Year 2019 / Volume 26 / Number 2

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Effectiveness of hand crossing to produce analgesia in patients with chronic pain of the upper limb

Rev. Soc. Esp. Dolor. 2019; 26(2): 81-88 / DOI: 10.20986/resed.2019.3674/2018

Ivonne Jorquera Cáceres, Danny Ilaja Cid, Constanza Magaña Aguilar, Melissa Tabilo Ponce, Sergio Jimenez Torres, Hipólito Núñez Montenegro


ABSTRACT

Background: Recent studies report that patients with chronic pain, they undergo changes in the processing of information that reaches them from the periphery with the mere fact of changing the order in which the stimuli are exercised, for example, when their hands are crossed. In patients with chronic pain, the presence of alterations in their somatotropic frames of reference has been demonstrated, and this is why the strategy of crossing the extremities through the midline could generate changes in the perception of pain.
Objective: To evaluate if an analgesic physiotherapy program with hand crossing technique is more effective than a program without crossing hands, in order to reduce pain.
Material and method: Sixteen patients with chronic pain in elbow, wrist or hand, were randomized in two groups. One received transcutaneous electrical nerve stimulation (TENS) with hand crossing and closed eyes, and the other (control group) received only the application of TENS. Each group was evaluated before and after the intervention with the McGill pain questionnaire and the visual analog scale (VAS).
Results: A decrease in post-intervention pain was observed in both groups; where the control group decreased an average of 3.5 cm and the experimental group 3.75 cm. All sessions of the experimental group were statistically significant (P = <0.05), while one session in the control group was not statistically significant (P = 0.051). However, the Analysis of variance (ANOVA) between both groups, did not give statistically signifi cant (p = 0.863).
Conclusions: The results do not show that the crossing of hands potentiates the effects of analgesic therapy on pain intensity. More information is the effects to include this technique as a support strategy in patients with chronic pain, and to manage sensory alterations and changes in the processing of information that reaches the periphery.



RESUMEN

Antecedentes: Estudios recientes refieren que los pacientes con dolor crónico sufren cambios en el procesamiento de la información que les llega desde la periferia con el solo hecho de cambiar el orden en que los estímulos les son ejercidos, por ejemplo, cuando se les cruzan las manos. En los pacientes con dolor crónico se ha demostrado la presencia de alteraciones en sus marcos de referencia somatotópicos, y es por esto que la estrategia de cruzar las extremidades por la línea media, podría generar cambios en la percepción dolorosa.
Objetivo: Evaluar si un programa de fisioterapia analgésica aplicada con cruce de manos es más eficaz que uno sin el cruce para disminuir el dolor.
Material y método: 16 pacientes con dolor crónico de codo, muñeca o mano ingresaron al estudio. Fueron aleatorizados en un grupo experimental, que recibió la aplicación de electroanalgesia nerviosa transcutánea (TENS) con cruce de manos y ojos cerrados, además de un grupo control, que recibió solo electroanalgesia. A cada grupo se les evaluó su dolor pre y postintervención, con el cuestionario del dolor de McGill y la escala visual análoga (EVA).
Resultados: Ambos grupos, el control y experimental, presentaron una disminución en el dolor postintervención; el grupo control disminuyó una media de 3,5 cm y el grupo experimental con una media de 3,75 cm. Todas las sesiones del grupo experimental fueron estadísticamente significativas (p < 0,05), mientras que el grupo control presentó una sesión no estadísticamente significativa (p = 0,051). El análisis de varianza (ANOVA) entre ambos grupos, sin embargo, no dio estadísticamente significativo (p = 0,863).
Conclusiones: Los resultados no evidencian convincentemente que el cruce de manos potencia los efectos de la terapia analgésica en relación con la intensidad dolorosa. Más estudios serían necesarios para incluir esta técnica como una estrategia de apoyo en pacientes con dolor crónico, y poder manejar así las alteraciones sensoperceptivas y los cambios en el procesamiento de la información que les llega de la periferia.


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Instrucciones para citar

Jorquera Cáceres I, Ilaja Cid D, Magaña Aguilar C, Tabilo Ponce M, Jimenez Torres S, Núñez Montenegro H, et all. Effectiveness of hand crossing to produce analgesia in patients with chronic pain of the upper limb. Rev Soc Esp Dolor 2019; 26(2): 81-88 / DOI: 1020986/resed20193674/2018


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Recibido: 23/03/2018

Aceptado: 20/01/2019

Prepublicado: 19/03/2019

Publicado: 15/04/2019

Tiempo de revisión del artículo: 271 días

Tiempo de prepublicación: 361 días

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