Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFSCAR |
Texto Completo: | https://repositorio.ufscar.br/handle/ufscar/9824 |
Resumo: | Fibromyalgia syndrome (FMS) has multifactorial etiology characterized by various clinical manifestations and low ability to perform physical activities which contributes to low aerobic functional capacity, and consequently worsens pain sensitivity and quality of life. In addition, studies have shown that autonomic dysfunction plays an important role in FMS. Thus, the present thesis consisted of three studies in order to elucidate unknown aspects regarding the aforementioned dysfunctions. The Study I, entitled Reliability of heart period and systolic arterial pressure variabilities in women with fibromyalgia syndrome", aimed to define absolute and relative reliability of spectral indices of cardiovascular autonomic control in the supine position in women with FMS. The results presented good relative reliability, indicating that the indices can be useful as parameters to quantify if a variation was consistent and accurate in the retest besides adding crucial information for clinical research and clinical evaluation of FMS patients. The Study II, entitled "Cardiovascular autonomic control and baroreflex sensitivity after aquatic physical training in women with fibromyalgia: a randomized controlled clinical trial", aimed to evaluate the effect of aquatic physical training (APT) on cardiovascular autonomic control and baroreflex sensitivity (BRS) in women with FMS. After the APT, in supine position, training group (TG) showed a cardiovascular autonomic profile characterized by higher values of HFRR (nu) (p=0.01) and lower values of LFRR/HFRR (p=0.03) and LFSAP (p=0.04) compared to control group (CG). In addition, the indexes of BRS resulted increased in TG compared to CG both in supine (p=0.05) and during standing (p=0.03). The Study III, entitled " Oxygen uptake and body composition after aquatic physical training in women with fibromyalgia: a randomized controlled trial", aimed to investigate whether APT can help improve body composition and increase the aerobic functional capacity in women with FMS, and whether oxygen uptake (VO2) related to lower body mass (LBM) can better quantify the functional capacity of this population. APT with standardized intensities did not cause significant changes in body composition, but was effective in promoting increased VO2 at peak CPET in women with FMS. However, VO2 related to LBM more accurately reflected changes in aerobic functional capacity at ventilatory anaerobic threshold (VAT) level after to APT. The Study IV, entitled “Effects of aquatic training and detraining on women with fibromyalgia: controlled randomized clinical trial” aimed to evaluate variables VO2 relative to LBM and clinical symptomatology in women with FMS submitted to APT and after 16 weeks of detraining period, and to evaluate the association between the magnitude of VO2 improvement relative to LBM and clinical symptomatology. After APT, TG presented an increase in VO2 relative to LBM (p <0.05), in addition to an increase in pressure pain threshold (PPT) and visual analogue scale (VAS) well-being and lower VAS pain and Fibromyalgia Impact Questionnaire score (FIQ) (p <0.05). However, these improvements were not maintained after the 16-week detraining period (p> 0.05). In addition, no significant correlations were observed between improvement of clinical manifestations and increased VO2 relative to LBM after APT (p> 0.05). |
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Andrade, Carolina PieroniSilva, Ester dahttp://lattes.cnpq.br/0120120410847507Zamunér, Antonio Robertohttp://lattes.cnpq.br/7721580783871165http://lattes.cnpq.br/611122780891352400256ade-8f33-4396-845c-808d8524faa62018-04-26T14:07:00Z2018-04-26T14:07:00Z2018-01-11ANDRADE, Carolina Pieroni. Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica. 2018. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2018. Disponível em: https://repositorio.ufscar.br/handle/ufscar/9824.https://repositorio.ufscar.br/handle/ufscar/9824Fibromyalgia syndrome (FMS) has multifactorial etiology characterized by various clinical manifestations and low ability to perform physical activities which contributes to low aerobic functional capacity, and consequently worsens pain sensitivity and quality of life. In addition, studies have shown that autonomic dysfunction plays an important role in FMS. Thus, the present thesis consisted of three studies in order to elucidate unknown aspects regarding the aforementioned dysfunctions. The Study I, entitled Reliability of heart period and systolic arterial pressure variabilities in women with fibromyalgia syndrome", aimed to define absolute and relative reliability of spectral indices of cardiovascular autonomic control in the supine position in women with FMS. The results presented good relative reliability, indicating that the indices can be useful as parameters to quantify if a variation was consistent and accurate in the retest besides adding crucial information for clinical research and clinical evaluation of FMS patients. The Study II, entitled "Cardiovascular autonomic control and baroreflex sensitivity after aquatic physical training in women with fibromyalgia: a randomized controlled clinical trial", aimed to evaluate the effect of aquatic physical training (APT) on cardiovascular autonomic control and baroreflex sensitivity (BRS) in women with FMS. After the APT, in supine position, training group (TG) showed a cardiovascular autonomic profile characterized by higher values of HFRR (nu) (p=0.01) and lower values of LFRR/HFRR (p=0.03) and LFSAP (p=0.04) compared to control group (CG). In addition, the indexes of BRS resulted increased in TG compared to CG both in supine (p=0.05) and during standing (p=0.03). The Study III, entitled " Oxygen uptake and body composition after aquatic physical training in women with fibromyalgia: a randomized controlled trial", aimed to investigate whether APT can help improve body composition and increase the aerobic functional capacity in women with FMS, and whether oxygen uptake (VO2) related to lower body mass (LBM) can better quantify the functional capacity of this population. APT with standardized intensities did not cause significant changes in body composition, but was effective in promoting increased VO2 at peak CPET in women with FMS. However, VO2 related to LBM more accurately reflected changes in aerobic functional capacity at ventilatory anaerobic threshold (VAT) level after to APT. The Study IV, entitled “Effects of aquatic training and detraining on women with fibromyalgia: controlled randomized clinical trial” aimed to evaluate variables VO2 relative to LBM and clinical symptomatology in women with FMS submitted to APT and after 16 weeks of detraining period, and to evaluate the association between the magnitude of VO2 improvement relative to LBM and clinical symptomatology. After APT, TG presented an increase in VO2 relative to LBM (p <0.05), in addition to an increase in pressure pain threshold (PPT) and visual analogue scale (VAS) well-being and lower VAS pain and Fibromyalgia Impact Questionnaire score (FIQ) (p <0.05). However, these improvements were not maintained after the 16-week detraining period (p> 0.05). In addition, no significant correlations were observed between improvement of clinical manifestations and increased VO2 relative to LBM after APT (p> 0.05).A disfunção autonômica exerce importante papel na sintomatologia da síndrome fibromiálgica (SFM), caracterizada por hiperatividade simpática em repouso, alta prevalência de síncope e pré síncope e aumento exacerbado da frequência cardíaca (FC) frente ao esforço físico. Além disso, estudos têm mostrado que essa síndrome apresenta etiologia multifatorial caracterizada por outras manifestações clínicas e baixa capacidade em realizar atividades físicas o que contribui para a baixa capacidade funcional aeróbia, e consequentemente piora a sensibilidade dolorosa e a qualidade de vida. Assim, visando elucidar esses aspectos, foram desenvolvidos quatro estudos sobre as disfunções supracitadas. O Estudo I, intitulado “Confiabilidade da variabilidade da frequência cardíaca e da pressão arterial sistólica em mulheres com síndrome fibromiálgica”. Esse estudo teve como objetivo investigar a confiabilidade absoluta e relativa dos índices espectrais da modulação autonômica cardiovascular, na posição supina, em mulheres com SFM. Os resultados mostraram boa confiabilidade relativa, o que sugere que os índices podem ser úteis como parâmetros para quantificar se a variação modulação autonômica cardiovascular foi consistente e precisa no reteste, além de agregar informações cruciais para a pesquisa e avaliação clínica em pacientes com SFM. A partir dos resultados da confiabilidade do Estudo I, foi realizado o Estudo II, intitulado “Controle autonômico cardiovascular e sensibilidade barorreflexa após o treinamento físico aquático em mulheres com fibromialgia: estudo clínico randomizado controlado”. Esse estudo teve como objetivo avaliar o efeito do Treinamento físico aquático (TFA) no controle autonômico cardiovascular e na sensibilidade barorreflexa (SBR) em mulheres com SFM. Após o TFA, na postura supina, o grupo treinado (GT) apresentou aumento do índice AFRR (u.n.) (p=0,01) e redução dos valores de BFRR/AFRR (p=0,03) e BFPAS (p=0,04) comparado ao grupo controle (GC). Além disso, o GT apresentou aumento dos índices da SBR comparado ao GC na postura supina (p<0,05) e durante a mudança ortostática ativa. Tendo em vista que o TFA programado em intensidade individualizada, baseado no limiar de anaerobiose, contribuiu para o aumento da modulação vagal e redução da simpática e melhora da BRS, visamos dar continuidade ao estudo para investigar se o TFA poderia contribuir para a melhora de outras variáveis, como o consumo de oxigênio (VO2) relativo à massa corporal magra (MCM). Assim, foi realizado o Estudo III intitulado “Consumo de oxigênio e composição corporal após treinamento físico aquático em mulheres com fibromialgia: Estudo randomizado e controlado”. O TFA, com intensidades padronizadas, não promoveu mudanças significativas na composição corporal, mas foi eficaz em promover aumento do VO2 no pico do TECP em mulheres com SFM. Além disso, o VO2 relativo à MCM refletiu mais adequadamente as modificações da capacidade funcional aeróbia no nível do limiar de anaerobiose ventilatório (LAV) frente o TFA. Tendo em vista essas adaptações, consideramos importante verificar se elas se mantiveram após 16 semanas de interrupção do TFA. Assim, foi desenvolvido o Estudo IV, intitulado “Efeitos do treino e destreino aquático em mulheres com fibromialgia: estudo clínico randomizado controlado”. Cujo o objetivo foi avaliar a associação entre a magnitude da melhora do VO2 relativo à MCM e a sintomatologia clínica, após o TFA, bem como avaliar o efeito do TFA e do destreino sobre VO2 relativo à MCM e à sintomatologia clínica em mulheres com SFM. O GT apresentou aumento do VO2 relativo à MCM (p<0,05), além de aumento no limiar de dor à pressão (LDP) e escala visual analógica (EVA) bem estar e menor EVA dor e menor impacto da fibromialgia na qualidade de vida (QIF) (p<0,05). Não foram observadas correlações significativas entre essas variáveis após o TFA. Após o período de 16 semanas de destreino, houve redução dessas variáveis próximo aos valores basais (p>0,05). Esses resultados, sugerem que o TFA deva ser realizado continuamente visando a melhora da sintomatologia clínica e aumento da capacidade funcional aeróbia em mulheres com SFM.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)CNPq: 483032/2012-3CNPq: 307187/2013-6FAPESP: 2011/22122-5FAPESP: 2013/17504-1FAPESP: 2015/23449-9porUniversidade Federal de São CarlosCâmpus São CarlosPrograma de Pós-Graduação em Fisioterapia - PPGFtUFSCarSíndrome fibromiálgicaControle autonômico cardiovascularSensibilidade barorreflexaTreinamento físico aquáticoAptidão cardiovascularFibromyalgia syndromeCardiovascular autonomic controlBaroreflex sensitivityAquatic physical trainingCardiorespiratory fitnessCIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALEfeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgicainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisOnline7b52f307-371f-40ba-9e95-dfc2ed1b86e8info:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFSCARinstname:Universidade Federal de São Carlos (UFSCAR)instacron:UFSCARORIGINALTESE CAROLINA PIERONI ANDRADE.pdfTESE CAROLINA PIERONI ANDRADE.pdfTese de doutorado Carolina Pieroni Andradeapplication/pdf8332284https://repositorio.ufscar.br/bitstream/ufscar/9824/3/TESE%20CAROLINA%20PIERONI%20ANDRADE.pdfaf8cc227ca77cf74162ceca905947342MD53CARTA COMPROVANTE.pdfCARTA COMPROVANTE.pdfCarta comprovante assinada pelo orientadorapplication/pdf204977https://repositorio.ufscar.br/bitstream/ufscar/9824/4/CARTA%20COMPROVANTE.pdff0128d83df665eb44c7ee66c13076d7eMD54LICENSElicense.txtlicense.txttext/plain; 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dc.title.por.fl_str_mv |
Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica |
title |
Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica |
spellingShingle |
Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica Andrade, Carolina Pieroni Síndrome fibromiálgica Controle autonômico cardiovascular Sensibilidade barorreflexa Treinamento físico aquático Aptidão cardiovascular Fibromyalgia syndrome Cardiovascular autonomic control Baroreflex sensitivity Aquatic physical training Cardiorespiratory fitness CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
title_short |
Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica |
title_full |
Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica |
title_fullStr |
Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica |
title_full_unstemmed |
Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica |
title_sort |
Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica |
author |
Andrade, Carolina Pieroni |
author_facet |
Andrade, Carolina Pieroni |
author_role |
author |
dc.contributor.authorlattes.por.fl_str_mv |
http://lattes.cnpq.br/6111227808913524 |
dc.contributor.author.fl_str_mv |
Andrade, Carolina Pieroni |
dc.contributor.advisor1.fl_str_mv |
Silva, Ester da |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/0120120410847507 |
dc.contributor.advisor-co1.fl_str_mv |
Zamunér, Antonio Roberto |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/7721580783871165 |
dc.contributor.authorID.fl_str_mv |
00256ade-8f33-4396-845c-808d8524faa6 |
contributor_str_mv |
Silva, Ester da Zamunér, Antonio Roberto |
dc.subject.por.fl_str_mv |
Síndrome fibromiálgica Controle autonômico cardiovascular Sensibilidade barorreflexa Treinamento físico aquático Aptidão cardiovascular |
topic |
Síndrome fibromiálgica Controle autonômico cardiovascular Sensibilidade barorreflexa Treinamento físico aquático Aptidão cardiovascular Fibromyalgia syndrome Cardiovascular autonomic control Baroreflex sensitivity Aquatic physical training Cardiorespiratory fitness CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
dc.subject.eng.fl_str_mv |
Fibromyalgia syndrome Cardiovascular autonomic control Baroreflex sensitivity Aquatic physical training Cardiorespiratory fitness |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
description |
Fibromyalgia syndrome (FMS) has multifactorial etiology characterized by various clinical manifestations and low ability to perform physical activities which contributes to low aerobic functional capacity, and consequently worsens pain sensitivity and quality of life. In addition, studies have shown that autonomic dysfunction plays an important role in FMS. Thus, the present thesis consisted of three studies in order to elucidate unknown aspects regarding the aforementioned dysfunctions. The Study I, entitled Reliability of heart period and systolic arterial pressure variabilities in women with fibromyalgia syndrome", aimed to define absolute and relative reliability of spectral indices of cardiovascular autonomic control in the supine position in women with FMS. The results presented good relative reliability, indicating that the indices can be useful as parameters to quantify if a variation was consistent and accurate in the retest besides adding crucial information for clinical research and clinical evaluation of FMS patients. The Study II, entitled "Cardiovascular autonomic control and baroreflex sensitivity after aquatic physical training in women with fibromyalgia: a randomized controlled clinical trial", aimed to evaluate the effect of aquatic physical training (APT) on cardiovascular autonomic control and baroreflex sensitivity (BRS) in women with FMS. After the APT, in supine position, training group (TG) showed a cardiovascular autonomic profile characterized by higher values of HFRR (nu) (p=0.01) and lower values of LFRR/HFRR (p=0.03) and LFSAP (p=0.04) compared to control group (CG). In addition, the indexes of BRS resulted increased in TG compared to CG both in supine (p=0.05) and during standing (p=0.03). The Study III, entitled " Oxygen uptake and body composition after aquatic physical training in women with fibromyalgia: a randomized controlled trial", aimed to investigate whether APT can help improve body composition and increase the aerobic functional capacity in women with FMS, and whether oxygen uptake (VO2) related to lower body mass (LBM) can better quantify the functional capacity of this population. APT with standardized intensities did not cause significant changes in body composition, but was effective in promoting increased VO2 at peak CPET in women with FMS. However, VO2 related to LBM more accurately reflected changes in aerobic functional capacity at ventilatory anaerobic threshold (VAT) level after to APT. The Study IV, entitled “Effects of aquatic training and detraining on women with fibromyalgia: controlled randomized clinical trial” aimed to evaluate variables VO2 relative to LBM and clinical symptomatology in women with FMS submitted to APT and after 16 weeks of detraining period, and to evaluate the association between the magnitude of VO2 improvement relative to LBM and clinical symptomatology. After APT, TG presented an increase in VO2 relative to LBM (p <0.05), in addition to an increase in pressure pain threshold (PPT) and visual analogue scale (VAS) well-being and lower VAS pain and Fibromyalgia Impact Questionnaire score (FIQ) (p <0.05). However, these improvements were not maintained after the 16-week detraining period (p> 0.05). In addition, no significant correlations were observed between improvement of clinical manifestations and increased VO2 relative to LBM after APT (p> 0.05). |
publishDate |
2018 |
dc.date.accessioned.fl_str_mv |
2018-04-26T14:07:00Z |
dc.date.available.fl_str_mv |
2018-04-26T14:07:00Z |
dc.date.issued.fl_str_mv |
2018-01-11 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
ANDRADE, Carolina Pieroni. Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica. 2018. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2018. Disponível em: https://repositorio.ufscar.br/handle/ufscar/9824. |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufscar.br/handle/ufscar/9824 |
identifier_str_mv |
ANDRADE, Carolina Pieroni. Efeitos da hidroterapia sobre o sistema cardiorrespiratório e manifestações clínicas em mulheres com síndrome fibromiálgica. 2018. Tese (Doutorado em Fisioterapia) – Universidade Federal de São Carlos, São Carlos, 2018. Disponível em: https://repositorio.ufscar.br/handle/ufscar/9824. |
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https://repositorio.ufscar.br/handle/ufscar/9824 |
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por |
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openAccess |
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Universidade Federal de São Carlos Câmpus São Carlos |
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Programa de Pós-Graduação em Fisioterapia - PPGFt |
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UFSCar |
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Universidade Federal de São Carlos Câmpus São Carlos |
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Universidade Federal de São Carlos (UFSCAR) |
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UFSCAR |
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Repositório Institucional da UFSCAR |
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