Prescrevendo e monitorando exercício intervalado pela percepção subjetiva de esforço em diabéticos tipo 2: respostas metabólica e hemodinâmica
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Data
2017-06-23
Autores
Viana, Ariane Aparecida [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Pesquisas recentes têm mostrado que o treinamento intervalado de alta intensidade (TI) é superior ao treinamento contínuo de moderada intensidade (TC) para a melhora da capacidade cardiorrespiratória, bem como de inúmeras variáveis associadas à fisiopatologia do Diabetes Mellitus (DM). A atual prescrição de TI é baseada na resposta da frequência cardíaca (FC) máxima, consumo máximo de oxigênio e/ou limiares ventilatórios durante um teste progressivo de esforço máximo, o que requer equipamentos de alto custo. A percepção subjetiva de esforço (PSE) é uma medida simples e sem custo, sendo opção atrativa para prescrição e automonitoramento do exercício. Porém, pouco se sabe sobre as respostas agudas do TI prescrito e automonitorado por essa ferramenta em indivíduos diabéticos. O objetivo deste estudo foi investigar a eficiência da escala de PSE como ferramenta de prescrição e automonitoramento do TI em indivíduos com DM tipo 2 (DM2). Foram estudados 11 indivíduos (2 homens) portadores de DM2 (idade = 52,3±3 anos; tempo de diagnóstico = 9,5±1,6 anos). Foi realizado teste ergométrico em esteira e 4 intervenções em ordem aleatória: TI–PSE, 4 min de aquecimento caminhando no nível 9 de PSE e 21 min de TI alternando 1 min de caminhada/corrida no nível 15–17 com 2 min de caminhada no nível 9–11; TI–FC, 4 min de aquecimento caminhando com FC a 50% da FC de reserva e 21 min de TI alternando 1 min de caminhada/corrida com FC a 85% da FC de reserva com 2 min de caminhada com FC a 50% da FC de reserva; TC–PSE, 4 min de aquecimento caminhando no nível 9 da PSE e 21 min de TC caminhando/correndo no nível 11–14 e sessão controle sem exercício (CON), 25 min de repouso sentado. As seguintes variáveis foram avaliadas em repouso (antes), imediatamente após e 45 minutos após cada intervenção: pressão arterial (PA), FC, glicemia capilar, variabilidade da FC, rigidez arterial e função endotelial. PA e FC ambulatorial também foram monitoradas durante 24 horas. Não houve diferença significativa no comportamento da FC, distância percorrida e velocidade do exercício entre as sessões TI-PSE e TI-FC. Houve redução similar da glicemia capilar imediatamente após as sessões TI-PSE (22,5±3,6%) e TI-FC (23,5±4,7%), sendo ambas maiores (p<0,05) que a redução observada imediatamente após a sessão TC-PSE (16,9±5,7%) em comparação com a sessão CON. O comportamento da pressão arterial ambulatorial foi semelhante entre as sessões TI-PSE e TI-FC; no entanto, a PA sistólica 24 horas foi significativamente inferior apenas após a sessão TI-PSE em comparação à sessão CON (p<0,05). Estes resultados sugerem que a PSE pode ser uma ferramenta eficiente para prescrever e automonitorar o TI em indivíduos com DM2.
High-intensity interval training (HIIT) is a time-efficient intervention for preventing and treating type 2 diabetes mellitus (T2DM). Its prescription requires an expensive method (cardiopulmonary exercise testing, CPX) that is not commonly available to general population. Rate of perceived exertion scale (RPE) is a simple and inexpensive tool for prescribing and self-regulating exercise. However, its usefulness for prescribing and self-regulating HIIT in T2DM is unkown. The objective of this study was to analyze the use and efficiency of the 6–20 RPE scale for prescribing and self-regulating HIIT in patients with T2DM. Eleven (two males) T2DM patients (time since diagnosis = 9.5±1.6 yr) aged 52.3±3 yr underwent a symptom-limited CPX on a treadmill to determine their heart rate (HR) response to exercise. Patients were then assigned to perform of HIITRPE (4 min of warm-up and 21 min of jogging/running at 15-17 (1 min) alternating with walking at 9-11 (2 min) on the 6-20 RPE scale), HIIT prescribed and regulated by HR response to CPX (HIITHR, 4 min of warm-up and 21 min of jogging/running at 85% (1 min) alternating with walking at 50% (2 min) of reserve HR), continous moderate exercise (CME) prescribed and self-regulated by RPE (30 min of walking at 11-13 on the 6-20 RPE scale), and control session (CON, sitting in a quiet environment) in a random order (3 to 15 days between intervention). Blood pressure, heart rate, capillary glucose, heart rate variability, endothelial function and carotid-femoral pulse wave velocity (PWV) were assessed before, immediately after and 45 min after each intervention. 24-h ambulatory HR and blood pressure (ABP) after each intervention. Exercise HR, distance and speed were not different between HIITRPE and HIITHR. T2DM patients showed similar reductions in capillary glucose after HIITRPE (22.5±3.6%) and HIITHR (23.5±4.7%), wich were greater (p<0.05) than the observed after CME (16.9±5.7%). T2DM patients also showed similar 24-h ABP reductions after HIITRPE and HIITHR, when compared to CON; but the reduction was statistically significant (p<0.05) only after HIITRPE. No ABP reductions was found after CME. No significant differences on endothelial function and PWV were observed during all interventions. HIIT was superior to CME to acutely reduce capillary glucose and ABP, independently if it was prescribed and regulated by RPE or the HR response to CPX. This result suggest that the 6–20 RPE scale may be an efficient tool for prescribing and self-regulating HIIT in T2DM patients.
High-intensity interval training (HIIT) is a time-efficient intervention for preventing and treating type 2 diabetes mellitus (T2DM). Its prescription requires an expensive method (cardiopulmonary exercise testing, CPX) that is not commonly available to general population. Rate of perceived exertion scale (RPE) is a simple and inexpensive tool for prescribing and self-regulating exercise. However, its usefulness for prescribing and self-regulating HIIT in T2DM is unkown. The objective of this study was to analyze the use and efficiency of the 6–20 RPE scale for prescribing and self-regulating HIIT in patients with T2DM. Eleven (two males) T2DM patients (time since diagnosis = 9.5±1.6 yr) aged 52.3±3 yr underwent a symptom-limited CPX on a treadmill to determine their heart rate (HR) response to exercise. Patients were then assigned to perform of HIITRPE (4 min of warm-up and 21 min of jogging/running at 15-17 (1 min) alternating with walking at 9-11 (2 min) on the 6-20 RPE scale), HIIT prescribed and regulated by HR response to CPX (HIITHR, 4 min of warm-up and 21 min of jogging/running at 85% (1 min) alternating with walking at 50% (2 min) of reserve HR), continous moderate exercise (CME) prescribed and self-regulated by RPE (30 min of walking at 11-13 on the 6-20 RPE scale), and control session (CON, sitting in a quiet environment) in a random order (3 to 15 days between intervention). Blood pressure, heart rate, capillary glucose, heart rate variability, endothelial function and carotid-femoral pulse wave velocity (PWV) were assessed before, immediately after and 45 min after each intervention. 24-h ambulatory HR and blood pressure (ABP) after each intervention. Exercise HR, distance and speed were not different between HIITRPE and HIITHR. T2DM patients showed similar reductions in capillary glucose after HIITRPE (22.5±3.6%) and HIITHR (23.5±4.7%), wich were greater (p<0.05) than the observed after CME (16.9±5.7%). T2DM patients also showed similar 24-h ABP reductions after HIITRPE and HIITHR, when compared to CON; but the reduction was statistically significant (p<0.05) only after HIITRPE. No ABP reductions was found after CME. No significant differences on endothelial function and PWV were observed during all interventions. HIIT was superior to CME to acutely reduce capillary glucose and ABP, independently if it was prescribed and regulated by RPE or the HR response to CPX. This result suggest that the 6–20 RPE scale may be an efficient tool for prescribing and self-regulating HIIT in T2DM patients.
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Palavras-chave
Diabetes mellitus tipo 2, Exercício intervalado, Função endotelial, Glicemia capilar, Percepção subjetiva de esforço, Pressão arterial