Análise do controle autonômico cardíaco em indivíduos com paralisia cerebral praticantes de bocha

Abstract

Cerebral palsy (CP) is lifelong related to the emergence of chronic non-communicable diseases and autonomic nervous system dysfunctions. The focus of the study on sympathovagal balance is increasing over time, and its behavior in people with CP is important in determining the probability of developing heart disease. As a possibility of physical exercise, Bocce is considered an excellent sports intervention in rehabilitation for this population, even for cases with greater impairment. Therefore, our study aimed to evaluate the behavior of cardiac autonomic modulation in Bocce athletes with CP. Forty-five volunteers of both sexes with 26.5 ± 1.7 years old and a body mass index (BMI) of 24.1 ± 1.4 kg/m2, were allocated into 3 groups according to the characteristics of each individual, being a control group (CON), composed of 15 individuals with appropriate motor development, sedentary CP group (sCP), composed of 15 individuals with clinical diagnosis of CP and who did not perform any type of physical activity and the Bocce CP group (BCP), composed of 15 individuals with clinical diagnosis of CP, assiduous practitioners of Bocce. Anthropometric profile, hemodynamic and cardiac autonomic parameters were measured at rest. We observed a greater bradycardia at rest in the BCP and CON groups compared to the sCP group (p<0.01). Diastolic and mean blood pressure were higher in the CON group compared to the BCP group (p<0.05 and p<0.01), respectively. Both the BCP and CON groups showed lower values of double product when compared to the sCP group (p<0.01). The indices for cardiac parasympathetic modulation were significantly higher in the BCP and CON groups compared to the sCP group (p<0.01). Sympathetic activity to the heart was higher in the sCP group than in the BCP group (p<0.01) and CON (<0.01). We found a moderate and negative correlation between the increase in cardiac parasympathetic modulation and the reduction in resting HR (r=-0.662; p<0.01). We can conclude that the regular practice of Bocce reduces the sympathetic activity and increases the parasympathetic performance on the heart of the individuals with CP.