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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2022.tde-20042023-113810
Document
Author
Full name
Michelle Cristina Oliveira da Silva
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2022
Supervisor
Committee
Silva, Hamilton Augusto Roschel da (President)
Kanegusuku, Hélcio
Batista, Carla da Silva
Gualano, Bruno
Title in Portuguese
Efeitos de uma sessão de treinamento com restrição de fluxo nas respostas hemodinâmicas e vasculares em indivíduos com osteoartrite de joelho
Keywords in Portuguese
Pressão arterial
Reflexo pressor do exercício
Treinamento com oclusão
Vasodilatação mediada pelo fluxo
Abstract in Portuguese
O exercício de força com restrição de fluxo sanguíneo (EFRF) tem sido sugerido como estratégia eficaz para o aumento da força e funcionalidade em pacientes com osteoartrite (OA) de joelho. Entretanto, dúvidas ainda permanecem sobre a segurança cardiovascular do EFRF, pois hipotetiza-se que esse tipo de exercício possa promover maiores picos pressóricos e alterações negativas na função vascular. Desta forma, o presente estudo avaliou o impacto de uma sessão de EFRF sobre respostas hemodinâmicas e vasculares em mulheres com OA de joelho. Para isto, 12 mulheres pós-menopausa com OA de joelho realizaram quatro sessões experimentais compostas da realização de 4 séries dos exercícios Leg Press 45º (LP45) e cadeira extensora (CE) nas seguintes condições: i) 15 repetições a 30% de 1RM sem restrição de fluxo (30%1RM); ii) 15 repetições a 30% de 1RM com restrição de fluxo (30%1RM+oclusão); iii) 8 repetições a 80% de 1RM sem restrição de fluxo (80%1RM); iv) sessão controle sem exercício. Durante o protocolo, a frequência cardíaca e a pressão arterial sistólica e diastólica (PAS e PAD) foram obtidas continuamente e o shear rate e vasodilatação mediada pelo fluxo (VMF) foram avaliados nos períodos pré e pós-exercício. Esses desfechos foram comparados entre as sessões experimentais por meio da análise de variância para medidas repetidas com post-hoc de Tukey (p < 0,05). Em ambos os execícios, foram observados maiores valores de PAS e PAD na sessão 30%1RM+oclusão (LP45: PAS/PADpico=208/117mmHg; CE: PAS/PADpico=214/121mmHg) em comparação às sessões 30%1RM (LP45: PAS/PADpico=177/99mmHg; CE: PAS/PADpico=188/105mmHg), 80%1RM (LP45: PAS/PADpico=184/100mmHg; CE: PAS/PADpico=188/108mmHg) e controle (P<0,05). Por outro lado, não foram observadas diferenças na VMF e shear rate entre as sessões. Conclui-se que o EFRF promove maiores picos pressóricos durante o exercício, o que pode levar a um maior risco de eventos cardiovasculares em indivíduos com risco cardiovascular aumentado. No entanto, este estresse hemodinâmico parece não produzir alterações vasculares agudas
Title in English
Effects of a single session of blood flow-restricted training on hemodynamic and vascular responses in individuals with knee osteoarthritis
Keywords in English
Arterial pressure
Exercise pressor reflex
Flow-mediated dilation
Occlusion training
Abstract in English
Resistance exercise with blood-flow restriction (RE-BFR) have been recommended as an effective strategy to increase strength and improve functionality in patients with knee osteoarthritis (OA). However, questions remain about the cardiovascular safety of RE-BFR as it is hypothesized that this type of exercise may promote larger increases in blood pressure and negative changes in vascular function. Therefore, this study assessed the acute impact of a single session of RE-BFR on hemodynamic and vascular responses in women with knee OA. Twelve women with knee OA performed four sessions of 4 sets of the exercises Leg Press 45º (LP45) and knee extension (KE) in the following conditions: i) 15 repetitions at 30%1RM without blood flow restriction (30%1RM); ii) 15 repetitions at 30%1RM with blood flow restriction (30%1RM+occlusion); iii) 15 repetitions at 80%1RM without blood flow restriction (80%1RM) and; iv) control session. During the protocol, heart rate and systolic and diastolic blood pressure (SBP and DBP) were continuously recorded and the shear rate and flow-mediated dilation (FMD) were assessed pre- and post-exercise. These outcomes were compared between sessions using the two-way repeated analysis of variance with Tukeys post-hoc (P<0,05). In both exercises, SBP and DBP were higher in the 30%1RM+occlusion session (LP45: SBP/DBPpeak=208/117mmHg; KE: SBP/DBPpeak=214/121mmHg) in comparison with the sessions 30%1RM (LP45: SBP/DBPpeak=177/99mmHg; KE: SBP/DBPpeak=188/105mmHg), 80%1RM (LP45: SBP/DBPpeak=184/100mmHg; KE: SBP/DBPpeak=188/108mmHg) and control (P<0,05). On the other hand, there were no differences in FMD and shear rate between sessions. It is concluded that RE-BFR promotes higher blood pressure responses during exercise, which may lead to an increased risk of cardiovascular events in subjects with knee OA. However, this hemodynamic stress is not accompanied by deterioration of vascular function
 
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Publishing Date
2023-05-05
 
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