Aptidão neuromuscular em adolescentes com cardiopatias congênitas no estado de Alagoas

Abstract

Introduction: The amount of adolescents with congenital heart disease (CHD) and inadequate functional capacity is high. Low muscle fitness (MF), understood as the ability to perform well in strength manifestations, whether pure strength, explosive strength or strength endurance, are documented in this population and may be associated with clinical and morphological behavioral factors. Justification: Low MF in adolescents with CHD compromise functional capacity, which requires knowledge of different manifestations of muscle strength in this population. There are few studies that relate MF to clinical, physiological, behavioral and morphological conditions, suggesting potential clinical and diagnostic application. Objective: To evaluate MF and its relationship with clinical and morphological factors in adolescents with CHD. Methods: Observational, cross-sectional study, carried out in a single stage with adolescents with CHD, betweem 10 and 18 years of ager, receiving care at the reference service in the state of Alagoas, Casa do Coraçãozinho. MF was evaluated by the sum of the individual z-scores of the four tests that measure manifestations of strength: maximum isometric strength relativized by body mass index (BMI) (handgrip test), rapid strength (vertical jump test) and endurance strength (abdominal and elbow flexion test relativized by body mass). The complexity and clinical factors of CHD were assessed by analysis of medical records and questionnaires. The morphological indicators analyzed were the waist-to-height ratio (WHR), the sum of skinfolds (ƩDC) and the arm muscle area (AMA). Descriptive statistics and inferential analysis were performed using Pearson’s correlation, analysis of covariance and simple and adjusted linear regression. Results: 60 adolescents with CHD were evaluated, 55% (n=33) female, aged 12,7±2.1 years. The most prevalent heart diseases were interventricular communication (21,7%, n=13), interatrial communication (18,3%, n=11) and tetralogy of fallot (13,3%, n=8). Maximum isometric strength was reduced in 33% of participants (n=20 of 60), fast strength in 33% (n=19 of 57), abdominal strength endurance in 78% (n=42 of 54) and arm strength resistance, in 27% (n=11 of 56). The z-MF was calculated for adolescents who completed the four strength tests (n= 53), with a median (IIQ) of -0,2 (-1,6; 1,2). z-MF was reduced in 89% (n=47) of participants. In the simple regression analysis, z-MF was directly and significantly associated with AMA (β=0,12; p=0,02; R2adj=0,08) and in the adjusted regression it was significantly lower in the CHD group cyanotic-type (vs. acyanotic) (β=-1,76; p=0,03 R2adj=0,24). Conclusion: Inadequate levels of MF were evident in adolescents with CHD, in singular manifestations of strength and in the grouped score. z-MF was shown to be correlated with AMA and the presence of cyanosis-type CHD in adolescents. The present study highlights deficits in morphological and functional indicators of skeletal muscle, as well as associations with indicators of body composition and clinical factors of CHD. The reduction in muscle mass and the presence of cyanotic-type CHD imply a reduction in MF in adolescents.