Comportamento sedentário em participantes de um programa de reabilitação cardíaca: relação com a ocorrência de sinais e sintomas, perfil bioquímico e composição corporal
Carregando...
Data
2022-03-08
Autores
Silva, João Pedro Lucas Neves
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Exercícios físicos realizados em Programas de Reabilitação Cardíaca (PRC) podem promover diversos benefícios, contudo durante a sua execução existe maior probabilidade da ocorrência de sinais e sintomas (SS). Nesta perspectiva, torna-se importante identificar fatores que possam predizer o risco de ocorrência de SS durante a sessão de um PRC. O comportamento sedentário (CS) está associado ao aumento no risco de desenvolver doenças cardiovasculares e a modificações negativas no perfil bioquímico inflamatório (PBI) e composição corporal (CC) do indivíduo e, nesse contexto, pode ser importante para essa identificação. Objetivos: 1) avaliar a correlação de CS com a ocorrência de SS nesses programas; 2) avaliar a correlação entre o CS com o PBI (TNF-alpha, IL-6 e IL-10) e CC (peso e percentual da gordura corporal, peso da massa magra e total de água corporal) de pacientes que frequentam um PRC. Métodos: Foram avaliados 60 pacientes (64,98 anos) atendidos em um PRC. Inicialmente foi analisado o prontuário de cada paciente para a caracterização populacional e avaliado o nível do CS por meio do uso de acelerômetro por um período de 7 dias. Após esse período, o CS foi também avaliado por meio do questionário LASA – SBQ modificado para idosos e relato de tempo médio gasto sentado por dia durante a semana. Em seguida foi realizada uma coleta sanguínea para mensuração dos marcadores bioquímicos e avaliado a CC utilizando a bioimpedância. Na segunda fase do protocolo, os pacientes foram acompanhados por 24 sessões durante as rotinas do PRC para análise e registro da ocorrência de SS. Para análise dos dados, as relações entre o CS com a ocorrência de SS, variáveis bioquímicas e CC foram feitas pelas correlações de Spearman ou Pearson, de acordo com a normalidade dos dados (Teste Shapiro-Wilk). Todos os resultados foram discutidos no nível inferior a 5% de significância. Resultados: É possível observar correlações positivas entre CS avaliado pelo acelerômetro e sintomas (r = 0,336; p = 0,020), e o CS avaliado pelo relato de tempo sentado com o total de SS (r = 0,296; p = 0,036), e correlação negativa entre a quebra de CS e sintomas (r = -0,361; p = 0,012). Quando avaliada a relação CS e SS de acordo com o sexo, foram notadas correlações positivas apenas para o sexo feminino (p<0,05). Não houve correlações significantes entre o CS e sua quebra com o PBI e CC (p>0,05). Ausência de correlações significantes se mantiveram quando analisado se as mudanças ocorridas no CS e na sua quebra foram correlacionadas as obtidas para o PBI e CC com o desenvolvimento do programa. Conclusão: Quanto maior o CS, maior é a presença de SS observados em pacientes inseridos em um PRC. Já a quebra de CS, quanto maior, menor a presença de SS. Em relação aos perfis, o CS e sua quebra não apresentaram relações 11 com o PBI e CC. Também não foram observadas relações entre as modificações do CS e sua quebra após 6 meses de realização do PRC com aquelas observadas para o PBI e CC. Informações dessa natureza demontram a importância sobre o incentivo a abordagem quanto a quebra de CS nos programas de educação em saúde, a fim de reduzir as influências negativas desse comportamento de rotina, a saúde cardiovascular, e consequentemente favorecer o prognóstico e qualidade de vida.
Background: Physical exercises performed in Cardiac Rehabilitation Programs (CRP) can promote benefits, however during their execution there is a greater probability of signs and symptoms (SS). In this perspective, it becomes important to identify factors that can predict or risk the occurrence of SS during a CRP session. Sedentary behavior (SB) is associated with an increased risk of developing cardiovascular diseases and negative changes in the inflammatory biochemical profile (IBP) and body composition (BC) of the individual and, in this context, it may be important for this identification. Aim: 1) to evaluate the relationship between SB with the occurrence of SS in a CRP. 2) to evaluate the relationship between SB and the IBP (TNF-alpha, IL-6 and IL-10) and BC (weight and percentage of fat body weight, lean mass weight and total body water) of patients who attend CRP. Methods: There were 65 patients treated in a CRP. Initially, the medical record of each patient was detailed for the characterization evaluated and the SB level was evaluated through the use of the accelerometer for a period of 7 days. After this period, and also evaluated through the time of SB per LASA – SBQ modified for the elderly, average spent per day during the week. Then, a blood collection was performed to measure the biochemical markers and evaluated as BC using bioimpedance. In the second phase of the protocol, patients were followed up for 24 sessions during the CRP routines for analysis and recording of the occurrence of SS. For data analysis, such as relationships between SB with the occurrence of SS, biochemical variables and BC were made by Spearman or Pearson correlations, according to the normality of the data (Shapiro-Wilk test). All results were discussed at a level of less than 5% significance. Results: It is possible to observe positive correlations between SB assessed by the accelerometer and symptoms (r = 0.336; p = 0.020), and the SB assessed by the report of sitting time with the total SS (r = 0.296; p = 0.036), and correlation negative difference between the break in SB and symptoms (r = -0.361; p = 0.012). When evaluating the SB and SS relationship according to sex, positive correlations were observed only for females (p<0.05). There were no significant correlations between SB and its break with IBP and BC (p>0.05). Absence of significant correlations remained when analyzing whether the changes that occurred in the SB and in its breakdown were correlated with those obtained for the IBP and BC with the development of the program. Conclusion: The higher the SB, the greater the presence of SS observed in patients enrolled in a CRP. On the other hand, the higher the SB break, the lower the presence of SS. In terms of profiles, the SB and its breakdown did not present relationships with the IBP and BC. There were also no relationships between the 13 changes in the SB and its breakage after 6 months of performing the PRC with those observed for the IBP and BC. Information of this nature demonstrates the importance of encouraging the approach to the breakdown of SB in health education programs, in order to reduce the negative influences of this routine behavior, cardiovascular health, and consequently favor the prognosis and quality of life.
Background: Physical exercises performed in Cardiac Rehabilitation Programs (CRP) can promote benefits, however during their execution there is a greater probability of signs and symptoms (SS). In this perspective, it becomes important to identify factors that can predict or risk the occurrence of SS during a CRP session. Sedentary behavior (SB) is associated with an increased risk of developing cardiovascular diseases and negative changes in the inflammatory biochemical profile (IBP) and body composition (BC) of the individual and, in this context, it may be important for this identification. Aim: 1) to evaluate the relationship between SB with the occurrence of SS in a CRP. 2) to evaluate the relationship between SB and the IBP (TNF-alpha, IL-6 and IL-10) and BC (weight and percentage of fat body weight, lean mass weight and total body water) of patients who attend CRP. Methods: There were 65 patients treated in a CRP. Initially, the medical record of each patient was detailed for the characterization evaluated and the SB level was evaluated through the use of the accelerometer for a period of 7 days. After this period, and also evaluated through the time of SB per LASA – SBQ modified for the elderly, average spent per day during the week. Then, a blood collection was performed to measure the biochemical markers and evaluated as BC using bioimpedance. In the second phase of the protocol, patients were followed up for 24 sessions during the CRP routines for analysis and recording of the occurrence of SS. For data analysis, such as relationships between SB with the occurrence of SS, biochemical variables and BC were made by Spearman or Pearson correlations, according to the normality of the data (Shapiro-Wilk test). All results were discussed at a level of less than 5% significance. Results: It is possible to observe positive correlations between SB assessed by the accelerometer and symptoms (r = 0.336; p = 0.020), and the SB assessed by the report of sitting time with the total SS (r = 0.296; p = 0.036), and correlation negative difference between the break in SB and symptoms (r = -0.361; p = 0.012). When evaluating the SB and SS relationship according to sex, positive correlations were observed only for females (p<0.05). There were no significant correlations between SB and its break with IBP and BC (p>0.05). Absence of significant correlations remained when analyzing whether the changes that occurred in the SB and in its breakdown were correlated with those obtained for the IBP and BC with the development of the program. Conclusion: The higher the SB, the greater the presence of SS observed in patients enrolled in a CRP. On the other hand, the higher the SB break, the lower the presence of SS. In terms of profiles, the SB and its breakdown did not present relationships with the IBP and BC. There were also no relationships between the 13 changes in the SB and its breakage after 6 months of performing the PRC with those observed for the IBP and BC. Information of this nature demonstrates the importance of encouraging the approach to the breakdown of SB in health education programs, in order to reduce the negative influences of this routine behavior, cardiovascular health, and consequently favor the prognosis and quality of life.
Descrição
Palavras-chave
Reabilitação cardíaca, Doenças cardiovasculares, Sinais e sintomas, Comportamento sedentário, Biomarcadores, Composição corporal, Cardiac rehabilitation, Cardiovascular diseases, Signs and symptoms, Sedentary behavior, Biomarkers, Body composition