Aquatic exercise and cardiac autonomic modulation of postmenopausal women with type 2 diabetes
DOI:
https://doi.org/10.33233/rbfe.v19i2.3120Abstract
Objective: Investigating the effect of 12 weeks of an aquatic exercise program on cardiac autonomic modulation by heart rate variability index of postmenopausal women with type 2 diabetes mellitus (T2DM). Methods: A randomized clinical trial was performed in 25 women aged 51 to 83 years, divided into exercise group (EG) (n = 13) submitted for 12 weeks to two weekly sessions of 50 minutes each, and control group (CG) (n = 12) without exercise. Results: Regarding cardiac autonomic modulation significant interaction was observed for TINN values (ms), indicating a slight increase in EG, but mostly a reduction in CG. The regression analysis also pointed effect of aquatic exercise on reducing the LF/HF ratio, after controlling for covariates, diastolic blood pressure and dyslipidemia. Conclusion: The aquatic exercise had a significant effect on the reduction of cardiovascular risk, mainly in relation to glycemia and abdominal obesity, which may represent a protective effect of exercise in the progression of autonomic dysfunction, but its effect on autonomic modulation seems to depend on a greater volume and time with aquatic exercise.
References
Barbosa JHP, Oliveira SL, Seara LT. O papel dos produtos finais da glicação avançada (AGEs) no desencadeamento das complicações vasculares do diabetes. Arq Bras Endocrinol Metab 2008;52(6):940-50. Doi: 10.1590/S0004-27302008000600005
Hautamäki H, Mikkola TS, Sovijärvi ARA, Piirilä P, Haapalahti P. Menopausal hot flushes do not associate with changes in heart rate variability in controlled testing: A randomized trial on hormone therapy. Acta Obstet Gynecol Scand 2013;92(8):902-8. doi: 10.1111/aogs.12164
Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care [Internet] 2003;26(5):1553-79. doi: 10.2337/diacare.26.5.1553
Fleischer J, Yderstraede K, Gulichsen E, Jakobsen PE, Lervang HH, Eldrup E, et al. Cardiovascular autonomic neuropathy is associated with macrovascular risk factors in type 2 diabetes: New technology used for routine large-scale screening adds new insight. J Diabetes Sci Technol 2014;8(4):874-80. doi: 10.1177/1932296814528616
Lopes PFF, Oliveira MIB, André SMS, Nascimento DLA, Silva CSS, Rebouças GM, et al. Aplicabilidade clínica da variabilidade da frequência cardíaca. Rev Neurociencias 2013;21(4):600-3. doi: 10.4181/RNC.2013.21.870.4p
Narayanaswamy N, Moodithaya S, Halahalli H, Mirajkar AM. Assessment of risk factor for cardiovascular disease using heart rate variability in postmenopausal women: a comparative study between urban and rural Indian women. ISRN Cardiol [Internet]. 2013;2013:1-6. doi: 10.1155/2013/858921
Stranieri A, Abawajy J, Kelarev A, Huda S, Chowdhury M, Jelinek HF. An approach for Ewing test selection to support the clinical assessment of cardiac autonomic neuropathy. Artif Intell Med 2013;58(3):185-93. doi: 10.1016/j.artmed.2013.04.007
Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC et al. Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care 2016;39(11):2065-79. doi: 10.2337/dc16-1728
American Diabetes Association (ADA). Standards of medical care in diabetes. Diabetes Care 2019;42(s1).
Voulgari C, Pagoni S, Vinik A, Poirier P. Exercise improves cardiac autonomic function in obesity and diabetes. Metabolism 2013;62(5):609-21. doi: 10.1016/j.metabol.2012.09.005
Sacre JW, Jellis CL, Jenkins C, Haluska BA, Baumert M, Coombes JS et al. A six-month exercise intervention in subclinical diabetic heart disease: Effects on exercise capacity, autonomic and myocardial function. Metabolism 2014;63(9):1104-14. doi: 10.1016/j.metabol.2014.05.007
Kang S-J, Ko K-J, Baek U-H. Effects of 12 weeks combined aerobic and resistance exercise on heart rate variability in type 2 diabetes mellitus patients. J Phys Ther Sci 2016;28(7):2088-93. Available from: https://www.jstage.jst.go.jp/article/jpts/28/7/28_jpts-2016-178/_article
Zamunér AR, Andrade CP, Forti M, Marchi A, Milan J, Avila MA et al. Effects of a hydrotherapy programme on symbolic and complexity dynamics of heart rate variability and aerobic capacity in fibromyalgia patients. Clin Exp Rheumatol 2015;33(14):S73-81.
Albinet CT, Abou-Dest A, André N, Audiffren M. Executive functions improvement following a 5-month aquaerobics program in older adults: Role of cardiac vagal control in inhibition performance. Biol Psychol 2016;115:69-77. doi: 10.1016/j.biopsycho.2016.01.010
ABESO. Diretrizes Brasileiras de obesidade. 4th ed. https://abeso.org.br/wp-content/uploads/2019/12/Diretrizes-Download-Diretrizes-Brasileiras-de-Obesidade-2016.pdf
Laborde S, Mosley E, Thayer JF. Heart rate variability and cardiac vagal tone in psychophysiological research - Recommendations for experiment planning, data analysis, and data reporting. Front Psychol 2017;8(2):1-18. doi: 10.3389/fpsyg.2017.00213
Olkoski MM, Matheus SC, Moraes EC, Tusset D. Metodologia para o planejamento de aulas de hidroginastica. Motricidade 2013;9(3):36-43. doi: 10.6063/motricidade.9(3).688
Borg G. Psychophysical basis of perceived exhertion. Med Sci Sports Exerc 1982;14(5):377-81.
Filippatos T, Tsimihodimos V, Pappa E, Elisaf M. Pathophysiology of diabetic dyslipidaemia. Curr Vasc Pharmacol 2017;15(6):1-10. doi: 10.5551/jat.RV17023
Bianchi L, Volpato S. Muscle dysfunction in type 2 diabetes: a major threat to patient"™s mobility and independence. Acta Diabetol 2016;53(6):879-89. doi: 10.1007/s00592-016-0880-y
Bauer A, Camm AJ, Cerutti S, Guzik P, Huikuri H, Lombardi F et al. Reference values of heart rate variability. Heart Rhythm 2017;14(2):302-3. doi: 10.1016/j.hrthm.2016.12.015
Lee CH, Lee JH, Son JW, Kim U, Park JS, Lee J et al. Normative values of short-term heart rate variability parameters in koreans and their clinical value for the prediction of mortality. Heart Lung Circ 2018;27(5):576-87. doi: 10.1016/j.hlc.2017.04.009
Sammito S, Böckelmann I. New reference values of heart rate variability during ordinary daily activity. Heart Rhythm 2017;14(2):304-7. doi: 10.1016/j.hrthm.2016.12.016
Michael S, Graham KS, Davis GM. Cardiac autonomic responses during exercise and post-exercise recovery using heart rate variability and systolic time intervals-a review. Front Physiol 2017;8:1-19.
Chagas EFB, Bonfim MR, Turi BC, Brondino NCM, Monteiro HL. Effect of moderate-intensity exercise on inflammatory markers among postmenopausal women. J Phys Act Heal 2017;14(6):479-85. doi: 10.1123/jpah.2016-0319
Sales ARK, Silva BM, Neves FJ, Rocha NG, Medeiros RF, Castro RRT et al. Diet and exercise training reduce blood pressure and improve autonomic modulation in women with prehypertension. Eur J Appl Physiol 2012;112(9):3369-78. doi: 10.1007/s00421-012-2315-y.
Duarte A, Soares PP, Pescatello L, Farinatti P. Aerobic training improves vagal reactivation regardless of resting vagal control. Med Sci Sports Exerc 2015;47(6):1159-67. doi: 10.1249/MSS.0000000000000532
Simmonds MJ, Minahan CL, Serre KR, Gass GC, Marshall-Gradisnik SM, Haseler LJ et al. Preliminary findings in the heart rate variability and haemorheology response to varied frequency and duration of walking in women 65-74 yr with type 2 diabetes. Clin Hemorheol Microcirc 2012;51(2):87-99. doi: 10.3233/CH-2011-1514
Zoppini G, Cacciatori V, Gemma ML, Moghetti P, Targher G, Zamboni C et al. Effect of moderate aerobic exercise on sympatho-vagal balance in Type 2 diabetic patients. Diabet Med 2007;24(4):370-6. doi: 10.1111/j.1464-5491.2007.02076.x
Figueroa A, Baynard T, Fernhall B, Carhart R, Kanaley JA. Endurance training improves post-exercise cardiac autonomic modulation in obese women with and without type 2 diabetes. Eur J Appl Physiol 2007;100(4):437-44. doi: 10.1007/s00421-007-0446-3
Pagkalos M, Koutlianos N, Kouidi E, Pagkalos E, Mandroukas K, Deligiannis A. Heart rate variability modifications following exercise training in type 2 diabetic patients with definite cardiac autonomic neuropathy. Br J Sports Med. 2008;42(1):47-54. doi: 10.1136/bjsm.2007.035303
Earnest CP, Poirier P, Carnethon MR, Blair SN, Church TS. Autonomic function and change in insulin for exercising postmenopausal women. Maturitas 2010;65(3):284-91.
Badea AR, Nedelcu L, Valeanu M, Zdrenghea D. The relationship between serum lipid fractions and heart rate variability in diabetic patients with statin therapy. Clujul Med 2014;87(3):152. http://www.clujulmedical.umfcluj.ro/index.php/cjmed/article/view/313
Dimitropoulos G. Cardiac autonomic neuropathy in patients with diabetes mellitus. World J Diabetes 2014;5(1):17. training improves baroreflex sensitivity in type 2 diabetes. Diabetes 2003;52(7):1837-42. doi: 10.2337/diabetes.52.7.1837
Bernardi L, Bianchi L. Integrated cardio-respiratory control: insight in diabetes. Curr Diab Rep 2016;16(11). doi: 10.1007/s11892-016-0804-9
Jones SMW, Guthrie KA, Lacroix AZ, Sternfeld B, Landis CA, Reed SD et al. Is heart rate variability associated with frequency and intensity of vasomotor symptoms among healthy perimenopausal and postmenopausal women? Clin Auton Res 2016;26(1):7-13. doi: 10.1007/s10286-015-0322-x
Loimaala A, Huikuri HV, Kööbi T, Rinne M, Nenonen A, Vuori I. Exercise training improves baroreflex sensitivity in type 2 diabetes. Diabetes 2003;52:1837-42.
Igarashi Y, Nogami Y. The effect of regular aquatic exercise on blood pressure: A meta-analysis of randomized controlled trials. Eur J Prev Cardiol 2018;25(2):190-9. doi: 10.1177/2047487317731164
Rees JL, Johnson ST, Boulé NG. Aquatic exercise for adults with type 2 diabetes: a meta-analysis. Acta Diabetol 2017;54(10):895-904. doi: 10.1007/s00592-017-1023-9
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