Análise de parâmetros de impedância bioelétrica, bioquímicos, morfológicos e funcionais em idosos sarcopênicos e não sarcopênicos submetidos a treinamento resistido convencional e com resistência elástica: ensaio clínico aleatório
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Data
2019-02-13
Autores
Osco, Karla Minacca [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A população idosa com idade igual ou superior a 60 anos dobrou na última metade do século XX. O envelhecimento é um processo inevitável com consequências deletérias e progressivas para o corpo humano, comprometendo os seus diferentes sistemas, tais como o fisiológico, o morfológico, o funcional e o endócrino. A perda progressiva de massa e força muscular, associada à função é denominada sarcopenia, e como consequência, promove maior risco para incapacidade funcional, fragilidade, quedas, fraturas, hospitalizações, institucionalizações, óbito precoce e alterações imunológicas. Em idosos as alterações no sistema imunológico podem ocorrer devido ao aumento da concentração sanguínea de citocinas pró-inflamatórias que agrava o estado sarcopênico, acarretando um processo de inflamação crônica de baixo grau (LGI, low grade inflammation). Dentre os parâmetros observados na avaliação da sarcopenia, a análise de impedância bioelétrica (BIA) vem sendo utilizada há tempo para mensuração dos diferentes componentes corporais dentro do sistema morfológico, especialmente os tecidos adiposo e muscular. Mais recentemente, parâmetros brutos da BIA (R, resistência e Xc, reatância) têm sido utilizados para a avaliação da saúde celular (PhA, ângulo de fase e a análise de vetores de impedância bioelétrica (BIVA, bioimpedance vector analysis). Com a finalidade de reverter ou atenuar os efeitos deletérios do envelhecimento, programas de treinamento físico, mais especificamente o treinamento resistido (TR), tem sido proposto para promover sobretudo a funcionalidade e a independência dos idosos. Profissionais procuram com o avançar das pesquisas, propostas que possam ser ao mesmo tempo, simples, eficaz, segura e de baixo custo a este grupo etário. Neste sentido, a intervenção com resistência elástica aparece como uma boa alternativa para atingir tais objetivos. Objetivos: Desta forma, o objetivo do presente projeto foi analisar o efeito de diferentes programas de treinamento resistido sobre parâmetros brutos de impedância bioelétrica e marcadores inflamatórios em idosos sarcopênicos. Métodos: Para tanto, 66 idosos de ambos os sexos, divididos em sarcopênicos e não sarcopênicos, foram aleatoriamente distribuídos em dois grupos de treinamento: grupo de treinamento com resistência elástica (GTE) e grupo de treinamento resistido convencional (GTC). Os idosos foram avaliados em momentos pré e pós treinamento, com mensuração da composição corporal (tecido adiposo e muscular), saúde celular (PhA e BIVA), força, qualidade muscular (QM) e marcadores inflamatórios. O programa de treinamento (12 semanas, três sessões semanais) foi composto por treino com resistência elástica (sete exercícios: abdução de ombro, flexão de cotovelo, extensão de cotovelo, flexão de ombro, extensão de ombro, flexão de joelho e extensão de joelho), e convencional (os mesmos grupos musculares em equipamentos e pesos livres). Análise estatística foi realizada em programa SPSS 22.0, com nível de significância adotado em 5%. Resultados: O programa de treinamento resistido convencional (musculação) e com resistência elástica apresentaram respostas similares especialmente a variável força de preensão manual (FPM) e a fração do colesterol HDL (lipoproteína de alta densidade). Idosos sarcopênicos tiveram maior aumento da massa muscular, representada pelo índice de massa muscular (IMM, em kg.m-2 ) ao longo do programa comparado aos pares nãosarcopênicos. Foram verificadas correlações positivas no momento inicial do estudo entre parâmetros de bioimpedância (R e PhA) com a FPM, e relação inversa entre a Xc e o índice de massa corporal (IMC). Ao longo do programa de treinamento, as alterações na variável R se correlacionaram positivamente com as triglicérides (TAG), e na variável PhA com glicemia e HDL, enquanto as reduções nos valores de R se correlacionaram aos aumentos nos valores da massa isenta de gordura e osso (MIGO). Conclusão: Os resultados apresentados são inéditos, e apontam para maiores investigações, especificamente para se entender a relação de causa e efeito das variáveis estudadas, a fim de elucidar melhor o papel da bioimpedância na avaliação da saúde celular de pessoas idosas, envolvidas em programa de treinamento resistido. Também, a utilização de tubos elásticos se apresentou de forma interessante e favorável, tendo em vista os resultados comparados ao método convencional (não superior, mas não inferior). A proposta pode ser implementada em diversos ambientes, de forma a auxiliar os idosos mais longevos e em situação de fragilidade.
The elderly population aged 60 or older doubled in the latter half of the 20th century. Aging is an inevitable process with deleterious and progressive consequences for the human body, compromising its different systems, such as physiological, morphological, functional and endocrine. The progressive loss of mass and muscle strength associated with the function is called sarcopenia, and as consequence it promotes a greater risk for functional disability, frailty, falls, fractures, hospitalizations, institutionalization, death and immunological changes. In the elderly the alterations in the immune system can occur due to the increase of the blood concentration of pro-inflammatory cytokines that aggravates the sarcopenic state, causing a process of chronic low-grade inflammation (LGI). Among the parameters observed in the assessment of sarcopenia, bioelectrical impedance analysis (BIA) has been used for measuring the different body components within the morphological system, especially the adipose and muscular tissues. More recently, BIA raw parameters (R, resistance and Xc, reactance) have been used for cellular health assessment (PhA, phase angle) and bioelectrical impedance vector analysis (BIVA). With the purpose of reversing or attenuating the deleterious effects of aging, physical training programs, more specifically resistance training (TR), have been proposed to promote primarily the functionality and independence of the elderly. Professionals seek to advance research, proposals that can be at the same time simple, effective, safe and low cost to this age group. In this sense, the elastic resistance intervention appears as a good alternative to reach such objectives. Objective: In this sense, the objective of the present project was to analyze the effect of different resistance training programs on raw parameters of bioelectrical impedance and inflammatory markers in sarcopenic elderly. Methods: For this purpose, 66 elderly men and women, divided into sarcopenic and non-sarcopenic were randomly distributed in two training groups: training group with elastic resistance (GTE) and conventional resistance training group (TGC). The elderly were evaluated at pre and post training times, measuring body composition (adipose and muscle tissue), cellular health (PhA and BIVA), strength, muscle quality (QM) and inflammatory markers. The training program (12 weeks, three weekly sessions) consisted of training with elastic resistance (seven exercises: shoulder abduction, elbow flexion, elbow extension, shoulder flexion, shoulder extension, leg flexion and leg extension), and conventional (the same muscle groups in equipment and free weights). Statistical analysis were performed in SPSS 22.0 program, with a level of significance set at 5%. Results: The conventional resistance training program (bodybuilding) and elastic resistance presented similar responses especially to the manual grip strength variable (FPM) and the HDL (high density lipoprotein) cholesterol fraction. Sarcopenic elderly patients had a greater increase in muscle mass, represented by the muscle mass index (IMM, in kg.m-2 ) throughout the program compared to the non-sarcopenic pairs. Positive correlations were verified at the initial moment of the study between parameters of bioimpedance (R and PhA) with FPM, and inverse relationship between Xc and body mass index (IMC). Throughout the training program, changes in the R variable correlated positively with triglycerides (TAG), and in the variable PhA with glycemia and HDL, while reductions in R values correlated with increases in fat and bone free mass (MIGO). Conclusion: The results presented are unpublished, and point to further investigations, specifically to understand the cause and effect relationship of the variables studied, in order to better elucidate the role of bioimpedance in the assessment of the cellular health of elderly people involved in resistance training program. Also, the use of elastic tubes was presented in an interesting and favorable way, considering the results compared to the conventional method (not superior, but not inferior). The proposal can be implemented in several environments, in order to help older people who are older and in fragility situations.
The elderly population aged 60 or older doubled in the latter half of the 20th century. Aging is an inevitable process with deleterious and progressive consequences for the human body, compromising its different systems, such as physiological, morphological, functional and endocrine. The progressive loss of mass and muscle strength associated with the function is called sarcopenia, and as consequence it promotes a greater risk for functional disability, frailty, falls, fractures, hospitalizations, institutionalization, death and immunological changes. In the elderly the alterations in the immune system can occur due to the increase of the blood concentration of pro-inflammatory cytokines that aggravates the sarcopenic state, causing a process of chronic low-grade inflammation (LGI). Among the parameters observed in the assessment of sarcopenia, bioelectrical impedance analysis (BIA) has been used for measuring the different body components within the morphological system, especially the adipose and muscular tissues. More recently, BIA raw parameters (R, resistance and Xc, reactance) have been used for cellular health assessment (PhA, phase angle) and bioelectrical impedance vector analysis (BIVA). With the purpose of reversing or attenuating the deleterious effects of aging, physical training programs, more specifically resistance training (TR), have been proposed to promote primarily the functionality and independence of the elderly. Professionals seek to advance research, proposals that can be at the same time simple, effective, safe and low cost to this age group. In this sense, the elastic resistance intervention appears as a good alternative to reach such objectives. Objective: In this sense, the objective of the present project was to analyze the effect of different resistance training programs on raw parameters of bioelectrical impedance and inflammatory markers in sarcopenic elderly. Methods: For this purpose, 66 elderly men and women, divided into sarcopenic and non-sarcopenic were randomly distributed in two training groups: training group with elastic resistance (GTE) and conventional resistance training group (TGC). The elderly were evaluated at pre and post training times, measuring body composition (adipose and muscle tissue), cellular health (PhA and BIVA), strength, muscle quality (QM) and inflammatory markers. The training program (12 weeks, three weekly sessions) consisted of training with elastic resistance (seven exercises: shoulder abduction, elbow flexion, elbow extension, shoulder flexion, shoulder extension, leg flexion and leg extension), and conventional (the same muscle groups in equipment and free weights). Statistical analysis were performed in SPSS 22.0 program, with a level of significance set at 5%. Results: The conventional resistance training program (bodybuilding) and elastic resistance presented similar responses especially to the manual grip strength variable (FPM) and the HDL (high density lipoprotein) cholesterol fraction. Sarcopenic elderly patients had a greater increase in muscle mass, represented by the muscle mass index (IMM, in kg.m-2 ) throughout the program compared to the non-sarcopenic pairs. Positive correlations were verified at the initial moment of the study between parameters of bioimpedance (R and PhA) with FPM, and inverse relationship between Xc and body mass index (IMC). Throughout the training program, changes in the R variable correlated positively with triglycerides (TAG), and in the variable PhA with glycemia and HDL, while reductions in R values correlated with increases in fat and bone free mass (MIGO). Conclusion: The results presented are unpublished, and point to further investigations, specifically to understand the cause and effect relationship of the variables studied, in order to better elucidate the role of bioimpedance in the assessment of the cellular health of elderly people involved in resistance training program. Also, the use of elastic tubes was presented in an interesting and favorable way, considering the results compared to the conventional method (not superior, but not inferior). The proposal can be implemented in several environments, in order to help older people who are older and in fragility situations.
Descrição
Palavras-chave
Envelhecimento, Ângulo de fase, Análise de vetores de impedância bioelétrica, Inflamação, Composição corporal, Aging, Phase angle, Bioimpedance vector analysis, Inflammation, Body composition