Abstract

Multimodal physiotherapy is a physiotherapeutic approach where the professional combines several therapeutic resources in the same session. We can mention, for example, the use of manual therapy techniques associated with exercises (motor control), among other therapeutic resources in treating Pain.

Combining two or more techniques is a therapeutic standard commonly used in clinical practice. Still, it is only in recent years that we have seen research using this therapeutic approach.

When applying this therapeutic model, the professional must be conscientious since we already have a base of evidence for the use of different therapeutic resources and the treatment of different pathologies. To obtain therapeutic efficacy, skill and mastery of the techniques used are necessary, as well as adequate scientific knowledge. Randomly using different therapeutic techniques and resources will not benefit your patient.

This treatment model is centered on the individuality of each patient, knowing that no patient responds to a specific treatment in the same way and each clinical case has its individuality.  Study and research centers must start to be more specific in their work, I have not yet been able to observe studies using manual therapy techniques that used passive mobilization of low amplitude and speed, being applied after a thorough evaluation of the joint segment with potential interference biomechanics and not in the specific location of the pain, in patients with scores of 8 to 10 points on the analog pain scale, associated with pain education to understand the etiology of pain, being approached differently between acute and chronic pain and its specificity of according to the pathology, being related to the optimization of motor control after assessment, with different approaches to muscle activation or inhibition strategies, self-treatment and pain management being recommended.

This is just a single example of a prevalent situation in clinical practice, among many others, but very difficult to observe in lines of research. Many studies are generalist when carrying out research using the techniques mentioned above, especially when evaluating individuals with pain. Multimodal treatment becomes even more relevant when we analyze a situation among chronic patients who present various musculoskeletal pathologies with different characteristics associated with comorbidities with cardiac dysfunction and diabetes, among other metabolic disorders.

We must emphasize the daily assessment of our patients and be able to identify the main areas of risk, focusing on functional improvement reflected in their daily activities. Improving pain perception scores is part of multidisciplinary work. Still, physiotherapists have enough tools to strengthen and demonstrate the dysfunctional improvement that the patient presents, preventing comorbidities and enhancing their quality of life.

This criticism arises from the latest published studies demonstrating the importance of a better assessment approach and scientific knowledge of professionals working with these specific techniques to treat pain. In conclusion, this text encourages new scientists to take a more comprehensive look at clinical practice with methodological concepts that use clinical reasoning and management of multimodal physiotherapy in treating Pain.