Efeitos do treinamento funcional isolado, da terapia interdisciplinar e da educação em saúde sobre adaptações cardiorrespiratórias e fisiológicas de mulheres com obesidade
Arquivos
Data
2020-03-16
Autores
Teixeira, Cauê Vazquez La Scala [UNIFESP]
Orientadores
Gomes, Ricardo José [UNIFESP]
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A obesidade é uma doença crônica em crescimento acelerado. Além de ser responsável direta por diversas mortes ao redor do mundo, a obesidade está associada ao desenvolvimento de diversas doenças (comorbidades) que elevam as chances de morbidade e mortalidade precoce. Porém, elevados níveis de aptidão cardiorrespiratória parecem gerar efeito protetor contra morbidade e mortalidade, mesmo em pessoas com obesidade. Assim, o foco no tratamento da obesidade deve se dar não somente sobre a perda de peso, mas também sobre o
aumento da aptidão cardiorrespiratória. Objetivos: Analisar e comparar os efeitos do treinamento funcional (TF) realizado de forma isolada, da terapia interdisciplinar (INT) e da educação em saúde (ES) sobre aptidão cardiorrespiratória e variáveis fisiológicas em mulheres adultas com obesidade. Métodos: Quarenta e quatro mulheres completaram 30 semanas de intervenção distribuídas de forma randomizada em 3 grupos: TF (n=14, idade=39,7±6,6 anos, IMC=34,5±2,6 kg/m²), INT (n=19, idade=39,0±5,5 anos, IMC=35,8±3,0 kg/m²) e ES (n=11, idade=41,0±6,3 anos, IMC=36,3±2,7 kg/m²). O TF foi submetido a treinamento físico combinado (exercício aeróbios + exercícios resistidos funcionais) com frequência de 3x/sem, INT recebeu a mesma intervenção de treinamento complementada por intervenções de Nutrição (1x/sem), Psicologia (1x/sem) e Fisioterapia (1x/sem) e o ES participou de encontros interdisciplinares com temas relacionados à promoção de saúde em geral (1x/mês). Avaliações de consumo máximo de oxigênio (VO2máx), variáveis antropométricas, cardiometabólicas, hormonais e nível de atividade física foram realizadas nos momentos pré e pós-intervenção. Resultados: Todas as intervenções proporcionaram resultados favoráveis à melhora do perfil de saúde das voluntárias, porém a terapia INT mostrou-se superior às demais, em virtude de ter influenciado positivamente mais variáveis. Em INT, foram observadas
melhora no VO2máx (↑10,8%), massa corporal (MC; ↓4,4% ), índice de massa corporal (IMC; ↓4,4%), massa gorda (MG; ↓2,3% ), perímetro de cintura (PC; ↓5,1% ), relação cintura-estatura (RCE; ↓5,1% ), pressão arterial (PA) sistólica (↓3,8%) , glicemia (GLIC; ↓14,1% ) e leptina (LEP; ↓10,8%). Em TF, observou-se melhora do VO2máx (↑7,5%), PC (↓3,4%), RCE (↓3,4%) e GLIC (↓19,4%). Já em ES, MC (↓3,7%), IMC (↓3,7%), PC (↓3,5%), RCE (↓3,5%), PA sistólica (↓12,6%),
diastólica (↓11,5%) e média (↓10,3%) , GLIC (↓16,0%) e razão leptina-adipnectina (↓18,1%) melhoraram após a intervenção. Conclusão: O presente estudo revelou superioridade da INT sobre os demais modelos de intervenção para tratamento da obesidade. A INT promoveu melhora no VO2máx e variáveis antropométricas analisadas, além de melhora em parte das variáveis cardiometabólicas e hormonais. ES pode ser uma opção quando o objetivo for a melhora das
variáveis antropométricas, cardiometabólicas e hormonais, e o TF pode ser alternativa quando o foco se dá sobre o VO2máx de mulheres com obesidade.
Introduction: Obesity is a chronic disease with rapid growth. In addition to being directly responsible for several deaths around the world, obesity is associated with the development of several diseases (comorbidities) that increase the chances of early morbidity and mortality. However, high levels of cardiorespiratory fitness seem to have a protective effect against morbidity and mortality, even in people with obesity. Thus, the focus on the treatment of obesity must be not only on weight loss, but also on increasing cardiorespiratory fitness. Objective: Analyze and compare the effects of isolated functional training (TF), interdisciplinary therapy (INT) and health education (ES) on cardiorespiratory fitness and physiological variables in adult women with obesity. Methods: Forty-four women completed 30 weeks of intervention randomly distributed into 3 groups: TF (n=14, age=39.7±6.6 years, BMI=34.5±2.6 kg/m²), INT (n=19, age=39.0±5.5 years, BMI=35.8±3.0 kg/m²) and ES (n=11, age=41.0±6.3 years, BMI=36, 3±2.7 kg/m²). The TF was submitted to combined physical training (aerobic exercise + functional resistance exercises) with a frequency of 3x/week, INT received the same training program complemented by Nutrition advice (1x/week), Psychology advice (1x/week) and Physiotherapy (1x/week) and the ES participated in interdisciplinary meetings/lectures on topics related to general health promotion (1x/month). Measurements of the maximum oxygen consumption (VO2máx), anthropometric, cardiometabolic, hormonal variables and level of physical activity were performed at pre and post-intervention. Results: All interventions provided favorable results for the improvement of the volunteers' health profile, but INT proved to be superior to the others, due to the positive influence on more variables. In INT, improvement was observed in VO2max (↑10,8%), body mass (BM; ↓4,4%)), body mass index (BMI; ↓4,4%)), fat mass (FM; ↓2,3%), waist circumference (WC; ↓5,1%), waist/height ratio (WHR; ↓ 5,1%), systolic blood pressure (BP; (↓3,8%), blood glucose (GLU; ↓14,1% ) and leptin (LEP; ↓1 0,8%). In TF, there was an improvement in VO2max (↑7,5%), WC (↓3,4%), WHR (↓3,4%) and GLU (↓19,4%). In ES, BM (↓3,7%), BMI (↓3,7%), WC (↓3,5%), WHR (↓3,7%), systolic (↓12,6%), diastolic (↓11,5%) and mean BP (↓10,3%), GLU (↓16,0%) and leptin/adipnectin ratio (↓18,1%) improved after the intervention. Conclusion: The present study revealed INT's superiority over the other intervention models for treating obesity. INT promoted an improvement in VO2max and anthropometric variables analyzed, in addition to an improvement in part of the cardiometabolic and hormonal variables. ES can be an option when the aim is to improve anthropometric, cardiometabolic and hormonal variables, and TF can be an alternative when the focus is on the VO2max of women with obesity
Introduction: Obesity is a chronic disease with rapid growth. In addition to being directly responsible for several deaths around the world, obesity is associated with the development of several diseases (comorbidities) that increase the chances of early morbidity and mortality. However, high levels of cardiorespiratory fitness seem to have a protective effect against morbidity and mortality, even in people with obesity. Thus, the focus on the treatment of obesity must be not only on weight loss, but also on increasing cardiorespiratory fitness. Objective: Analyze and compare the effects of isolated functional training (TF), interdisciplinary therapy (INT) and health education (ES) on cardiorespiratory fitness and physiological variables in adult women with obesity. Methods: Forty-four women completed 30 weeks of intervention randomly distributed into 3 groups: TF (n=14, age=39.7±6.6 years, BMI=34.5±2.6 kg/m²), INT (n=19, age=39.0±5.5 years, BMI=35.8±3.0 kg/m²) and ES (n=11, age=41.0±6.3 years, BMI=36, 3±2.7 kg/m²). The TF was submitted to combined physical training (aerobic exercise + functional resistance exercises) with a frequency of 3x/week, INT received the same training program complemented by Nutrition advice (1x/week), Psychology advice (1x/week) and Physiotherapy (1x/week) and the ES participated in interdisciplinary meetings/lectures on topics related to general health promotion (1x/month). Measurements of the maximum oxygen consumption (VO2máx), anthropometric, cardiometabolic, hormonal variables and level of physical activity were performed at pre and post-intervention. Results: All interventions provided favorable results for the improvement of the volunteers' health profile, but INT proved to be superior to the others, due to the positive influence on more variables. In INT, improvement was observed in VO2max (↑10,8%), body mass (BM; ↓4,4%)), body mass index (BMI; ↓4,4%)), fat mass (FM; ↓2,3%), waist circumference (WC; ↓5,1%), waist/height ratio (WHR; ↓ 5,1%), systolic blood pressure (BP; (↓3,8%), blood glucose (GLU; ↓14,1% ) and leptin (LEP; ↓1 0,8%). In TF, there was an improvement in VO2max (↑7,5%), WC (↓3,4%), WHR (↓3,4%) and GLU (↓19,4%). In ES, BM (↓3,7%), BMI (↓3,7%), WC (↓3,5%), WHR (↓3,7%), systolic (↓12,6%), diastolic (↓11,5%) and mean BP (↓10,3%), GLU (↓16,0%) and leptin/adipnectin ratio (↓18,1%) improved after the intervention. Conclusion: The present study revealed INT's superiority over the other intervention models for treating obesity. INT promoted an improvement in VO2max and anthropometric variables analyzed, in addition to an improvement in part of the cardiometabolic and hormonal variables. ES can be an option when the aim is to improve anthropometric, cardiometabolic and hormonal variables, and TF can be an alternative when the focus is on the VO2max of women with obesity
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Citação
TEIXEIRA, Cauê Vazquez La Scala. Efeitos do treinamento funcional isolado, da terapia interdisciplinar e da educação em saúde sobre adaptações cardiorrespiratórias e fisiológicas de mulheres com obesidade. 2020. 70 f. Tese (Doutorado Interdisciplinar em Ciências da Saúde) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2020.