Efeitos do exercício aquático sobre os fatores de risco cardiovasculares e modulação autonômica cardíaca de mulheres na pós-menopausa com diabetes mellitus tipo 2
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Data
2017-10-19
Autores
Chagas, Eduardo Federighi Baisi [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O exercício físico tem papel relevante na terapêutica do diabetes mellitus tipo 2 (DM2), porém em pacientes mais velhos e com comorbidades a prática de atividade física em terra pode representar uma limitação para a adoção de um estilo de vida ativo. Embora haja evidência de que o exercício aquático possa contribuir positivamente sobre a condição de saúde dessa população poucos estudos analisaram o efeito desta modalidade de exercício sobre o sistema nervoso autônomo cardíaco, principalmente em mulheres com DM2 na pós-menopausa. Assim, o objetivo desse estudo foi investigar o efeito de um programa de exercício aquático sobre os fatores de risco para doenças cardiovasculares e modulação autonômica cardíaca de mulheres com DM2 na pós-menopausa. A amostra foi constituída de 25 mulheres com idade entre 51 a 83 anos, com diagnóstico de DM2 há mais de três anos, divididas em grupo exercício (n=13) e grupo controle (n=12). O grupo exercício foi submetido a duas sessões semanais de exercício aquático de 50 minutos cada, durante 12 semanas. Foi observada no grupo exercício diminuição da glicemia de jejum, colesterol total, triglicerídeos, circunferência de cintura, índice de massa corporal e percentual de gordura. Valores reduzidos dos índices lineares da variabilidade da frequência cardíaca na linha de base sugerem a presença de disfunção autonômica em parte da amostra estuda. Foi observada interação significativa entre grupo e tempo de intervenção para os valores de TINN (ms), apontado discreto aumento no grupo com exercício aquático, mas principalmente uma redução no grupo controle. A análise da regressão também apontou efeito do exercício aquático sobre redução da razão LF/HF. Embora tenha sido observada importante redução dos fatores de risco cardiovascular, principalmente sobre a glicemia de jejum, efeitos de mesma amplitude não foram observados sobre a modulação autonômica cardíaca. Apesar disto, mesmo com volumes de exercício e tempo de intervenção reduzido já é possível observar o efeito protetor do exercício físico na progressão da disfunção autonômica e na melhora do controle metabólico.
Physical exercise plays an important role in the treatment of type 2 diabetes mellitus (DM2), but in older patients and with comorbidities, the practice of physical activity on land may represent a limitation for the adoption of an active lifestyle. Although there is evidence that aquatic exercise can contribute positively to the health condition of this population, few studies have analyzed the effect of this exercise modality on the autonomic cardiac nervous system, especially in women with postmenopausal DM2. Thus, the objective of this study was to investigate the effect of an aquatic exercise program on risk factors for cardiovascular diseases and cardiac autonomic modulation of postmenopausal women with T2DM. The sample consisted of 25 women aged 51 to 83 years, with a diagnosis of DM2 for more than three years, divided into exercise group (n = 13) and control group (n = 12). The exercise group was submitted to two weekly sessions of aquatic exercise of 50 minutes each, during 12 weeks. It was observed in the exercise group decreased fasting glucose, total cholesterol, triglycerides, waist circumference, body mass index and percentage of fat. Reduced values of linear indexes of heart rate variability at the baseline suggest the presence of autonomic dysfunction in part of the study sample. Significant interaction between group and intervention time was observed for the TINN values (ms), indicated a slight increase in the group with aquatic exercise, but mainly a reduction in the control group. Regression analysis also indicated effect of aquatic exercise on LF / HF ratio reduction. Although a significant reduction in cardiovascular risk factors was observed, especially on fasting glycemia, effects of the same amplitude were not observed on cardiac autonomic modulation. Despite this, even with exercise volumes and reduced intervention time, it is possible to observe the protective effect of physical exercise on the progression of autonomic dysfunction and on the improvement of metabolic control.
Physical exercise plays an important role in the treatment of type 2 diabetes mellitus (DM2), but in older patients and with comorbidities, the practice of physical activity on land may represent a limitation for the adoption of an active lifestyle. Although there is evidence that aquatic exercise can contribute positively to the health condition of this population, few studies have analyzed the effect of this exercise modality on the autonomic cardiac nervous system, especially in women with postmenopausal DM2. Thus, the objective of this study was to investigate the effect of an aquatic exercise program on risk factors for cardiovascular diseases and cardiac autonomic modulation of postmenopausal women with T2DM. The sample consisted of 25 women aged 51 to 83 years, with a diagnosis of DM2 for more than three years, divided into exercise group (n = 13) and control group (n = 12). The exercise group was submitted to two weekly sessions of aquatic exercise of 50 minutes each, during 12 weeks. It was observed in the exercise group decreased fasting glucose, total cholesterol, triglycerides, waist circumference, body mass index and percentage of fat. Reduced values of linear indexes of heart rate variability at the baseline suggest the presence of autonomic dysfunction in part of the study sample. Significant interaction between group and intervention time was observed for the TINN values (ms), indicated a slight increase in the group with aquatic exercise, but mainly a reduction in the control group. Regression analysis also indicated effect of aquatic exercise on LF / HF ratio reduction. Although a significant reduction in cardiovascular risk factors was observed, especially on fasting glycemia, effects of the same amplitude were not observed on cardiac autonomic modulation. Despite this, even with exercise volumes and reduced intervention time, it is possible to observe the protective effect of physical exercise on the progression of autonomic dysfunction and on the improvement of metabolic control.
Descrição
Palavras-chave
Diabetes, Mulheres, Menopausa, Variabilidade da frequência cardíaca, Women, Menopause, Variability of heart rate