Estimulação elétrica funcional associada ao treinamento combinado pós-CRM: ensaio clínico randomizado

Autores

DOI:

https://doi.org/10.1590/1809-2950/20031628012021

Palavras-chave:

Estimulação Elétrica, Índice Tornozelo-Braço, Qualidade de Vida, Cardipatias, Cardiomiopatias, Ensaio Clínico Controlado Aleatório

Resumo

Os efeitos da adição da estimulação elétrica funcional (EEF) ao treinamento aeróbico e resistido (treino combinado) de curto prazo em pacientes submetidos à cirurgia de revascularização do miocárdio (CRM) ainda não foram estabelecidos. O objetivo do presente estudo é avaliar o impacto da adição da EEF ao treino combinado no fluxo arterial periférico, na capacidade funcional e na qualidade de vida de pacientes pós-CRM participantes de um programa de reabilitação cardíaca – Fase II. Trata-se de um ensaio clínico randomizado, duplo cego, composto por 17 pacientes (54,8±10,5 anos, 12 homens) randomizados ou em grupo
intervenção (GI, n=8,) submetido à EEF no músculo quadríceps associada ao treino combinado, ou em grupo sham (GS, n=9), que realizou a EEF sham em associação ao treino combinado. Os desfechos avaliados foram: fluxo arterial periférico (índice tornozelo-braquial), capacidade funcional (distância percorrida no teste de caminhada de seis minutos – DTC6M)
e qualidade de vida (questionário MacNew). Na comparação entre os grupos, o aumento do índice tornozelo-braquial (GI: 0,14±0,08 mmHg vs. GC: 0,05±0,04 mmHg; p=0,020) e do escore do domínio global do questionário MacNew (GI: 1,1±0,3 pontos vs. GC: 0,6±0,4 pontos; p=0,020) foi maior no GI. Entretanto, não foi observada diferença entre os grupos para a DTC6M (GI: 130,9±73,7 m vs. GS: 73,7±32,6 m; p=0,072). A adição da EEF, durante curto período, potencializou os efeitos do exercício aeróbico e resistido sobre o fluxo arterial
periférico e a qualidade de vida em pacientes pós CRM em Fase II da reabilitação cardíaca.

Downloads

Os dados de download ainda não estão disponíveis.

Biografia do Autor

  • Nubia Gonzatti, Universidade Federal de Santa Maria (UFSM) - Santa Maria (RS), Brasil.

    quality of life of post-CABG patients participating in a cardiac
    rehabilitation program – Phase II. This is a randomized, double-blind,
    clinical trial, composed of 17 patients (54.8±10.5 years old, 12 men)
    randomized or in an intervention group (IG, n=8,) submitted to FES
    in the quadriceps muscle associated with combined training, or in a
    sham group (SG, n=9), which performed the FES sham in association
    with the combined training. The evaluated outcomes were: peripheral
    arterial flow (ankle-brachial index), functional capacity (distance
    covered in the six-minute walk test – 6MWT) and quality of life
    (MacNew questionnaire). In the comparison between the groups,
    the increase in the ankle-brachial index (IG: 0.14±0.08mmHg vs. CG:
    0.05±0.04mmHg; p=0.020) and the score of the global MacNew
    questionnaire (IG: 1.1±0.3 points vs. CG: 0.6±0.4 points; p=0.020) was
    higher in the IG. However, no difference was observed between the
    groups for the 6MWT (IG: 130.9±73.7m vs. SG: 73.7±32.6m; p=0.072).
    The addition of FES, during a short period, potentiated the effects of
    aerobic and resistance exercise on peripheral arterial flow and quality
    of life in patients after CABG in Phase II of cardiac rehabilitation

Referências

Organização Pan-Americana de Saúde. Doenças cardiovasculares [Internet]. Brasília; 2017 [cited 2020 July 29]. Available from: https://www.paho.org.braindex.php?option=com_content&v

iew=article&id=5253:doencas-cardiovasculares&Itemid=1096

Kandaswamy E, Zuo L. Recent advances in treatment of coronary artery disease: role of science and technology. Int J Mol Sci. 2018;19(2):424. doi: 10.3390/ijms19020424

Van Venrooij LM, Verberne HJ, de Vos R, Borgmeijer-Hoelen MM, van Leeuwen PA, de Mol BA. Postoperative loss of skeletal muscle mass, complications and quality of life in patients

undergoing cardiac surgery. Nutrition. 2012;28:40-5. doi: 10.1016/j.nut.2011.02.007

Iida Y, Yamazaki T, Arima H, Kawabe T, Yamada S. Predictors of surgery-induced muscle proteolysis in patients undergoing cardiac surgery. J Cardiol. 2016;68(6):536-41. doi: 10.1016/j.

jjcc.2015.11.011

Santos KM, Cerqueira Neto ML, Carvalho VO, Santana Filho VJ, Silva Junior WM, Araújo Filho AA, et al. Evaluation of peripheral muscle strength of patients undergoing elective cardiac surgery: a longitudinal study. Rev Bras Cir Cardiovasc. 2014;29(3):355-9. doi: 10.5935/1678-9741.20140043

Herdy AH, López-Jimenez F, Terzic CP, Milani M, Stein R, Carvalho T, et al. South American guidelines for cardiovascular disease prevention and rehabilitation. Arq Bras Cardiol. 2014;103(2 Suppl 1):1-31. doi: 10.5935/abc.2014s003

Smart NA, Dieberg G, Giallauria F. Functional electrical stimulation for chronic heart failure: a meta-analysis. Int J Cardiol. 2013;167(1):80-6. doi: 10.1016/j.ijcard.2011.12.019

Schardong J, Kuinchtner GC, Sbruzzi G, Plentz RDM, Silva AMVD. Functional electrical stimulation improves muscle strength and endurance in patients after cardiac surgery: a

randomized controlled trial. Braz J Phys Ther. 2017;21(4):268-73. doi: 10.1016/j.bjpt.2017.05.004.

Maffiuletti NA, Gondin J, Place N, Stevens-Lapsley J, Vivodtzev I, Minetto MA. Clinical use of neuromuscular electrical stimulation for neuromuscular rehabilitation: what are we overlooking? Arch Phys Med Rehabil. 2018;99:806-12. doi: 10.1016/j.apmr.2017.10.028

Hill K, Cavalheri V, Mathur S, Roig M, Janaudis-Ferreira T, Robles P, Dolmage TE, Goldstein R. Neuromuscular electrostimulation for adults with chronic obstructive pulmonary disease (Review). Cochrane Database Syst Rev. 2018;29(5):1-76. doi: 10.1007/BF00581062

Gomes Neto M, Oliveira FA, Reis HFC, Rodrigues ES, Bittencourt HS, Carvalho VO. Effects of neuromuscular electrical stimulation on physiologic and functional measurements in patients

with heart failure: a systematic review with meta-analysis. J Cardiopulm Rehabil Prev. 2016;36(3):157-66. doi: 10.1097/HCR.0000000000000151

American Thoracic Society. ATS Statement: Guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111-7. doi: 10.1164/ajrccm.166.1.at1102

Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998;158(5):1384-7. doi: 10.1164/ajrccm.158.5.9710086

Nakajima KM, Rodrigues RC, Gallani MC, Alexandre NM, Oldridge N. Psychometric properties of MacNew Heart Disease Health-related Quality of Life Questionnaire: Brazilian version. J Adv

Nurs. 2009;65(5):1084-94. doi: 10.1080/ac.67.1.2146563

Giollo Júnior LT, Martin JFV. Índice tornozelo-braquial no diagnóstico da doença aterosclerótica carotídea. Rev Bras Hipertens. 2010;17(2):117-8.

Resnick HE, Lindsay RS, McDermott MM, Devereux RB, Jones KL, Fabsitz RR, et al. Relationship of high and low ankle brachial index to all-cause and cardiovascular disease mortality:

The strong heart study. Circulation. 2004;109(6):733-9. doi: 10.1161/01.CIR.0000112642.63927.54

Hermes BM, Cardoso DM, Gomes TJN, dos Santos TD, Vicente MS, Pereira SN, et al. Short-term inspiratory muscle training potentiates the benefits of aerobic and resistance training in patients undergoing CABG in phase II cardiac rehabilitation program. Rev Bras Cir Cardiovasc. 2015;30(4):474-81. doi: 10.5935/1678-9741.20150043

Karavidas A, Driva M, Parissis JT, Farmakis D, Mantzaraki V, Varounis C, et al. Functional electrical stimulation of peripheral muscles improves endothelial function and clinical and

emotional status in heart failure patients with preserved left ventricular ejection fraction. Am Heart J. 2013;166(4):760-7. doi: 10.1016/j.ahj.2013.06.021

Parissis J, Karavidas A, Farmakis D, Papoutsidakis N, Matzaraki V, Arapi S, et al. Efficacy and safety of functional electrical stimulation of lower limb muscles in elderly patients with chronic

heart failure: A pilot study. Eur J Prev Cardiol. 2015;22(7):831-6. doi: 10.1177/2047487314540546

Karavidas A, Parissis JT, Matzaraki V, Arapi S, Varounis C, Ikonomidis I, et al. Functional electrical stimulation is more effective in severe symptomatic heart failure patients and

improves their adherence to rehabilitation programs. J Card Fail. 2010;16(3): 244-9. doi: 10.1016/j.cardfail.2009.10.023

Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, et al. Measurement and interpretation of the Ankle-Brachial Index: A scientific statement from the American

Heart Association. Circulation. 2012,126:2890-909. doi: 10.1161/CIR.0b013e318276fbcb

Sasaki M, Mitsutake Y, Ueno T, Fukami A, Sasaki KI, Yokoyama S, et al. Low ankle brachial index predicts poor outcomes including target lesion revascularization during the long-term

follow up after drug-eluting stent implantation for coronary artery disease. J Cardiol. 2020;75(3):250-4. doi: 10.1016/j.jjcc.2019.07.015

Medeiros AHO, Chalegre ST, Carvalho CC. Eletroestimulação muscular: alternativa de tratamento coadjuvante para pacientes com doença arterial obstrutiva periférica. J Vasc

Bras. 2007;6(2):152-62.

Hellsten Y, Nyberg M. Cardiovascular adaptations to exercise training. Compr Physiol. 2015;15;6(1):1-32. doi: 10.1002/cphy.c140080

Pačarić S, Turk T, Erić I, Orkić Z, Erić AP, Milostić-Srb A, et al. Assessment of the quality of life in patients before and after coronary artery bypass grafting (CABG): A Prospective Study.

Int J Environ Res Public Health. 2020;17(4):1417. doi: 10.3390/ijerph17041417

Downloads

Publicado

2023-02-23

Edição

v. 28 n. 1 (2021)

Seção

Pesquisa Original

Licença

Copyright (c) 2021 Gonzatti N, Castagna L, Carvalho MTX, Santos TD, Cardoso DM, Callegaro CC, Albuquerque IM

Creative Commons License
Este trabalho está licenciado sob uma licença Creative Commons Attribution-ShareAlike 4.0 International License.

Como Citar

Estimulação elétrica funcional associada ao treinamento combinado pós-CRM: ensaio clínico randomizado. (2023). Fisioterapia E Pesquisa, 28(1), 101-108. https://doi.org/10.1590/1809-2950/20031628012021