Efeito do treino aeróbio no equilíbrio de indivíduos pós-acidente vascular encefálico (AVE): uma revisão sistemática

Abstract

Stroke is one of the main causes of disability. Individuals after stroke with balance impairments are more dependent on activities and are at increased risk of falls. Therefore, strategies to improve balance are necessary. Thus, the aim of this study was to investigate the effect of aerobic exercise on balance in individuals after stroke and, in addition, to investigate what are the optimal parameters for exercise prescription for this population. For the present systematic review, searches were carried out in the PEDro, MEDLINE (through Pubmed) and Cochrane databases, using terms related to stroke, aerobic training and balance. There was no restriction on the date of publication or language used. Twelve randomized controlled trials (RCT) were selected with a total of 490 individuals. The methodological quality of the included studies was assessed using the PEDro scale, and included studies obtained on average seven points. The studies used treadmill, circuit, exercise in water or bicycle as aerobic training modality. The intensity ranged from 40-80% of the heart rate reserve, 60-75% of the VO2peak or 50-80% of the maximum heart rate. The duration of the sessions varied from 30-60 minutes. The duration of the program varied between 4-14 weeks and the frequency varied between 2-5 times a week. Most of the included studies used the Berg Balance Scale to measure balance. Four studies (33.3%) showed an improvement in the balance of post-stroke individuals after aerobic training compared to the control group (passive exercises associated with balance training, only guidance and exercises that simulated skate movements). In 3 studies (25%), the groups underwent aerobic training, the difference between them being only in the training modality or the form of intensity monitoring, and it was possible to observe improvement in balance in both groups. In 5 studies (41.7%) the aerobic training groups and the group that performed another type of intervention (balance training and/or strengthening) showed improvement in balance after intervention. There was no difference in the effectiveness of aerobic training for improving balance when considering different training parameters. Therefore, aerobic training can be used in clinical practice with the aim of improving the balance of post-stroke individuals.