Efeitos do condicionamento aquático no sistema cardiorrespiratório de pessoas com diabetes Mellitus tipo 2: estudo clínico randomizado, controlado.

Abstract

The aim of this study was to evaluate the effect of an aquatic conditioning protocol on the cardiorespiratory system of people with T2DM. A clinical, randomized and controlled study was approved by the Ethics Committee of UNIFAL-MG. The sample consisted of 52 people diagnosed with DM2 for more than 5 years, as evidenced by glycated hemoglobin. Random ORG was randomized into two groups: control (CG n = 25), which received guidelines at the end of the study on DM2, cardiorespiratory rehabilitation, impact on health status and importance of physical exercise in quality of life, and intervention group (GI n = 27), underwent an aquatic conditioning protocol three times a week for five weeks, totaling fifteen visits, also receiving guidelines at the end of the study. The evaluators were blinded to the allocation of these people. The evaluation consisted of anamnesis, physical examination (systolic blood pressure, diastolic and anthropometry), respiratory muscle strength (maximal inspiratory and expiratory pressures, MIP and MEP by the manovacuometer), peak expiratory flow (PEF) and exercise capacity six-minute walk test-TC6). Both groups were evaluated in three moments: initial; after five weeks of aquatic conditioning (final evaluation) and after fifteen days of the final evaluation (follow-up). Statistical analysis was performed by Pearson's Chi-square test, Kruskal-Wallis, Anova followed by Bonferroni, Friedman followed by Wilcoxon and Mann-Whitney. The results show that, in relation to SBP and DBP, initial, final and follow-up respectively, a significant difference was observed in the intragroup comparison of GI (p = 0.004), between initial and final assessment moments (145.68 ± 22 , 19; 139.72 ± 23.71) and initial follow-up (145.68 ± 22.19; 137.12 ± 21.86). In relation to DBP, a significant difference in the intra-group comparison of the GI (p = 0.001) was observed, between the moments of initial evaluation with final (85.52 ± 9.93, 79.32 ± 10.90) and initial follow-up (85.52 ± 9.93, 77.00 ± 11.64). In the intragroup comparison of CG and intergroups, in relation to BP, the result was not significant. There was statistical significance of the MIP of the CG in the intra group comparison (p = 0.004), between the final evaluation moments with initial (81.20 ± 32.34, 71.20 ± 29.05), follow-up with initial (83 , 40 ± 32.36, 71.20 ± 29.05) and predicted initial value (87.25 ± 14.39, 71.20 ± 29.05). In the intragroup comparison of IGmax of IG, there was no statistical significance, showing that aquatic conditioning did not provide change in IGmax. There was also no significance in intergroup comparison. In the PEmax there was no statistical significance in the intra and intergroup comparisons, both groups exceeded the predicted value already in the initial evaluation. In the PFE, the GC presented statistical significance in the intragroup comparison (p = 0.000), between the moments of final evaluation with initial (387.20 ± 122.39, 359.20 ± 111.53), follow-up with initial (391, 20 ± 60.94, 359.20 ± 111.53) and predicted value with all moments, being lower in all evaluations. The GI presented statistical significance in the intragroup comparison (p = 0.008), among all the evaluation moments with the predicted value, the GI did not reach its reference value even after the aquatic conditioning. In the intergroup comparison, there was no statistical significance. In relation to the 6MWT, in the intragroup comparison, the CG presented statistical significance (p = 0.000), between the moments of initial evaluation with final, but showing the deconditioning of this group during all moments of evaluation, not reaching its predicted value. The GI presented an initial mean of 430.44 ± 94.52, end of 453.00 ± 80.83, follow-up of 446, 47 ± 84.52 and predicted value of 459.85 ± 59.41, being statistically significant in the intragroup comparison, (p = 0.000), with a difference between the initial and final evaluation moments, showing improvement of the functional capacity after the aquatic conditioning. It can be concluded that aquatic conditioning with the practice of aerobic, resistance and strength exercises has provided benefits, such as improvement in cardiorespiratory fitness mainly in the reduction of systolic blood pressure, diastolic blood pressure and improvement of functional capacity exercise in people with T2DM.