Treinamento de força para pacientes com doença pulmonar obstrutiva crônica
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Data
2008-06-01
Autores
Silva, Evelise Guimarães da [UNESP]
Dourado, Victor Zuniga
Título da Revista
ISSN da Revista
Título de Volume
Editor
Sociedade Brasileira de Medicina do Exercício e do Esporte
Resumo
Pacientes com doença pulmonar obstrutiva crônica apresentam comumente fraqueza muscular periférica associada à intolerância ao exercício. Embora efetivo, o exercício aeróbio apresenta pouco ou nenhum efeito na fraqueza e atrofia muscular, além de não ser tolerado pela maioria dos pacientes com DPOC. Nesse sentido, o treinamento de força é opção racional para aumentar a força muscular, além de já ter se mostrado mais tolerável que o exercício aeróbio. O aumento de força muscular periférica é o benefício mais consistente do treinamento de força e, quando este é associado ao exercício aeróbio, não resulta em melhora adicional da capacidade de exercício, da dispnéia e da qualidade de vida. Contudo, observa-se que o treinamento combinado é fisiologicamente mais completo e pode ser uma opção de condicionamento físico mais diversificado. O treinamento de moderada a alta intensidade resulta em maiores adaptações fisiológicas, entretanto o exercício de baixa intensidade é tolerável, simples, de fácil execução domiciliar, não requer equipamentos sofisticados e resulta em benefícios significativos. Este exercício é indicado, sobretudo, para os pacientes com DPOC mais avançada. Finalmente, há evidências recentes de que o treinamento de força para os músculos do tronco é alternativa válida para melhorar a capacidade funcional de exercício e a função pulmonar em pacientes com DPOC. A presente revisão de literatura sugere a incorporação do treinamento de força como estratégia de rotina nos programas de reabilitação pulmonar. Pesquisas futuras são necessárias para avaliar os efeitos do treinamento de força na saúde mental, no desempenho em atividades de vida diária, na saúde osteoarticular, no risco de quedas e na função pulmonar, entre outros.
Patients with chronic obstructive pulmonary disease commonly present peripheral muscular weakness associated with intolerance to exercise. Although being effective, aerobic exercise presents little or no effect on the muscular weakness and atrophy, besides not being tolerated by the majority of patients with COPD. Within this context, strength training is a rational option for increasing muscular strength; it is also more tolerable than aerobic exercise. The increase in peripheral muscular strength is the most consistent benefit of strength training and, when it is added to aerobic exercise; it does not result in additional improvement in exercise capacity, dyspnea or quality of life. Nevertheless, it has been observed that combined training is physiologically more complete and can be a reasonable option of a more diverse physical conditioning. Training of moderate to high intensity results in greater physiological adaptations; however, low-intensity exercise is tolerable, simple and easy to be performed at home, does not require any sophisticated equipment and results in significant benefits. This exercise is indicated, above all, to patients with more advanced COPD. Finally, there is recent evidence that strength training for trunk muscles is a valid alternative for improving functional exercise capacity and pulmonary function in patients with COPD. The present review suggests the incorporation of strength training as a routine strategy in pulmonary rehabilitation programs. Future studies are necessary to evaluate the effects of strength training in the mental health, in the performance of daily tasks, in the bone and joint health, in the risk of falls and in the pulmonary function, among others.
Patients with chronic obstructive pulmonary disease commonly present peripheral muscular weakness associated with intolerance to exercise. Although being effective, aerobic exercise presents little or no effect on the muscular weakness and atrophy, besides not being tolerated by the majority of patients with COPD. Within this context, strength training is a rational option for increasing muscular strength; it is also more tolerable than aerobic exercise. The increase in peripheral muscular strength is the most consistent benefit of strength training and, when it is added to aerobic exercise; it does not result in additional improvement in exercise capacity, dyspnea or quality of life. Nevertheless, it has been observed that combined training is physiologically more complete and can be a reasonable option of a more diverse physical conditioning. Training of moderate to high intensity results in greater physiological adaptations; however, low-intensity exercise is tolerable, simple and easy to be performed at home, does not require any sophisticated equipment and results in significant benefits. This exercise is indicated, above all, to patients with more advanced COPD. Finally, there is recent evidence that strength training for trunk muscles is a valid alternative for improving functional exercise capacity and pulmonary function in patients with COPD. The present review suggests the incorporation of strength training as a routine strategy in pulmonary rehabilitation programs. Future studies are necessary to evaluate the effects of strength training in the mental health, in the performance of daily tasks, in the bone and joint health, in the risk of falls and in the pulmonary function, among others.
Descrição
Palavras-chave
DPOC, treinamento de força, reabilitação pulmonar, qualidade de vida, COPD, strength training, pulmonary rehabilitation, quality of life
Como citar
Revista Brasileira de Medicina do Esporte. Sociedade Brasileira de Medicina do Exercício e do Esporte, v. 14, n. 3, p. 231-238, 2008.