Resumo

CAMARGO, Diana M et al. Hemodynamic response to training in resistance and muscular strength of upper limbs in cardiac rehabilitation. Rev. Col. Cardiol. [online]. 2007, vol.14, n.4, pp.198-206. ISSN 0120-5633.

Antecedentes: training of muscular strength in patients with cardiovascular events was totally contraindicated because of the risk of incrementing the systolic and diastolic arterial pressure values, as well as the submission to a myocardial overload. Objective: evaluate the hemodynamic response (heart rate, arterial pressure) during the resistance to muscular strength training in patients assisting to a heart rehabilitation program. Design: quasi experimental prospective study. Setting: resistance training to muscular strength in upper limbs to patients during stage II of cardiac rehabilitation was realized. Subjects: 175 patients were included. 135 men and 40 women with mean age 58.79 years with coronary disease, with or without revascularization procedures, valvular surgery, syncope and surgical correction of congenital heart disease. Procedure: previous aerobic training (treadmill or static bicycle), muscular strength evaluation was realized through maximal repetition and the strength training was initiated at 30%-50% of this, in a three different exercise circuit in upper limbs, 10 repetitions in three series with a twice a week frequency. Besides, monitoring of heart frequency, electrocardiogram by telemetry (V5), arterial pressure recording before, during and after the session, and subjective perception of the effort by the Borg scale were made, and signs and symptoms of intolerance to the activity or decompensation were observed. For the statistical analysis, measures of central tendency with the cardiovascular changes were used and in order to compare the change in muscular strength, a paired t test with significance level 0.05 was utilized. Results: mean muscular strength with maximal repetition evidenced a significant increase of 1.92 ± 2.49 lb (p<0.001) in the general population, with an increment of 2.03 ± 2.57 lb (p<0.001) in men and of 1.46 ± 2.1 lb (p<0.001) in women. The muscular resistance training was realized with a mean load of 39.1% (3.9 lb) of the maximal resistance (17%-80%) in the general population, being of 39.5% (4.3 lb) and of 37.4% (2.2 lb) for men and women respectively. During the load lifting, the systolic arterial pressure response was 121.6 mm Hg, 122.3 mm Hg and 118.5 mm Hg for the total population, men and women respectively and the diastolic arterial pressure was 75 mm Hg, 75.5 mm Hg and 73.3 mm Hg, respectively. No cardiac arrhythmias, electrical changes in the ST segment nor signs or cardiovascular adverse symptoms were evidenced. Conclusions: aerobic treatment accompanied by muscular strength resistance exercises in patients who are in cardiovascular rehabilitation stage II is effective as long as an adequate evaluation, prescription and exercise monitoring are made, thus allowing a safe participation in daily life activities, those of free time, recreational and labor activities, so that a better and greater social and familiar integration is obtained.

Palavras-chave : muscular resistance; cardiovascular response; cardiovascular rehabilitation; exercise prescription.

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