Variabilidade da frequência cardíaca em repouso em mulheres idosas praticantes de Tai Chi Chuan em comparação com controles que não praticam exercícios: um estudo comparativo transversal
DOI:
https://doi.org/10.15517/ke199s42Palavras-chave:
atividade física, pessoas idosas, saúde, Tai Chi ChuanResumo
OBJETIVO: O estudo comparou a variabilidade da frequência cardíaca em repouso (VFC) entre mulheres idosas que praticavam Tai Chi Chuan (doravante TCC) e mulheres do grupo de controle que não praticavam exercícios, com o objetivo de avaliar seu impacto na modulação autonômica cardíaca. METODOLOGIA: Vinte mulheres idosas foram divididas em dois grupos: praticantes de TCC (n = 10) e grupo controle que não praticam exercícios (n = 10). Os grupos apresentaram características basais semelhantes, incluindo a idade (TCC: 64,6 ± 3,3 anos; grupo de controle: 66,5 ± 7,3 anos), massa corporal (TCC: 60,8 ± 4,3 kg; grupo de controle: 65,5 ± 12,1 kg) e altura (TCC: 1,52 ± 0,07 m; grupo de controle: 1,50 ± 0,05 m) e IMC (TCC: 26,2 ± 2,7 kg/m2; grupo de controle: 28.9 ± 4.3 kg/m2). A VFC foi avaliada por meio de um monitor de frequência cardíaca e análise simbólica, com ênfase nos índices 0V% (atividade simpática) e 2ULV% (atividade parassimpática). RESULTADOS: Para a modulação simpática (0% V), o grupo TCC apresentou valores significativamente mais baixos no momento 1 (TCC: 28,7 ± 7,9 em comparação com o grupo de controle: 41,6 ± 8,6, p = 0,003, 95%CI: -20,74 a -5,07; d = -1,56) e no momento 2 (TCC: 27,0 ± 12,0 em comparação com o grupo de controle: 38,9 ± 11,7, p = 0,038, 95%CI: -23,09 a -0,72; d = -1,00), o que indica uma menor dominância simpática entre as praticantes de TCC. Em contrapartida, a modulação parassimpática (2ULV%) foi significativamente maior no grupo TCC tanto no momento 1 (TCC: 13,9 ± 3,5 em comparação com o grupo de controle: 10,6 ± 2,5, p = 0,032, 95%CI: 0,31 a 6,17; d = 1,08) e no momento 2 (TCC: 14,4 ± 3,5 em comparação com o grupo de controle: 10,5 ± 3,3, p = 0,021, 95%CI: 0,67 a 7,21; d = 1,15). CONCLUSÃO: Os resultados destacam os benefícios da prática regular da TCC, demonstrando seu potencial para aumentar a atividade parassimpática e reduzir a simpática, o que contribui para o equilíbrio autonômico e para uma possível proteção cardiovascular. Apesar de limitações como o tamanho reduzido da amostra e o desenho transversal, o TCC se destaca como uma intervenção não farmacológica promissora para a melhoria da saúde cardiovascular em mulheres idosas, sendo a análise simbólica uma ferramenta eficaz para identificar os padrões de regulação autonômica.
Downloads
Referências
American Heart Association. (1996). Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation, 93, 1043–1065.
Arantes, F. S., Rosa Oliveira, V., Leão, A. K. M., Afonso, J. P. R., Fonseca, A. L., Fonseca, D. R. P., Mello, D. A. C. P. G., Costa, I. P., Oliveira, L. V. F., & da Palma, R. K. (2022). Heart rate variability: A biomarker of frailty in older adults? Frontiers in Medicine, 9(2). https://doi.org/10.3389/fmed.2022.1008970
Bellenger, C. R., Fuller, J. T., Thomson, R. L., Davison, K., Robertson, E. Y., & Buckley, J. D. (2016). Monitoring Athletic Training Status Through Autonomic Heart Rate Regulation: A Systematic Review and Meta-Analysis. Sports Medicine, 46(10), 1461–1486. https://doi.org/10.1007/s40279-016-0484-2
Billman, G. E. (2013). The LF/HF ratio does not accurately measure cardiac sympatho-vagal balance. Frontiers in Physiology, 4. https://doi.org/10.3389/fphys.2013.00026
Blake, H., & Hawley, H. (2012). Effects of Tai Chi Exercise on Physical and Psychological Health of Older People. Current Aging Science, 5(1), 19–27. https://doi.org/10.2174/1874612811205010019
Cambri, L. T., Fronchetti, L., Oliveira, F. R. de, & Gevaerd, M. da S. (2008). Variabilidade da frequência cardíaca e controle metabólico. Arquivos Sanny de Pesquisa em Saúde, 1(1), 72–82.
Camilo Pereira, L., Barbosa de Lima Pinto, J. C., de Caldas Honorato, R., Mohamed Elsangedy, H., & Fonteles, A. I. (2026). Data base of Variability in resting heart rate in older women practicing Tai Chi Chuan versus non-exercising controls: a cross-sectional comparative study. Pensar en Movimiento: Revista de Ciencias del Ejercicio y la Salud, 24(1). https://doi.org/10.15517/a4s3cn26
Cancino, J. (2011). Variabilidad del ritmo cardiaco: ¿Por qué el caos puede ser saludable? Pensar en Movimiento: Revista de Ciencias del Ejercicio y la Salud, 9(1), 22–32. https://doi.org/10.15517/pensarmov.v9i1.389
Chen, H., Wang, Y., Zhang, M., Wang, N., Ge, S., & Liu, Y. (2024). Effectiveness of Tai Chi on cognitive function among older adults with mild cognitive impairment: a systematic review and meta-analysis of randomized controlled trials. Aging and Mental Health, 28(2), 285–293. https://doi.org/10.1080/13607863.2023.2253183
Ekelund, U., Tarp, J., Steene-Johannessen, J., Hansen, B. H., Jefferis, B., Fagerland, M. W., Whincup, P., Diaz, K. M., Hooker, S. P., Chernofsky, A., Larson, M. G., Spartano, N., Vasan, R. S., Dohrn, I. M., Hagströmer, M., Edwardson, C., Yates, T., Shiroma, E., Anderssen, S. A., & Lee, I. M. (2019). Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: Systematic review and harmonised meta-analysis. The BMJ, 366, 1–10. https://doi.org/10.1136/bmj.l4570
Fang, S. C., Wu, Y. L., & Tsai, P. S. (2020). Heart Rate Variability and Risk of All-Cause Death and Cardiovascular Events in Patients With Cardiovascular Disease: A Meta-Analysis of Cohort Studies. Biological Research for Nursing, 22(1), 45–56. https://doi.org/10.1177/1099800419877442
Francesco Sessa, Valenzano Anna, Giovanni Messina, Giuseppe Cibelli, Vincenzo Monda, Gabriella Marsala, Maria Ruberto, Antonio Biondi, Orazio Cascio, Giuseppe Bertozzi, Daniela Pisanelli, Francesca Maglietta, Antonietta Messina, Maria P. Mollica, & Monica Salerno. (2018). Heart rate variability as predictive factor for sudden cardiac death. Aging, 10(2), 166–177.
Gąsior, J. S., Rosoł, M., Młyńczak, M., Flatt, A. A., Hoffmann, B., Baranowski, R., & Werner, B. (2022). Reliability of Symbolic Analysis of Heart Rate Variability and Its Changes During Sympathetic Stimulation in Elite Modern Pentathlon Athletes: A Pilot Study. Frontiers in Physiology, 13. https://doi.org/10.3389/fphys.2022.829887
Guzzetti, S., Borroni, E., Garbelli, P. E., Ceriani, E., Bella, P. Della, Montano, N., Cogliati, C., Somers, V. K., & Mallani, A. (2005). Symbolic Dynamics of Heart Rate Variability A Probe to Investigate Cardiac Autonomic Modulation. Circulation, 26, 465–470. https://doi.org/10.1161/CIRCULATIONAHA.104.518449
Hayano, J., & Yuda, E. (2019). Pitfalls of assessment of autonomic function by heart rate variability. Journal of Physiological Anthropology, 38(1), 1–8. https://doi.org/10.1186/s40101-019-0193-2
Hillebrand, S., Gast, K. B., De Mutsert, R., Swenne, C. A., Jukema, J. W., Middeldorp, S., Rosendaal, F. R., & Dekkers, O. M. (2013). Heart rate variability and first cardiovascular event in populations without known cardiovascular disease: Meta-analysis and dose-response meta-regression. Europace, 15(5), 742–749. https://doi.org/10.1093/europace/eus341
Julious, S. A. (2005). Sample size of 12 per group rule of thumb for a pilot study. Pharmaceutical Statistics, 4(4), 287–291. https://doi.org/10.1002/pst.185
Kaufmann, S., Gronwald, T., Herold, F., & Hoos, O. (2023). Heart Rate Variability-Derived Thresholds for Exercise Intensity Prescription in Endurance Sports: A Systematic Review of Interrelations and Agreement with Different Ventilatory and Blood Lactate Thresholds. Sports Medicine - Open, 9(1). https://doi.org/10.1186/s40798-023-00607-2
Laborde, S., Mosley, E., & Thayer, J. F. (2017). Heart rate variability and cardiac vagal tone in psychophysiological research - Recommendations for experiment planning, data analysis, and data reporting. Frontiers in Psychology, 8, 1–18. https://doi.org/10.3389/fpsyg.2017.00213
Lan, C., Chen, S., Lai, J., & Wong, A. M. (2013). Tai Chi Chuan in Medicine and Health Promotion. Evidence-Based Complementary and Alternative Medicine, 2013(1). https://doi.org/10.1155/2013/502131
Larkey, L., James, D., Vizcaino, M., & Kim, S. W. (2024). Effects of Tai Chi and Qigong on Heart Rate Variability: A Systematic Review and Meta-Analysis. Heart and Mind, 8(4), 310–324. https://doi.org/10.4103/hm.HM-D-24-00045
Lu, W. A., & Kuo, C. D. (2003). The Effect of Tai Chi Chuan on the Autonomic Nervous Modulation in Older Persons. Medicine and Science in Sports and Exercise, 35(12), 1972–1976. https://doi.org/10.1249/01.MSS.0000099242.10669.F7
Magagnin, V., Bassani, T., Bari, V., Turiel, M., Maestri, R., Pinna, G. D., & Porta, A. (2011). Non-stationarities significantly distort short-term spectral, symbolic and entropy heart rate variability indices. Physiological Measurement, 32(11), 1775–1786. https://doi.org/10.1088/0967-3334/32/11/S05
Michael, S., Graham, K. S., & Oam, G. M. D. (2017). Cardiac autonomic responses during exercise and post-exercise recovery using heart rate variability and systolic time intervals-a review. Frontiers in Physiology, 8, 1–19. https://doi.org/10.3389/fphys.2017.00301
Monahan, K. D. (2007). Effect of aging on baroreflex function in humans. American Journal of Physiology - Regulatory Integrative and Comparative Physiology, 293(1). https://doi.org/10.1152/ajpregu.00031.2007
Porta, A., D’Addio, G., Guzzetti, S., Lucini, D., & Pagani, M. (2004). Testing the Presence of Non Stationarities in Short Heart Rate Variability Series Methods. Computers in Cardiology, 31, 645–648. https://doi.org/10.1109/CIC.2004.1443021
Porta, A., Guzzetti, S., Montano, N., Furlan, R., Pagani, M., Malliani, A., & Cerutti, S. (2001). Entropy, entropy rate, and pattern classification as tools to typify complexity in short heart period variability series. IEEE Transactions on Biomedical Engineering, 48(11), 1282–1291. https://doi.org/10.1109/10.959324
Porta, A., Tobaldini, E., Guzzetti, S., Furlan, R., Montano, N., & Gnecchi-Ruscone, T. (2007). Assessment of cardiac autonomic modulation during graded head-up tilt by symbolic analysis of heart rate variability. American Journal of Physiology-Heart and circulatory Physiology, 293(1), H702-H708. https://doi.org/10.1152/ajpheart.00006.2007
Rebelo-Marques, A., Lages, A. D. S., Andrade, R., Ribeiro, C. F., Mota-Pinto, A., Carrilho, F., & Espregueira-Mendes, J. (2018). Aging hallmarks: The benefits of physical exercise. Frontiers in Endocrinology, 9, 1–15. https://doi.org/10.3389/fendo.2018.00258
Rogers, B., Mourot, L., Doucende, G., & Gronwald, T. (2021). Fractal correlation properties of heart rate variability as a biomarker of endurance exercise fatigue in ultramarathon runners. Physiological Reports, 9(14), 1–9. https://doi.org/10.14814/phy2.14956
Schüttler, D., Hamm, W., Bauer, A., & Brunner, S. (2020). Routine heart rate-based and novel ecg-based biomarkers of autonomic nervous system in sports medicine. Deutsche Zeitschrift Fur Sportmedizin, 71(6), 141–150. https://doi.org/10.5960/DZSM.2020.428
Shaffer, F., & Ginsberg, J. P. (2017). An Overview of Heart Rate Variability Metrics and Norms. Frontiers in Public Health, 5, 1–17. https://doi.org/10.3389/fpubh.2017.00258
Singh, N., Moneghetti, K. J., Christle, J. W., Hadley, D., Froelicher, V., & Plews, D. (2018). Heart rate variability: An old metric with new meaning in the era of using mHealth technologies for health and exercise training guidance. Part two: Prognosis and training. Arrhythmia and Electrophysiology Review, 7(4), 247–255. https://doi.org/10.15420/aer.2018.30.2
Soares-Miranda, L., Sattelmair, J., Chaves, P., Duncan, G., Siscovick, D., Stein, P., & Mozaffarian, D. (2014). Physical Activity and Heart Rate Variability in Older Adults: The Cardiovascular Health Study. Circulation, 21, 256–262. https://doi.org/10.1161/CIRCULATIONAHA.113.005361.Physical
Stanley, J., Peake, J. M., & Buchheit, M. (2013). Cardiac parasympathetic reactivation following exercise: Implications for training prescription. Sports Medicine, 43(12), 1259–1277. https://doi.org/10.1007/s40279-013-0083-4
Takahashi, A. C. M., Porta, A., Melo, R. C., Quitério, R. J., da Silva, E., Borghi-Silva, A., Tobaldini, E., Montano, N., & Catai, A. M. (2012). Aging reduces complexity of heart rate variability assessed by conditional entropy and symbolic analysis. Internal and emergency medicine, 7(3), 229–235. https://doi.org/10.1007/s11739-011-0512-z
Tan, T., Meng, Y., Lyu, J. L., Zhang, C., Wang, C., Liu, M., Zhao, X., Lyu, T., & Wei, Y. (2022). A Systematic Review and Meta-Analysis of Tai Chi Training in Cardiorespiratory Fitness of Elderly People. Evidence-Based Complementary and Alternative Medicine, 2022(1). https://doi.org/10.1155/2022/4041612
Thayer, J. F., Åhs, F., Fredrikson, M., Sollers, J. J., & Wager, T. D. (2012). A meta-analysis of heart rate variability and neuroimaging studies: Implications for heart rate variability as a marker of stress and health. Neuroscience and Biobehavioral Reviews, 36(2), 747–756. https://doi.org/10.1016/j.neubiorev.2011.11.009
Xia, H. (2023). Tai Chi Influence on Cardiopulmonary Function in the Elderly. Revista Brasileira de Medicina Do Esporte, 29, 6–9. https://doi.org/10.1590/1517-8692202329012022_0413
Xianjian, C., & Datao, X. (2021). Effects of Tai Chi Chuan on the Physical and Mental Health of the Elderly: A Systematic Review. Physical Activity and Health, 5(1), 21–27. https://doi.org/10.5334/paah.70
Yadav, R. L., Yadav, P. K., Yadav, L. K., Agrawal, K., Sah, S. K., & Islam, M. N. (2017). Association between obesity and heart rate variability indices: An intuition toward cardiac autonomic alteration-a risk of CVD. Diabetes, Metabolic Syndrome and Obesity, 10, 57–64. https://doi.org/10.2147/DMSO.S123935
Young, H. A., & Benton, D. (2018). Heart-rate variability: A biomarker to study the influence of nutrition on physiological and psychological health? Behavioural Pharmacology, 29, 140–151. https://doi.org/10.1097/FBP.0000000000000383
Zheng, G., Li, S., Huang, M., Liu, F., Tao, J., & Chen, L. (2015). The effect of Tai Chi training on cardiorespiratory fitness in healthy adults: A systematic review and meta-analysis. PLoS ONE, 10(2), 1–20. https://doi.org/10.1371/journal.pone.0117360
Zou, L., Sasaki, J. E., Wei, G. X., Huang, T., Yeung, A. S., Neto, O. B., Chen, K. W., & Hui, S. S. C. (2018). Effects of mind–body exercises (Tai Chi/Yoga) on heart rate variability parameters and perceived stress: A systematic review with meta-analysis of randomized controlled trials. Journal of Clinical Medicine, 7(11). https://doi.org/10.3390/jcm7110404
