Prescrição de exercícios para pacientes aguardando cirurgia bariátrica: avaliando uma estratégia de intervenção
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Data
2021-06-11
Autores
Oliveira, Natalia Redondo de
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Universidade Estadual Paulista (Unesp)
Resumo
A obesidade vem crescendo significativamente no Brasil nesses últimos anos. É considerada como uma doença multifatorial decorrente de fatores genéticos, falta de exercícios físicos, alimentação inadequada, entre outros. A partir disso, é crescente o número de pessoas que têm buscado como alternativa ao combate da obesidade a cirurgia bariátrica, uma vez que é eficaz na perda de peso. Deste modo, o objetivo do estudo foi apresentar um possível protocolo de treinamento, com auxílio de aplicativos de celular, como estratégia de intervenção para pacientes aguardando cirurgia bariátrica. A amostra contou com 21 pacientes, sendo 17 mulheres e 4 homens, e foi realizada em uma clínica particular de Bauru e no Sistema Único de Saúde em Pederneiras. Os pacientes foram avaliado antes da cirurgia bariátrica e os exercícios físicos foram prescritos com acompanhamento de equipe multidisciplinar de uma clínica especializada. O exercício físico proposto foi de maneira individual com caminhada, variando entre 10 e 30 minutos de acordo com a limitação do paciente. Eram monitorados por meio de dois aplicativos (Strava e Pedômetro) e os relatórios eram enviados via WhatsApp. Os resultados com dados clínicos dos pacientes foram apresentados no geral e em agrupamentos, avaliando pré e pós-treinamento. Para a avaliação dos resultados da intervenção efetuada, foi realizado o teste F para análise de variância e o teste de Scot-Knott a 5% para comparação múltipla das médias. Todos os resultados foram considerados significantes para p≤0,05. Como resultados houve aumento da força de preensão manual da mão dominante e não dominante, da força de cintura escapular e da força de membros inferiores no grupo NM+EF, sem medicamentos e adesão à atividade física, e melhora da força de cintura escapular e da força de membros inferiores no grupo D, diabéticos. Entretanto estas melhorias não foram suficientes para a diminuição do índice de massa corporal dos pacientes. Além disso, foi observada a baixa adesão dos indivíduos (47,61%) ao exercício físico. Em relação ao uso de aplicativos, os pacientes foram treinados e receberam o manual de funcionamento, mesmo com essa facilidade, foi observado que utilizavam mais os aplicativos de contagem de passos do que o de exercício propriamente dito. Além disso, os pacientes precisavam portar o celular o tempo todo, o que muitas vezes não acontecia. Assim, os aplicativos não ocasionaram uma motivação nos pacientes para a realização dos exercícios físicos.
Obesity has been growing significantly in Brazil in recent years. It is considered a multifactorial disease resulting from genetic factors, lack of physical exercise, inadequate nutrition, among others. From this, the number of people who have sought bariatric surgery as an alternative to fighting obesity, since it is effective in weight loss, is growing. Thus, the objective of the study was to present a possible training protocol, with the aid of mobile applications, as an intervention strategy for patients awaiting bariatric surgery. The sample consisted of 21 patients, 17 women and 4 men, and was carried out in a private clinic in Bauru and in the Unified Health System in Pederneiras. Patients were evaluated before bariatric surgery and physical exercises were prescribed with follow-up by a multidisciplinary team from a specialized clinic. The proposed physical exercise was individually with walking, varying between 10 and 30 minutes according to the patient's limitations. They were monitored through two applications (Strava and Pedometer) and reports were sent via WhatsApp. The results with clinical data of the patients were presented in general and in groups, evaluating pre- and post-training. To assess the results of the intervention performed, the F test was performed for analysis of variance and the Scot-Knott test at 5% for multiple comparison of means. All results were considered significant at p≤0.05. As a result, there was an increase in the handgrip strength of the dominant and non-dominant hand, the shoulder girdle strength, and the strength of the lower limbs in the NM+EF group, without medication and adherence to physical activity, and improvement in the shoulder girdle strength and lower limb strength in group D, diabetics. However, these improvements were not enough to decrease the patients' body mass index. In addition, low adherence of individuals (47.61%) to physical exercise was observed. Regarding the use of apps, patients were trained and received the operating manual, even with this ease, it was observed that they used more the step counting apps than the exercise itself. In addition, patients had to always carry their mobile, which often did not happen. Thus, the applications did not motivate patients to perform physical exercises.
Obesity has been growing significantly in Brazil in recent years. It is considered a multifactorial disease resulting from genetic factors, lack of physical exercise, inadequate nutrition, among others. From this, the number of people who have sought bariatric surgery as an alternative to fighting obesity, since it is effective in weight loss, is growing. Thus, the objective of the study was to present a possible training protocol, with the aid of mobile applications, as an intervention strategy for patients awaiting bariatric surgery. The sample consisted of 21 patients, 17 women and 4 men, and was carried out in a private clinic in Bauru and in the Unified Health System in Pederneiras. Patients were evaluated before bariatric surgery and physical exercises were prescribed with follow-up by a multidisciplinary team from a specialized clinic. The proposed physical exercise was individually with walking, varying between 10 and 30 minutes according to the patient's limitations. They were monitored through two applications (Strava and Pedometer) and reports were sent via WhatsApp. The results with clinical data of the patients were presented in general and in groups, evaluating pre- and post-training. To assess the results of the intervention performed, the F test was performed for analysis of variance and the Scot-Knott test at 5% for multiple comparison of means. All results were considered significant at p≤0.05. As a result, there was an increase in the handgrip strength of the dominant and non-dominant hand, the shoulder girdle strength, and the strength of the lower limbs in the NM+EF group, without medication and adherence to physical activity, and improvement in the shoulder girdle strength and lower limb strength in group D, diabetics. However, these improvements were not enough to decrease the patients' body mass index. In addition, low adherence of individuals (47.61%) to physical exercise was observed. Regarding the use of apps, patients were trained and received the operating manual, even with this ease, it was observed that they used more the step counting apps than the exercise itself. In addition, patients had to always carry their mobile, which often did not happen. Thus, the applications did not motivate patients to perform physical exercises.
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Palavras-chave
Obesidade, Cirurgia bariátrica, Exercício físico, Obesity, Bariatric surgery, Physical exercise