bachelorThesis
Eventos adversos cardiovasculares e respiratórios reportados durante o treino de marcha em esteira em indivíduos com Acidente Vascular Cerebral: uma revisão sistemática
Fecha
2020-12-10Registro en:
AZEVEDO, Josicleide Araújo de. Eventos adversos cardiovasculares e respiratórios reportados durante o treino de marcha em esteira em indivíduos com Acidente Vascular Cerebral: uma revisão sistemática. 2020. 46 f. Trabalho de Conclusão de Curso (Graduação em Fisioterapia) - Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, 2019.
Autor
Azevedo, Josicleide Araújo de
Resumen
Introduction: Gait impairment is one of the main limitations in post-stroke individuals, making it difficult to perform functional activities. Treadmill training has been suggested as the most effective exercise to improve the aerobic capacity in those individuals; however, there is potential risk and even real damage can happen as a result of such training. Therefore, assessing adverse cardiovascular and respiratory events that can occur at this kind of training is important. Objectives: To analyze cardiovascular and respiratory adverse events reported in clinical trials that used treadmill training to individuals who have suffered a stroke. Methodology: This study consisted of a systematic review of interventions, that included studies that performed treadmill training in people who had a stroke. Searches were made without restriction of date, in October to November 2019, on the following databases: MEDLINE Ovid; CINAHL EBSCO; Cochrane Central Register of Controlled Trials (CENTRAL); PsycINFO Ovid; LILACS Bireme; SPORTDiscus EBSCO; PEDro. Full works in English were included, comprising of clinical trials, controlled or not, randomized or not. Three independent reviewers assessed titles and abstracts assessed the full text of potentially eligible studies, as well as extracted relevant data. The outcome measures were the cardiovascular/respiratory adverse events evaluated and/or occurred during clinical trials. Data were presented according to the characteristics of the included studies. Results: The electronic search resulted in 53,068 abstracts, and after screening, 250 were identified as potentially eligible. We included 25 studies reporting events of cardiovascular and/or respiratory nature, comprising 780 participants diagnosed with ischemic and/or hemorrhagic stroke, where the majority were experiencing the chronic stage of the disease, with average ages ranging from 49.5 to 68.6 years. The included studies used treadmill training in at least one group, either in isolation or associated to another intervention during treadmill training. The most frequently reported adverse events were decompensated heart rate and systemic blood pressure, high perceived exertion (fatigue), and a new stroke. Compared to the groups that did not receive treadmill training, the groups that received treadmill training presented a larger number of cardiovascular/respiratory events, although this cannot be attributed to the interventions. The assessment time of adverse events occurred, in most cases, at the intervention sessions. Most of the included studies did not classify the adverse event as serious or not serious. Conclusion: The prediction or even occurrence of cardiovascular and/or respiratory events was common in studies that performed post-stroke treadmill training. Despite the inherent risk in gait training on treadmill, especially for those individuals, the authors of included studies do not approach the occurrence of adverse events in a clear and systematic way. It is recommended, therefore, that future clinical trials can comply more to the methodological guidelines for the quality of information presentation, and that they may use instruments capable of identifying, classifying, and quantifying the frequency, duration, and intensity of adverse events.