Efeitos da terapia vibratória sistêmica na funcionalidade de indivíduos com doença pulmonar obstrutiva crônica e de mulheres na pós-menopausa

Abstract

Systemic vibration therapy (SVT) has been used as an intervention in several populations, including individuals with chronic obstructive pulmonary disease (COPD) and in postmenopausal women.. COPD is progressive and irreversible, characterized by airflow limitation and an inflammatory response that compromise functionality and quality of life (QoL). Pulmonary rehabilitation (PR) is suggested for individuals with COPD and is effective in relieving dyspnea and fatigue, improving muscle function and QoL. Physical exercise (PE) is part of PR interventions. Exercise intolerance limits the individual with COPD from fully benefiting from PR, and whole body vibration exercise (WBVE), a type of PE, which is generated in systemic vibration therapy (SVT), could benefit individuals with COPD. WBVE is produced when mechanical vibration (MV) generated on a vibrating platform (VP) is transmitted to an individual. Menopausal women have a series of clinical impairments and PE is suggested for them. WBVE has been studied as an effective and safe form of exercise also for individuals with COPD and for postmenopausal women. Biomechanical parameters of MV, patient positioning, working time and resting time should be considered when designing an WBVE protocol. The objectives of this thesis were (i) in individuals with COPD, to evaluate, in an observational study, the effects of SVT on functionality through the acute effects of SVT on anterior trunk flexion (ATF), on subjective perception of exertion (SPE) and on hand grip strength (HGS) and (ii) on the functionality of postmenopausal women (PMW), to carry out a systematic review (SR) verifying the effects of SVT on the functionality of. In the observational study, an open clinical trial was carried out in patients with COPD, aged ≥ 40 years, treated at the Serviço de Pneumologia da Policlínica Universitária Piquet Carneiro, Universidade do Estado do Rio de Janeiro. Thirty-eight individuals underwent a single SVT session (five sets, 25 Hz, 2.5mm peak-to-peak displacement) in a VP: Sitting Group on an auxiliary chair positioned in front of the VP (GS n = 21) or Uprigth Group at the base of the VP (GU n = 17) . In both positions, the feet were at the base of the VP. HGS and ATF were performed before and after the session, and SPE was measured during the ATF. For RS, 8 databases were used and 8 randomized clinical trials were selected. ATF in GS (p ≤ 0.05) and GU (p ≤ 0.05) improved significantly, but comparing the two groups there was no significant reduction (p = 0.14). SPE was not influenced by SVT. There was a significant increase in HGS in the GU after TVS (33.49 ± 10.30 kgf) p = 0.03, but not in the GS (p = 0.12) or between the two groups (p = 0.55). In SR, the level of evidence of the selected studies was II. The mean methodological quality score was moderate, the risk of bias was low in two studies, high in four studies, and uncertain in two studies. There was an increase in functionality, muscle strength, jumping, balance, and ATF in PMW. SVT is recommended as a non-pharmacological option, for the decline in bone density and symptoms of osteoporosis and sarcopenia, promoting functional benefits for PMW. In conclusion, it is suggested that SVT would be adequate for individuals with COPD and MPM and the inclusion of this type of exercise in PR protocols is indicated.