A acupuntura como terapia complementar para a saúde e para a performance física
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2016
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A acupuntura (ACP) tem demonstrado eficácia clínica em sintomatologia associada a algias músculo-esqueléticas, sendo que a maior parte de sua aplicabilidade comprovada é relacionada à atenção clínico-curativa. No entanto, há dúvidas com relação à sua possível viabilidade em algumas áreas como imunologia e desporto existindo poucas publicações a este respeito e, muitas vezes sem qualidade metodológica. Assim o objetivo geral desta tese é preencher lacunas do conhecimento da aplicabilidade da ACP em imunidade, performance física e dessensibilização álgica pós-exercício. Esta tese está organizada em 5 capítulos independentes: O capítulo 1 aborda os aspectos da aplicabilidade da ACP na modulação de imunidade, buscando responder as lacunas da literatura: os capítulos 2 e 3 abordam estudos experimentais relativos à influência da ACP na performance de membros inferiores. O capítulo 4 também é um estudo experimental que avaliou o efeito da ACP na força de membros superiores (preensão palmar). No capítulo 5 reporta-se a avaliação dos efeitos da ACP no limiar de pressão dolorosa (LPD) na região da panturrilha, após exercícios repetitivos. Os capítulos 3, 4 e 5 foram realizados com a colaboração de voluntários sadios e sedentários e o capítulo 2 com indivíduos sadios, praticantes de atividades físicas regulares. Em todos os estudos experimentais foi realizada uma única aplicação de ACP. Os principais resultados encontrados da intervenção por ACP foram: (a) ganho de performance física em membros inferiores após 24 horas, aumentando de maneira significativamente o número de agachamentos em um minuto, quando comparado com o grupo sham; (b) ganho significativo no número de repetições máximas em um minuto em exercícios de plantiflexão e dorsiflexão de tornozelo no momento imediato a ACP, mas não após 24 horas, quando comparado com grupos controle e sham; (c) ganho significativo imediato de força de preensão palmar, avaliado por dinamometria após ACP, quando comparado com os grupos sham e controle; (d) aumento significativo imediato e após 24 horas no limiar de pressão dolorosa (LPD) avaliados por algometria de pressão após intervenção por ACP, quando comparado com os grupos sham e controle. Evidenciou-se que a ACP é capaz de responder com efeitos imunomoduladores, fortalecendo as defesas do organismo possivelmente pelo aumento das proteínas de defesa ou pela inibição dos processos inflamatórios e alérgicos. O melhor acuponto encontrado foi o E36 (Zusanli). Quanto ao desempenho físico, a ACP demonstrou possíveis aplicabilidades, embora sutis, de ganho de performance de membros superiores e inferiores em uma única intervenção; de maneira imediata na força de preensão palmar, e no número de repetições em um minuto de plantiflexão e dorsiflexão de tornozelo; e tardiamente (após 24 horas), no número de agachamentos em um minuto. A ACP apresentou, ainda, efeitos na redução da percepção álgica imediata e após 24 horas, em uma única intervenção, observados pelo aumento no limiar de pressão dolorosa na panturrilha. Recomenda-se o uso da ACP para estudos clínicos com praticantes de exercício físico e a necessidade de efetuar estudos com atletas em fases ou interfases de treinamento.
Acupuncture (ACP) has demonstrated its efficacy for treating symptoms associated to musculoskeletal pain, in such a way that most of its proven applicability is related to clinical and curative care. However, there are some doubts related to its possible viability in some areas such as immunology and sports, in which few publications can be found, and frequently without methodological quality. Therefore, the general objective of this thesis is to fill knowledge gaps of the applicability of ACP in immunity, physical performance, and post-exercise algic desensitization. This thesis is organized in 5 independent chapters. Chapter 1 approaches the applicability aspects of ACP in the modulation of immunity, aiming at responding to the literature gaps. Chapters 2 and 3 focus on experimental studies related to the influence of ACP in the performance of the lower limbs. Chapter 4 also reports an experimental study that evaluated the effect of ACP in the strength of the upper limbs (hand grip). Chapter 5 reports the evaluation of ACP in the painful pressure threshold (LPD) of the calf region after repetitive exercises. Chapters 3, 4 and 5 were performed with the collaboration of healthy and sedentary volunteers, and chapter 2 with healthy amateur athletes. In all the experimental studies only one application of ACP was done. The main results found of the ACP intervention were: (a) physical performance gain in the lower limbs after 24 hours, with significantly increase of the number of squats in one minute, compared with the sham group; (b) significant gain in the number of maximum repetitions in a minute of plantar flexion exercises and ankle dorsiflexion at the time immediately after the ACP, but not after 24 hours, compared to sham and control groups; (c) immediate significant gain in palmar grasping, measured by dynamometry after ACP, compared with the sham and control groups; (d) significant immediate and after 24 hours increase in the pain pressure threshold (PPT) evaluated by algometry after ACP intervention, when compared with the sham and control groups. It was evident that, regarding immunity, ACP is able to respond with immunomodulatory effects, strengthening the body’s defenses either by increasing the defense proteins, or by inhibiting inflammatory and allergic processes. The best acupoint was found to be ST36 (Zusanli). Regarding physical performance, ACP has shown potential, although subtle, applicability of performance gain for upper and lower limbs in a single intervention; immediate, in the palmar prehension and in the number of repetitions in one minute of plantiflexion and dosiflexion of the ankle; and late (after 24 hours) in the number of squats in a minute. Also, ACP showed immediate and after 24 hours, desensitization effects with a single intervention, observed by the increase in the pain pressure threshold in the calf. The use of ACP is recommended for clinical studies with athletes in training.
Acupuncture (ACP) has demonstrated its efficacy for treating symptoms associated to musculoskeletal pain, in such a way that most of its proven applicability is related to clinical and curative care. However, there are some doubts related to its possible viability in some areas such as immunology and sports, in which few publications can be found, and frequently without methodological quality. Therefore, the general objective of this thesis is to fill knowledge gaps of the applicability of ACP in immunity, physical performance, and post-exercise algic desensitization. This thesis is organized in 5 independent chapters. Chapter 1 approaches the applicability aspects of ACP in the modulation of immunity, aiming at responding to the literature gaps. Chapters 2 and 3 focus on experimental studies related to the influence of ACP in the performance of the lower limbs. Chapter 4 also reports an experimental study that evaluated the effect of ACP in the strength of the upper limbs (hand grip). Chapter 5 reports the evaluation of ACP in the painful pressure threshold (LPD) of the calf region after repetitive exercises. Chapters 3, 4 and 5 were performed with the collaboration of healthy and sedentary volunteers, and chapter 2 with healthy amateur athletes. In all the experimental studies only one application of ACP was done. The main results found of the ACP intervention were: (a) physical performance gain in the lower limbs after 24 hours, with significantly increase of the number of squats in one minute, compared with the sham group; (b) significant gain in the number of maximum repetitions in a minute of plantar flexion exercises and ankle dorsiflexion at the time immediately after the ACP, but not after 24 hours, compared to sham and control groups; (c) immediate significant gain in palmar grasping, measured by dynamometry after ACP, compared with the sham and control groups; (d) significant immediate and after 24 hours increase in the pain pressure threshold (PPT) evaluated by algometry after ACP intervention, when compared with the sham and control groups. It was evident that, regarding immunity, ACP is able to respond with immunomodulatory effects, strengthening the body’s defenses either by increasing the defense proteins, or by inhibiting inflammatory and allergic processes. The best acupoint was found to be ST36 (Zusanli). Regarding physical performance, ACP has shown potential, although subtle, applicability of performance gain for upper and lower limbs in a single intervention; immediate, in the palmar prehension and in the number of repetitions in one minute of plantiflexion and dosiflexion of the ankle; and late (after 24 hours) in the number of squats in a minute. Also, ACP showed immediate and after 24 hours, desensitization effects with a single intervention, observed by the increase in the pain pressure threshold in the calf. The use of ACP is recommended for clinical studies with athletes in training.
Descrição
Tese de Doutoramento em Ciências do Desporto
Palavras-chave
Acupuntura , Imunidade , Performance física