Eficácia do fortalecimento muscular no pós-operatório precoce de artroplastia total do joelho: revisão sistemática com metanálise
DOI:
https://doi.org/10.1590/Palavras-chave:
Artroplastia Total do Joelho, Exercício, Fisioterapia, Pós-operatório, ReabilitaçãoResumo
A artroplastia total do joelho (ATJ) trata-se de
uma intervenção cirúrgica, na qual ocorre a substituição
da articulação afetada por uma prótese. A fisioterapia é
fundamental na reabilitação após ATJ, podendo reduzir
os sintomas e possibilitar a melhora da função do joelho.
O objetivo foi analisar os efeitos do fortalecimento muscular
na força, funcionalidade e dor de indivíduos com ATJ
no período pós-operatório precoce. Os estudos foram
selecionados por meio de seis bases de dados (PubmMed,
PEDro, LILACS, Embase, CINAHL e Cochrane Library),
utilizando os termos e descritores: Arthroplasties, Knee
Replacement, Physiotherapy, Exercise, Rehabilitation e
Postoperative. Todos os estudos incluídos foram avaliados
quanto à qualidade metodológica, utilizando a escala PEDro.
Somente ensaios clínicos randomizados que envolveram
ATJ unilateral primária no pós-operatório precoce foram
incluídos. Todas as metanálises foram conduzidas por
meio do software Review Manager (RevMan) e descritos
por diferenças médias padronizadas (standardized
mean difference - SMD) com intervalos de confiança
de 95% (IC). Escolheu-se nove estudos para revisão do
texto completo. Os principais achados mostraram que
o fortalecimento muscular, quando confrontado com as
condições de comparação, foi eficaz apenas para a variável
força muscular, demonstrando melhora na função geral
(dois estudos, n=155; MD=-1,39, 95% IC [-2,58, -0,19];
p=0,02; I²=96%). Já para as demais análises não foram
observadas diferenças significativas. Os achados do presente
estudo demonstram que o fortalecimento muscular, quando
iniciado principalmente no pós-operatório precoce de ATJ,
é melhor que as condições de comparação na força
muscular do joelho
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