Efeitos de um programa de mindfulness para a dor crónica em atletas com deficiência física: um estudo quase experimental

Autores

  • Sandra Constantino Murillo Doctorando https://orcid.org/0000-0001-9341-8569
  • María Isabel Barriopedro Moro Departamento de Ciencias Sociales Aplicadas al Deporte, la Actividad Física y el Ocio, de la Facultad de Ciencias del Deporte, Universidad Politécnica de Madrid, Madrid, España. https://orcid.org/0000-0003-3872-5843

DOI:

https://doi.org/10.47197/retos.v65.111464

Palavras-chave:

Estratégias de coping, dor crónica, distúrbios emocionais, atenção plena, Para atletas, deficiência física

Resumo

Introdução: O programa Mindful Sport Performance Enhancement (MSPE) mostrou mudanças positivas em aspetos-chave que contribuem para o desempenho desportivo. Até à data, não foi realizado nenhum estudo em para-atletas com deficiência física utilizando programas baseados em mindfulness como estratégia para a gestão da dor crónica.
Objectivo: Determinar a utilidade do programa MSPE adaptado (combinação de MSPE e Mindfulness Based Stress Reduction [MBSR]) em comparação com o grupo de treino de relaxamento como estratégia para a gestão da dor crónica.
Metodologia: 36 para-atletas com dor crónica participaram num desenho quase experimental de dois grupos pré-pós-intervenção. Foram avaliados: 1) intensidade e frequência da dor com escala tipo Likert, 2) níveis de depressão, ansiedade e stress (Escalas de Depressão, Ansiedade e Stress [DASS-21]), 3) catastrofização (Coping Strategies Questionnaire [CSQ]), 4) aceitação da dor (Cronic Pain Acceptance Questionnaire [CPAQ-R]) e 5) satisfação com a vida (Life Satisfaction Scale [SWLS]).
Resultados: O grupo que recebeu o programa MSPE adaptado apresentou uma redução significativa da intensidade da dor, frequência, níveis de depressão e stress. Além disso, verificou-se um aumento da aceitação da dor e da satisfação com a vida. Tanto no grupo submetido a PEEM adaptada como no grupo de treino de relaxamento, observou-se uma redução dos níveis de ansiedade e catastrofização perante a dor.
Conclusões: Os resultados obtidos parecem indicar que o programa MSPE adaptado pode ser considerado como uma alternativa não farmacológica para a gestão da dor crónica, melhorando os cuidados e o apoio aos para-atletas de competição com deficiência física.

Referências

Atienza, F. L., Pons, D., Balaguer, I., & García-Merita, M. (2000). Propiedades psicométricas de la Escala de Satisfacción con la Vida en adolescentes. Psicothema, 314-319. https://www.psicothema.com/pdf/296.pdf

Baltzell, A., & Akhtar, V. (2014). Mindfulness meditation training for sport (MMTS) intervention: Im-pact of MMTS with division I female athletes. The Journal of Happiness & Well-Being, 2, 160-173.

Bernstein, D. A., Borkovec, T. D., & Hazlett-Stevens, H. (2000). New directions in progressive relaxation training: A guidebook for helping professionals. Praeger Publishers/Greenwood Publishing Group. Bloomsbury Academic.

Brintz, C. E., Roth, I., Faurot, K., Rao, S., & Gaylord, S. A. (2020). Feasibility and acceptability of an ab breviated, four-week mindfulness program for chronic pain management. Pain Medi-cine, 21(11), 2799-2810. https://doi.org/10.1093/pm/pnaa208

Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psycho logical well-being. Journal of personality and social psychology, 84(4), 822-848. https://doi.org/10.1037/0022-3514.84.4.822

Burke, D., Fullen, B. M., Stokes, D., & Lennon, O. (2017). Neuropathic pain prevalence following spinal cord injury: A systematic review and meta-analysis. European journal of pain (London, Eng-land), 21(1), 29-44. https://doi.org/10.1002/ejp.905

Cardle, P., Kumar, S., Leach, M., McEvoy, M., & Veziari, Y. (2023). Mindfulness and Chronic Muscu lo-skeletal Pain: An Umbrella Review. Journal of Multidisciplinary Healthcare, 16,515-533. https://doi.org/10.2147/JMDH.S392375

Castaño-Asins, J. R., Sanabria-Mazo, J. P., Luciano, J. V., Barceló-Soler, A., Martín-López, L. M., Del Arco-

Churruca, A., & Montes-Pérez, A. (2023). Effectiveness of Acceptance and Commitment Thera-py (ACT) for the Management of Postsurgical Pain: Study Protocol of a Randomized Controlled Trial (SPINE-ACT Study). Journal of Clinical Medicine, 12(12), 4066. https://doi.org/10.3390/jcm12124066

Catalá, P., Peñacoba, C., Pocinho, R., & Margarido, C. (2021). Effects of a psychological and physiothera-peutic intervention on the occurrence of injuries. Cultura, Ciencia y Deporte, 16(48), 225-234. https://doi.org/10.12800/ccd.v16i48.1715

Chen, M. A., & Meggs, J. (2021). The effects of Mindful Sport Performance Enhancement (MSPE) train-ing on mindfulness, and flow in national competitive swimmers. Journal of Human Sport and Exercise, 16(3), 517–527. http://hdl.handle.net/10045/106148

Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587

Cohen J. (1992). A power primer. Psychological bulletin, 112(1), 155–159. https://doi.org/10.1037//0033-2909.112.1.155

Cohen, S, P., Vase, L., & Hooten, W. M. (2021). Chronic pain: an update on burden, best practices, and new advances. Lancet, 397, 2082-97. https://doi.org/10.1016/S0140-6736(21)00393-7

Conti, Y., Vatine, J. J., Levy, S., Levin Meltz, Y., Hamdan, S., & Elkana, O. (2020). Pain Catastrophizing Me-diates the Association Between Mindfulness and Psychological Distress in Chronic Pain Syn

drome. Pain practice: the official journal of World Institute of Pain, 20(7), 714–723. https://doi.org/10.1111/papr.12899

Daza, P., Novy, D. M., Stanley, M. A., & Averill, P. (2002). The depression anxiety stress scale-21: Spanish translation and validation with a Hispanic sample. Journal of Psychopathology and Behavioral Assessment, 24(3), 195-205. https://doi.org/10.1023/A:1016014818163

Diener, E. D., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of personality assessment, 49(1), 71-75. https://doi.org/10.1207/s15327752jpa4901_13

European Pain Federation (EFIC). (2016). The European Year Against Joint Pain: Suffering patients must receive the right treatment as quickly as possible. https://www.europeanpainfederation.eu/wp-content/uploads/2016/06/PR-ES-EYAP-Launch-FREI.pdf

García-Esquinas, E., Rodríguez-Sánchez, I., Ortolá, R., Rodríguez- Mañas, L., Benegas, J., & Rodríguez-Artalejo, F. (2019). Gender Differences in Pain Risk in Old Age: Magnitude and Contributors. Mayo Clinic Proceedings, 94(9), 1707-1717. https://doi.org/10.1016/j.mayocp.2019.03.034

Glass, C.R., Spears, C. A., Perskaudas, R., & Kaufman, K.A. (2019). Mindful Sport Performance Enhance-ment: Randomized Controlled Trial of a Mental Training Program With Collegiate Ath-letes. Journal of Clinical Sport Psychology, 13, 609-628. https://doi.org/10.1123/jcsp.2017-0044

Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Kearney, D. J., & Simpson, T. L. (2019). Mind-fulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis. Cognitive behaviour therapy, 48(6), 445-462. https://doi.org/10.1080/16506073.2018.1556330

Gordon, S., Brown, R., Hogan, M., & Menzies, V. (2023). Mindfulness as a Symptom Management

Strategy for Fibromyalgia: An Integrative Review. Journal of Holistic Nursing, 41(2), 200-214. https://doi.org/10.1177/08980101221123833

Grobler, L., Derman, W., Blauwet, C. A., Chetty, S., Webborn, N., & Pluim, B. (2018). Pain management in athletes with impairment: a narrative review of management strategies. Clinical Journal of Sport Medicine, 28(5), 457-472. https://doi.org/10.1097/JSM.0000000000000600

Gross, M., Moore, Z. E., Gardner, F. L., Wolanin, A. T., Pess, R., & Marks, D. R. (2016). An empirical ex

amination comparing the Mindfulness-Acceptance- Commitment approach and Psychological Skills Training for the mental health and sport performance of female student athletes. Interna-tional Journal of Sport and Exercise Psychology, 16(4), 431-451. https://doi.org/10.1080/1612197X.2016.1250802

Haugmark, T., Hagen, K. B., Smedslund, G., & Zangi, H. A. (2019). Mindfulness and acceptance based in-terventions for patients with fibromyalgia. A systematic review and meta-analyses. PloSone, 14(9), e0221897. https://doi.org/10.1371/journal.pone.0221897

Henriksson, J., Wasara, E., & Rönnlund, M. (2016). Effects of eight-week-web-based mindfulness train-ing on pain intensity, pain acceptance, and life satisfaction in individuals with chronic pain. Psychological reports, 119(3), 586-607. https://doi.org/10.1177/0033294116675086

Hill, A., Niven, C. A., & Knussen, C. (1995). The role of coping in adjustment to phantom limb pain. Pain, 62, 79–86. https://doi.org/10.1016/0304-3959(94)00253-B

Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., Colaiaco, B., Maher, A. R.,

Shanman, R. M., Sorbero, M. E., & Maglione, M. A. (2017). Mindfulness Meditation for Chronic Pain: Sys-tematic Review and Meta-analysis. Annals of behavioral medicine: a publication of the Society of Behavioral Medicine, 51(2), 199–213. https://doi.org/10.1007/s12160-016-9844-2

Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of consulting and clinical psycholo-gy, 78(2), 169–183. https://doi.org/10.1037/a0018555

Hunt, C., Moman, R., Peterson, A., Wilson, R., Covington, S., Mustafa, R., Murad, M. H., & Hooten, W. M. (2021). Prevalence of chronic pain after spinal cord injury: a systematic review and meta-analysis. Regional anesthesia and pain medicine, 46(4), 328–336. https://doi.org/10.1136/rapm-2020-101960

Instituto Nacional de Estadística. (2020). Encuesta Europea de Salud en España (EESE). Principales

enfermedades crónicas o de larga evolución. https://www.ine.es/prensa/eese_2020.pdf

Jamil, A., Gutlapalli, S. D., Ali, M., Oble, M. J. P., Sonia, S. N., George, S., Shahi, S. R., Ali, Z., Abaza, A., & Mo-hammed, L. (2023). Meditation and Its Mental and Physical Health Benefits in 2023. Cureus, 15(6), e40650. https://doi.org/10.7759/cureus.40650

Kabat-Zinn, J. (1982). An Outpatient Program in Behavioural Medicine For Chronic Pain Patients Based on the Practice of Mindfulness Meditation: Theoretical Considerations and Preliminary Results. General hospital psychiatry, 4, 33-47. https://doi.org/10.1016/0163-8343(82)90026-3

Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. Delacorte Press Editions.

Kabat-Zinn, J. (2010). El poder de la atención: 100 lecciones sobre el Mindfulness. Kairós.

Kabat-Zinn, J. (2012). Mindfulness en la vida cotidiana: donde quiera que vayas, ahí estás. Paidós Ibéri-ca.

Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditations for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8(2), 163-190. https://doi.org/10.1007/bf00845519

Kaufman, K. A., Glass, C. R., & Pineau, T. R. (2018). Mindful Sport Performance Enhancement. Mental training for athletes and coaches. (1st Electronic edition published). America Psychological As-sociation. https://doi.org/10.1037/0000048-000

Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: a review of empirical studies. Clinical psychology review, 31(6), 1041–1056. https://doi.org/10.1016/j.cpr.2011.04.006

Khoo, E. L., Small, R., Cheng, W., Hatchard, T., Glynn, B., Rice, D. B., Skidmore, B., Kenny, S., Hutton, B., &

Poulin, P. A. (2019). Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis. Evidence-based mental health, 22(1), 26–35. https://doi.org/10.1136/ebmental-2018-300062

Khoury, B., Knäuper, B., Schlosser, M., Carrière, K., & Chiesa, A. (2017). Effectiveness of traditional medi-tation retreats: A systematic review and meta-analysis. Journal of psychosomatic research, 92, 16–25. https://doi.org/10.1016/j.jpsychores.2016.11.006

Kim, H. S., & Kim, E. J. (2018). Effects of relaxation therapy on anxiety disorders: a systematic review and meta-analysis. Archives of psychiatric nursing, 32(2), 278-284. https://doi.org/10.1016/j.apnu.2017.11.015

Kurt, B., & Kapucu, S. (2018). The effect of relaxation exercises on symptom severity in patients with breast cancer undergoing adjuvant chemotherapy: An open label non-randomized controlled clinical trial. European Journal of Integrative Medicine, 22(54-61). https://doi.org/10.1016/j.eujim.2018.08.002

La Cour, P., & Petersen, M. (2015). Effects of Mindfulness Meditation on Chronic Pain: A Randomized Controlled Trial. Pain Medicine, 16(4), 641–652. https://doi.org/10.1111/pme.12605

Lundqvist, C., Stahl, L., Kenttä, G., & Thulin, U. (2018). Evaluation of a mindfulness intervention for Par-alympic leader sprior to the Paralympic Games. International Journal of Sports Science & Coaching, 13(1), 62-71. https://doi.org/10.1177/1747954117746495

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Invento-ries. Behaviour research and therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-u

Lutz, A., McFarlin, D. R., Perlman, D. M., Salomons, T. V., & Davidson, R. J. (2013). Altered anterior isula activation during anticipation and experience of painful stimuli in expert meditators. Neu-roimage, 64, 538-546. https://doi.org/10.1016/j.neuroimage.2012.09.030

Maddock, A., & Blair, C. (2023). How do mindfulness-based programmes improve anxiety, depression and psychological distress? A systematic review. Current Psychology, 42, 10200-10222. https://doi.org/10.1007/s12144-021-02082-y

Martín-Asuero. (2008). Con rumbo propio. Disfruta de la vida sin estrés. Plataforma.

Martín-Asuero, A., & García de la Banda, G. (2007). Las ventajas de estar presente: desarrollando una conciencia plena para reducir el malestar psicológico. Internacional Journal of Clinical and Health Psychology, 2, 369-384. https://www.redalyc.org/articulo.oa?id=33717060008

McCracken, L.M., Goetsch, V.L., & Semenchuk, E. M. (1998). Coping with pain produced by physical ac-tivity in persons with chronic low Back pain: Immediate assessment following a specific pain event. Behavioral Medicine, 24, 29–34. https://doi.org/10.1080/08964289809596378

McCracken, L. M., & Vowles, K. E. (2014). Acceptance and commitment therapy and mindfulness for chronic pain: Model, process, and progress. American psychologist, 69(2), 178. https://doi.org/10.1037/a0035623

McCracken, L. M., Vowles, K. E., & Eccleston, C. (2004). Acceptance of chronic pain: component analysis and a revised assessment method. Pain, 107(1-2), 159–166. https://doi.org/10.1016/j.pain.2003.10.012

Meints, S. M., & Edwards, R. R. (2018). Evaluating psychosocial contributions to chronic pain out-comes. Progress in neuro-psychopharmacology & biological psychiatry, 87(Pt B), 168–182. https://doi.org/10.1016/j.pnpbp.2018.01.017

Menéndez, A. G., García, P. F., & Viejo, I. T. (2010). Aceptación del dolor crónico en pacientes con fibro-mialgia: adaptación del Chronic Pain Acceptance Questionnaire (CPAQ) a una muestra españo-la. Psicothema, 997-1003.

Mistretta, E. G., Glass, C. R., Spears, C. A., Perskaudas, R., Kaufman, K. A., & Hoyer, D. (2017). Collegiate Athletes' Expectations and Experiences with Mindful Sport Performance Enhancement. Journal of clinical sport psychology, 11(3), 201–221. https://doi.org/10.1123/jcsp.2016-0043

Moen, F., Abrahamsen, F.E., & Furrer, P. (2015). The Effects from Mindfulness Training on Norwegian Junior elite Athletes in Sport. International Journal of Applied Sports Sciences, 27 (2), 98-114.

https://doi.org/10.24985/IJASS.2015.27.2.98

Olivares, E. M., López, J. J. & Garcés de los Fayos, E. J. (2016). Entrenamiento psicológico en tiro olímpi-co: Estudio de un caso. Revista de Psicología del Deporte, 25(1), 131-135. http://www.redalyc.org/articulo.oa?id=235143645017

Palacio, R., Rodríguez-Martínez, D., & León- Zarceño. (2022). Programas de Intervención Psicológica con atletas para la mejora del rendimiento: una revisión actual. Revista de Psicología Aplicada al Deporte y al Ejercicio Físico, 7(1), 1-17. https://doi.org/10.5093/rpadef2022a6

Parmentier, F. B., García-Toro, M., García-Campayo, J., Yañez, A. M., Andrés, P., & Gili, M. (2019). Mind-fulness and Symptoms of Depression and Anxiety in the General Population: The Mediating Roles of Worry, Rumination, Reappraisal and Suppression. Frontiers in psychology, 10, 506. https://doi.org/10.3389/fpsyg.2019.00506

Pérez-Fernández, J. I., Salaberria, K., & Ruiz de Ocenda, Á. (2022). Mindfulness-Based Pain Management (MBPM) for Chronic Pain: a Randomized Clinical Trial. Mindfulness, 13(12), 3153-3165. https://doi.org/10.1007/s12671-022-02023-1

Pleman, B., Park, M., Han, X., Price, L. L., Bannuru, R. R., Harvey, W. F., Driban, J. B., & Wang, C. (2019). Mindfulness is associated with psychological health and moderates the impact of fibromyal-gia. Clinical rheumatology, 38(6), 1737–1745. https://doi.org/10.1007/s10067-019-04436-1

Raja, S. N., Carr, D. B., Cohen, M., Finnerup, N. B., Flor, H., Gibson, S., Keefe, F. J., Mogil, J. S., Ringkamp, M., Sluka, K. A., Song, X. J., Stevens, B., Sullivan, M. D., Tutelman, P. R., Ushida, T., & Vader, K. (2020). The revised International Association for the Study of Pain definition of pain: concepts, chal-lenges, and compromises. Pain, 161(9), 1976-1982. https://doi.org/10.1097/j.pain.0000000000001939

Rodríguez, L., Cano, F. J., & Blanco, I. (2004). Evaluación de las estrategias de afrontamiento del dolor crónico. Actas Españolas de Psiquiatría, 32(2), 82-91. http://hdl.handle.net/11441/56855

Rosenstiel, A. K., & Keefe, F. J. (1983). The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain, 17(1), 33–44. https://doi.org/10.1016/0304-3959(83)90125-2

Ruiz, F. J., Martín, M. B. G., Falcón, J. C. S., & González, P. O. (2017). The hierarchical factor structure of

the Spanish version of Depression Anxiety and Stress Scale-21. International Journal of Psychology and Psychological Therapy, 17(1), 97-105.

https://www.redalyc.org/articulo.oa?id=56049624007

Sappington, R., & Longshore, K. (2015). Systematically Reviewing the Efficacy of Mindfulness-Based Interventions for Enhanced Athletic Performance. Journal of Clinical Sport Psychology, 9(3), 232-262. https://doi.org/10.1123/jcsp.2014-0017

Schütze, R., Rees, C., Preece, M., & Schütze, M., (2010). Low mindfulness predicts pain catastrophizing in a fear-avoidance model of chronic pain. Pain, 148(1), 120- 127. https://doi.org/10.1016/j.pain.2009.10.030

Soler Ribaudi, J., Tejedor, R., Feliu-Soler, A., Pascual Segovia, J. C., Cebolla Marti, A., Soriano, J., & Perez,

V. (2012). Psychometric proprieties of Spanish version of Mindful Attention Awareness Scale (MAAS). Actas Españolas de Psiquiatría, 40(1), 19-26. https://actaspsiquiatria.es/index.php/actas/article/view/588

Turk, D. C., Fillingim, R. B., Ohrbach, R., & Patel, K. V. (2016). Assessment of psychosocial and functional impact of chronic pain. The Journal of Pain, 17(9), 21–49. https://doi.org/10.1016/j.jpain.2016.02.006

Vernaza-Pinzón, P., Posadas-Pérez, L., & Acosta-Vernaza, C. (2019). Dolor y emoción, una reflexión para el profesional en ciencias de la salud. Duazary, 16(1), 145-155. https://doi.org/10.21676/2389783X.2639

Wilson, J. M., Colebaugh, C. A., Flowers, K. M., Meints, S. M., Edwards, R. R., &Schreiber, K. L. (2022). So-cial Support and Psychological Distress among Chronic Pain Patients: The

Mediating Role of Mindfulness. Personality and individual differences, 190, 111551. https://doi.org/10.1016/j.paid.2022.111551

Wong, R. S. K., How, P. N., & Cheong, J. P. G. (2022). The Effectiveness of a Mindfulness Training Pro-gram on Selected Psychological Indices and Sports Performance of Sub-Elite Squash Ath-letes. Frontiers in psychology, 13, 906729. https://doi.org/10.3389/fpsyg.2022.906729

Zhao, X., Boersma, K., Gerdle, B., Molander, P., & Hesser, H. (2023). Fear network and pain extent: Inter-plays among psychological constructs related to the fear-avoidance model. Journal of Psycho-somatic Research, 167, 111176. https://doi.org/10.1016/j.jpsychores.2023.111176

Publicado

2025-02-24

Como Citar

Constantino Murillo, S., & Barriopedro Moro, M. I. (2025). Efeitos de um programa de mindfulness para a dor crónica em atletas com deficiência física: um estudo quase experimental. Retos, 65, 1120–1137. https://doi.org/10.47197/retos.v65.111464

Edição

Secção

Artigos de caráter científico: trabalhos de pesquisas básicas e/ou aplicadas.