Efeito da Estimulação Transcraniana por Corrente Contínua (ETCC) e treino multicomponente na capacidade funcional de indivíduos idosos– ensaio clínico, controlado, randomizado, duplo cego

Abstract

Aging can bring limitations of functional capacity (FC). Physical activity can prevent these limitations and Transcranial Direct Current Stimulation (tDCS) can assist in the effects of physical activity (AF). Objectives: To evaluate the effects of PA by multicomponent training (TM) associated with tDCS on CF. Correlate these effects with effects of training on balance, mobility, functional independence and QOL of elderly individuals. Methods: 28 elderly (67 ± 5) were evaluated pre, post treatment and 30-day follow-up with the following instruments: CF by the AVD-Glittre test, locomotion ability by the six-minute walk test (6MWT), Independence Functional Independence Measurement (FIM) scale, balance by the Mini Balance Evaluation Systems Test (BESTest) and QoL by the World Health Organization Quality of Life Instrument (WHOQOL) and randomized into two treatment groups: tDCSa (TM associated with active tDCS) ; tDCSs (TM associated with tDCS sham), performed twice a week / 12 weeks totaling 24 sessions, 50 minutes each. tDCS: Anode was applied over the lateral dorsal prefrontal cortex (CPFDL) (F3), cathode in the supraorbital region contralateral to the anode, current of 2mA, for 20 minutes associated with the TM. The TM was composed of warm-up (walking a 20 meter straight and flat track for 5 minutes), aerobic exercise (on an exercise bike for 20 minutes), strength training (sitting and rising from a chair for 5 minutes), balance ( walk 10 meters over obstacles and on uneven surfaces, go up and down two steps for (10 minutes), upper limb exercises (transfer objects weighing 1 kg from a shelf with different levels for 5 minutes) and cool down (stretching and relaxing for 5 minutes). Results: HR improved after treatment (p = 0.001) and at follow up (p = 0.001) only for the tDCSa group, with significant difference (p = 0.001) intergroup. = 0.02) for tDCSs (p = 0.006), the follow-up results were maintained only for tDCSa (p = 0.002), there was no intergroup difference (p = 0.73). after treatment, tDCSa (p = 0.001) and tDCSs (p = 0, In the follow-up, the results were not maintained for any group. FIM: there was improvement after treatment (p = 0.001) for the tDCSa group; for tDCSs there was no improvement (p = 0.49); there was no improvement for follow-up tDCSa (p = 0.83); follow-up tDCSs (p = 1.00) there was no intergroup difference. QOL: There was no improvement for both posttreatment and follow-up groups; tDCSa (p = 0.55) and tDCSs (p = 0.64). There was a moderate correlation between the AVD-Glittre test with the 6MWT and Min-BESTest, concluding that the CF improvement may have been due to walking and balance ability. Conclusion: tDCS potentiated the TM results in FC, functional independence and balance. The maintenance of CF effects was also higher for the active group compared to the sham group. Improvement in functional capacity correlated with improvement in locomotion and balance.