Impacto de un programa cuerpomente, basado en ejercicios de fisioterapia y técnicas psicológicas, en el bienestar psíquico de una población de pacientes diabéticos tipo 2
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may 22, 2017
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En los pacientes con diabetes tipo 2, el riesgo de sufrir algún tipo de malestar psicológico, con síntomas de depresión y ansiedad, es aproximadamente el doble que en población normal. Cuando son síntomas relacionados con condiciones concomitantes, físicas y psicológicas deben ser tratados. El objetivo de este trabajo, fue examinar los efectos de un programa de ejercicios de fisioterapia y técnicas psicológicas, en el bienestar psíquico de una población diabética. El programa de 12 semanas, se aplicó en 25 pacientes y se evaluó: dolor, tensión arterial, antropometría, analítica sanguínea y bienestar psíquico (cuestionario de Goldberg de 28 ítems: GHQ-28). A pesar de la edad (84% < de 65 años), solo el 12% trabajaban, debido a su situación clínica de alto riesgo cardiovascular, presencia de comorbilidades (96%) y dolor asociado. Todo ello afectaba negativamente el bienestar psíquico de los pacientes que puntuaron alto en el GHQ: disfunción social (14.8±2.2), síntomas somáticos (13.5±3.6), ansiedad e insomnio (11.9±3.4) y depresión severa (9.2±4.4). La situación clínica determinó el diseño del programa, que mostró gran eficacia terapéutica para el dolor y el aumento del bienestar psicológico, con gran repercusión en la puntuación total del GHQ, en los síntomas somáticos y en la disfunción social, aunque en la ansiedad e insomnio y la depresión los cambios fueron menores. En síntesis, el programa mejoró el bienestar físico y psíquico de la muestra, lo que aumenta la evidencia sobre la opción de incluir fisioterapia y psicología para tratar las circunstancias que causan malestar psíquico en la diabetes.
Keywords
diaabetes mellitus, mental health, physical therapy modalities, phychological techniques, exercise therapyDiabetes Mellitus tipo 2, modalidades de fisioterapia, técnicas psicológicas
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Chambliss, H. O. (2005). Exercise duration and intensity in a weight-loss program. Clinical Journal of Sport Medicine, 15(2), 113-115.
Chien, I. -C., & Lin, C. -H. (2016). Increased risk of diabetes in patientes with anxiety disorders: A population-based study. Journal of Psychosomatic Research, 86(1), 47-52.
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Fisher, L., Mullan, J. T., Arean, P., Glasgow, R. E., Hessler, D., & Masharani, U. (2010). Diabetes distress but not clinical depression or depressive symptoms is associated with glycemic control in both cross-sectional and longitudinal analyses. Diabetes Care, 33, 23-28.
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Gilleard, W., & Smith, T. (2007). Effect of obesity on posture and hip joint moments during a standing task, and trunk forward flexion motion. International Journal of Obesity, 31(2), 267-271.
Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139-145.
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Gonzalez, J. S., Fisher, L., & Polonsky, W. H. (2011). Depression in diabetes: Have we been missing something important? Diabetes Care, 34(1), 236-239. doi: 10.2337/dc10-1970
Hartmann, M., Kopf, S., Kircher, C., Faude-Lang, V., Djuric, Z., Augstein, F., … Nawroth, P. P. (2012). Sustained effects of a mindfulness-based stress-reduction intervention in type 2 diabetic patients: Design and first results of a randomized controlled trial (the Heidelberger Diabetes and Stress-study). Diabetes Care, 35(5), 945-947.
Hooper, M. M., Stellato, T. A., Hallowell, P. T., Seitz, B. A., & Moskowitz, R. W. (2007). Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery. International Journal Obesity, 31(1), 114-120.
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Khuwaja, A. K., Lalani, S., Dhanani, R., Azam, I. S., Rafique, G., & White, F. (2010). Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetology & Metabolic Syndrome, 2(72), 1-10. doi:10.1186/1758-5996-2-72
Liu, X., Miller, Y. D., Burton, N. W., & Brown, W. J. (2010). A preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome, glycaemic control, health-related quality of life, and psychological health in adults with elevated blood glucose. British Journal Sports Medicine, 44(10), 704-709.
Lobo, A., Pérez-Echeverría, M. J., & Artal, J. (1986). Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population. Psychological Medicine, 16(1), 135-140.
Lobo, A., Pérez-Echeverría, M. J., Jiménez-Aznárez, A., & Sancho, M. A. (1988). Emotional disturbances in endocrine patients. Validity of the scaled version of the General Health Questionnaire (GHQ-28). British Journal of Psychiatry, 152, 807-812.
Lucha-López, M. O., Lucha-López, A. C., Vidal-Peracho, C., Tricás-Moreno, J. M., Estebanez-De Miguel, E., Salavera-Bordás, C., … Caudevilla-Polo, S. (2012). Impact of supervised physiotherapeutic exercises for obese adults with diabetes mellitus type 2. Journal of Physical Therapy Science, 24(12), 1299-1305.
Lucha-López, M. O., Lucha-López, A. C., Vidal-Peracho, C., Tricás-Moreno, J. M., Estébanez-De Miguel, E., Salavera-Bordás, C., & Hidalgo-García, C. (2014). Analysis of a sample of type 2 diabetic patients with obesity or overweight and at cardiovascular risk: A cross sectional study in Spain. BMC Research Notes, 7. doi:10.1186/1756-0500-7-48
Mäntyniemi, A., Oksanen, T., Salo, P., Virtanen, M., Sjösten, N., Pentti, J., … & Vahtera, J. (2012). Job strain and the risk of disability pension due to musculoskeletal disorders, depression or coronary heart disease: A prospective cohort study of 69,842 employees. Occupational and Environmental Medicine, 69(8), 574-581.
Merkes, M. (2010). Mindfulness-based stress reduction for people with chronic diseases. Australian Journal of Primary Health, 16(3), 200-210.
Nicolucci, A., Balducci, S., Cardelli, P., Cavallo, S., Fallucca, S., Bazuro, A., … Pugliese, G. (2012). Italian diabetes exercise study investigators. Relationship of exercise volume to improvements of quality of life with supervised exercise training in patients with type 2 diabetes in a randomized controlled trial: The Italian Diabetes and Exercise Study (IDES). Diabetologia, 55(3), 579-588.
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Cómo citar
Lucha-Lopez, M. O., Lucha-López, A. C., Tricás-Moreno, J. M., Vidal-Peracho, C., Salavera-Bordás, C., & Estébanez De Miguel, E. (2017). Impacto de un programa cuerpomente, basado en ejercicios de fisioterapia y técnicas psicológicas, en el bienestar psíquico de una población de pacientes diabéticos tipo 2. Universitas Psychologica, 16(1). https://doi.org/10.11144/Javeriana.upsy16-1.ipcb
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