Effects of Exercise Training on Cardiovascular and Autonomic Parameters in Stroke Survivors: A Systematic Review

Gambassi, Bruno Bavaresco; Almeida, Fabiano de Jesus Furtado; Almeida, Ana de; Ribeiro, João Alberto; Novais, Tânia Maria Gaspar; Schwingel, Paulo Adriano; Queiroz, Ciro Oliveira; Santos, Clarcson Plácido Conceição dos; Rodrigues, Bruno

doi:10.5935/2359-4802.20190047

Cited by 3 publications

(4 citation statements)

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“…Além disso, os estudos incluídos na avaliação da qualidade metodológica, apresentaram uma pontuação média na escala de qualidade PEDro de 5,6, sendo que apenas 1 estudo (Cvetković et al, 2018) foi considerado uma evidência de nível 1 boa, os demais foram considerados evidência de nível 2aceitável ou ruim (Gambassi et al, 2019). A qualidade metodológica pode comprometer os achados do presente estudo, uma vez que a média do escore PEDro se encontra na classificação de estudos "aceitáveis" o que não confere uma boa qualidade.…”

Section: Discussionunclassified

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Efeitos do treinamento físico na pressão arterial de adolescentes com sobrepeso e obesidade: Uma revisão sistemática

Coelho

Pinto

Lino

et al. 2021

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O objetivo desta revisão foi analisar os efeitos do treinamento físico na pressão arterial de adolescentes com sobrepeso e obesidade, buscando identificar a magnitude do efeito em relação ao tipo de treinamento. A presente revisão utilizou as bases de dados do PUBMED, SCOPUS, WEB OF SCIENCE, COCHRANE LIBRARY e LILACS. Os critérios de inclusão foram: (1) Ensaios Clínicos Randomizados; (2) Adolescentes com sobrepeso e obesidade; (3) Mínimo de 8 semanas de Intervenção com treinamento físico; (4) medidas de resultados de pressão arterial pré e pós treinamento; (5) grupo controle sem intervenção e mantendo seus hábitos diários. Os estudos selecionados foram analisados em sua qualidade metodológica pela escala PEDro. Oito artigos, de um total de 625, atenderam aos critérios de inclusão, totalizando 249 participantes. Três estudos se utilizaram do treinamento físico aeróbio como intervenção, dois do treinamento físico de força e quatro estudos da combinação dos treinamentos, aeróbio e de força, para responderem seus objetivos. Dos trabalhos selecionados, cinco apresentaram reduções significativas em seus valores de pressão arterial após intervenção do treinamento, principalmente na PAS. Os resultados sugerem que o treinamento físico é capaz de reduzir os valores de pressão arterial, independentemente do tipo, sendo ele de características aeróbias, de força, ou a combinação das duas. Embora os valores de pressão arterial tendam a apresentar maior redução quando realizado o treinamento aeróbio em comparação ao treinamento de força ou combinado, a literatura carece de consenso sobre as características de cada tipo de treinamento e a melhor estratégia de prescrição.

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Section: Discussionunclassified

“…A pontuação final pode variar entre 0 e 10 pontos (Shiwa et al, 2011). Um estudo com uma pontuação PEDro de 7 foi considerado evidência de nível 1 (7-8 bom, 9-10 excelente) e um estudo com uma pontuação de 6 foi considerado evidência de nível 2 (5-6 aceitável, ≤ 4 ruim) (Gambassi et al, 2019).…”

Section: Análise Qualitativa Dos Estudosunclassified

Efeitos do treinamento físico na pressão arterial de adolescentes com sobrepeso e obesidade: Uma revisão sistemática

Coelho

Pinto

Lino

et al. 2021

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“…Thus, cardiovascular rehabilitation for these patients is important and can be achieved through aerobic training. The average time for aerobic training to result in an adaptive response of the autonomous system is approximately two to three months, with moderate intensity 47,[49][50][51] , which makes the rehabilitation process costly both in terms of time and money, causing many individuals to give up during this process.…”

Section: Discussionmentioning

confidence: 99%

Effect of Transcranial Direct Current Stimulation associated with aerobic exercise on the autonomic modulation of hemiparetic individuals due to stroke: a study protocol for a double-blind randomized controlled trial

et al. 2021

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Background: Individuals after a stroke have an imbalance in the autonomic nervous system, which increases the risk of death or recurrent episodes of stroke. Transcranial Direct Current Stimulation (tDCS) combined with aerobic exercise has shown an effect on the modulation of this system. Objective: The Heart Rate Variability (HRV) and the distance traveled on the exercise bike will be assessed to verify the additional impact of tDCS combined with aerobic exercise on individuals with chronic stroke sequelae. Methods: The 34 adult individuals with diagnoses of chronic stroke will be randomized into two aerobic exercise intervention groups: G1 (with active tDCS) and G2 (with sham tDCS), three times a week, for 12 weeks. Procedures: tDCS will be implemented during the aerobic exercise with the anodal electrode positioned over the lateral dorsal prefrontal left cortex, and the cathodal electrode over the contralateral supraorbital region, with 2mA, for 20 minutes. Assessments will be carried out pre, immediately after the intervention, and on the 12th, 24th, 36th interventions, and 30 days later. The HRV data that are pulse interval (PI), square root of the mean of the squares of the differences between adjacent normal RR intervals (rMSSD), absolute high frequency (HF), absolute low frequency (LF), high and low frequency ratio (LF / HF) will be collected using a cardio frequency meter. The analysis of the distance traveled on the exercise bike before and after interventions will be analyzed in meters. Discussion: The autonomic control via brain networks after a stroke can be altered and can promote an increase in sympathetic tone, and a higher risk of sudden death or relapse of stroke. It is crucial to demonstrate the effectiveness of available treatments to improve the autonomic function. Trial registration: The study is registered as a BRAZILIAN CLINICAL TEST RECORD (ReBEC): U1111-1222-4588 on the 2018/10/16

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“…To the best of our knowledge, there have been few experimental studies evaluating the effect of physical activity on HRV in stroke patients, and their results have at times been divergent. In the chronic phase of recovery, aerobic and resistance exercise programs increase vagal nerve activity in stroke patients [21][22][23]. While HRV seems to gradually increase after stroke, HRV does not return to values before stroke in the subacute phase of recovery [24].…”

Section: Introductionmentioning

confidence: 99%

The effect of a home-based coaching program on heart rate variability in subacute stroke patients: a randomized controlled trial

Guediri

Chaparro

Borel

et al. 2022

International Journal of Rehabilitation Research

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Autonomic imbalance in stroke is characterized by increased sympathetic activity and reduced vagal nerve activity. Physical activity could be a strategy to counteract autonomic control impairments after a stroke. The aim of the study was to evaluate the effect on heart rate variability of a 6-month coaching program in a home setting in subacute stroke patients. Eighty-four stroke patients participated in the study. They were randomly assigned to the experimental group or the control group. The intervention was a coaching program, consisting of physical activity, home visits and a weekly phone call. Patients were evaluated after hospital discharge (T0) and at the end of the 6-month period (T1). Heart rate variability measures were recorded in the supine and orthostatic positions. Time and frequency domain values were treated using Kubios. Distance on 6 minutes walking test (6MWT), Barthel and motricity index and modified functional ambulation categories were evaluated. No effects were found on time and frequency domain values in the supine and orthostatic positions in either group. Walking distance on 6MWT increased significantly between T0 and T1 in experimental group (377 ± 141–448 ± 140 m; P < 0.02) with no effects in control group (373.6 ± 150.6–394.6 ± 176.4 m). No other functional effects were found. A coaching program in a home setting had no effect on heart rate variability, probably due to time of recovery and exercise intensity. Future research is needed to understand the lack of changes in heart rate variability by physical activity in subacute stroke patients.

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Effects of Exercise Training on Cardiovascular and Autonomic Parameters in Stroke Survivors: A Systematic Review

Cited by 3 publications

References 11 publications

Efeitos do treinamento físico na pressão arterial de adolescentes com sobrepeso e obesidade: Uma revisão sistemática

Efeitos do treinamento físico na pressão arterial de adolescentes com sobrepeso e obesidade: Uma revisão sistemática

Effect of Transcranial Direct Current Stimulation associated with aerobic exercise on the autonomic modulation of hemiparetic individuals due to stroke: a study protocol for a double-blind randomized controlled trial

The effect of a home-based coaching program on heart rate variability in subacute stroke patients: a randomized controlled trial

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