Efeitos do treinamento funcional na cognição e capacidade funcional de idosos com doença de Alzheimer
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Data
2017-05-15
Autores
Pedroso, Renata Valle [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A Doença de Alzheimer (DA) é caracterizada por declínios cognitivos, motores e funcionais que tendem a se agravar com o avanço da doença. O exercício físico é uma das alternativas de tratamento que parece atenuar tais alterações. Assim, com o objetivo geral de analisar os efeitos do treinamento funcional e do convívio social na cognição e capacidade funcional de idosos com doença de Alzheimer, esta tese está estruturada em 6 capítulos, sendo o Capitulo 1: objetivos, revisão de literatura e delineamento do estudo; Capítulo 2: artigo de revisão sistemática que mostrou as evidências sobre os efeitos positivos da atividade física sobre o potencial evocado P300 em idosos; Capítulo 3: estudo transversal que teve como objetivo comparar a cognição, P300 e capacidade funcional de idosos preservados cognitivamente e idosos no estágio leve e moderado da DA. Participaram deste estudo 24 idosos preservados cognitivamente, 35 idosos com DA leve e 22 com DA moderado. Todos os participantes foram submetidos a uma bateria de avaliação cognitiva, de medição do P300, do desempenho em atividades de vida diária (AVD) e dos componentes da capacidade funcional. Os resultados mostraram que o declínio dessas variáveis ocorre de forma progressiva, de acordo com a gravidade da doença. Capítulo 4: estudo longitudinal com objetivo de verificar os efeitos do treinamento funcional (TF) e do convívio social na cognição, nas atividades da vida diária e na capacidade funcional de idosos com DA. No estudo descrito no Capítulo 4, somente participaram idosos com DA que foram distribuídos em três grupos, avaliados antes e após um período de intervenção de 12 semanas: Grupo Controle (GC; n=14); Grupo Treinamento Funcional (GTF; n=22) e Grupo Convívio Social (GCS; n=21). Os participantes em ambos os grupos de intervenção realizaram três sessões semanais de uma hora por sessão, por 12 semanas. Todos os participantes foram submetidos à mesma avaliação descrita no Capítulo 3, nos momentos pré e pós intervenção. Foram observadas melhorias significativas nas funções executivas e resistência aeróbia, no GCS; e na memória, força de membros superiores e agilidade, no GTF. Capítulo 5: artigo versando sobre outro estudo longitudinal, agora com o objetivo de verificar os efeitos do TF e do convívio social no P300 de idosos com DA. Os participantes com DA foram divididos nos grupos GCS (n=14) e GTF (n=22), avaliados nos momentos pré e pós intervenção (12 semanas). Neste estudo participaram também 19 idosos preservados cognitivamente, que não passaram por intervenção. Os resultados mostraram que o TF promoveu redução do tempo de reação e melhora da amplitude do potencial P300 e o convívio social promoveu diminuição da latência do P300. Por fim, o Capítulo 6 traz as considerações gerais da tese e as principais conclusões: o TF promoveu efeitos positivos nas funções cognitivas, também reveladas na amplitude e/ou latência de P300, atividades de vida diária e capacidade funcional de idosos com DA, contribuindo para retardar o processo de deterioração causado por esta doença.
Alzheimer's disease (AD) is characterized by cognitive, motor and functional declines that tend to worsen with disease progression and physical exercise is one alternative treatment that seems to attenuate such alterations. Thus, the aim of this study was to analyze the effects of functional training and social interaction on the cognition and functional capacity of elderly people with Alzheimer's disease, and this thesis is structured in 6 chapters. Chapter 1: objectives, literature review and research design. Chapter 2: systematic review about the positive effects of physical activity on the P300 evoked potential in the elderly people. Chapter 3: transversal study article aiming to compare cognition, P300 and functional capacity of healthy elderly controls and elderly in the mild and moderate stage of AD. Participants of the Chapter 3 study included 24 healthy elderly control, 35 elderly with mild AD and 22 with moderate AD. All participants were evaluated by a battery of cognitive assessment, P300 measurement, performance in activities of daily living (ADL) and components of functional capacity. The results showed a progressive decline of these variables, related to disease severity. Chapter 4: longitudinal study article intending to verify the effects of functional training (FT) and social interaction on cognition, performance on daily living activities and functional fitness in elderly with AD. In the fourth-chapter study, only the elderly with AD were invited to participate and they were divided into three groups, which were then evaluated before and after a 12-week intervention period: Control Group (CG; n = 14); Functional Training Group (FTG, n = 22) and Social Gathering Group (SGG; n = 21).Participants in both intervention groups carried out three one-hour sessions per week of a functional-task program and social gathering activities for 12 weeks. Both groups performed the same evaluation protocol described in Chapter 3, in the pre and post-intervention moments. Significant improvements were observed on executive functions and aerobic endurance in the SGG; and on memory, upper limb strength and agility, in the FTG. Chapter 5: another longitudinal study article, now aiming to verify the effects of FT and social interaction on the P300 of elderly with AD. Participants with AD were divided into GCS (n = 14) and GTF (n = 22) groups, evaluated at the pre- and postintervention moments (12 weeks). Also participated in this study 19 cognitively preserved elderly individuals, who did not undergo intervention. The results showed that TF promoted a reduction in reaction time and an improvement in the amplitude of the P300 potential, and social interaction promoted a decrease in P300 latency. Finally, Chapter 6 presents the general considerations of the thesis and the main conclusions: TF promoted improvements or maintenance of cognitive functions, also revealed in the amplitude and / or latency of P300, daily life activities and functional capacity of elderly with AD, contributing to delay the process of deterioration caused by this disease.
Alzheimer's disease (AD) is characterized by cognitive, motor and functional declines that tend to worsen with disease progression and physical exercise is one alternative treatment that seems to attenuate such alterations. Thus, the aim of this study was to analyze the effects of functional training and social interaction on the cognition and functional capacity of elderly people with Alzheimer's disease, and this thesis is structured in 6 chapters. Chapter 1: objectives, literature review and research design. Chapter 2: systematic review about the positive effects of physical activity on the P300 evoked potential in the elderly people. Chapter 3: transversal study article aiming to compare cognition, P300 and functional capacity of healthy elderly controls and elderly in the mild and moderate stage of AD. Participants of the Chapter 3 study included 24 healthy elderly control, 35 elderly with mild AD and 22 with moderate AD. All participants were evaluated by a battery of cognitive assessment, P300 measurement, performance in activities of daily living (ADL) and components of functional capacity. The results showed a progressive decline of these variables, related to disease severity. Chapter 4: longitudinal study article intending to verify the effects of functional training (FT) and social interaction on cognition, performance on daily living activities and functional fitness in elderly with AD. In the fourth-chapter study, only the elderly with AD were invited to participate and they were divided into three groups, which were then evaluated before and after a 12-week intervention period: Control Group (CG; n = 14); Functional Training Group (FTG, n = 22) and Social Gathering Group (SGG; n = 21).Participants in both intervention groups carried out three one-hour sessions per week of a functional-task program and social gathering activities for 12 weeks. Both groups performed the same evaluation protocol described in Chapter 3, in the pre and post-intervention moments. Significant improvements were observed on executive functions and aerobic endurance in the SGG; and on memory, upper limb strength and agility, in the FTG. Chapter 5: another longitudinal study article, now aiming to verify the effects of FT and social interaction on the P300 of elderly with AD. Participants with AD were divided into GCS (n = 14) and GTF (n = 22) groups, evaluated at the pre- and postintervention moments (12 weeks). Also participated in this study 19 cognitively preserved elderly individuals, who did not undergo intervention. The results showed that TF promoted a reduction in reaction time and an improvement in the amplitude of the P300 potential, and social interaction promoted a decrease in P300 latency. Finally, Chapter 6 presents the general considerations of the thesis and the main conclusions: TF promoted improvements or maintenance of cognitive functions, also revealed in the amplitude and / or latency of P300, daily life activities and functional capacity of elderly with AD, contributing to delay the process of deterioration caused by this disease.
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Palavras-chave
Doença de Alzheimer, Exercício físico, Treinamento funcional, Processamento cognitivo, Capacidade funcional