Efeitos do exercício físico na composição coporal e na funcionalidade de indivíduos com doença pulmonar obstrutiva crônica: uma revisão sistemática

Abstract

Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition with airflow limitation and restrictive characteristics of respiratory function. This condition can lead to musculoskeletal dysfunctions and changes in body composition, such as an increase in fat mass and a reduction in fat-free mass. Thus contributing to a low quality of life for these individuals. Pulmonary Rehabilitation (RP) contributes positively to improving the clinical conditions of individuals with COPD, with physical exercise being one of the approaches proposed by RP. This systematic review aims to investigate the impact of physical exercise on body composition and functionality in individuals with COPD. It was based on the recommendations of the Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42022333706. The Pubmed, Embase, Scopus and Web of Science databases were used and the search terms involved the keywords: COPD, body mass, physical activity and functional capacity. The inclusion criteria considered investigations into the effects of physical exercise on the body composition and functionality of individuals with COPD, RCT studies, publications regardless of the year, physical exercise alone or combined with other therapies and publications in English. These studies presented level II evidence according to criteria from the National Health and Medical Research Council (NHMRC), and a predominance of regular methodological quality according to the PEDro scale. Four studies presented a high risk of bias and two low risk of bias according to the criteria of the RoB II instrument. The isolated assessment of each domain (2.0 Cochrane) showed a prevalence of 57% with low risk of bias, followed by 23% with high risk and 20% with uncertain risk of bias. 597 articles were identified and of these 591 were excluded. Therefore, 6 studies met the eligibility criteria and were included in this review. According to all the studies included, an improvement in functional capacity was observed, using the 6MWT, TUG, stairs going up and down tests, the 6-minute step test and the 1-minute sit-up test as parameters, using the physical exercise in individuals with COPD. Regarding body composition, the results were inconclusive, where 4 of these included studies did not demonstrate significant improvement in increasing fat-free mass and reducing fat mass. This systematic review presents evidence on the potential benefit in improving the functionality of individuals with COPD. Other aspects of this population's health were also improved, such as quality of life. However, the results related to body composition are inconclusive regarding the decrease in fat mass and the increase in fat-free mass. Therefore, new studies with higher methodological quality are suggested to evaluate the effects of physical exercise on the body composition of individuals with COPD.