Importância do destreinamento físico sobre a capacidade funcional em indivíduos com doença arterial obstrutiva crônica periférica: estudo transversal piloto
Importance of physical detraining in functional capacity of individuals with chronic peripheral arterial occlusive disease: a cross-sectional pilot study
Mabel Marciela Ahner; Adamastor Humberto Pereira; Alexandre Araújo Pereira; Gabriel Alves Fonseca; Gabriel Pereira dos Reis Zubaran; Débora dos Santos Macedo; Eduardo Lima Garcia; Leandro Tolfo Franzoni
Resumo
Palavras-chave
Abstract
Background: Physical training is a well-established strategy for rehabilitation of the functional capacity of individuals with chronic peripheral arterial occlusive disease (PAOD). However, some individuals quit training after participating in a physical training program, undergoing detraining. There is scant literature on the effects of physical detraining in individuals with PAOD and it is therefore important to investigate the effects of this phenomenon. Objectives: The objective of this article was to evaluate the effects of physical detraining on functional capacity in individuals with PAOD. Methods: Cross-sectional study with 22 individuals. Participants were divided into two groups: a detraining group (DG) and a control group (CG). The distance covered in the 6-minute walk test (6MWTD) and the pain-free walking distance (PFWD) were evaluated. The PFWD is the distance covered until claudication begins, i.e., the distance covered without pain. Results: Mean age was 66 ± 8 in the DG and 67 ± 7 in the CG. There were no differences between the groups in either the 6MWTD or the PFWD (p = 0.428; p = 0.537, respectively). Conclusions: The present pilot study allows us to conclude that the functional capacity of individuals with PAOD who participated in a physical training program and subsequently underwent detraining was not superior in relation to individuals who did not participate in a physical training program. The results of the present study serve to encourage maintenance of physical exercise, since physical training is no longer effective if detraining occurs.
Keywords
References
1 Signorelli SS, Marino E, Scuto S, Di Raimondo D. Pathophysiology of Peripheral Arterial Disease (PAD): a review on oxidative disorders. Int J Mol Sci. 2020;21(12):4393. PMid:32575692.
2 Olin JW, Sealove BA. Peripheral artery disease: current insight into the disease and its diagnosis and management. Mayo Clin Proc. 2010;85(7):678-92.
3 França MA, Lima TM, Santana FS, et al. Relação entre o desempenho nos testes de esforço em esteira e de seis minutos de caminhada em pacientes com claudicação intermitente dos membros inferiores. J Vasc Bras. 2012;11(4):263-8.
4 Treat-Jacobson D, McDermott MM, Bronas UG, et al. Optimal exercise programs for patients with peripheral artery disease: a scientific statement from the American Heart Association. Circulation. 2019;139(4):e10-33.
5 Farah BQ, Ritti-Dias RM, Montgomery P, Cucato GG, Gardner A. Exercise intensity during 6-minute walk test in patients with peripheral artery disease. Arq Bras Cardiol. 2020;114(3):486-92. PMid:32267319.
6 Gerage AM, Correia MA, Oliveira PML, et al. Níveis de atividade física em pacientes com doença arterial periférica. Arq Bras Cardiol. 2019;113(3):410-6. PMid:31365605.
7 McDermott MM, Kibbe MR, Guralnik JM, et al. Durability of benefits from supervised treadmill exercise in people with peripheral artery disease. J Am Heart Assoc. 2019;8(1):e009380.
8 McDermott MM. Reducing disability in peripheral artery disease: the role of revascularization and supervised exercise therapy. JACC Cardiovasc Interv. 2019;12(12):1137-9.
9 Treat-Jacobson D, McDermott MM, Beckman JA, et al. Implementation of supervised exercise therapy for patients with symptomatic peripheral artery disease: a science advisory from the American Heart Association. Circulation. 2019;140(13):e700-10.
10 Gardner AW, Katzel LI, Sorkin JD, Goldberg AP. Effects of long-term exercise rehabilitation on claudication distances in patients with peripheral arterial disease: a randomized controlled trial. J Cardiopulm Rehabil. 2002;22(3):192-8.
11 Neufer PD. The effect of detraining and reduced training on the physiological adaptations to aerobic exercise training. Sports Med. 1989;8(5):302-21.
12 Bocalini DS, Serra AJ, Rica RL, Santos L. Repercussions of training and detraining by water-based exercise on functional fitness and quality of life: a short-term follow-up in healthy older women. Clinics. 2010;65(12):1305-9.
13 Nolan PB, Keeling SM, Robitaille CA, Buchanan CA, Dalleck LC. The effect of detraining after a period of training on cardiometabolic health in previously sedentary individuals. Int J Environ Res Public Health. 2018;15(10):2303.
14 ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-7.
15 Mays RJ, Casserly IP, Kohrt WM, et al. Assessment of functional status and quality of life in claudication. J Vasc Surg. 2011;53(5):1410-21.
16 Jelani QU, Mena-Hurtado C, Burg M, et al. Relationship between depressive symptoms and health status in peripheral artery disease: role of sex differences. J Am Heart Assoc. 2020;9(16):e014583.
17 Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.
18 Hagströmer M, Oja P, Sjöström M. The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutr. 2006;9(6):755-62.
19 McDermott MM, Tian L, Liu K, et al. Prognostic value of functional performance for mortality in patients with peripheral artery disease. J Am Coll Cardiol. 2008;51(15):1482-9.
20 Gardner AW. Exercise rehabilitation for peripheral artery disease: an exercise physiology perspective with special emphasis on the emerging trend of home-based exercise. Vasa. 2015;44(6):405-17.
21 Belardinelli R, Georgiou D, Cianci G, Purcaro A. 10-year exercise training in chronic heart failure: a randomized controlled trial. J Am Coll Cardiol. 2012;60(16):1521-8.
22 Gomes ANF, Prazeres TMP, Correia MA, Santana FS, Farah BQ, Ritti-Dias RM. Cardiovascular responses of peripheral artery disease patients during resistance exercise. J Vasc Bras. 2015;14(1):55-61.
23 Gardner AW, Montgomery PS, Wang M. Minimal clinically important differences in treadmill, 6-minute walk, and patient-based outcomes following supervised and home-based exercise in peripheral artery disease. Vasc Med. 2018;23(4):349-57.
Submitted date:
12/18/2020
Accepted date:
01/18/2021