Hacer una revisión sistemática de la literatura sobre la efectividad de los programas supervisados de ejercicios frente a intervenciones breves en pacientes con Trastornos Asociados al Latigazo Cervical (WAD) grado II subagudo o crónico, en las bases: PubMed, PEDro y Cochrane; se incluyeron ensayos clínicos controlados aleatorizados (RCT) de los últimos 10 años.
Resultados: Se encontraron cinco estudios de bajo sesgo; en cuatro no hay evidencia clara de la ventajas
del ejercicio supervisado; el único en que en la intervención breve incluyó ejercicios de cuello, muestra
que no hay diferencia entre intervenciones.
Conclusión: En la evidencia existente no encontramos razones para recomendar las intervenciones
supervisadas de ejercicios con el fin de reducir el dolor o la discapacidad. La evidencia sobre la efectividad del ejercicio sigue siendo contradictoria, pero sí abunda en que no tiene que ser necesariamente supervisado: siempre que incluya movimientos activos específicos de cuello. Estos resultados suponen beneficios potenciales en cuanto a la eficiencia y a la posibilidad de evitar exponer a los pacientes a tratamientos innecesarios. Se necesita más investigación sobre los efectos de la terapia de ejercicio, así como explorar nuevas estrategias que incluyan tanto el abordaje bottom-up como top-down.
[EN]Objectives and Methods. This study is aimed at reviewing the current evidence about the effectiveness of supervised exercise programmes for subacute or chronic WAD (whiplash associated disorders) versus minimal intervention; RCT from PubMed, PEDro and Cochrane databases published in the last 10 years were included. Results: Five low-bias studies were found; four of them didn’t show any clear evidence of the advantages of supervised exercise programmes. The only one which included active neck exercises showed that there were no differences between tretaments. Conclusion: We cannot find any reason in the current evidence that supports the use supervised exercise programmes for reducing pain or disability. The evidence about effectiveness of exercise is still controversial but it seems that the way it is applied doesn’t have to be supervised. These results mean potential benefits in their efficiency and the likelihood of avoiding unnecessary over%treatment. However more studies are needed about the effects of exercise therapy as well as exploring new strategies that combine bottom%up and top%down approaches. o differences between treatments.
[EN]Objectives and Methods. This study is aimed at reviewing the current evidence about the effectiveness of supervised exercise programmes for subacute or chronic WAD (whiplash associated disorders) versus minimal intervention; RCT from PubMed, PEDro and Cochrane databases published in the last 10 years were included. Results: Five low-bias studies were found; four of them didn’t show any clear evidence of the advantages of supervised exercise programmes. The only one which included active neck exercises showed that there were no differences between tretaments. Conclusion: We cannot find any reason in the current evidence that supports the use supervised exercise programmes for reducing pain or disability. The evidence about effectiveness of exercise is still controversial but it seems that the way it is applied doesn’t have to be supervised. These results mean potential benefits in their efficiency and the likelihood of avoiding unnecessary over%treatment. However more studies are needed about the effects of exercise therapy as well as exploring new strategies that combine bottom%up and top%down approaches. o differences between treatments.