Eficácia de um protocolo de exercícios aeróbicos aquáticos na concentração de fator neurotrófico derivado do cérebro (BDNF) e o impacto em medidas clinicas em indivíduos após acidente vascular encefálico (AVE) na fase subaguda: um protocolo clínico randomizado

Abstract

Introduction: The stroke is one of the main causes of morbidity in the world. Among the existing rehabilitation strategies, Evidence shows that aerobic exercise is capable of promoting benefits in motor and cognitive parameters in post-stroke individuals. One of the suggested mechanisms that explain the effects of physical exercise is the increased of the brain-derived neurotrophic fator concentration (BDNF) – a neurotrophic protein involved in the neuroplasticity process. However, there is no information about the effect of aquatic aerobic exercising on the BDNF concentration in individuals after a subacute stage of a stroke, as well as the impact of such a BDNF level on clinical measures. Objectives: To present a protocol for a randomised clinical trial. An aquatic aerobic training will be done with individuals after the subacute stage of a stroke. The primary objective is assessing the effectiveness of an aquatic aerobic exercising programme on the increase of the serum concentration of the Brain-derived neurotrophic factor. The secondary objective is analysing whether the change of the BDNF concentration impacts on the improvement of mobility and capacity of exercising, cognitive and affective functions, functional performance and quality of life. Design: Randomised clinical trial. Study site: Aquatic Physical Therapy Clinic. Participants: The participants gathering will be done at the Ambulatory of Neurology of the Metropolitan Centre of Medical Specialties of Santa Casa de Belo Horizonte and Risoleta Neves Hospital. Treatment: Participants will be randomised in two groups. The treatment group will participate in a protocol of aquatic aerobic exercises for 6 weeks, being altogether 18 sessions of 40 minutes length each. The control group will participate in a protocol of aquatic exercises, which is based on global stretching and relaxation, for the same period of time and quantity of sessions. Endpoint measure: The primary measure will be the peripheric concentration of BDNF before and after the treatment. The secondary measures will be the mobility assessment (Timed Up and Go, TUG; 10-meter test, T10m), exercising capacity (6minute walking test, TC6m), functional performance (Functional Independence measure, FIM), cognitive functions (Monteral Cognitive Assessment, MOCA), psycho-affective function (Beck’s Depression inventory, BDI) and assessment of the quality of life (Quality of Life Questionnaire, SF-36). Conclusion: The findings presented in this essay can provide important information on the effects of an aquatic aerobic exercising protocol on BNDF concentration in individuals after the subacute stage of a stroke, as well as information on how such changes may impact on the improvement of the functional performance and quality of life.