Ozonioterapia associada a um programa de exercício na dor e incapacidade de indivíduos com dor lombar crônica: ensaio clínico controlado e randomizado

Abstract

Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders, prevalent worldwide and one of the main causes of disability and damage to quality of life, representing a significant economic burden. Ozone therapy (OT) has been suggested in clinical practice as an adjuvant therapy to physical exercise, however the evidence is limited for its recommendation. Thus, the aim of this study was to evaluate the effects of OT in combination with a physical exercise protocol on pain level in subjects with chronic low back pain. Forty-two volunteers were randomized into 2 groups: Control group (Ex): volunteers underwent a physical exercise protocol; Ozone Therapy Exercise Group (ExOT): volunteers underwent a resistance physical exercise protocol associated with OT. Interventions were performed twice a week for a period of 6 weeks, totaling 12 sessions. The exercise program consisted of exercises that strengthened, stretched, mobilized, coordinated and stabilized the abdominal, lumbar, pelvic and lower limb muscles. OT was applied at 5 points on the paravertebral muscles, bilaterally, totaling 10 points, through the intramuscular technique at a concentration of 20 g/ml and with a volume of 2 mL of ozone right after each proposed exercise session. For assessment and reassessment, the Numerical Pain Scale (END) was applied; disability index (Oswestry Disability Index); flexibility test (Third finger to floor test); trunk flexion/extension mobility test (Gonimetry); kinesiophobia (Kinesiophobia Cap Scale); emotional state (Anxiety Numerical Scale - ENA) and assessment of the perception of the global effect (Global Effect Perception Scale - EPEG). The results showed that both the Ex and the ExOT groups had a lower pain level, lower scores in disability tests, improved flexibility, lower scores in kinesiophobia when compared to the initial values. However, the lowest scores for the level of pain, disability and the highest scores for the level of perception of recovery were evidenced in the ExOT group. Thus, it can be suggested that OT associated with the physical exercise program was a more effective method in reducing pain and functional disability in the treatment of CLBP.