Background & Aims
In Brazil, chronic pain significantly extends public health waitlists due to the extensive treatment duration and sessions required for discharge. This issue worsens when patients have exhausted various treatments, from standard to alternative, to avoid invasive, costlier options. In light of this issue, the Mauá City´s Specialized Rehabilitation Center conducted a study on 312 chronic pain patients (18-85 years), waiting over three months. From October to December 2023, the “Proprioceptive Reload” technique, a novel proprioceptive feedback method, was applied. Pain levels were measured using the visual analogue scale before and after treatment. Results,The results, confirmed by the Wilcoxon test for paired samples (p<0.0001), indicated a significant reduction in pain. However, it is recommended to conduct prospective studies, monitoring the patients for up to 12 months, to fully assess the long-term efficacy.
Methods
The patient is informed through a consent form (both verbal and written) and undergoes anamnesis, visual analogue scale assessment, and physical examination before and after the procedure. Sessions are conducted every 2 days until five sessions are completed. The Proprioceptive Reload technique leverages the principle of myofascial biotensegrity and is divided into three phases: mandibular repositioning guided by the patient’s reported dental contact sensation, followed by proximal-distal stimuli along spinous process of the vertebra from the cervical to the coccyx bone, and finally proprioceptive stimuli in distal ligamentous regions in feet and hands. The intervention can be carried out in a seated position and doesn’t require a specific or controlled environment.
Statistical software used was BioStat Ver.5.3 and STATA release 17.
This study was approved by the research ethics committee of the Health Department of Mauá City (São Paulo State) under the number 2012/SSPMM001/2023.
Results
Out of 312 rehabilitation sessions, 84% involved female and 16% male participants. Pain duration varied: less than 1 year (17.6%), 1-2 years (27.6%), 3-9 years (23.1%), and 10+ years (25.3%), with 6.4% unspecified. Predominant pain areas were the lower back (22.4%), knee (17.6%), shoulder (17.3%), and cervical region (12.8%). Other affected areas included the hip (5.8%), TMJ (5.4%), foot (4.2%), hand and ankle (3.8%), and leg (1.9%), with sciatica, headaches, thoracic, and wrist pain each below 1%. In this study of 312 patients, 2.56% (n=8) showed no pain reduction post-rehabilitation, while 97.44% (n=304) responded positively. Median pain levels significantly improved from 7.0 (Quartiles: 6.0, 9.0) to 1.0 (Quartiles: 0.0, 2.0). The Wilcoxon test for paired samples confirmed significant therapeutic effectiveness with a p-value <0.0001.
Conclusions
Considering the sample included a wide range of ages, genders, pain durations, and affected areas, it was observed that the manipulative technique provided significant pain relief from the first session. The use of analgesics was not considered an exclusion factor for the treatment. The fact that the procedure did not require a controlled environment facilitated its application, needing only ordinary chairs and a simple room without specific equipment for conventional rehabilitation. However, further studies are necessary to verify the treatment’s long-term efficacy and the frequency of recurrence over 12 months.
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Presenting Author
Leticia Perez Pardo Dias
Poster Authors
Topics
- Specific Pain Conditions/Pain in Specific Populations: Pain in Chronic/Inflammatory Diseases