Repercussões cardiovasculares e funcionais de protocolos de treino em esteira com diferentes inclinações em indivíduos com acidente vascular cerebral

• Ano de defesa: 2022
• Autor(a) principal: Mendes, Thais Almeida Silveira
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Rio Grande do Norte; Brasil; UFRN; PROGRAMA DE PÓS-GRADUAÇÃO EM FISIOTERAPIA
• Palavras-chave em Português: Fisioterapia; Reabilitação; Exercício aeróbico; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
• Link de acesso: https://repositorio.ufrn.br/handle/123456789/49268

Background: Treadmill training has been widely used for gait rehabilitation in individuals after stroke. However, there’s still a shortage of aerobic training protocols on an inclined treadmill, which analyze the safety related to the cardiovascular and functional impact of this training in this population. Objective: To evaluate the cardiovascular and functional repercussions of a treadmill training protocol at different inclines in individuals with chronic stroke. Methodology: Randomized clinical trial, in which 26 individuals with chronic stroke were randomized into a Control Group (CG) - which performed gait training on a treadmill without incline, Experimental Group 1 (EG1) - which performed training on a treadmill with 5% anterior incline and Experimental Group 2 (EG2) - which performed training on a treadmill with 10% of anterior incline. In all groups, training sessions lasted 30 minutes, with a frequency of 3 times a week for 6 weeks, totaling 18 sessions. Participants were evaluated immediately before, during and after each training session regarding cardiovascular parameters, obtaining the following outcomes: heart rate [HR], blood pressure [BP], metabolic equivalents [METs], double product [SD]; in addition to measures of internal load: perceived exertion [PE] and muscle fatigue [FM]. In each session, functional variables were evaluated: gait speed and distance covered on the treadmill. In article 1, functional and cardiovascular data from the 1st, 9th and 18th sessions were compared between groups using Mixed Analysis of Variance with repeated measures (α=5%). In article 2, descriptive statistics were used to verify the behavior of cardiovascular parameters in each session, and mixed analysis of variance with repeated measures were applied to compare the groups in each session regarding these parameters (α=5%). Results: In article 1, no time*group interaction was observed in any of the cardiovascular outcomes (HR and BP), as well as for the functional outcomes. Regarding the BP variable, there seems to have been an effect of time over the training sessions (F=3.482; P=0.040). A similar effect of time could be observed in relation to the outcomes of gait speed and distance covered (F=21.618; P<0.001; F=22.402; P<0.001). Perceived exertion and muscle fatigue were not different between groups. In article 2, no time*group interaction was observed in the SBP, DBP and HR variables, with no difference between the groups in each training session. Regarding the systolic blood pressure (SBP) and diastolic blood pressure (DBP) variables, there seems to have been an effect over time in some training sessions; of SBP in sessions 9 (P=0.027); 15 (P=0.027) and 18 (P=0.027) and DBP in sessions 4 (P=0.026); 5 (P=0.014); 9 (P=0.005); 12 (P=0.022); 14 (P=0.008) and 17 (P=0.038). Conclusion: Training performed with increased intensity from the anterior incline of the treadmill was not different from training without incline, in relation to cardiovascular and functional parameters seen during training. The control group performed training on a treadmill with light intensity (62% of HRmax) and the experimental groups performed training on a treadmill with moderate intensity (both with 69% of HRmax), with inclines of 5% and 10% being safe and replicable for the rehabilitation of individuals with chronic stroke.