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Eficácia de abordagens multimodais em fisioterapia no tratamento da Síndrome da Dor Vesical/Cistite Intersticial: Revisão Sistemática
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A Síndrome da Dor Vesical/Cistite Intersticial (SDV/CI) é uma condição crónica que impacta a qualidade de vida. Intervenções em fisioterapia como terapia manual, biofeedback, TENS, exercícios posturais e educação têm demonstrado potencial na gestão da dor e dos sintomas urinários, embora ainda existam lacunas nas estratégias sustentadas por evidência atualizada. Verificar sistematicamente a eficácia de modalidades em fisioterapia, na dor, sintomas urinários e qualidade de vida em indivíduos com SDV/CI. Seguindo as recomendações PRISMA, foram pesquisadas as bases de dados PubMed, PEDro, Science Direct e Cochrane Library para identificar ensaios clínicos randomizados (RCTs) publicados entre 2015 e 2025 que cumprissem os critérios de inclusão. O risco de viés dos estudos foi avaliado com a ferramenta Cochrane RoB 2.0, e os resultados foram sintetizados narrativamente. Resultados: Seis RCTs mostraram que biofeedback com terapia manual e exercícios posturais melhoram a dor (p=0,002–0,026) e sintomas urinários (p=0,043–
0,048). Ondas de choque extracorporais apresentaram resultados significativas (p=0.035 e p=0.011). Mindfulness (p=0,030–0,049), varinha terapêutica e educação via mHealth (p<0,050) também apresentaram benefícios. A heterogeneidade e o risco de viés limitaram a evidência. Existem modalidades em fisioterapia promissoras para o tratamento da SDV/CI, contudo são necessários estudos rigorosos e metodologicamente robustos para consolidar as evidências.
Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) is a chronic condition that impacts quality of life. Physiotherapy interventions such as manual therapy, biofeedback, TENS, postural exercises and education have shown potential in the management of pain and urinary symptoms, although there are still gaps in strategies supported by up-to-date evidence. To systematically verify the effectiveness of physiotherapy modalities on pain, urinary symptoms and quality of life in individuals with VDS/CI. Methods: Following PRISMA recommendations, PubMed, PEDro, Science Direct and Cochrane Library databases were searched to identify randomized controlled trials (RCTs) published between 2015 and 2025 that met the inclusion criteria. The risk of bias of the studies was assessed with the Cochrane RoB 2.0 tool, and the results were synthesized narratively. Six RCTs showed that biofeedback with manual therapy and postural exercises improved pain (p=0.002-0.026) and urinary symptoms (p=0.043-0.048). Extracorporeal shock wave therapy showed statistically significant results (p=0.035 e p=0.011). Mindfulness (p=0.030-0.049), therapeutic wand and mHealth education (p<0.050) also showed benefits. Heterogeneity and risk of bias limited the evidence. There are promising physiotherapy modalities for the treatment of BPS/IC, but rigorous and methodologically robust studies are needed to consolidate the evidence.
Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) is a chronic condition that impacts quality of life. Physiotherapy interventions such as manual therapy, biofeedback, TENS, postural exercises and education have shown potential in the management of pain and urinary symptoms, although there are still gaps in strategies supported by up-to-date evidence. To systematically verify the effectiveness of physiotherapy modalities on pain, urinary symptoms and quality of life in individuals with VDS/CI. Methods: Following PRISMA recommendations, PubMed, PEDro, Science Direct and Cochrane Library databases were searched to identify randomized controlled trials (RCTs) published between 2015 and 2025 that met the inclusion criteria. The risk of bias of the studies was assessed with the Cochrane RoB 2.0 tool, and the results were synthesized narratively. Six RCTs showed that biofeedback with manual therapy and postural exercises improved pain (p=0.002-0.026) and urinary symptoms (p=0.043-0.048). Extracorporeal shock wave therapy showed statistically significant results (p=0.035 e p=0.011). Mindfulness (p=0.030-0.049), therapeutic wand and mHealth education (p<0.050) also showed benefits. Heterogeneity and risk of bias limited the evidence. There are promising physiotherapy modalities for the treatment of BPS/IC, but rigorous and methodologically robust studies are needed to consolidate the evidence.
Descrição
Palavras-chave
Dor Qualidade de vida Reabilitação Sintomas urinários