Como determinar a velocidade inicial da esteira no treinamento aeróbio de hemiparéticos crônicos?
DOI:
https://doi.org/10.5935/0104-7795.20160003Palavras-chave:
Acidente Vascular Cerebral, Exercício, MarchaResumo
Objetivo: Investigar os critérios para estabelecer a velocidade inicial da esteira e viabilizar um treinamento motor funcional ou cardiorrespiratório em hemiparéticos crônicos. Métodos: Foram recrutados 15 hemiparéticos crônicos determinados pelo Lower Extremity Motor Coordination Test (LEMOCOT) e submetidos à avaliação da marcha pelo Time up and go (TUG), Teste de Esforço Máximo (TES) e Teste de velocidade de marcha de 10 metros (TV10M). Resultados: A análise dos valores do LEMOCOT demonstrou uma média de 26,87 ± 9,76 acertos nos alvos no lado não parético e 15,40 ± 8,46 no lado parético. No TUG verificou-se a velocidade média de 0,37 ± 0,14 m/s e no TV10M 0,63 ± 0,23 m/s. No TES a velocidade média foi 0,60 ± 0,25 m/s. Houve correlação forte e significante entre os valores de TUG, TV10M e TEX. Conclusão: O TES e TV10M são testes adequados para serem utilizados como critério de elegibilidade da velocidade inicial para treinos aeróbios, todavia o TES é capaz de revelar o tempo em que o paciente consegue manter a marcha. O TUG não revelou ser um bom instrumento para estabelecer a velocidade inicial do treinamento
Downloads
Referências
Dobkin BH. Clinical practice. Rehabilitation after stroke. N Engl J Med. 2005;352(16):1677-84. DOI: http://dx.doi.org/10.1056/NEJMcp043511
Brogårdh C, Lexell J. Effects of cardiorespiratory fitness and muscle-resistance training after stroke. PM R. 2012;4(11):901-7. DOI: http://dx.doi.org/10.1016/j.pmrj.2012.09.1157
CIF: Classificação Internacional de Funcionalidade, Incapacidade e Saúde. São Paulo: Edusp, 2003.
Gordon NF, Gulanick M, Costa F, Fletcher G, Franklin BA, Roth EJ, et al. Physical activity and exercise recommendations for stroke survivors: an American Heart Association scientific statement from the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical Activity, and Metabolism; and the Stroke Council. Circulation. 2004;109(16):2031-41. DOI: http://dx.doi.org/10.1161/01.CIR.0000126280.65777.A4
van de Port IG, Wood-Dauphinee S, Lindeman E, Kwakkel G. Effects of exercise training programs on walking competency after stroke: a systematic review. Am J Phys Med Rehabil. 2007;86(11):935-51. DOI: http://dx.doi.org/10.1097/PHM.0b013e31802ee464
Donovan K, Lord SE, McNaughton HK, Weatherall M. Mobility beyond the clinic: the effect of environment on gait and its measurement in community-ambulant stroke survivors. Clin Rehabil. 2008;22(6):556-63. DOI: http://dx.doi.org/10.1177/0269215507085378
Hornby TG, Straube DS, Kinnaird CR, Holleran CL, Echauz AJ, Rodriguez KS, et al. Importance of specificity, amount, and intensity of locomotor training to improve ambulatory function in patients poststroke. Top Stroke Rehabil. 2011;18(4):293-307. DOI: http://dx.doi.org/10.1310/tsr1804-293
Brazzelli M, Saunders DH, Greig CA, Mead GE. Physical fitness training for patients with stroke: updated review. Stroke. 2012;43(4):e39-e40. DOI: http://dx.doi.org/10.1161/STROKEAHA.111.647008
Moore JL, Roth EJ, Killian C, Hornby TG. Locomotor training improves daily stepping activity and gait efficiency in individuals poststroke who have reached a "plateau" in recovery. Stroke. 2010;41(1):129-35. DOI: http://dx.doi.org/10.1161/STROKEAHA.109.563247
Saunders DH, Sanderson M, Brazzelli M, Greig CA, Mead GE. Physical fitness training for stroke patients. Cochrane Database Syst Rev. 2013;10:CD003316.
Polese JC, Ada L, Dean CM, Nascimento LR, Teixeira-Salmela LF. Treadmill training is effective for ambulatory adults with stroke: a systematic review. J Physiother. 2013;59(2):73-80. DOI: http://dx.doi.org/10.1016/S1836-9553(13)70159-0
Duncan P, Richards L, Wallace D, Stoker-Yates J, Pohl P, Luchies C, et al. A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke. Stroke. 1998;29(10):2055-60. DOI: http://dx.doi.org/10.1161/01.STR.29.10.2055
Kuys SS, Brauer SG, Ada L. Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: a pilot randomized trial. Clin Rehabil. 2011;25(4):316-26. DOI: http://dx.doi.org/10.1177/0269215510382928
Globas C, Becker C, Cerny J, Lam JM, Lindemann U, Forrester LW, et al. Chronic stroke survivors benefit from high-intensity aerobic treadmill exercise: a randomized control trial. Neurorehabil Neural Repair. 2012;26(1):85-95. DOI: http://dx.doi.org/10.1177/1545968311418675
Jorgensen JR, Bech-Pedersen DT, Zeeman P, Sorensen J, Andersen LL, Schonberger M. Effect of intensive outpatient physical training on gait performance and cardiovascular health in people with hemiparesis after stroke. Phys Ther. 2010;90(4):527-37. DOI: http://dx.doi.org/10.2522/ptj.20080404
Macko RF, Ivey FM, Forrester LW, Hanley D, Sorkin JD, Katzel LI, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke. 2005;36(10):2206-11 DOI: http://dx.doi.org/10.1161/01.STR.0000181076.91805.89
Askim T, Dahl AE, Aamot IL, Hokstad A, Helbostad J, Indredavik B. High-intensity aerobic interval training for patients 3-9 months after stroke. A feasibility study. Physiother Res Int. 2014;19(3):129-39. DOI: http://dx.doi.org/10.1002/pri.1573
Karvonen MJ, Kentala E, Mustala O. The effects of training on heart rate; a longitudinal study. Ann Med Exp Biol Fenn. 1957;35(3):307-15.
Mezzani A, Hamm LF, Jones AM, McBride PE, Moholdt T, Stone JA, et al. Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation. Eur J Prev Cardiol. 2013;20(3):442-67. DOI: http://dx.doi.org/10.1177/2047487312460484
Hansen D, Stevens A, Eijnde BO, Dendale P. Endurance exercise intensity determination in the rehabilitation of coronary artery disease patients: a critical re-appraisal of current evidence. Sports Med. 2012;42(1):11-30. DOI: http://dx.doi.org/10.2165/11595460-000000000-00000
Bertolucci PH, Brucki SM, Campacci SR, Juliano Y. The Mini-Mental State Examination in a general population: impact of educational status. Arq Neuropsiquiatr. 1994;52(1):1-7. DOI: http://dx.doi.org/10.1590/S0004-282X1994000100001
Gregson JM, Leathley M, Moore AP, Sharma AK, Smith TL, Watkins CL. Reliability of the Tone Assessment Scale and the modified Ashworth scale as clinical tools for assessing poststroke spasticity. Arch Phys Med Rehabil. 1999;80(9):1013-6. DOI: http://dx.doi.org/10.1016/S0003-9993(99)90053-9
Pinheiro MB, Scianni AA, Ada L, Faria CD, Teixeira-Salmela LF. Reference values and psychometric properties of the lower extremity motor coordination test. Arch Phys Med Rehabil. 2014;95(8):1490-7. DOI: http://dx.doi.org/10.1016/j.apmr.2014.03.006
Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. DOI: http://dx.doi.org/10.1111/j.1532-5415.1991.tb01616.x
Bowden MG, Balasubramanian CK, Behrman AL, Kautz SA. Validation of a speed-based classification system using quantitative measures of walking performance poststroke. Neurorehabil Neural Repair. 2008;22(6):672-5. DOI: http://dx.doi.org/10.1177/1545968308318837
Pang MY, Eng JJ, Dawson AS, Gylfadóttir S. The use of aerobic exercise training in improving aerobic capacity in individuals with stroke: a meta-analysis. Clin Rehabil. 2006;20(2):97-111. DOI: http://dx.doi.org/10.1191/0269215506cr926oa
Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334-59. DOI: http://dx.doi.org/10.1249/MSS.0b013e318213fefb
Salbach NM, Mayo NE, Wood-Dauphinee S, Hanley JA, Richards CL, Cote R. A task-orientated intervention enhances walking distance and speed in the first year post stroke: a randomized controlled trial. Clin Rehabil. 2004;18(5):509-19. DOI: http://dx.doi.org/10.1191/0269215504cr763oa
Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;81(4):409-17. DOI: http://dx.doi.org/10.1053/mr.2000.3839
Billinger SA, Arena R, Bernhardt J, Eng JJ, Franklin BA, Johnson CM, et al. Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(8):2532-53. DOI: http://dx.doi.org/10.1161/STR.0000000000000022
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2016 Acta Fisiátrica
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
