Impactos do treinamento aeróbico e resistido de alta intensidade na capacidade funcional de pacientes com doença de Parkinson: uma revisão sistemática

Introdução: A doença de Parkinson (DP) é uma patologia neurodegenerativa que apresenta manifestações clínicas, incluindo tremores involuntários, rigidez articular e declínio da força muscular. A DP é comumente associada à morte de neurônios dopaminérgicos na região dos gânglios da base, responsáveis pelo controle das atividades motoras. O tratamento consiste em medicamentos, no entanto, ferramentas não farmacológicas, como o exercício físico supervisionado, são amplamente recomendadas.

Objetivo: Resumir os impactos de protocolos de treinamento aeróbio e resistido de alta intensidade sobre a capacidade funcional de pacientes com DP.

Métodos: Quatro bases de dados [PubMed, Scopus, Embase e Science Direct. Após a aplicação dos critérios de elegibilidade, os artigos foram selecionados de forma independente por pares.

Resultados e Discussão: Foram identificados 4.745 estudos por meio de busca nas bases de dados, mas apenas 17 atenderam aos critérios de elegibilidade. Finalmente, 17 estudos foram incluídos nesta revisão sistemática. Foram extraídas informações sobre o estudo (autor e ano), características da amostra (idade, sexo, tamanho da amostra), informações sobre o tipo de exercício físico, duração do protocolo, descrição do exercício: aquecimento; frequência; volume, além de extrair resultados relacionados à capacidade funcional (aspectos motores e não motores). Ambas as modalidades de treinamento (HIA e HIRT) podem melhorar as variáveis da capacidade funcional em pacientes com DP. Ressalta-se que essas modalidades de treinamento podem atuar sinergicamente na promoção de uma melhor qualidade de vida/saúde desses pacientes.

Conclusão: Portanto, ambas as modalidades foram capazes de melhorar os componentes não motores e motores (força, potência, equilíbrio) relacionados à capacidade funcional em pacientes com DP.

Referências

Mak MK, Wong-Yu IS, Shen X, Chung CL. Long-term effects of exercise and physical therapy in people with Parkinson disease. Nature Reviews Neurology. 2017;13(11): 689–703. https://doi.org/10.1038/nrneurol.2017.128.

Fiorelli CM, Ciolac EG, Simieli L, Silva FA, Fernandes B, Christofoletti G, et al. Differential Acute Effect of High-Intensity Interval or Continuous Moderate Exercise on Cognition in Individuals With Parkinson’s Disease. Journal of Physical Activity and Health. 2019;16(2): 157–164. https://doi.org/10.1123/jpah.2018-0189.

Harvey M, Weston KL, Gray WK, O’Callaghan A, Oates LL, Davidson R, et al. High-intensity interval training in people with Parkinson’s disease: a randomized, controlled feasibility trial. Clinical Rehabilitation. 2019;33(3): 428–438. https://doi.org/10.1177/0269215518815221.

O’Callaghan A, Harvey M, Houghton D, Gray WK, Weston KL, Oates LL, et al. Comparing the influence of exercise intensity on brain-derived neurotrophic factor serum levels in people with Parkinson’s disease: a pilot study. Aging Clinical and Experimental Research. 2020;32(9): 1731–1738. https://doi.org/10.1007/s40520-019-01353-w.

Rose MH, Løkkegaard A, Sonne-Holm S, Jensen BR. Effects of training and weight support on muscle activation in Parkinson’s disease. Journal of Electromyography and Kinesiology. 2013;23(6): 1499–1504. https://doi.org/10.1016/j.jelekin.2013.07.012.

Schenkman M, Moore CG, Kohrt WM, Hall DA, Delitto A, Comella CL, et al. Effect of High-Intensity Treadmill Exercise on Motor Symptoms in Patients With De Novo Parkinson Disease: A Phase 2 Randomized Clinical Trial. JAMA Neurology. 2018;75(2): 219. https://doi.org/10.1001/jamaneurol.2017.3517.

Miller Koop M, Rosenfeldt AB, Alberts JL. Mobility improves after high intensity aerobic exercise in individuals with Parkinson’s disease. Journal of the Neurological Sciences. 2019;399: 187–193. https://doi.org/10.1016/j.jns.2019.02.031.

Cancela JM, Mollinedo I, Montalvo S, Vila Suárez ME. Effects of a High-Intensity Progressive-Cycle Program on Quality of Life and Motor Symptomatology in a Parkinson’s Disease Population: A Pilot Randomized Controlled Trial. Rejuvenation Research. 2020;23(6): 508–515. https://doi.org/10.1089/rej.2019.2267.

Reed JL, Terada T, Cotie LM, Tulloch HE, Leenen FH, Mistura M, et al. The effects of high-intensity interval training, Nordic walking and moderate-to-vigorous intensity continuous training on functional capacity, depression and quality of life in patients with coronary artery disease enrolled in cardiac rehabilitation: A randomized controlled trial (CRX study). Progress in Cardiovascular Diseases. 2022;70: 73–83. https://doi.org/10.1016/j.pcad.2021.07.002.

Shulman LM, Katzel LI, Ivey FM, Sorkin JD, Favors K, Anderson KE, et al. Randomized Clinical Trial of 3 Types of Physical Exercise for Patients With Parkinson Disease. JAMA Neurology. 2013;70(2): 183. https://doi.org/10.1001/jamaneurol.2013.646.

Duchesne C, Gheysen F, Bore A, Albouy G, Nadeau A, Robillard ME, et al. Influence of aerobic exercise training on the neural correlates of motor learning in Parkinson’s disease individuals. NeuroImage: Clinical. 2016;12: 559–569. https://doi.org/10.1016/j.nicl.2016.09.011.

Fisher BE, Wu AD, Salem GJ, Song J, Lin CH (Janice), Yip J, et al. The Effect of Exercise Training in Improving Motor Performance and Corticomotor Excitability in People With Early Parkinson’s Disease. Archives of Physical Medicine and Rehabilitation. 2008;89(7): 1221–1229. https://doi.org/10.1016/j.apmr.2008.01.013.

Dibble LE, Hale TF, Marcus RL, Droge J, Gerber JP, LaStayo PC. High‐intensity resistance training amplifies muscle hypertrophy and functional gains in persons with Parkinson’s disease. Movement Disorders. 2006;21(9): 1444–1452. https://doi.org/10.1002/mds.20997.

Morberg BM, Jensen J, Bode M, Wermuth L. The impact of high intensity physical training on motor and non-motor symptoms in patients with Parkinson’s disease (PIP): A preliminary study. NeuroRehabilitation. 2014;35(2): 291–298. https://doi.org/10.3233/NRE-141119.

Dibble LE, Hale TF, Marcus RL, Gerber JP, LaStayo PC. High intensity eccentric resistance training decreases bradykinesia and improves quality of life in persons with Parkinson’s disease: A preliminary study. Parkinsonism & Related Disorders. 2009;15(10): 752–757. https://doi.org/10.1016/j.parkreldis.2009.04.009.

Kelly NA, Ford MP, Standaert DG, Watts RL, Bickel CS, Moellering DR, et al. Novel, high-intensity exercise prescription improves muscle mass, mitochondrial function, and physical capacity in individuals with Parkinson’s disease. Journal of Applied Physiology. 2014;116(5): 582–592. https://doi.org/10.1152/japplphysiol.01277.2013.

Pechstein AE, Gollie JM, Guccione AA. Fatigability and Cardiorespiratory Impairments in Parkinson’s Disease: Potential Non-Motor Barriers to Activity Performance. Journal of Functional Morphology and Kinesiology. 2020;5(4): 78. https://doi.org/10.3390/jfmk5040078.

Petkus AJ, Jarrahi B, Holschneider DP, Gomez ME, Filoteo JV, Schiehser DM, et al. Thalamic volume mediates associations between cardiorespiratory fitness (VO2max) and cognition in Parkinson’s disease. Parkinsonism & Related Disorders. 2021;86: 19–26. https://doi.org/10.1016/j.parkreldis.2021.03.019.

Buchheit M, Laursen PB. High-Intensity Interval Training, Solutions to the Programming Puzzle: Part I: Cardiopulmonary Emphasis. Sports Medicine. 2013;43(5): 313–338. https://doi.org/10.1007/s40279-013-0029-x.

De Oliveira MPB, Lobato DFM, Smaili SM, Carvalho C, Borges JBC. Effect of aerobic exercise on functional capacity and quality of life in individuals with Parkinson’s disease: A systematic review of randomized controlled trials. Archives of Gerontology and Geriatrics. 2021;95: 104422. https://doi.org/10.1016/j.archger.2021.104422.

Ferreira RM, Alves WMGDC, Lima TAD, Alves TGG, Alves Filho PAM, Pimentel CP, et al. The effect of resistance training on the anxiety symptoms and quality of life in elderly people with Parkinson’s disease: a randomized controlled trial. Arquivos de Neuro-Psiquiatria. 2018;76(8): 499–506. https://doi.org/10.1590/0004-282x20180071.

Vieira De Moraes Filho A, Chaves SN, Martins WR, Tolentino GP, Homem R, Landim De Farias G, et al. Progressive Resistance Training Improves Bradykinesia, Motor Symptoms and Functional Performance in Patients with Parkinson’s Disease. Clinical Interventions in Aging. 2020;Volume 15: 87–95. https://doi.org/10.2147/CIA.S231359.

Yang X, Wang Z. Effectiveness of Progressive Resistance Training in Parkinson’s Disease: A Systematic Review and Meta-Analysis. European Neurology. 2023;86(1): 25–33. https://doi.org/10.1159/000527029.

Sale DG. Neural adaptation to resistance training: Medicine & Science in Sports & Exercise. 1988;20(Sup 1): S135–S145. https://doi.org/10.1249/00005768-198810001-00009.

Škarabot J, Brownstein CG, Casolo A, Del Vecchio A, Ansdell P. The knowns and unknowns of neural adaptations to resistance training. European Journal of Applied Physiology. 2021;121(3): 675–685. https://doi.org/10.1007/s00421-020-04567-3.

Dishman RK, Berthoud H, Booth FW, Cotman CW, Edgerton VR, Fleshner MR, et al. Neurobiology of Exercise. Obesity. 2006;14(3): 345–356. https://doi.org/10.1038/oby.2006.46.

Matta Mello Portugal E, Cevada T, Sobral Monteiro-Junior R, Teixeira Guimarães T, Da Cruz Rubini E, Lattari E, et al. Neuroscience of Exercise: From Neurobiology Mechanisms to Mental Health. Neuropsychobiology. 2013;68(1): 1–14. https://doi.org/10.1159/000350946.

Montero‐Odasso M, Speechley M, Muir‐Hunter SW, Sarquis‐Adamson Y, Sposato LA, Hachinski V, et al. Motor and Cognitive Trajectories Before Dementia: Results from Gait and Brain Study. Journal of the American Geriatrics Society. 2018;66(9): 1676–1683. https://doi.org/10.1111/jgs.15341.

Ruiz-González D, Hernández-Martínez A, Valenzuela PL, Morales JS, Soriano-Maldonado A. Effects of physical exercise on plasma brain-derived neurotrophic factor in neurodegenerative disorders: A systematic review and meta-analysis of randomized controlled trials. Neuroscience & Biobehavioral Reviews. 2021;128: 394–405. https://doi.org/10.1016/j.neubiorev.2021.05.025.

de Sousa Fernandes MS, Ordônio TF, Santos GCJ, Santos LER, Calazans CT, Gomes DA, et al. Effects of Physical Exercise on Neuroplasticity and Brain Function: A Systematic Review in Human and Animal Studies. Neural Plasticity. 2020;2020(1): 8856621. https://doi.org/10.1155/2020/8856621.

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