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Efeitos da Implementação de Consulta de Prescrição de Exercício Clínico na Saúde e Força em Doentes Hipertensos e/ou Diabéticos
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A inatividade física é um fator de risco modificável associado a mais de 35 doenças crónicas. A prática regular de atividade física contribui para a prevenção e controlo de doenças como a hipertensão arterial e a diabetes tipo 2. O projeto Consultas de Prescrição de Exercício Clínico surgiu com o objetivo de integrar o exercício clínico nos cuidados de saúde primários, promovendo a multidisciplinaridade. O projeto resulta de uma parceria entre a Escola Superior de Educação e Ciências Sociais e a Unidade Local de Saúde da Região de Leiria, com início em 2023. Este estudo tem como objetivo avaliar a eficácia e segurança de um programa de exercício físico prescrito para realização autónoma (home-based) ou supervisionada em contexto clínico (center-based) em utentes com hipertensão arterial e/ou diabetes tipo 2, tratando-se de um estudo longitudinal não randomizado. A amostra incluiu 12 participantes (57,3 ± 12,8 anos), divididos em dois grupos: home-based (n=4) e center-based (n=8). O programa de exercício físico combinou treino aeróbio e de força, realizado duas vezes por semana durante 24 semanas, com acompanhamento do fisiologista do exercício. Para o grupo home-based foi desenvolvida uma plataforma digital, com conteúdos de aconselhamento e prescrição individualizada de exercício. As variáveis analisadas incluíram parâmetros clínicos (pressão arterial, glicemia, perfil lipídico), composição corporal e força muscular. Os resultados mostraram um efeito significativo do tempo sobre os níveis de triglicerídeos (F(2)=3.764; p=0.041; =0.273) e hemoglobina glicada (F(2)=4.696; p=0.021; =0.320), indicando melhoria metabólica ao longo do tempo. Observou-se ainda efeito significativo do grupo na massa gorda (F(1)=9.018; p=0.013; =0.474), com valores inferiores no grupo home-based. Embora a maioria das variáveis não tenha apresentado interação tempo x grupo significativa, verificou-se tendência de melhoria na força dos membros inferiores (p=0.065;
=0.239). A participação em programas multidisciplinares de exercício físico, tanto supervisionados quanto autónomos, apresenta-se como segura e eficaz, particularmente na melhoria de parâmetros metabólicos e funcionais em indivíduos com hipertensão arterial e/ou diabetes tipo 2, sendo o modelo home-based uma alternativa viável ao center-based em contextos de cuidados de saúde primários. Esta abordagem oferece uma opção de exercício segura e sustentável para aqueles com acesso limitado a uma orientação profissional.
Physical inactivity is a modifiable risk factor associated with more than 35 chronic diseases. Regular physical activity contributes to the prevention and control of diseases such as high blood pressure and type 2 diabetes. The Clinical Exercise Prescription Consultations project was created with the aim of integrating clinical exercise into primary health care, promoting multidisciplinarity. The project is the result of a partnership between the School of Education and Social Sciences and the Local Health Unit of the Leiria Region, starting in 2023. The study aims to evaluate the efficacy and safety of a physical exercise programme prescribed for independent (home-based) or supervised (centre-based) performance in a clinical context in patients with high blood pressure and/or type 2 diabetes. This is a non-randomised longitudinal study. The sample included 12 participants (57.3 ± 12.8 years), divided into two groups: home-based (n=4) and centre-based (n=8). The physical exercise programme combined aerobic and strength training, performed twice a week for 24 weeks, with monitoring by an exercise physiologist. For the home-based group, a digital platform was developed with counselling content and individualised exercise prescriptions. The variables analysed included clinical parameters (blood pressure, blood glucose, lipid profile), body composition, and muscle strength. The results showed a significant effect of time on triglyceride levels (F(2)=3.764; p=0.041; = 0.273) and glycated haemoglobin (F(2)=4.696; p=0.021; =0.320), indicating metabolic improvement over time. A significant effect of group on fat mass was also observed (F(1)=9.018; p=0.013; =0.474), with lower values in the home-based group. Although most variables did not show significant time x group interaction, there was a trend towards improvement in lower limb strength (p=0.065; =0.239). Participation in multidisciplinary physical exercise programmes, whether supervised or self-directed, is safe and effective, particularly in improving metabolic and functional parameters in individuals with high blood pressure and/or type 2 diabetes, with the home-based model being a viable alternative to the centre-based model in primary healthcare settings. This approach offers a safe and sustainable exercise option for those with limited access to professional guidance.
Physical inactivity is a modifiable risk factor associated with more than 35 chronic diseases. Regular physical activity contributes to the prevention and control of diseases such as high blood pressure and type 2 diabetes. The Clinical Exercise Prescription Consultations project was created with the aim of integrating clinical exercise into primary health care, promoting multidisciplinarity. The project is the result of a partnership between the School of Education and Social Sciences and the Local Health Unit of the Leiria Region, starting in 2023. The study aims to evaluate the efficacy and safety of a physical exercise programme prescribed for independent (home-based) or supervised (centre-based) performance in a clinical context in patients with high blood pressure and/or type 2 diabetes. This is a non-randomised longitudinal study. The sample included 12 participants (57.3 ± 12.8 years), divided into two groups: home-based (n=4) and centre-based (n=8). The physical exercise programme combined aerobic and strength training, performed twice a week for 24 weeks, with monitoring by an exercise physiologist. For the home-based group, a digital platform was developed with counselling content and individualised exercise prescriptions. The variables analysed included clinical parameters (blood pressure, blood glucose, lipid profile), body composition, and muscle strength. The results showed a significant effect of time on triglyceride levels (F(2)=3.764; p=0.041; = 0.273) and glycated haemoglobin (F(2)=4.696; p=0.021; =0.320), indicating metabolic improvement over time. A significant effect of group on fat mass was also observed (F(1)=9.018; p=0.013; =0.474), with lower values in the home-based group. Although most variables did not show significant time x group interaction, there was a trend towards improvement in lower limb strength (p=0.065; =0.239). Participation in multidisciplinary physical exercise programmes, whether supervised or self-directed, is safe and effective, particularly in improving metabolic and functional parameters in individuals with high blood pressure and/or type 2 diabetes, with the home-based model being a viable alternative to the centre-based model in primary healthcare settings. This approach offers a safe and sustainable exercise option for those with limited access to professional guidance.
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Palavras-chave
Cuidados de saúde primários Exercício físico Hipertensão arterial Diabetes tipo 2 Primary healthcare Physical exercise High blood pressure Type 2 diabetes