Physiotherapeutic approach on the late phase of chikungunya: a case report

Abstract

Introduction: in April of 2016, the epidemiological bulletin reported 39,017 suspected cases of chikungunya fever in Brazil. The main symptoms of the disease in the acute phase are: high fever, polyarthralgia, back pain, headache and fatigue; while in the late phase present polyarthralgia or musculoskeletal pain which often has prolonged duration. Description: in the late phase, the patient presented complaints mainly of: severe pain on the ankle joints wrists, elbows and shoulders. The medical handling consisted of continuous ultrasound sessions with the frequency of 1 MHz. The infrared laser with a dosage of 4J and 3s per point; TENS-burst with a pulse width of 250 us and the frequency of 2Hz, carried out for 10 days. The physiotherapeutic treatment proposal was an innovation, however there are no medical literatures for completementary medication for the treatment which could reduce the use of analgesics and could cause prolonged comfort to the patient ratified by EVA and the SF-36. Discussion: the use of ultrasound and low intensity laser are performed on the signs of chronic articular treatment in order to reduce inflammation, pain and joint stiffness. Therefore, a remarkable reduction of the algic state and the improvement of the patient's life along the r ten consecutive sessions of a proposed protocol in this study, thus there is a need for further researches on this issue so it is possible to perform a medical handling based on evidences on the theme.

Treatment of chikungunya chronic arthritis: A systematic review

“…The studies selected for review of the literature were published between 2008 and 2016, with three studies conducted in India, 9,11 Asia; one in Reunion Island, 12 East Africa; one in the Dominican Republic, 13 Central America; and one in Brazil, 14 South America.…”

“…As for characteristics of methodological design, five studies were clinical trials, three of them contemplating the population group between 12 and 80 years, 11,12,15 while two did not describe the age of the sample group. 9,14 In the case of clinical trials, treatment outcome results with the following types of drugs were assessed: steroidal and non--steroidal anti-inflammatory drugs (SAIDs and NSAIDs), disease-modifying antirheumatic drugs (DMARDs) such as hydroxychloroquine, chloroquine, ribavirin, immuno--modulators and homoeopathic substance ( Table 1).…”

“…This study revealed the potential of such techniques in reducing the pain experienced by the patient reported, reflected in the decrease in the use of oral analgesics. 14 Among the pharmacological approach studies analyzed (Table 2), two presented an evaluation for NSAIDs. In both cases, there was improvement in the symptoms of arthritis with arthralgia and edema after using this class of drug.…”

Sequelas da febre Chikungunya e sua interferência na qualidade de vida de indivíduos

“…As doenças disseminadas pelos artrópodes, como dengue e CHIKV, estão incluídas em infecções emergentes e são vistas como um desafio para a saúde pública (RIBEIRO et al, 2016). A infecção aguda é identificada por febre alta e poliartralgia muito acentuada, após um período de incubação de dois a sete dias.…”

“…Essa avaliação é importante para possibilitar que os gerentes de programas de saúde projetem,programeme efetivem um contínuo de intervenções adequadas que, em última análise, protejam a saúde e proporcionem uma boa qualidade de vida para os indivíduos afetados (RAMACHANDRAN et al, 2012). É possível existir relação inversa entre dor e qualidade de vida, tendo em vista que esta se encontra entre os principais fatores que podem influenciar de forma negativa no bem-estar do indivíduo, pois restringe a efetivação de suas atividades, apresentando maior risco de estresse e isolamento social (RIBEIRO et al, 2016).…”