LER - lesão por esforços repetitivos: um conceito falho e prejudicial RSI - Repetitive Strain Injury: a questionable and harmful concept

O conceito de que movimentos repetitivos ou posturas prolongadas causam lesões não tem suporte científico. Os sintomas dolorosos e sensitivos apresentados pelos pacientes são melhor explicados como um fenômeno psicológico e psicossocial, como insatisfação e desadaptação no trabalho e desejo de obter benefícios. O conceito de lesões por esforços repetitivos é iatrogênico e de custo elevado para a sociedade, devendo ser abandonado.<br>The hypothesis that repetitive movements and postures cause musculoskeletal injury is not supported by scientific data. The sensory and pain symptoms are better explained as of psychological and psychosocial nature, such as job insatisfaction or disajustment, with financial gains objectives. The repetitive strain injury concept is iatrogenic and costly to society, and must be abandonned

A systematic review of bio-psychosocial risk factors for an unfavourable outcome after lumbar disc surgery.

Contains fulltext : 49588.pdf (publisher's version ) (Closed access)The objective of this systematic review is to summarize scientific evidence concerning the predictive value of bio-psychosocial risk factors with regard to the outcome after lumbar disc surgery. Medical and psychological databases were used to locate potentially relevant articles, which resulted in the selection of 11 studies. Each of these studies has a prospective design that examined the predictive value of preoperative variables for the outcome of lumbar disc surgery. Results indicated that socio-demographic, clinical, work-related as well as psychological factors predict lumbar disc surgery outcome. Findings showed relatively consistently that a lower level of education, a higher level of preoperative pain, less work satisfaction, a longer duration of sick leave, higher levels of psychological complaints and more passive avoidance coping function as predictors of an unfavourable outcome in terms of pain, disability, work capacity, or a combination of these outcome measures. The results of this review provide preliminary opportunities to select patients at risk for an unfavourable outcome. However, further systematic and methodologically high quality research is required, particularly for those predictors that can be positively influenced by multidisciplinary interventions