Aptidão funcional e factores de risco das doenças cardiovasculares em idosos: efeito prolongado de programas de exercício aeróbio e combinado
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Data
2008
Autores
Sousa, Nelson Joaquim Fortuna de
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Resumo
Os efeitos benéficos da prática regular de exercício físico na aptidão funcional (AFunc), e na prevenção das doenças cardiovasculares (DCV), em idosos, estão bem documentados na literatura. No presente estudo, procurou-se avaliar o efeito do exercício físico regular na AFunc de indivíduos idosos, comparando a resposta a dois programas tri-semanais com diferentes modos de exercício (exercício predominantemente aeróbio vs. exercício combinado). Depois de analisar a resposta ao nível da AFunc, procurou-se identificar os efeitos de ambos os programas em factores de risco das DCV e na sua agregação. A amostra foi constituída por 3 grupos (EXP1, n=15, 71,7 ± 4,7 anos; EXP2, n=16, 68,5 ± 3,5 anos; e o controlo, n=17, 67,0 ± 5,8 anos). Os indivíduos do EXP1 foram sujeitos a um programa de exercício predominantemente aeróbio (AERO), enquanto que os indivíduos do EXP2 a um programa combinando o AERO com o exercício resistido localizado (LOCAL), ambos com 32 semanas de duração (3 x semana). O programa de AERO consistiu em 2 sessões no meio terrestre, e 1 no meio aquático, constituídas essencialmente por exercícios cardio respiratórios, e uma pequena parte específica dedicada à resistência muscular e à flexibilidade, a uma intensidade percepcionada como moderada. O programa combinado (AERO+LOCAL) repetia as sessões do programa de AERO, mas substituía uma sessão de AERO do meio terrestre, por uma sessão de LOCAL. O LOCAL consistiu em 7 exercícios, realizados em aparelhos de resistência variável, para os principais grupos musculares, a uma intensidade progressiva (65%-75% de 1RM, 3 séries, 8-12 repetições). O grupo controlo efectuou todas as avaliações previstas, mas os sujeitos que o constituíam não fizeram exercício. Após as 32 semanas de exercício, identificaram-se ganhos significativos na flexibilidade e na força dos membros inferiores para o EXP1, e melhorias significativas em todas as componentes da AFunc no EXP2, comparativamente ao grupo de controlo. Nos factores de risco das DCV, identificou-se uma diminuição significativa na percentagem de massa gorda, mas apenas para o EXP2. Para este grupo verificou-se ainda uma redução significativa do número de indivíduos hipertensos, e com os valores de triglicerídeos, de colesterol total e de lipoproteínas de baixa densidade altos, assim como uma diminuição significativa do número de factores de risco agregados. Após análise dos resultados reportam-se as seguintes conclusões: (1) ambos os programas de exercício físico melhoraram a AFunc dos idosos, porém o programa de exercício combinado foi mais eficaz, na medida em que obteve ganhos mais elevados e em todas as componentes; (2) 32 semanas de exercício combinado resultaram em positivas e significativas alterações na composição corporal dos idosos, embora ambos os programas tenham sido insuficientes para alterar a massa magra e o índice de massa corporal; (3) 32 semanas de exercício físico resultaram em modificações positivas nos valores da pressão arterial e do perfil lipídico, porém apenas no EXP2 se identificaram repercussões significativas na saúde clínica dos indivíduos que o constituíam; (4) o efeito crónico do exercício combinado repercutiu-se numa modificação positiva nos factores de risco associados às DCV; (5) finalmente, a prática regular de exercício físico mostrou ser um meio não farmacológico seguro e eficaz na melhoria da saúde cardiovascular da amostra estudada. Esta protecção cardiovascular foi manifesta nos dois grupos experimentais, mas de forma mais evidente no EXP2.
Significant and consistent beneficial effects have been found in relation to physical exercise in elderly subjects, particularly in functional fitness and cardiovascular diseases (CVD) prevention. In the present study, we first examined the effects of prolonged physical exercise in functional fitness of elderly individuals, comparing 2 exercise programs (generalized aerobic exercise program vs. combined exercise program). Secondly, we examined both exercise programs on risk factors of CVD and corresponding aggregates. The sample was divided into 3 groups: 2 experimental groups (EXP1, n=15, 71,7 ± 4,7 years; EXP2, n=16, 68,5 ± 3,5 years) and one control group (CONT, n=17, 67,0 ± 5,8 years). The subjects from the EXP1 participated in a generalized aerobic exercise program (AERO), and the subjects from the EXP2 participated in a program combining AERO with local resistance exercise (LOCAL), both with 32 weeks (3 x week). The AERO program consisted of 2 sessions on land and 1 in an aquatic environment, which were mainly aerobic exercises and a small portion devoted to specific muscle resistance and flexibility, the intensity perceived as a moderate. The combined program (AERO+LOCAL) repeated the sessions of the AERO program, but replacing a session of the AERO-land by a session of LOCAL. The LOCAL consisted in 7 exercises for the major muscle groups with a gradual intensity (65% -75% of 1RM, 3 sets, 8-12 repetitions). After the 32 weeks of exercise there were significant gains in flexibility and strength of the lower limbs for the EXP1, and significant improvements in all components of functional fitness in EXP2, when compared to the control group. For the risk factors for CVD, there was a significant decrease in the percentage of fat mass, but only for the EXP2. For this group there was still a significant reduction in the number of hypertensive individuals, and with the high values of triglycerides, total cholesterol and low-density lipoprotein and a significant decrease in the number clusters of risk factors. In summary, the main study results showed: (1) both exercises programs improved the functional fitness in elderly subjects, however, combined exercise was more effective showing that EXP2 was significantly better compared to the other groups; (2) 32 weeks of combined exercise resulted in positive and significant changes in body composition of the elderly, on the other hand, neither exercise programs result in relevant improvements of the lean mass and body mass index; (3) 32 weeks of physical exercise resulted in positive changes in the blood pressure and lipid profile values, but only in EXP2 significant repercussions have been identified; (4) long term combined exercise significantly reduces the aggregate CVD risk factors in EXP2 (5) finally, the practice of regular physical exercise has proved to be a non-pharmacological means safe and effective in improving cardiovascular health of the sample studied. The cardiovascular protection was evident in the 2 experimental groups, but was more evident in EXP2.
Significant and consistent beneficial effects have been found in relation to physical exercise in elderly subjects, particularly in functional fitness and cardiovascular diseases (CVD) prevention. In the present study, we first examined the effects of prolonged physical exercise in functional fitness of elderly individuals, comparing 2 exercise programs (generalized aerobic exercise program vs. combined exercise program). Secondly, we examined both exercise programs on risk factors of CVD and corresponding aggregates. The sample was divided into 3 groups: 2 experimental groups (EXP1, n=15, 71,7 ± 4,7 years; EXP2, n=16, 68,5 ± 3,5 years) and one control group (CONT, n=17, 67,0 ± 5,8 years). The subjects from the EXP1 participated in a generalized aerobic exercise program (AERO), and the subjects from the EXP2 participated in a program combining AERO with local resistance exercise (LOCAL), both with 32 weeks (3 x week). The AERO program consisted of 2 sessions on land and 1 in an aquatic environment, which were mainly aerobic exercises and a small portion devoted to specific muscle resistance and flexibility, the intensity perceived as a moderate. The combined program (AERO+LOCAL) repeated the sessions of the AERO program, but replacing a session of the AERO-land by a session of LOCAL. The LOCAL consisted in 7 exercises for the major muscle groups with a gradual intensity (65% -75% of 1RM, 3 sets, 8-12 repetitions). After the 32 weeks of exercise there were significant gains in flexibility and strength of the lower limbs for the EXP1, and significant improvements in all components of functional fitness in EXP2, when compared to the control group. For the risk factors for CVD, there was a significant decrease in the percentage of fat mass, but only for the EXP2. For this group there was still a significant reduction in the number of hypertensive individuals, and with the high values of triglycerides, total cholesterol and low-density lipoprotein and a significant decrease in the number clusters of risk factors. In summary, the main study results showed: (1) both exercises programs improved the functional fitness in elderly subjects, however, combined exercise was more effective showing that EXP2 was significantly better compared to the other groups; (2) 32 weeks of combined exercise resulted in positive and significant changes in body composition of the elderly, on the other hand, neither exercise programs result in relevant improvements of the lean mass and body mass index; (3) 32 weeks of physical exercise resulted in positive changes in the blood pressure and lipid profile values, but only in EXP2 significant repercussions have been identified; (4) long term combined exercise significantly reduces the aggregate CVD risk factors in EXP2 (5) finally, the practice of regular physical exercise has proved to be a non-pharmacological means safe and effective in improving cardiovascular health of the sample studied. The cardiovascular protection was evident in the 2 experimental groups, but was more evident in EXP2.
Descrição
Tese de Doutoramento em Educação Física e Desporto
Palavras-chave
Exercício físico , Idosos , Doenças cardiovasculares , Perfil lipídico