The Borg scale as a tool for self-monitoring and self-regulation of the exercise effort in patients with heart failure in hydrotherapy and land: a randomized, blinded, controlled trial / A escala de Borg como ferramenta de auto-monitorização e auto-adaptação do esforço em pacientes com insuficiência cardíaca na hidroterapia e no solo: estudo randomizado, cego e controlado
AUTOR(ES)
Vitor Oliveira Carvalho
DATA DE PUBLICAÇÃO
2010
RESUMO
BACKGROUND: The Borg scale is the standardization of perceived exertion most widespread and has been proposed to ensure a submaximal effort in patients with the syndrome of heart failure (SIC). Hydrotherapy is a new method used in cardiovascular rehabilitation programs that seems to offer the patient an extra benefit compared to conventional exercise training. AIM: To evaluate the use of the Borg scale between "relatively easy and slightly tiring" as a tool for self-monitoring and self-adaptation to physical exertion in patients with the SIC on the land and on the hidrotherapy, by possibly lead the heart rate to a range between anaerobic threshold and respiratory compensation. METHODS: Patients performed the cardiopulmonary exercise test to determine the metabolic thresholds. The percentage of the mean heart rate during the exercise session in relation to the anaerobic threshold heart rate (%FCE-LA), in relation to the respiratory compensation point (%EHR-PCR), in relation to the peak heart rate by the exercise test (%EHR-Peak) and in relation to the maximum predicted heart rate (%EHR-Predicted) were performed. Then, patients were randomized into land or water groups. One investigator, blinded to metabolic thresholds heart rate, instructed the patients to walk between relatively easy and slightly tiring. The mean heart rate after the 30 minutes of exercise session was recorded. RESULTS: The %EHR-AT (114±11 to 111±11, p=0,352) and %EHR-Predicted (61±8 to 58±7, p=0,306) were not different between land and water groups; but different in the %EHR-PCR (95±7 to 86±7, p<0,001) and in the %EHR-Peak (85±8 to 78±9, p=0,007). The %EHR-AT (ri=0,63, p=0,018) showed an agreement between groups, but %EHR-VT (ri=0,33, p=0,192), %EHR-Peak (ri=-0,18, p=0,643) and %EHR-Predicted (ri=-0,38, p=0,755) did not. CONCLUSION: The exercise guided by the Borg scale has led to heart rate during exercise to a range between the threshold and respiratory compensation point (the target area of physical training). The hydrotherapy group had the heart rate closer to the anaerobic threshold as the land group that had closer to the respiratory compensation point, which seems to reflect the hemodynamic effect of immersion in hot water. This information is important to self-adapt and self-regulate the exercise training without a serial cardiopulmonary exercise test, what could imply in lowest cost.
ASSUNTO(S)
exercise exercício heart rate borg scale heart failure freqüência cardíaca escala de borg insuficiência cardíaca
