Nível de atividade física e comportamento sedentário em indivíduos com acidente vascular encefálico: caracterização e influência sobre marcadores de risco
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2021-02-11
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Universidade Estadual Paulista (Unesp)
Resumo
O interesse em avaliar os níveis habituais de atividade física (AF) e comportamento sedentário (CS) em indivíduos após o acidente vascular encefálico (AVE) tem aumentado devido à importância dessas variáveis e relação delas com marcadores de risco cardiovascular. Objetivos: Caracterizar o CS e os níveis habituais de AF e seus diferentes domínios em indivíduos após o AVE; verificar nesses indivíduos qual a relação entre o CS e os níveis habituais de AF com os marcadores de risco: modulação autonômica, frequência cardíaca de repouso (FCR) e pressão arterial (PA) de repouso; verificar se medidas do nível de AF e CS obtidas por meio de questionários estão associados a mensurações avaliadas pelo acelerômetro. Materiais e métodos: Foram recrutados voluntários com diagnóstico de AVE e realizadas avaliações do CS pelo Questionário de Comportamento Sedentário para Idosos (LASA- SBQ), nível de AF por meio da aplicação do Questionário Internacional de Atividade Física – IPAQ e Questionário de atividade física habitual de Baecke. Foi utilizada também a acelerometria para avaliar os níveis de AF e CS. Os marcadores de risco avaliados foram PA de repouso e FCR, além da modulação autonômica, avaliada pelos índices da variabilidade da frequência cardíaca (VFC). Resultados: Os valores do LASA-SBQ, IPAQ, Baecke e acelerometria indicam que estes indivíduos permanecem grande tempo em CS e a AF que realizam é de intensidade leve. Foram identificados maiores valores entre as mensurações obtidas pelo acelerômetro e aqueles obtidos pelos questionários (p<0,05) e concordância pobre tanto para o CS avaliado pelo LASA-SBQ e acelerômetro (IC95% = -0,338 – 0,282; R=2,575; CCI=-0,104; p=0,683) quanto para a avaliação entre IPAQ e acelerômetro (IC95% = -0,115 – 0,274; R=2,909; CCI=0,027; p=0,387). Os minutos semanais dispendidos em atividades leve, vigorosa e AF total apresentam diferença estatisticamente significantes, porém apresentam pobre concordância quando comparados IPAQ e acelerômetro. A atividade moderada + vigorosa apresentou concordância razoável. As concordâncias entre as classificações dos níveis de AF obtidas por meio de questionários autorrelatados (IPAQ e Baecke) e acelerômetro dos indivíduos analisados foram classificadas como fracas. Conclusão: Indivíduos com diagnóstico de AVE dispendem grande tempo em CS e realizam AF leves para lazer e deslocamento. Embora sejam leves, essa AF realizada apresenta uma relação positiva no aumento da atividade parassimpática, contribuindo para melhorar a modulação autonômica cardíaca. As medidas dos níveis habituais de AF e CS, subjetivas e objetivas, utilizadas nesse estudo em indivíduos após o AVE não apresentam concordância entre si.
The interest in assessing the usual levels of physical activity (PA) and sedentary behavior (SB) in individuals after stroke has increased due to the importance of these variables and their relationship with cardiovascular risk markers. Objectives: To characterize the SB and the usual levels of PA and its different domains in individuals after the stroke; verify in these individuals the relationship between SB and the usual levels of PA with risk markers: autonomic modulation, resting heart rate (HRR) and resting blood pressure (BP); to verify if measurements of the level of PA and SB obtained through questionnaires are associated with measurements evaluated by the accelerometer. Methods: Volunteers with a diagnosis of stroke were recruited and SB assessments were performed using the Sedentary Behavior Questionnaire for the Elderly (LASA-SBQ), PA level through the application of the International Physical Activity Questionnaire - IPAQ and Questionnaire of habitual physical activity of Baecke. Accelerometry was also used to assess the levels of PA and SB. The risk markers assessed were resting BP and HRR, in addition to autonomic modulation, assessed by heart rate variability (HRV) indices. Results: The values of LASA-SBQ, IPAQ, Baecke and accelerometry indicate that these individuals remain for a long time in SB and the PA they perform is of light intensity. Higher values were identified between the measurements obtained by the accelerometer and those obtained by the questionnaires (p <0.05) and poor agreement both for the SB assessed by LASA-SBQ and accelerometer (95% CI = -0.338 - 0.282; R = 2.575; CCI = -0.104; p = 0.683) as for the evaluation between IPAQ and accelerometer (95% CI = -0.115 - 0.274; R = 2.909; CCI = 0.027; p = 0.387). The weekly minutes spent in light, vigorous and total PA activities are statistically significant, but have poor agreement when compared to IPAQ and accelerometer. Moderate + vigorous activity showed reasonable agreement. The agreement between the classifications of PA levels obtained through self-reported questionnaires (IPAQ and Baecke) and accelerometer of the individuals analyzed were classified as weak. Conclusion: Individuals diagnosed with stroke spend a great deal of time in SB and perform mild PA for leisure and commuting. Although they are mild, this PA performed has a positive relationship in increasing parasympathetic activity, contributing to improve cardiac autonomic modulation. The measurements of the usual levels of PA and SB, subjective and objective, used in this study in individuals after the stroke are not in agreement with each other.
The interest in assessing the usual levels of physical activity (PA) and sedentary behavior (SB) in individuals after stroke has increased due to the importance of these variables and their relationship with cardiovascular risk markers. Objectives: To characterize the SB and the usual levels of PA and its different domains in individuals after the stroke; verify in these individuals the relationship between SB and the usual levels of PA with risk markers: autonomic modulation, resting heart rate (HRR) and resting blood pressure (BP); to verify if measurements of the level of PA and SB obtained through questionnaires are associated with measurements evaluated by the accelerometer. Methods: Volunteers with a diagnosis of stroke were recruited and SB assessments were performed using the Sedentary Behavior Questionnaire for the Elderly (LASA-SBQ), PA level through the application of the International Physical Activity Questionnaire - IPAQ and Questionnaire of habitual physical activity of Baecke. Accelerometry was also used to assess the levels of PA and SB. The risk markers assessed were resting BP and HRR, in addition to autonomic modulation, assessed by heart rate variability (HRV) indices. Results: The values of LASA-SBQ, IPAQ, Baecke and accelerometry indicate that these individuals remain for a long time in SB and the PA they perform is of light intensity. Higher values were identified between the measurements obtained by the accelerometer and those obtained by the questionnaires (p <0.05) and poor agreement both for the SB assessed by LASA-SBQ and accelerometer (95% CI = -0.338 - 0.282; R = 2.575; CCI = -0.104; p = 0.683) as for the evaluation between IPAQ and accelerometer (95% CI = -0.115 - 0.274; R = 2.909; CCI = 0.027; p = 0.387). The weekly minutes spent in light, vigorous and total PA activities are statistically significant, but have poor agreement when compared to IPAQ and accelerometer. Moderate + vigorous activity showed reasonable agreement. The agreement between the classifications of PA levels obtained through self-reported questionnaires (IPAQ and Baecke) and accelerometer of the individuals analyzed were classified as weak. Conclusion: Individuals diagnosed with stroke spend a great deal of time in SB and perform mild PA for leisure and commuting. Although they are mild, this PA performed has a positive relationship in increasing parasympathetic activity, contributing to improve cardiac autonomic modulation. The measurements of the usual levels of PA and SB, subjective and objective, used in this study in individuals after the stroke are not in agreement with each other.
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Palavras-chave
Acidente vascular cerebral, Exercício físico, Comportamento sedentário, Autorrelato, Acelerometria, Sistema nervoso autônomo, Stroke, Physical exercise, Sedentary behavior, Self-report, Accelerometry, Autonomic nervous system