Efeitos da imposição de mãos com ou sem componente espiritual como terapia complementar à cinesioterapianador e funcionalidade de idosas com osteoartrite de joelhos: ensaio clínico controlado randomizado

Abstract

Laying on of hands (LooH) is a culturally-accepted therapy, that can be used without any religious/spiritual component (e.g. therapeutic touch, healing touch and Reiki)) or in spiritual traditions (e.g. Spiritist passe –used in Spiritism, the third-largest religion in Brazil). Despite some positive results with LooHin healthy, there is a scarcity of studies concerning its use in knee osteoarthiritis (KOA) and, to our knowledge, no study comparing LooH with and without a “spiritual component”in KOA. This study aimed to assess the effects of LooH (withand without a spiritual component) as a complementary therapy to kinesiotherapy on pain, joint stiffness, and functional capacity of older women with KOA.In this randomized controlled clinical trial, older women with KOA were assigned to three groups: LooH with a spiritual component (“Spiritist passe” group -SPG), LooH group without a spiritual component (LooH provided by Lay people group -LHG), and a control group receiving no LooH (CG). Participants in all groups received 16 sessions of the same kinesiotherapy protocol. The SPG and LHG received eight five-minute sessions of LooH corresponding to the group. Patients were assessed at baseline and after 8 and 16 weeks. Primary outcomes were joint stiffness, and functional capacity (assessed using Western Ontario and McMaster Universities Osteoarthritis Index –WOMAC) and pain (assessed using WOMAC and Visual Analog Scale -VAS). Secondary outcomes were anxiety, depression, mobility, and quality of life(assessed using HAD, TUG e WHOQOL-Bref, respectively).Differences between groups were evaluated using an intention-to-treat approach.A total of120 women with KOA were randomized (40 participants for each group). After the intervention (8 weeks), SPG was significantly different from LHG in WOMAC Pain (Cohen-d=0.56) and WOMAC Functional Status (Cohen-d=0.70); and was also significant different from the CG in all outcomes (Cohen-d varying from 0.57 to 1.11). After 16 weeks, results were maintained and SPG was significantly different from LHG in WOMAC Pain (Cohen-d=0.53) and WOMAC Functional Status (Cohen-d=0.72); and was also significant different from the CG in virtually all outcomes (Cohen-d varying from 0.82 to 1.02), with exception of depression.The present study suggests that LooH with a “spiritual component” may have better outcomes as compared to LooH without a “spiritual component” or to a control group without LooH. The results were maintained after 16 weeks and the effect sizes were moderate to large.