Modulação autonômica da frequência cardíaca e metabolismo láctico em diabéticos tipo 2: efeito crônico do treinamento resistido
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Data
2022-04-26
Autores
Cruz, Angélica Cristiane da [UNESP]
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Universidade Estadual Paulista (Unesp)
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Introdução: Durante o exercício físico, os ramos simpático e parassimpático, por meio dos mecanismos centrais e periféricos, interagem entre si causando ajustes nas respostas da frequência cardíaca (FC), algumas patologias podem alterar esses ajustes, como é o caso da diabetes Mellitus tipo 2 (DM2), essas alterações podem ser avaliadas por meio da variabilidade da frequência cardíaca (VFC). O exercício físico (EF) regular é um dos tratamentos não medicamentosos e, nos últimos tempos o treinamento resistido (TR) vem se destacando com efeitos benéficos para essa população. Objetivo: investigar o efeito crônico do treinamento resistido sobre a variabilidade da frequência cardíaca e metabolismo lático de pacientes com DM2. Materiais e Métodos: foram estudados dois grupos de voluntários, um grupo constituído por 8 indivíduos com DM2 (GDM2) com média de idade de 62,37±9,65 anos e outro grupo com 6 indivíduos aparentemente saudáveis (média 58,67±5,28 anos). Após avaliação inicial (anamnese, exames físicos e clínico) foram coletos os intervalos R-R (iRR) da FC na condição de repouso supino por 20 minutos. Os pacientes foram submetidos a teste de 1 repetiçao máxima (1RM) e, após, a um teste com as cargas submáximas de 10% à 50% de 1RM. A VFC foi analisada por método linear utilizando-se os índices no domínio do tempo RMSSD e índice geométrico SD1. Foi coletado também o lactato sanguíneo por meio do aparelho Accutrend Plus – Roche, USA, em repouso e nas cargas submáximas. Os voluntários do GDM2 participaram de uma intervenção com TR que foi composto por 12 semanas, 60% 1RM, 5 exercícios para grandes grupos musculares (2 exercícios para membros superiores e tórax e outros 3 para membros inferiores). Após o término do TR os pacientes foram reavaliados nas mesmas condições que no pré TR. O GC foi orientado a não mudar seus hábitos durante o período de 12 semanas. Foi utilizada a técnica de Bootstrap de reamostragem para uma amostra de 1000 sujeitos e intervalo de confiança de 95% para o percentil e foi realizado teste de normalidade de Shapiro-Wilk e os testes t-Student para amostras pareadas e de Wilcoxon quando não houve normalidade. Significância para p<0,05. Resultados: Os valores de lactato não apresentaram diferença significativa entre os momentos pré e pós TR, entretanto no momento pré o aumento significativo do lactato foi em 30% e no momento pós ocorreu em 40%, no GC não foram encontradas diferenças. Em relação aos índices da VFC não foi encontrada diferença estatística entre os momentos. Conclusão: 12 semanas de TR moderado não promove efeitos sobre a VFC em pacientes com DM2, porém sugere uma melhora da capacidade oxidativa do lactato sanguíneo durante o exercício em pacientes com DM2.
Introduction: During physical exercise, the sympathetic and parasympathetic branches, through central and peripheral mechanisms, interact with each other causing adjustments in heart rate (HR) responses, some pathologies can change these adjustments, as is the case of diabetes Mellitus type 2 (DM2), these changes can be evaluated through heart rate variability (HRV). Regular physical exercise (PE) is one of the non-drug treatments and, in recent times, resistance training (RT) has been highlighted with beneficial effects for this population. Objective: to investigate the chronic effect of resistance training on heart rate variability and lactic metabolism in patients with DM2. Materials and Methods: two groups of volunteers were studied, a group consisting of 8 individuals with DM2 (GDM2) with a mean age of 62.37±9.65 years and another group of 6 apparently healthy individuals (average 58.67±5 ,28 years). After the initial evaluation (history, physical and clinical examinations), the HR R-R intervals (iRR) were collected in the supine rest condition for 20 minutes. Patients underwent a 1-repetition maximal test (1RM) and then a test with submaximal loads of 10% to 50% of 1RM. HRV was analyzed by a linear method using the time domain indices RMSSD and geometric index SD1. Blood lactate was also collected using the Accutrend Plus device – Roche, USA, at rest and at submaximal loads. GDM2 volunteers participated in a RT intervention that consisted of 12 weeks, 60% 1RM, 5 exercises for large muscle groups (2 exercises for upper limbs and chest and another 3 for lower limbs). After the end of the RT, the patients were reassessed under the same conditions as in the pre RT. The CG was instructed not to change their habits during the 12-week period. The Bootstrap resampling technique was used for a sample of 1000 subjects and a 95% confidence interval for the percentile. . Significance for p<0.05. Results: The lactate values showed no significant difference between the pre and post TR moments, however in the pre moment the significant increase in lactate was in 30% and in the post moment it occurred in 40%, in the CG no differences were found. Regarding the HRV indexes, no statistical difference was found between the moments. Conclusion: 12 weeks of moderate RT does not promote effects on HRV in patients with DM2, but suggests an improvement in the oxidative capacity of blood lactate during exercise in patients with DM2.
Introduction: During physical exercise, the sympathetic and parasympathetic branches, through central and peripheral mechanisms, interact with each other causing adjustments in heart rate (HR) responses, some pathologies can change these adjustments, as is the case of diabetes Mellitus type 2 (DM2), these changes can be evaluated through heart rate variability (HRV). Regular physical exercise (PE) is one of the non-drug treatments and, in recent times, resistance training (RT) has been highlighted with beneficial effects for this population. Objective: to investigate the chronic effect of resistance training on heart rate variability and lactic metabolism in patients with DM2. Materials and Methods: two groups of volunteers were studied, a group consisting of 8 individuals with DM2 (GDM2) with a mean age of 62.37±9.65 years and another group of 6 apparently healthy individuals (average 58.67±5 ,28 years). After the initial evaluation (history, physical and clinical examinations), the HR R-R intervals (iRR) were collected in the supine rest condition for 20 minutes. Patients underwent a 1-repetition maximal test (1RM) and then a test with submaximal loads of 10% to 50% of 1RM. HRV was analyzed by a linear method using the time domain indices RMSSD and geometric index SD1. Blood lactate was also collected using the Accutrend Plus device – Roche, USA, at rest and at submaximal loads. GDM2 volunteers participated in a RT intervention that consisted of 12 weeks, 60% 1RM, 5 exercises for large muscle groups (2 exercises for upper limbs and chest and another 3 for lower limbs). After the end of the RT, the patients were reassessed under the same conditions as in the pre RT. The CG was instructed not to change their habits during the 12-week period. The Bootstrap resampling technique was used for a sample of 1000 subjects and a 95% confidence interval for the percentile. . Significance for p<0.05. Results: The lactate values showed no significant difference between the pre and post TR moments, however in the pre moment the significant increase in lactate was in 30% and in the post moment it occurred in 40%, in the CG no differences were found. Regarding the HRV indexes, no statistical difference was found between the moments. Conclusion: 12 weeks of moderate RT does not promote effects on HRV in patients with DM2, but suggests an improvement in the oxidative capacity of blood lactate during exercise in patients with DM2.
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Palavras-chave
Variabilidade da frequência cardíaca, Metabolismo lático, Diabetes mellitus, Heart rate variability, Lactic metabolism