Efeito de 12 semanas de Mat Pilates sobre o força muscular e equilíbrio de indivíduos hemiparéticos em fase crônica do acidente vascular encefálico

Abstract

Introduction: Stroke (Cerebrovascular Accident – CVA) has a high disabling potential due to hemiparesis sequelae. Physical training has been shown to be effective in improving the functional autonomy of these individuals; however, the benefits of the Mat Pilates are still not well established. Objective: To investigate the effect of a Mat Pilates-based training program on isokinetic strength, motor function, and balance in individuals with chronic post-stroke conditions. Methods: Non-randomized controlled clinical trial. Eighteen participants with post-stroke hemiparesis were allocated into a Mat Pilates group (MPG) (5 men and 5 women, 51.9±8.3 years) and a conventional aerobic group (CAG) (5 men and 3 women, 49.4±12.1 years). The MPG underwent 36 sessions consisting of 16 exercises (modified every 12 sessions), performed in a single set of 10 repetitions at moderate intensity, three times per week. The CAG completed 36 sessions of treadmill walking or stationary cycling (5 consecutive minutes), alternating with step exercises (15 repetitions), for a total of 30 minutes at light intensity, three times per week. All participants were assessed for isokinetic knee extensor and flexor torque as the primary outcome, and for secondary outcomes including time on the five-times sit-to-stand test, center of pressure (COP) sway area during stabilometry, and score on the Berg Balance Scale (BBS), before the interventions, after 12 sessions, and at the end of the interventions. Results: The MPG showed significant improvement in normalized torque of the paretic knee extensors at 60º/s (p = 0.006) and 30º/s (p = 0.038), in FTSST time (p < 0.001), and in BBS score (p = 0.001). The CAG showed a significant reduction in anteroposterior velocity during stabilometry with eyes closed (p = 0.021), but no reduction in COP amplitude. The MPG was superior to the CAG in improving FTSST time (p = 0.005) and BBS score (p = 0.011). Conclusion: Compared to conventional aerobic training, Mat Pilates-based training can improve indicators of strength, motor function, and dynamic balance in individuals with hemiparesis due to stroke sequelae