Efeitos do exercício sobre a modulação autonômica em crianças: atualização de literatura

Mondoni, Gustavo Henrique de Oliveira; Vanderlei, Luiz Carlos Marques; Saraiva, Bruno; Vanderlei, Franciele Marques

doi:10.1590/0103-5150.028.003.AR03

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Sumário

Review articles • Fisioter. Mov. 28 (3) • Jul-Sep 2015 • https://doi.org/10.1590/0103-5150.028.003.AR03 copiar

Efeitos do exercício sobre a modulação autonômica em crianças: atualização de literatura

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

Introdução

Sabe-se que a prática de exercícios físicos é benéfica e proporciona adaptações ao sistema nervoso autônomo. No entanto, o efeito do exercício sobre a modulação autonômica cardíaca em crianças, apesar de ser uma condição importante, é pouco investigada.

Objetivo

Reunir informações atuais a respeito dos efeitos do exercício físico sobre a variabilidade da frequência cardíaca de crianças saudáveis e obesas.

Método

A atualização da literatura foi realizada por meio de uma busca dos artigos nas bases de dados PubMed, PEDro, Scielo e Lilacs — por meio dos descritores “exercício” e “criança” em cruzamento com os descritores “sistema nervoso autônomo”, “sistema nervoso simpático”, “sistema nervoso parassimpático” e também com o não descritor, mas palavra chave deste estudo, “variabilidade da frequência cardíaca” — publicados no período de janeiro de 2005 a dezembro de 2012.

Resultados

Após a eliminação dos artigos que não se enquadravam no tema do artigo foi selecionado um total de nove artigos, sendo cinco com crianças saudáveis e quatro com obesas.

Conclusão

Os achados sugerem que o exercício físico pode atuar na normalização das alterações existentes no sistema nervoso autonômico de crianças obesas, assim como servir como um fator de prevenção em crianças saudáveis, para que ocorra um desenvolvimento saudável do sistema nervoso autonômico até que a crianças atinja a idade adulta.

Exercício físico; Criança; Variabilidade da frequência cardíaca; Sistema nervoso autônomo

Author and year	Study objectives	Study population	Physical exercise performed	Indices evaluated	Conclusion
Gamelin et al., 2009 (35)	To investigate the effects of high intensity intermittent training of short duration on autonomic cardiovascular control.	52 children. -Training group (n = 26; 15 boys and 11 girls; 9.8 ± 0.7 years). -Control group (n = 26; 14 boys and 12 girls; 9.3 ± 1.2 years).	Intermittent exercise for 30 minutes, 3 times per week for 7 weeks. The sessions were composed of short and intermittent running with an intensity of between 100 and 190% of maximal aerobic speed (MAS).	SDNN, rMSSD, LF, HF, SD1 and SD2.	The high-intensity intermittent training improved aerobic conditioning, but did not affect cardiac autonomic regulation in children.
Goulopoulou et al., 2010 (18)	To analyze the differences in the blood pressure response and cardiovagal autonomic modulation during isometric handgrip exercises between children and adults.	-23 healthy children aged 7 to 9 years. -23 healthy adults aged 20 to 25 years.	Participants were seated, positioned with the elbow of the dominant upper limb at 90o. A maximal voluntary strength test (MVS) was performed and the best of three attempts used as the value of MVS. After determining the maximum force, the subjects performed a sustained isometric contraction to 30% of MVS for 3 minutes.	SDNN*, rMSSD^x and HF^x.	The differences in blood pressure responses of children and adults during an isometric contraction cannot be explained by differences in cardiovagal autonomic modulation and appear to be associated with factors that contribute to the force.
Iwasa et al., 2005 (36)	To investigate the relationship between HRV at night and physical activity in children.	29 children (17 boys and 12 girls; 7.5 ± 1.4 years).	Using a pedometer and multimemory accelerometer, the authors measured the number of steps and the intensity of the exercise performed during the day. These findings were associated with HRV collected during the night (12 p.m. – 5 a.m.).	SDNN*, rMSSD^x, SDANN, LF, HF^x, LF/HF and RR50^x.	Physical activity increases heart rate during sleep, but reduces the activity of the parasympathetic nervous system during the night, characterized by reduction in the HF and RR50 indices.
Leicht et al., 2008 (37)	To examine the moderate term reproducibility of heart rate and frequency domain indices of HRV at rest and during light to moderate exercise in children.	10 healthy and active children (6 boys and 4 girls, aged 7 to 12 years).	Training for 8 weeks, continuous walking on a treadmill at 3 workloads: 2 km/h at 0% inclination, 50% and 60% of MHR predicted by age. Each work intensity lasted for 10 minutes.	FC, LF (ms²/hz), LF* (nu), HF^x (ms²/hz), HF^x (nu) and LF/HF.	During eight weeks of training with light and moderate exercise, the reproducibility of HRV was considered low, but there were limitations regarding the sample size, and only measures of HRV in the frequency domain were analyzed.
Longin et al., 2009 (33)	To introduce a battery of autonomic tests, specifically for children and adolescents, to establish normative parameters of HRV and compare the impact of these autonomic tests.	100 healthy individuals between 6 and 15 years of age (51 girls and 49 boys). -Group of children (5 to 11 years). -Group of adolescents (12 to 15 years).	Sustained manual isometrics for 2 minutes with 30% of the established maximum power.	rMSSD (ms), LF (ms²) and HF (ms²).	The study provides the first normative data for HRV for the battery of autonomic tests specifically for children and adolescents in addition to quantifying autonomic changes induced by the test procedures compared with measurements from the database.

Author and year	Study objectives	Study population	Physical exercise realized	Indices evaluated	Conclusion
Lira et al., 2012 (34)	To compare the parameters of cardiac autonomic modulation between obese and eutrophic individuals and to analyze the effect of supplementation with vitamin C on cardiac autonomic modulation in obese children, at rest and during isometric exercise respectively.	8 eutrophic (BMI = 18 ± 1 kg/cm2) and 21 obese (BMI = 29 ± 1 kg/cm2) children, aged 8 to 11 years, both genders, divided into two groups: supplemented with 500 mg of vitamin C (n = 11) and placebo (n = 10) for 45 days.	Isometric handgrip of the dominant limb.	FC (bpm), LF* (un), HF^x (un) and LF/HF*.	Obese children present higher sympathetic activity and lower vagal activity at rest and during isometric exercise when compared with eutrophic children. In addition, oral supplementation with vitamin C, in high doses, can restore cardiac autonomic dysfunction in obese children.
Lucini et al., 2013 (38)	To evaluate whether the cardiac baroreflex and autonomic indices are altered in overweight football players.	103 boys of 11.1 ± 1 year, soccer practitioners.	3 weekly training sessions of 1 and-a-half hours composed of resistance exercise at moderate/vigorous intensity and a football match at least 1 hour per week.	LF (ms²), LF (nu), HF (ms²), HF (nu), LF/HF and LF⁺ (mmHg).	Overweight child soccer players have an altered cardiovascular autonomic profile despite intense aerobic training.
Nagai et al., 2004 (39)	To investigate cardiac autonomic activity in slim and obese children; focused on different levels of physical activity.	1080 healthy children (576 boys and 504 girls) aged 6 to 12 years. Subsequently 96 children were selected divided into four groups: active slim (23 boys and 1 girl); inactive slim (8 boys and 16 girls); active obese (23 boys and 1 girl); and inactive obese (8 boys and 16 girls).	Physical activity was classified as the frequency of participation in extracurricular activities (active: 3 times a week; inactive: none).	LF*⁺ (ms²) and HF^x+ (ms²).	Obese children exhibited a reduction in sympathetic and parasympathetic modulation compared with slim children who had similar levels of physical activity. This autonomic reduction was related to the amount of body fat in the inactive state. On the other hand, normal physical activity can contribute to improvement in the overall autonomic activity in both slim and obese children.
Prado et al., 2010 (40)	To assess the relationship between heart rate recovery in one minute, ANS activity, cardiorespiratory fitness, and anthropometric variables in obese children undergoing hypocaloric diet in isolation and diet associated with training.	33 children aged 8 to 12 years, BMI > 95th percentile and without participating in an exercise program. They were divided into two groups: hypocaloric diet (n = 15) and hypocaloric diet associated with exercise (n = 18).	Maximum stress test on a treadmill, using a progressive ramp protocol, with minute by minute load progression. The training program consisted of 3 sessions of 60 minutes of training per week over a period of 4 months. Each session was held with a 30 minute walk and/or run on the jogging track followed by 30 minutes of recreational exercises.	FC^≠ (bpm), LF^≠ (nu), LF^≠ (ms²), HF^≠ (nu), HF^≠ (ms²) and LF/HF ratio^≠.	The hypocaloric diet combined with physical training, in contrast to the hypocaloric diet alone, promoted improvement in heart rate recovery in 1 minute and in the activity of the ANS in obese children.

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[1] *GHOM: specialist, e-mail:gustavohomondoni@gmail.com LCMV: PhD, e-mail:lcmvanderlei@fct.unesp.br BS: specialist, e-mail:bsl87@hotmail.com FMV: PhD, e-mail:franmvanderlei@gmail.com