Efeitos de um programa educacional promovendo a prática regular de exercício físico sobre a capacidade física, funcional, qualidade de vida e nível de atividade física de indivíduos com osteoartrite de joelho durante 4 anos de seguimento
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2018-12-19
Autores
Silva, José Messias Rodrigues da
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Universidade Estadual Paulista (Unesp)
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Introdução: O objetivo do presente estudo foi analisar quais mudanças na recomendação a longo prazo da prática regular de exercícios físicos, combinadas com outros fatores educacionais multiprofissionais, poderiam causar na qualidade de vida, capacidade funcional e nível de atividade física diária indivíduos com OA de joelho durante 4 anos de seguimento. Métodos: Os indivíduos sob tratamento de osteoartrite primária do joelho (N = 153; idade = 67 ± 2), do sistema público de saúde, foram alocados aleatoriamente em grupo educacional (GI; n = 83) ou controle (GC; n = 70). Os voluntários foram solicitados a responder ao Western Ontario e ao McMaster Universities Osteoarthritis Index (WOMAC ™), para a avaliação da dor, função e qualidade de vida. A versão curta do Questionário Internacional de Atividade Física (IPAQ) (validada na população brasileira) foi utilizada para avaliar o nível de atividade física diária em todos os voluntários, a capacidade funcional incluiu o teste de sentar e alcançar, teste de caminhada de 6 min (TC6’) teste de subir e descer escadas (TSDE), time up and go test (TUGT), e o teste senta e levanta cinco vezes (FTSST), e foram avaliados no início do estudo (pré), 24 e 48 meses de seguimento. Resultados: O índice de massa corporal (IMC) reduziu significativamente (P <0,05) após 24 meses (3,5%) e manteve-se após 48 meses de seguimento em GI, no GC ocorreu um leve aumento ao longo do seguimento. Grupo GI melhorou o desempenho (P <0,001), no TUGT (27%) e FTSST (36,5%) após 48 meses de seguimento. GC não mudou no TUGT durante o mesmo período, no FTSST teve uma redução significativa porém em menor magnitude quando comparado ao GI. O escore total do WOMAC caiu 8,0 pontos, a dor do WOMAC diminuiu 2,5 pontos e a rigidez do WOMAC diminuiu 0,5 ponto no GI, cujo valores foram maiores para o GC (P <0,001). Houve também um aumento (P <0,001) na prevalência de ativos “ativos” (26,6%) e “muito ativos” (30%), assim como uma redução na prevalência de sedentários (12,5%) no GI durante o seguimento. Os GI e GC não melhoram significativamente nos testes de sentar e alcançar, TSDE e TC6’ em ambos os grupos. Conclusões: Os resultados apresentados sugerem que um programa promovendo a prática regular de exercícios físicos pode ser uma ferramenta eficaz para melhorar a aptidão física, capacidade funcional, qualidade de vida e nível de atividade física diária em indivíduos com OA de joelho, mesmo por um período tão longo.
Background: The objective of the present study was to analyze which changes in the long-term recommendation of regular physical exercise combined with other multiprofessional educational factors could cause in the quality of life, functional capacity and level of daily physical activity individuals with knee OA during 4 years of followup. Methods: Individuals undergoing primary knee osteoarthritis (N = 153; age = 67 ± 2) of the public health system were randomly assigned to either educational group (GI; n = 83) or control (CG; n = 70). The volunteers were asked to respond to Western Ontario and the McMaster Universities Osteoarthritis Index (WOMAC ™) for the assessment of pain, function, and quality of life. The short version of the International Physical Activity Questionnaire (IPAQ) (validated in the Brazilian population) was used to assess the level of daily physical activity in all volunteers, functional capacity included sit-and-reach test, 6-min walk test (6MWT), timed up and down stairs test (TUDST) Timed Up and go test (TUGT), and the test sit and lift five times (FTSST), and were evaluated at baseline (pre), 24 and 48 months follow-up. Results: Body mass index (BMI) significantly decreased (P <0.05) after 24 months (3.5%) and remained reduced after 48 months of follow-up in GI, a slight increase was observed in GC during follow-up. Group GI improved (P <0.001), TUGT (27%) and FTSST (36.5%) performance after 48 months of follow-up. GC did not change during the same period. Total WOMAC score fell by 8.0 points, WOMAC pain decreased by 2.5 points, and WOMAC stiffness decreased by 0.5 point in GI, which was higher for GC (P <0.001). There was also an increase (P <0.001) in the prevalence of "active" (26.6%) and "very active" (30%), as well as a reduction in sedentary prevalence (12.5%) in GI during follow-up. GI and GC did not improve significantly in sit-and-reach, TUDST and TC6’ 'tests in both groups. Conclusions: The results suggest that a program promoting regular physical exercise can be an effective tool to improve physical fitness, functional capacity, quality of life and level of daily physical activity in individuals with knee OA, even for a period so long.
Background: The objective of the present study was to analyze which changes in the long-term recommendation of regular physical exercise combined with other multiprofessional educational factors could cause in the quality of life, functional capacity and level of daily physical activity individuals with knee OA during 4 years of followup. Methods: Individuals undergoing primary knee osteoarthritis (N = 153; age = 67 ± 2) of the public health system were randomly assigned to either educational group (GI; n = 83) or control (CG; n = 70). The volunteers were asked to respond to Western Ontario and the McMaster Universities Osteoarthritis Index (WOMAC ™) for the assessment of pain, function, and quality of life. The short version of the International Physical Activity Questionnaire (IPAQ) (validated in the Brazilian population) was used to assess the level of daily physical activity in all volunteers, functional capacity included sit-and-reach test, 6-min walk test (6MWT), timed up and down stairs test (TUDST) Timed Up and go test (TUGT), and the test sit and lift five times (FTSST), and were evaluated at baseline (pre), 24 and 48 months follow-up. Results: Body mass index (BMI) significantly decreased (P <0.05) after 24 months (3.5%) and remained reduced after 48 months of follow-up in GI, a slight increase was observed in GC during follow-up. Group GI improved (P <0.001), TUGT (27%) and FTSST (36.5%) performance after 48 months of follow-up. GC did not change during the same period. Total WOMAC score fell by 8.0 points, WOMAC pain decreased by 2.5 points, and WOMAC stiffness decreased by 0.5 point in GI, which was higher for GC (P <0.001). There was also an increase (P <0.001) in the prevalence of "active" (26.6%) and "very active" (30%), as well as a reduction in sedentary prevalence (12.5%) in GI during follow-up. GI and GC did not improve significantly in sit-and-reach, TUDST and TC6’ 'tests in both groups. Conclusions: The results suggest that a program promoting regular physical exercise can be an effective tool to improve physical fitness, functional capacity, quality of life and level of daily physical activity in individuals with knee OA, even for a period so long.
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Palavras-chave
Atividade física diária, Programa educacional, Capacidade funcional, Qualidade de vida, Osteoartrite de joelho, Daily living physical activity, Educational program, Physical fitness, Functional capacity, Physical exercise, Quality of life, Knee osteoarthritis