Jornal Vascular Brasileiro
https://jvascbras.org/journal/jvb/article/doi/10.1590/S1677-54492007000300008
Jornal Vascular Brasileiro
Review Article

Exercícios resistidos terapêuticos para indivíduos com doença arterial obstrutiva periférica: evidências para a prescrição

Therapeutic resistance exercises for individuals with peripheral arterial obstructive disease: evidence for prescription

Lucas Caseri Câmara; José Maria Santarém; Nelson Wolosker; Raphael Mendes Ritti Dias

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Resumo

A prática regular de exercícios é parte do tratamento clínico inicial para pacientes com doença arterial obstrutiva periférica. Nesse sentido, a utilização de exercícios contra resistência (exercícios resistidos) tem sido amplamente recomendada para diferentes populações, especialmente para pessoas idosas com e sem doenças associadas. Os poucos trabalhos encontrados utilizando essa forma de exercícios em pacientes com doença arterial obstrutiva periférica documentam a sua eficiência terapêutica. No entanto, os efeitos documentados dos exercícios resistidos em outras populações têm evidenciado melhoria da aptidão física e da qualidade de vida, com segurança cardiovascular e músculo-esquelética. Essas informações fornecem indicativos sobre os possíveis benefícios dos exercícios resistidos na terapia de indivíduos com doença arterial obstrutiva periférica. Nesse sentido, esta revisão objetivou apresentar informações científicas que permitam auxiliar a prescrição dos exercícios resistidos para essa população.

Palavras-chave

Doenças vasculares periféricas, claudicação intermitente, levantamento de peso, terapia por exercício

Abstract

A regular physical activity program is part of the initial clinical approach to patients with peripheral arterial obstructive disease. Therefore, use of exercises against resistance loads (resistance training) has been widely recommended for different populations, especially for elderly individuals with and without associated diseases. The few studies that have used this form of exercise in patients with peripheral arterial obstructive disease demonstrated its therapeutic efficiency. However, reported effects of resistance training in other populations have evidenced improvement in physical fitness and quality of life, with cardiovascular and musculoskeletal safety. These data indicate the possible benefits of resistance training in peripheral arterial obstructive disease therapy. Thus, this review aimed at presenting scientific information that can help prescription of resistance training for this population.

Keywords

Peripheral vascular disease, intermittent claudication, weight lifting, exercise therapy

References

Sontheimer DL. Peripheral vascular disease: diagnosis and treatment. Am Fam Physician.. 2006;73:1971-6.

Stewart KJ, Hiatt WR, Regensteiner JG, Hirsch AT. Exercise training for claudication. N Engl J Med.. 2002;347:1941-51.

Gardner AW, Womack CJ, Sieminski DJ, Montgomery PS, Killewich LA, Fonong T. Relationship between free-living daily physical activity and ambulatory measures in older claudicants. Angiology. 1998;49:327-37.

Garg PK, Tian L, Criqu MH. Physical activity during daily life and mortality in patients with peripheral arterial disease. Circulation. 2006;114:242-8.

Spronk S, White JV, Bosch JL, Hunink MG. Impact of claudication and its treatment on quality of life. Semin Vasc Surg.. 2007;20:3-9.

Aydemir O, Ozdemir C, Koroglu E. The impact of co-morbid conditions on the SF-36: a primary-care-based study among hypertensives. Arch Med Res.. 2005;36:136-41.

Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg.. 2007;45(^sS):S5-67.

Cassar K. Intermittent claudication. BMJ.. 2006;333:1002-5.

Wolosker N, Nakano L, Rosoky RA, Puech-Leao P. Evaluation of walking capacity over time in 500 patients with intermittent claudication who underwent clinical treatment. Arch Intern Med.. 2003;163:2296-300.

Rosoky RM, Wolosker N, Puech-Leao P. Performance of patients with intermittent claudication undergoing physical training, with or without an aggravation of arterial disease: retrospective cohort study. Clinics. 2006;61:535-8.

Collins EG, Langbein WE, Orebaugh C, Bammert C, Hanson K, Reda D. Cardiovascular training effect associated with polestriding exercise in patients with peripheral arterial disease. J Cardiovasc Nurs.. 2005;20:177-85.

Imfeld S, Singer L, Degischer S, Aschwanden M, Thalhammer C, Labs KH. Quality of life improvement after hospital- based rehabilitation or home-based physical training in intermittent claudication. Vasa. 2006;35:178-84.

McDermott MM, Tiukinhoy S, Greenland P, Liu K, Pearce WH, Guralnik JM. A pilot exercise intervention to improve lower extremity functioning in peripheral arterial disease unaccompanied by intermittent claudication. J Cardiopulm Rehabil.. 2004;24:187-96.

Sanderson B, Askew C, Stewart I, Walker P, Gibbs H, Green S. Short-term effects of cycle and treadmill training on exercise tolerance in peripheral arterial disease. J Vasc Surg.. 2006;44:119-27.

Zwierska I, Walker RD, Choksy SA, Male JS, Pockley AG, Saxton JM. Upper- vs. lower-limb aerobic exercise rehabilitation in patients with symptomatic peripheral arterial disease: a randomized controlled trial. J Vasc Surg.. 2005;42:1122-30.

Treesak C, Kasemsup V, Treat-Jacobson D, Nyman JA, Hirsch AT. Cost-effectiveness of exercise training to improve claudication symptoms in patients with peripheral arterial disease. Vasc Med.. 2004;9:279-85.

Graves JE, BA Franklin. Resistance training for health and rehabilitation. 2001.

Dias RMR, Gurjão ALD, Marucci MFN. Benefícios do treinamento com pesos para a aptidão física de idosos. Acta Fisiatr.. 2006;13:90-5.

Beniamini Y, Rubenstein JJ, Zaichkowsky LD, Crim MC. Effects of high-intensity strength training on quality-of-life parameters in cardiac rehabilitation patients. Am J Cardiol.. 1997;80:841-6.

Singh NA, Clements KM, Fiatarone MA. A randomized controlled trial of progressive resistance training in depressed elders. J Gerontol A Biol Sci Med Sci.. 1997;52:M27-35.

Fleck SJ, Kraemer WJ. Fundamentos do treinamento de força muscular. 2006.

Dias RMR, Salvador EP, Wolosker N, Marucci MFN. Novas tendências no tratamento de indivíduos com claudicação intermitente por meio do exercício físico. Rev Bras Cienc Mov.. 2006;14:111-5.

Câmara LC, Santarém Sobrinho JM, Kuwakino MH, Jacob Filho W. Exercícios resistidos em idosos portadores de insuficiência arterial periférica: revisão bibliográfica. Acta Fisiatr.. 2006;13:96-102.

Gardner AW, Clancy RJ. The relationship between ankle-brachial index and leisure-time physical activity in patients with intermittent claudication. Angiology. 2006;57:539-45.

McDermott MM, Criqui MH, Greenland P. Leg strength in peripheral arterial disease: associations with disease severity and lower-extremity performance. J Vasc Surg.. 2004;39:523-30.

Demonty B, Detaille V, Pasquier AY. Study and evaluation of patients with obliterating arteriopathy of the lower limbs: use of isokinetics to analyze muscular strength and fatigue. Ann Readapt Med Phys.. 2004;47:597-603.

Gerdle B, Hedberg B, Angquist KA, Fugl-Meyer AR. Isokinetic strength and endurance in peripheral arterial insufficiency with intermittent claudication. Scand J Rehabil Med.. 1986;18:9-15.

Hiatt WR, Wolfel EE, Meier RH, Regensteiner JG. Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease: Implications for the mechanism of the training response. Circulation. 1994;90:1866-74.

Regensteiner JG, Wolfel EE, Brass EP. Chronic changes in skeletal muscle histology and function in peripheral arterial disease. Circulation. 1993;87:413-21.

McDermott MM, Guralnik JM, Albay M, Bandinelli S, Miniati B, Ferrucci L. Impairments of muscles and nerves associated with peripheral arterial disease and their relationship with lower extremity functioning: the InCHIANTI Study. J Am Geriatr Soc.. 2004;52:405-10.

Askew CD, Green S, Walker PJ. Skeletal muscle phenotype is associated with exercise tolerance in patients with peripheral arterial disease. J Vasc Surg.. 2005;41:802-7.

Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation. 2004;110:738-43.

Passos VM, Barreto SM, Guerra HL, Firmo JO, Vidigal PG, Lima-Costa MF. The Bambui health and aging study (BHAS): Prevalence of intermittent claudication in the aged population of the community of Bambui and its associated factors. Arq Bras Cardiol.. 2001;77:453-62.

Ettinger WH. Arthritis and related musculoskeletal disorders. Resistance training for health and rehabilitation. 2001:347-56.

McCartney N. The safety of resistance training: hemodynamic factors and cardiovascular incidents. Resistance training for health and rehabilitation. 2001:83-93.

Kraemer WJ, Adams K, Cafarelli E. American College of Sports Medicine position stand: Progression models in resistance training for healthy adults. Med Sci Sports Exerc.. 2002;34:364-80.

Exercise and physical activity for older adults. Med Sci Sports Exerc.. 1998;30:992-1008.

Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA. American College of Sports Medicine position stand: Exercise and hypertension. Med Sci Sports Exerc.. 2004;36:533-53.

Albright A, Franz M, Hornsby G. American College of Sports Medicine position stand: Exercise and type 2 diabetes. Med Sci Sports Exerc.. 2000;32:1345-60.

Jakicic JM, Clark K, Coleman E. American College of Sports Medicine position stand: Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc.. 2001;33:2145-56.

Kohrt WM, Bloomfield SA, Little KD, Nelson ME, Yingling VR. American College of Sports Medicine Position Stand: physical activity and bone health. Med Sci Sports Exerc.. 2004;36:1985-96.

Verrill DE, Ribisl PM. Resistive exercise training in cardiac rehabilitation. An update.Sports Med.. 1996;21:347-83.

Rimmer JH. Resistance training for persons with physical disabilities. Resistance training for health and rehabilitation. 2001:321-45.

Santarém Sobrinho JM. Princípios profiláticos e terapêuticos do exercício. Reabilitação em medicina do esporte. 2004:17-25.

Vincent KR, Vincent HK. Resistance training for individuals with cardiovascular disease. J Cardiopulm Rehabil.. 2006;26:207-16.

Barbosa AR, Santarem JM, Filho WJ, Marucci Mde F. Effects of resistance training on the sit-and-reach test in elderly women. J Strength Cond Res.. 2002;16:14-8.

Rezk CC, Marrache RC, Tinucci T, Mion Jr. D, Forjaz CL. Post-resistance exercise hypotension, hemodynamics, and heart rate variability: influence of exercise intensity. Eur J Appl Physiol.. 2006;98:105-12.

Melo CM, Alencar Filho AC, Tinucci T, Mion Jr. D, Forjaz CL. Postexercise hypotension induced by low-intensity resistance exercise in hypertensive women receiving captopril. Blood Press Monit.. 2006;11:183-9.

McCartney N. Acute responses to resistance training and safety. Med Sci Sports Exerc.. 1999;31:31-7.

Bertagnoli K, Hanson P, Ward A. Attenuation of exercise-induced ST depression during combined isometric and dynamic exercise in coronary artery disease. Am J Cardiol.. 1990;65:314-7.

Daub WD, Knapik GP, Black WR. Strength training early after myocardial infarction. J Cardiopulm Rehabil.. 1996;16:100-8.

Featherstone JF, Holly RG, Amsterdam EA. Physiologic responses to weight lifting in coronary artery disease. Am J Cardiol.. 1993;71:287-92.

Haykowsky MJ, Findlay JM, Ignaszewski AP. Aneurysmal subarachnoid hemorrhage associated with weight training: three case reports. Clin J Sport Med.. 1996;6:52-5.

Fleck SJ, Dean LS. Resistance-training experience and the pressor response during resistance exercise. J Appl Physiol.. 1987;63:116-20.

Carpenter DM, Nelson BW. Low back strengthening for the prevention and treatment of low back pain. Med Sci Sports Exerc.. 1999;31:18-24.

Schilke JM, Johnson GO, Housh TJ, O'Dell JR. Effects of muscle-strength training on the functional status of patients with osteoarthritis of the knee joint. Nurs Res.. 1996;45:68-72.

McGuigan MR, Bronks R, Newton RU. Resistance training in patients with peripheral arterial disease: effects on myosin isoforms, fiber type distribution, and capillary supply to skeletal muscle. J Gerontol A Biol Sci Med Sci.. 2001;56:B302-10.

Regensteiner JG, Steiner JF, Hiatt WR. Exercise training improves functional status in patients with peripheral arterial disease. J Vasc Surg.. 1996;23:104-15.

Gardner AW, Poehlman ET. Exercise rehabilitation programs for the treatment of claudication pain: A meta-analysis. JAMA.. 1995;274:975-80.

Bhatt DL, Steg PG, Ohman EM. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA.. 2006;295:180-9.

Wieser M, Haber P. The effects of systematic resistance training in the elderly. Int J Sports Med.. 2007;28:59-65.

Sharman MJ, Newton RU, Triplett-McBride T. Changes in myosin heavy chain composition with heavy resistance training in 60- to 75-year-old men and women. Eur J Appl Physiol.. 2001;84:127-32.

Rhea MR, Alvar BA, Burkett LN. Single versus multiple sets for strength: a meta-analysis to address the controversy. Res Q Exerc Sport.. 2002;73:485-8.

Byrd R, Chandler TJ, Conley MS. Strength training: single versus multiple sets. Sports Med.. 1999;27:409-16.

Symons TB, Vandervoort AA, Rice CL, Overend TJ, Marsh GD. Effects of maximal isometric and isokinetic resistance training on strength and functional mobility in older adults. J Gerontol A Biol Sci Med Sci.. 2005;60:777-81.

Huggett DL, Elliott ID, Overend TJ, Vandervoort AA. Comparison of heart-rate and blood-pressure increases during isokinetic eccentric versus isometric exercise in older adults. J Aging Phys Act.. 2004;12:157-69.

Bjarnason-Wehrens B, Mayer-Berger W, Meister ER, Baum K, Hambrecht R, Gielen S. The stakes of force perseverance training and muscle structure training in rehabilitation: Recommendations of the German Federation for Prevention and Rehabilitation of Heart-Circulatory Diseases e.v.. Z Kardiol.. 2004;93:357-70.

Campos GE, Luecke TJ, Wendeln HK. Muscular adaptations in response to three different resistance-training regimens: specificity of repetition maximum training zones. Eur J Appl Physiol.. 2002;88:50-60.

Carpinelli RC, Otto RM, Winett RA. A critical analysis of the ACSM position stand on resistance training: insufficient evidence to suppot recommended training protocols. J Exercise Physiol online. 2004;7:1-60.

Lamotte M, Niset G, van de Borne P. The effect of different intensity modalities of resistance training on beat-to-beat blood pressure in cardiac patients. Eur J Cardiovasc Prev Rehabil.. 2005;12:12-7.

Taaffe DR, Pruitt L, Pyka G, Guido D, Marcus R. Comparative effects of high- and low-intensity resistance training on thigh muscle strength, fiber area, and tissue composition in elderly women. Clin Physiol.. 1996;16:381-92.

Kalapotharakos VI, Michalopoulou M, Godolias G, Tokmakidis SP, Malliou PV, Gourgoulis V. The effects of high- and moderate-resistance training on muscle function in the elderly. J Aging Phys Act.. 2004;12:131-43.

Gomides RS, Nery SS, Mion Júnior D, Tinucci T, Forjaz CLM. Pressão Arterial durante o exercício resistido de diferentes intensidades em indivíduos hipertensos. Coleção pesquisa em educação física. 2007:435-42.

Borg G. Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health.. 1990;16(^s1):55-8.

Nery SS. Pressão arterial de hipertensos estágio I durante diferentes intensidades de exercício resistido. 2005.

Kraemer WJ, Marchitelli L, Gordon SE. Hormonal and growth factor responses to heavy resistance exercise protocols. J Appl Physiol.. 1990;69:1442-50.

Kraemer WJ, Fleck SJ, Dziados JE. Changes in hormonal concentrations after different heavy-resistance exercise protocols in women. J Appl Physiol.. 1993;75:594-604.

Ahtiainen JP, Pakarinen A, Alen M, Kraemer WJ, Hakkinen K. Short vs. long rest period between the sets in hypertrophic resistance training: influence on muscle strength, size, and hormonal adaptations in trained men. J Strength Cond Res.. 2005;19:572-82.

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