Banca de QUALIFICAÇÃO: Juliana Goulart Prata Oliveira Milani

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : Juliana Goulart Prata Oliveira Milani
DATE: 28/03/2023
TIME: 14:00
LOCAL: : Laboratório de Fisiologia Clínica do Exercício (LabFCE)
TITLE:

EXERCISE INTENSITY DOMAINS RECOMMENDATIONS DETERMINED BY HEART RATE AT VENTILATORY THRESHOLDS: STUDY ON RECOMMENDATIONS FOR CARDIOVASCULAR REHABILITATION PRESCRIPTION AND DEVELOPMENT OF NEW METHODOLOGIES.

KEY WORDS:

Cardiovascular Disease, Cardiac Rehabilitation, Exercise Test, Cardiopulmonary Exercise Testing, Exercise, Health Planning Guidelines

PAGES: 116
BIG AREA: Outra
AREA: Multidisciplinar
SUMMARY:

Background: Exercise prescription is a cornerstone of efficient and safe cardiovascular rehabilitation (CR). Although the direct identification of ventilatory thresholds (VTs) by cardiopulmonary exercise testing (CPET) is the gold standard, such testing is not always available, and prescription by indirect methods remains challenging. Aims: To compare elicited exercise responses at VTs, identified by CPET, with the recommendations of current CR guidelines for the prescription of physical exercises in individuals with heart diseases; to propose a new methodology for defining prescription parameters; and to compare the accuracy of different prescribing methods (guideline recommendations and new equations). Methods: Retrospective cross-sectional study, which assessed 972 maximum treadmill CPET in patients with cardiovascular disease (CVD). VTs were identified and compared with the prescription’s recommendations for exercise intensity domains reported in the guidelines. Multilinear regression analyzes were performed to generate prediction equations for heart rate at VTs. Accuracy was assessed by the mean absolute percentage error (MAPE) of the prescribing methods. Results: Significant dispersions of individual responses were found for both VTs, with the same relative intensity of effort corresponding to different guideline-based intensity domains. Specific equations for the patients with CVD were yielded using variables from the ergometry test, with r2 of 0.726 for the first ventilatory threshold (LV1) and 0.901 for the second ventilatory threshold (LV2). The MAPE for the VT1 equation was 6.0% and 4.3% for VT2, both lower than the values calculated for other indirect prescription methods based on percentages of measured and estimated peak heart rate recommended by the guidelines (9.5 to 28 .6% for VT1 and 5.8 to 24.5% for VT2), which indicates better accuracy of the new equations. Regarding the prescription methods based on the percentages of heart rate reserve, the new equation for VT1 revealed similar accuracy to the European and American recommendations, but superior to the Brazilian recommendation. Regarding VT2, the new equation showed better accuracy than the guideline recommendations. Conclusions: The guideline-based exercise intensity domains for CR revealed important inconsistencies and heterogeneity, which limits the currently used methods. New equations specific for patients with CVD were developed and demonstrated superior accuracy, indicating that this methodology may be a valid alternative when CPET is not available.

BANKING MEMBERS:
Externo à Instituição - ANDERSON DONELLI DA SILVEIRA - UFRGS
Externa à Instituição - APARECIDA MARIA CATAI - UFSCAR
Presidente - 1657320 - GERSON CIPRIANO JUNIOR
Interno - 1684032 - JOAO PAULO CHIEREGATO MATHEUS