MÉTODOS PARA AVALIAÇÃO DA MODULAÇÃO CONDICIONADA DA DOR EM PACIENTES COM DISTÚRBIOS MUSCULOESQUELÉTICOS: UMA REVISÃO DE ESCOPO DA LITERATURA
DOI:
https://doi.org/10.20873/abef.2595-0096v6n16581Palavras-chave:
modulação condicionada da dor, controle inibitório descendenteResumo
Introdução: A dor é uma experiência complexa que pode variar muito entre os indivíduos dependendo do contexto. O processamento e modulação da dorenvolvem diversas regiões cerebrais. O controle inibitório descendente da dor pode ser avaliado através de um teste psicofísico denominado de modulação condicionada da dor. Apesar de muita evolução na compreensão do mecanismo e nas formas de avaliação, há uma grande variabilidade nos métodos utilizados para realização deste teste, dificultando seu uso tanto na pesquisa quanto na prática clínica.
Objetivos: Identificar os principais métodos utilizados na avaliação da modulação condicionada da dor e avaliar as diferentes formas de execução de cada método nos últimos dez anos.
Métodos: Foi realizada uma pesquisa na base de dados Medline via PubMed em julho de 2021. A estratégia de busca utilizou os seguintes descritores na língua inglesa: (conditioned pain modulation) AND ((conditioning stimuli) OR (conditioning stimulus) OR (test stimuli) OR (test stimulus) OR (cold pressor test) OR (cuff pressor test) OR (cuff pressor stimulation) OR (cuff algometry)). Foram considerados estudos escritos em Inglês ou Português e publicados a partir de 2012.
Resultados: A pesquisa inicial identificou um total de 324 estudos. O rastreio de títulos e resumo resultou em 77 artigos potenciais.Após uma análise detalhada do texto completo dos estudos selecionados, um total de 59 estudos permaneceram na amostra final. Entre os protocolos desenvolvidos para avaliação da modulação condicionada da dor, o estímulo teste mais utilizado de acordo com os estudos incluídos (n = 59), foi o limiar de dor à pressão (n = 45).. Já o estímulo condicionante mais frequente entre os estudos foi o teste pressor frio (n = 35).
Conclusão: Esta revisão de escopo identificou que o limiar de dor à pressão e o teste pressor ao frio foram os estímulos teste e condicionante, respectivamente, mais utilizados entre os estudos incluídos, embora exista uma falta de padronização em relação aos protocolos adotados para realização da modulação condicionada da dor, dificultando a interpretação dos resultados e a escolha de uma metodologia para aplicação na prática clínica.
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