Uno Intervenciones multimodales para el manejo del dolor crónico en adultos mayores: un ensayo controlado aleatorio en entornos de atención primaria de salud.
DOI:
https://doi.org/10.70860_abef20253344Resumen
El dolor musculoesquelético crónico (CMSP) es una afección prevalente entre los adultos mayores, que puede reducir significativamente la capacidad funcional y la calidad de vida. Las intervenciones multimodales (IM), que combinan ejercicios aeróbicos, de resistencia y de equilibrio, son prometedoras pero poco estudiadas en entornos de atención primaria. Objetivo: Evaluar la efectividad de un programa de IM de 12 semanas para reducir la intensidad del dolor y mejorar los resultados funcionales en adultos mayores con CMSP. Métodos: Se realizó un ensayo controlado aleatorizado con 113 participantes (edad media: 68,5 ± 5,3 años), asignados aleatoriamente a un grupo experimental (GE, n = 57) o grupo control (GC, n = 56). Se evaluaron la intensidad del dolor (Escala numérica de calificación), la capacidad funcional (prueba de marcha de 6 minutos; 6MWT) y la fuerza de las extremidades inferiores (prueba de sentarse y levantarse de 30 segundos; 30 s-CST) al inicio y después de la intervención. Los datos se analizaron mediante ANOVA de medidas repetidas, con tamaños del efecto calculados para la relevancia clínica. Resultados: La intensidad del dolor disminuyó en 2,53 puntos (IC del 95 %: 2,34-2,72) en el GE, superando el umbral de MCID de 1-2 puntos (p < 0,0001). La capacidad funcional mejoró en 23,87 metros (IC del 95 %: 5,27-42,47) en el 6MWT, superando el rango de MCID de 14-30 metros (p < 0,0001). La fuerza de las extremidades inferiores aumentó en 0,89 repeticiones (IC del 95 %: 0,15-1,26) en el 30 s-CST, lo que representa un progreso significativo a pesar de no alcanzar el umbral de MCID de 2 repeticiones. Los tamaños del efecto fueron de moderados a grandes para todos los resultados. Conclusión: La intervención multimodal redujo significativamente el dolor y mejoró la capacidad funcional, lo que demuestra su impacto clínico y utilidad práctica para el manejo del CMSP. La investigación adicional debe evaluar los impactos a largo plazo de los IM y explorar la implementación en diversos entornos.
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