A lombalgia tem consequências como dor, incapacidade funcional e diminuição da qualidade de vida, que pode acometer cerca de 70 a 90% da população brasileira em algum período de sua vida. A fisioterapia dispõe de inúmeros recursos dentre eles a Mobilização Neural, que facilita a condutibilidade nervosa, melhorando consequentemente o quadro álgico. O tratamento consiste em restaurar a mobilidade e a elasticidade do sistema nervoso periférico por meio de tensões, oscilações e angulações articulares. Neste sentido, este estudo teve como objetivo avaliar os efeitos da técnica e avaliar o comportamento álgico, bem como o possível envolvimento de citocinas pró e anti-inflamatórias após o tratamento. A técnica foi aplicada três vezes por semana, num total de 10 intervenções, com duração de dez minutos cada sessão. Participaram deste estudo 46 indivíduos (28 mulheres e 18 homens), que foram alocados em três grupos: grupo MOB, grupo MOB+MED e Grupo CONTROLE. Foram utilizadas ferramentas para avaliar tais efeitos, dentre elas: Escala Visual Analógica (EVA); Teste da Distância do 3º dedo ao solo; Goniometria; Fotogrametria; Avaliação da qualidade de vida - WHOQOL-bref; Questionário de incapacidade de Roland Morris; Índice de Oswestry sobre Incapacidade e Ensaios de Multiplex para a dosagem de citocinas no tecido sanguíneo.Os resultados demonstraram uma melhora significativa na intensidade da dor (p<0,02) e mobilidade lombar (p<0,04), quando comparamos as medidas antes e após o tratamento, e consequentemente, uma melhora significativa na qualidade de vida e incapacidade dos pacientes. Ao analisarmos as citocinas (p<0,05), houve uma redução estatisticamente significativa nas citocinas pró-inflamatórias (IL-1&#946;, IL-6 e TNF&#945;) e aumento estatisticamente significativo de citocina anti-inflamatória (IL-4). Esperamos, por meio deste estudo, contribuir e compreender alguns mecanismos envolvidos durante o processo de reabilitação com a Mobilização Neural. / Low back pain has consequences such as pain, functional disability and decreased quality of life, which can affect approximately 70 to 90% of the Brazilian population in some period of their life. Physiotherapy has innumerable resources, among them Neural Mobilization, which facilitates the nervous conductivity, consequently improving the pain. The treatment consists in restoring the mobility and the elasticity of the peripheral nervous system through tensions, oscillations and articular angulations. In this sense, this study aimed to evaluate the effects of the technique and to evaluate the algic behavior, as well as the possible involvement of pro and anti-inflammatory cytokines after treatment. The technique was applied three times a week, in a total of 10 interventions, lasting ten minutes each session. A total of 46 individuals (28 women and 18 men) participated in this study, which was allocated in three groups: MOB group, MOB + MED group and CONTROL group. Tools were used to evaluate such effects, among them: Visual Analog Scale (EVA); 3rd finger distance test to the ground; Goniometry; Photogrammetry; Quality of life assessment - WHOQOL-bref; Roland Morris Inaptation Questionnaire; Oswestry Index on Disability and Multiplex Assays for dosing cytokines in blood tissue. The results showed a significant improvement in pain intensity (p <0.02) and lumbar mobility (p <0.04), when we compared the measures before and after treatment, and consequently, a significant improvement in the quality of life and disability of patients. When we analyzed the cytokines (p <0.05), there was a statistically significant reduction in the proinflammatory cytokines (IL-1&#946;, IL-6, and FTN&#945;) and a statistically significant increase in anti-inflammatory cytokine (IL-4). We hope, through this study, to contribute and understand some mechanisms involved during the rehabilitation process with Neural Mobilization.

SyfteUndersöka påverkan av kronisk orofacial smärta och psykologiska faktorer på sömnkvalitet vid käkmuskelmyalgi.Material och metoderDenna retrospektiva studie omfattade 37 patienter (6 män, 31 kvinnor, medelålder: 49 år) med käkmuskelmyalgi. Sömnkvalitet (Pittsburgh Sleep Quality Index), smärtintensitet och smärtrelaterad funktionsnedsättning (Graded Chronic Pain Scale), depression (Patient Health Questionnaire-9), ångest (General Anxiety Disorder-7), stress (Perceived Stress Scale-10) och katastrofiering (Patient Catastrophizing Scale) undersöktes med varierade formulär. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) användes för att identifiera patienter med myalgi i käkmuskulatur.Resultat75% av patienterna rapporterade dålig sömnkvalitet, 73% rapporterade minst mild depressionsgrad, 54% rapporterade minst mild ångest, 59% rapporterade måttlig stressnivå och 38% rapporterade kliniskt relevant katastrofiering. Försämrad sömnkvalitet var relaterad till depression (rs = 0.45, n = 37, p = 0.008) ångest (rs = 0.46, n = 37, p = 0.007), stress (rs = 0.43, n = 37, p = 0.014) och katastrofiering (rs = 0.37, n = 37, p = 0.034). Multivariat logistisk regression visade att smärtintensitet, smartrelaterad funktionsnedsättning, depression, ångest, stress, katastrofiering och antal käkmuskler med refererad palpationssmärta förklarade dålig sömnkvalitet signifikant (p = 0.031).KonklusionSömnkvaliteten hos patienter med käkmuskelmyalgi påverkas i hög grad av kronisk smärtintensitet, smärtrelaterad funktionsnedsättning, antal käkmuskler med refererad palpationssmärta och depression samt ångest, stress och katastrofiering. / AimInvestigate the influence of chronic orofacial pain and psychological factors on sleep quality in patients with myalgia of the masticatory muscles.Material and methodsThis retrospective study included 37 patients (6 men, 31 women, mean age: 49 years) with masticatory muscle myalgia. Sleep quality (Pittsburgh Sleep Quality Index), pain intensity and pain-related disability (Graded Chronic Pain Scale), depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), stress (Perceived Stress Scale-10) and catastrophizing (Patient Catastrophizing Scale) were assessed by questionnaires. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were used to identify patients with myalgia.Results75% of the patients reported poor sleep quality, 73% reported at least mild depression degree, 54% reported at least mild degree of anxiety, 59% reported at least a moderate stress level and 38% reported a clinically relevant degree of catastrophizing. Impaired sleep quality was related to degree of depression (rs = 0.45, n = 37, p = 0.008), anxiety (rs = 0.46, n = 37, p = 0.007), stress (rs = 0.43, n = 37, p = 0.014) and catastrophizing (rs = 0.37, n = 37, p = 0.034). Multivariate logistic regression showed that characteristic pain intensity, degree of pain-related disability, depression, anxiety, stress, catastrophizing and number of masticatory muscle sites with referred pain significantly explained poor sleep quality (p = 0.031).ConclusionSleep quality in patients with masticatory myalgia is influenced by chronic pain intensity and related disability, number of masticatory muscle sites with referred pain as well as depression, anxiety, stress and catastrophizing.