Comparação dos parâmetros clínicos e funcionais de pacientes hipertensos submetidos a programa de reabilitação cardíaca supervisionada e parcialmente supervisionada

• Ano de defesa: 2015
• Autor(a) principal: Parreira, Larissa Barreto
• Orientador(a): Souza, Weimar Kunz Sebba Barroso de
• Banca de defesa: Souza, Weimar Kunz Sebba Barroso de, Jardim, Paulo César Brandão Veiga, Sousa, Ana Luiza Lima, Freitas Júnior, Aguinaldo Figueiredo, Vitorino, Priscila Valverde de Oliveira
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Goiás
• Programa de Pós-Graduação: Programa de Pós-graduação em Ciências da Saúde (FM)
• Departamento: Faculdade de Medicina - FM (RG)
• País: Brasil
• Palavras-chave em Português: Hipertensão; Exercício; Reabilitação
• Palavras-chave em Inglês: Hypertension; Exercise; Rehabilitation
• Área do conhecimento CNPq: CIENCIAS DA SAUDE
• Link de acesso: http://repositorio.bc.ufg.br/tede/handle/tede/7626

Introduction: Systemic arterial hypertension (SAH) is the main cause of death in developing and developed countries. A number of factors contribute to increase blood pressure, but the main factors are age, excessive ingestion of salt, obesity and sedentary lifestyle. Insufficient or lack of exercise plays an important role in the genesis of SAH and is also behind the high prevalence of this disease in the adult Brazilian population. Regular physical activity is effective at both reducing and maintaining blood pressure at normal levels. The main objective of cardiovascular rehabilitation is health education and monitored physical exercise programs for specific groups of patients. This rehabilitation consists of four phases; phase IV is considered partially supervised. Objective: To compare clinical and functional parameters in hypertensive patients who underwent two cardiac rehabilitation protocols: supervised and partially supervised. Methods: This randomized clinical trial included patients with stage I or II hypertension, aged >18 years, with no contraindication to physical exercise, who did not use beta blockers and used at least three antihypertensive drugs and also did not have limited voluntary ambulation. Group 1 participated in partially supervised cardiac rehabilitation and group 2, supervised rehabilitation. All participants did warm-up exercises, physical conditioning, resistance training, and cool-downs three days a week with sessions lasting 45 minutes over a period of three months. Before and after the intervention, the patients underwent physical evaluation, a six-minute walking test, treadmill exercise test, metabolic exams, and central and peripheral measures of blood pressure. Results: We evaluated 61 patients (30 in group 1 and 31 in group 2) with a mean age of 60.3±11.3 years; 78.7% were women. In the initial evaluation, the groups were homogenous with regard to all parameters except for mean body mass index values, which were 30.1±5.5 Kg/m² in group 1 and 26.6±7.0 Kg/m² in group 2 (p=0.040). After the intervention, both groups were able to walk farther in the six-minute walking test: group 1 increased mean distance by 30.6 meters (p=0.004) and group 2 increased by 55.0 meters (p<0.001). In addition, group 2 had higher values for weight bearing achieved in muscular strength tests, advancing from 2.3±0.7 Kg to 3.0±0.7 for upper limbs (p<0.001) and from 3.4±0.9 Kg to 3.8±0.8 Kg for the lower limbs (p<0.001). Gains were also seen in the maximal consumption of oxygen, from 24.7±8.6 mlO2/Kg/min to 28.4±7.5 mlO2/Kg/min (p=0.003). Adherence to the intervention was similar for both groups: 77.5±11% (G1) and 82±10% (G2) (p=0.124). Conclusion: The partially supervised cardiac rehabilitation program resulted in significant improvements in the distance covered in the six-minute walking test. The supervised cardiac rehabilitation program yielded, in addition to this gain, significant improvements in muscular strength and maximal consumption of oxygen. Adherence was satisfactory in both groups, showing that the two procedures were well-tolerated in the studied population. Considering the scarcity of supervised rehabilitation programs and increasing patient demand for these services, partially-supervised programs can provide an interesting option.