Banca de DEFESA: Caroline Ribeiro Tottoli

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : Caroline Ribeiro Tottoli
DATE: 31/08/2023
TIME: 09:00
LOCAL: Ambiente virtual (Microsoft Teams)
TITLE:

Economic evaluation of interventions based on physical exercises for the management of people with chronic low back pain

KEY WORDS:

Back pain; Exercise; Pilates; Disability; Quality of life; Economic evaluation

PAGES: 108
BIG AREA: Ciências da Saúde
AREA: Educação Física
SUMMARY:

Objective: To investigate the cost-effectiveness of a Pilates exercise program compared with homebased exercises in individuals with chronic non-specific low back pain. Design: Randomized controlled trial with a 6-month follow-up alongside a economic evaluation. Setting: Rehabilitation clinic. Participants: One hundred and forty-five individuals (18-50 years of age) with low back pain for ≥ 12 consecutive weeks were enrolled and randomly allocated in a 1:1 ratio to either Pilates (n=72) or homebased exercise groups (n=73). Interventions: Method Pilates (Mat Pilates exercises using accessories) versus home-based exercise (postural exercises, muscle stretching and strengthening, and spine stabilization/mobilization), twice a week, for six weeks. Main outcome measures: Assessments were performed at baseline, post-intervention, and six months follow-up. Outcomes were pain intensity (0 to 10), disability (0 to100), and health-related quality of life (-0.176 1). The costs included were direct medical costs, direct non-medical costs and indirect costs. Results: At post-intervention, the Pilates group had significantly lower pain intensity (difference= - 1.14, 95%CI -0.25; 0.67), less disability (difference= -6.66, 95%CI -11.29; - 2.03), and higher healthrelated quality of life (difference= 0.102, 95%CI 0.054; 0,151) compared to the home-based exercise group. At follow-up, the Pilates group had a significantly higher health-related quality of life (difference= 0.055, 95%CI 0.003; 0.106) compared to the home-based exercise group but there were no significant differences in pain and disability. A significant overall effect of Pilates compared to homebased exercise was found for disability (difference = -4.4, 95%CI -7.6; -1.1), and health-related quality of life (difference = 0.049, 95%CI 0.022; 0.076), but not for pain. The main contributors to total societal costs were indirect costs in both groups. Costs of lost productivity at work (presenteeism) were higher in PG, however, these differences were not statistically significant between groups. Pilates intervention dominated from a societal perspective, demonstrating to be more effective and less costly for pain, disability and QALY. Conclusions: Our findings demonstrated that Pilates was more effective compared to home-based exercise in individuals with CNLBP, but it is uncertain whether these results are clinically relevant. Additionally, Pilates was cost-effective compared to home-based exercises for improving pain, disability and quality adjusted live years of individuals with CNLBP in the public health system and societal perspectives. Clinical trial registration number: NCT03113292. 

COMMITTEE MEMBERS:
Interna - 1998953 - LIDIA MARA AGUIAR BEZERRA DE MELO
Interno - 1724901 - RODRIGO LUIZ CARREGARO
Externo ao Programa - 3011946 - HENRY MAIA PEIXOTO - UnBExterno à Instituição - THOMAZ NOGUEIRA BURKE - UFMS
Externo à Instituição - DENISE DE FATIMA BARROS CAVALCANTE - UNICAMP