Efeitos do treinamento com ergômetro de braços na capacidade funcional, cognição e qualidade de vida de pacientes com doença arterial periférica: um ensaio clínico randomizado controlado

Abstract

Introduction: Peripheral arterial disease (PAD) is a condition caused by the occlusion of peripheral arterial beds, the main symptom of which is intermittent claudication (IC), which leads to limited mobility capacity. Patients with PAD have reduced mobility and functional capacity and associated with this clinical condition, there are cognitive impairments and worsening quality of life (QoL). Physical exercise is one of the strategies for managing the symptoms and prognosis of PAD, with positive effects on functional capacity and QoL, however its effects on cognition are still unknown. Functional limitations and pain from IC can be barriers in walking training (WT), and the arm-crank exercise training (ACT) has been shown to be an alternative for exercise in patients with PAD and IC symptoms, with promising results in the ability to walking and QoL of these patients. Objectives: to verify the effect of training with ACT on functional capacity, cognition and QoL and compare it to the current recommendation of WT for patients with PAD. Methods: a randomized controlled clinical trial was carried out, lasting 12 weeks and with 3 intervention groups: control (CG), WT and ACT. Exercise groups perform two sessions per week, at intervals, with 15 to 10 sets of 2 to 5 minutes. Before and after 12 weeks of training, functional capacity was assessed using the 6-minute walk test (6MWT), 2-minute step test, handgrip strength, Short Physical Performance Battery (SPPB), Walking Impairment Questionnaire (WIQ), Walking Estimated Limitation Calculated by History (WELCH), Baltimore Activity Scale for Intermittent Claudication (BASIC); cognition, through the Trail Making Test (TMT), the Hopkins Verbal Learning Test (HVLT), the Wechsler scale digits subtest and the verbal fluency test; and quality of life, through the WHOQOL-bref and VascuQoL-6 questionnaires. Results: patients in the WT group showed improvement in the WIQ speed domain (25 [20] vs. 38 [25], p 0.026). In the ACT group, an increase in the digit subtest score was observed (8 [12] vs. 16 [4], p < 0.001). In the WT group, an increase in the total HVLT score was observed (19 [8] vs. 22 [7], p < 0.001), and a reduction in the execution time of part A of the TMT (50 [43] vs. 48 [36], p 0.000). Conclusions: our findings showed ACT training has the potential to improve memory and attention, thought the digits subtest, in patients with PAD, and WT improves the patient’s perception of their walking speed.