EFEITOS CRÔNICOS DO EXERCÍCIO AERÓBIO SOBRE O TRANSTORNO DO PÂNICO: UMA REVISÃO SISTEMÁTICA DE ENSAIOS CLÍNICOS RANDOMIZADOS E NÃO-RANDOMIZADOS

Lattari, Eduardo; Paes, Flávia; Machado, Ana; Rocha, Nuno Barbosa Ferreira; Nardi, Antônio Egidio; Machado, Sérgio

doi:10.5935/MedicalExpress.2015.06.02

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

Reviews • MedicalExpress (São Paulo, online) 2 (6) • Dez 2015 • https://doi.org/10.5935/MedicalExpress.2015.06.02 linkcopiar

EFEITOS CRÔNICOS DO EXERCÍCIO AERÓBIO SOBRE O TRANSTORNO DO PÂNICO: UMA REVISÃO SISTEMÁTICA DE ENSAIOS CLÍNICOS RANDOMIZADOS E NÃO-RANDOMIZADOS

Autoria SCIMAGO INSTITUTIONS RANKINGS

INTRODUÇÃO: Em geral, grande parte dos estudos indicam a existência de uma associação entre os efeitos agudos do exercício aeróbio e um estado de ansiedade reduzida; no entanto, estes estudos não conseguem elucidar completamente a relação entre o efeito crônico do exercício aeróbio e traços de ansiedade.

OBJETIVO: O objetivo deste estudo foi revisar sistematicamente a literatura sobre o efeito crônico do exercício sobre sintomas associados com transtorno do pânico.

MÉTODOS: Os estudos foram recuperados de: MEDLINE/PubMed, ISI Web of Knowledge e SciELO. Adotamos a estratégia PICOS para determinar os critérios de elegibilidade. A estratégia de busca foi realizada utilizando uma pesquisa avançada no ISI Web of Science, MEDLINE/PubMed e SciELO com os seguintes termos: “Transtorno de Pânico” e “Exercício”. Operadores booleanos AND e OR foram utilizados para combinação dos termos. A seleção dos estudos foi realizada por dois pesquisadores independentes que, em caso de desacordo, procuraram um consenso sobre a seleção.

RESULTADOS: Foram identificados um total de 265 artigos: 199 artigos do PubMed/Medline, 63 artigos do ISI Web of Science e 3 artigos através de pesquisas manuais. Assim, 31 artigos foram analisados pelos critérios de elegibilidade e os critérios de exclusão, sendo que um total de cinco estudos foram incluídos na revisão sistemática.

CONCLUSÃO: A prática regular de exercício aeróbio parece ser uma intervenção apropriada para promover a melhoria da gravidade dos sintomas de ansiedade em pacientes com transtorno de pânico.

PALAVRAS-CHAVE: Efeitos crônicos; exercício aeróbio; transtorno do pânico

Author, Year	N Patient (age)	Treatment	Medication	Duration	Supervision	Diagnostic/ severity	Measures	Comorbidity	Randomized	Main results
Hovland et al.¹⁷	PE= 17(38,1 ±8,6 years) CBT= 19 (37,8 ± 8,9 years)	PE Day 1 - aerobic exercise (walk and/or run), three weekly sessions, 60minutes, and with 60%-80% of HRmax Day 2- circuit training (nine exercises, 15-second break between each exercises and 2-minutes break between each circuit) Day 3- sports and play with 60 minutes CBT Emphasis on cognitive restructuring and behavioural experiments, one weekly session, and two hours per session	PE 17,6% BZD 41,2% SSRIs CBT 10,5% BZD 31,6% SSRIs	12 week, and 6 to 12 months of follow-up	PE Physiotherapist, Occupational Therapist and Nurse; CBT specialist clinical psychologist	DSM-IV/ not mentioned	Mi ACQ BSQ	80,6% agoraphobia 38,9% Major depression	Yes	Mi-Alone, Mi-Accompanied, and BSQ Interaction for group x moment for CBT group after treatment. Main effect to moment, revealed increased after treatment, and follow-up compared to baseline. ACQ Main effect to moment, with decreased compared to baseline
Wedekind et al.¹⁸	GEP=5 GEPL=5 GRP = 4 GRPL= 1	Exercise Running, three weekly sessions, 45 minutes, and with 70% of V0_2max Drug 20 mg of paroxetine or placebo per day (two weeks); 40 mg of paroxetine or placebo per day (3ª to 10ª week) Relaxation Autogenic Training, once a week, and 5 to 20 minutes at the end of the study	Promethazine (25-50 mg) in cases of panic attack	10 weeks	Exercise Coach Relaxation Trainer	DSM-IV ICD-10/PAS (minimum= 18 points)	P&A	Not mentioned	Yes	P&A The use of paroxetine was more effcient the fourth week com pa red to placebo; Compared exercise vs relaxation, after four week there was an improvement in the exercise group greater than relaxation
Broocks et al.¹⁵	GE = 11 Clom = 15 Control = 11	Exercise First week-three or four weekly sessions, and 4 miles Second week- short run (2 to4 minutes), and 4 miles Third week- Gradual increase of running Forth week- Encouraged to run Clomipramine First week- one capsules per day (37,5 mg); Second week- two capsules per day (37,5 mg); Third- 3 capsules per day (37,5 mg); Forth week- 3 capsules per day (37,5 mg) Control Placebo pills	Promethazine (25-50 mg) in cases of panic attack	10 weeks	Exercise Trainer	DSM-III ICD-10/ not mentioned	HAMA P&A (Obser- ver-Rated) P&A (Patient- -Rated)	Not mentioned	Yes	HAMA Improvements in Clom vs Control (6^th, 8^th, and 10^thweek) Improvements in GE vs Control (8^th, and 10^th week) P&A (Observer-Rated) Improvements in Clom vs Control (4^th, 6^th, 8^th, and 10^th week) Improvements in Clom vs GE (6^th, and 8^th week) Improvements in GE vs Control (8^th, and 10^th week) P&A (Patient-Rated) Improvements in Clom vs Contr (4^th, 6^th, and 8^th week) Improvements in Clom vs GE (6^th, and 8^th week) Improvements in GE vs Control (10^th week)
Merom et al.²¹	CBT + Exercise= 38 (34% TP) CBT+ ED=36 (36% TP)	CBT 90 minutes Exercise 30 minutes, 150 minutes per week, and moderate intensity self-selected by individual Educational (Contr) Healthy eating guidance	Not mentioned	8 weeks	Exercise Trainer CBT Psychologist experienced	DSM-IV/not mentioned	DASS-21	Not mentioned	Yes	DASS-21 No change in patients with PD
Meyer et al.¹³	GPE= 15 GPC= 15 GPPL= 15 HCG=11	Exercise Running, 3x per week, 45 to 60 minutes, and not mentioned intensity	No medication	10 weeks	Exercise Experienced runner	DSM-III/ P&A (Patient--Rated) mean= 25 points PAS (Observer--Rated) mean= 25.4 points) HAMA (mean = 22.6 points)	HAMA P&A (Obser-ver-Rated) P&A (Patient-Rated)	Not mentioned	Yes	HAMA Improvements in GPC vs GPPL (6th, and 10th week) Improvements in GPE vs GPPL (6th, and 10th week) P&A (Observer-Rated) Improvements in GPC vs GPPL, and GPE (6th week) Improvements in GPC, and GPE vs GPPL (10th week) P&A (Patient-Rated) Improvements in GPC vs GPPL, and GPE (6th week) Improvements in GPC e GPE vs GPPL (10th week)

vertical_align_top file_download show_chart

more_horizclose
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Mavera Edições Técnicas e Científicas Ltda Rua Professor Filadelfo Azevedo, 220, Cep: 04508-010, tel: (11) 3051 3043 - São Paulo - SP - Brazil
E-mail: medicalexpress@me.net.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

Acessibilidade / Reportar erro

[TFN01] CBT: Cognitive Behavior Therapy; BZD: benzodiazepines; SSRIs: selective serotonin reuptake inhibitor; HRmâx: maximum heart rate; DSM-III: Diagnostic and Statistical Manual of Mental Disorders (3ª edition); DSM-IV: Diagnostic and Statistical Manual of Mental Disorders (4ª edition); ICD-10: International Statistical Classification of Diseases and Related Health Problems (10ª edition); Ml: Mobility Inventory; ACQ: Agorafobia Cognitions Questionnaire; BSQ: Body Sensations Questionnaire; P&A: Panic and Agoraphobia Scale; ED: Educational; GEP: Group exercise + paroxetine; GEPL: Group exercise + placebo; GRP: Group relaxation + paroxetine; GRPL: Group relaxation + placebo; V0₂max: maximal oxygen consumption; Clom: clomipramine; Contr: contrôle; HAMA: Hamilton Anxiety Scale; DASS-21 : Depression Anxiety Stress Scale; PD: Panic disease; GPE: Group Panic + exercise; GPC: Group Panic + clomipramine; GPPL: Group Panic + placebo; HCG: healthy control group.