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Abstract(s)
Introdução: O tabagismo é uma causa importante de doença e a eficácia da cessação
tabágica atual não ultrapassa os 45% após um ano de descontinuação do consumo.
Diversos ensaios clínicos têm sido realizados para avaliar a complementação da
cessação tabágica com um programa de exercício físico. No entanto ainda não está
estabelecido quais os tipos de exercício físico que são eficazes.
Objetivo: Determinar a eficácia de programas de exercício físico como complemento à
cessação tabágica convencional na abstinência.
Metodologia: Foi realizada uma pesquisa na PubMed de ensaios clínicos
randomizados que estudassem uma intervenção de exercício físico como
complementação a um programa de cessação tabágica. O risco de viés foi avaliado. O
principal outcome foi a diferença na percentagem de abstinentes entre os grupos
intervencionados. Outros outcomes foram o consumo tabágico diário, o ganho de peso
e eventos adversos.
Resultados: Foram incluídos 17 ensaios clínicos (4 com baixo risco de viés geral, 1
com algumas preocupações no risco de viés geral e 12 com alto risco de viés geral) que
envolveram 3166 participantes (experimental: n=1581 vs controlo: n=1543; um estudo
não discriminou esta distribuição, n=42), dos quais, 14 avaliaram um programa de
exercício físico aeróbico, 1 avaliou um programa de treino de força e 2 avaliaram um
programa de Yoga. 5 estudos revelaram resultados significativos no outcome principal:
dois avaliaram exercício físico aeróbico vigoroso e evidenciaram que o grupo
experimental tinha maior proporção de abstinentes no fim do tratamento e no followup, comparativamente com o controlo (n=281, FdT: 19.4% EF vs 10.8% C p=0.03,
follow-up: 11.9% EF vs 53.4% C p=0.05; subpopulação com alta sensibilidade à
ansiedade, FdT: 25.6% EF vs 11.6% C p=0.005; follow-up: 23.3% EF vs 10.2% C
p=0.005); um avaliou exercício físico aeróbico vigoroso numa população com
depressão e relatou uma maior percentagem de abstinentes no grupo teste no fim do
tratamento, comparativamente com o controlo (n=30 FdT: 73% vs 33%, p=0.028); dois
investigaram um programa de Yoga e concluíram que o grupo piloto tinha maior
probabilidade de estar abstinente no final do tratamento, comparativamente com o
controlo (n=55, FdT: OR =4.56, 95% CI 1.1-18.6, p=0.034; n=227, FdT: OR = 1.37, 95%
CI 1.07-2.79, p=0.05) Conclusão: Evidenciaram-se benefícios promissores na associação de exercício físico
a um programa de cessação tabágica, porém revelaram-se lacunas no conhecimento
atual. Assim, não é possível recomendar esta intervenção na prática clínica, sendo
necessários mais estudos para colmatar estas falhas.
Introduction: Smoking is an important cause of illness and the effectiveness of current treatments does not exceed 45% after one year of abstinence. Several clinical trials have been carried out to evaluate the complementation of smoking cessation programs with physical exercise. However, it is yet to be established what types of exercise programs are effective. Objective: Determine the effectiveness of physical exercise programs as a complement to conventional smoking cessation treatments in abstinence rates. Methods: A search was conducted at PubMed for randomized clinical trials. The risk of bias was assessed. The main outcome was the difference in the percentage of abstinent participants between intervention groups. Other outcomes were daily smoking consumption, weight gain and adverse events. Results: 17 clinical trials were included (4 had a low risk of bias, 1 had some concerns about the risk of bias, 12 had high risk of bias) involving 3166 participants (experimental: n=1581 vs control: n=1543; one study did not discriminate this distribution, n=42), of which 14 evaluated an aerobic exercise program, 1 evaluated a strength training program and 2 evaluated a Yoga program. 5 studies revealed significant results in the main outcome: two evaluated a vigorous aerobic exercise program and showed that the experimental group had higher proportion of abstinent individuals at the end of treatment and follow-up, compared to the control (n=281, EOT: 19.4% PE vs 10.8% C p=0.03, follow-up: 11.9% PE vs 53.4% C p=0.05; high anxiety sensitivity subpopulation, EOT: 25.6% PE vs 11.6% C p=0.005; follow-up: 23.3% PE vs 10.2% C p=0.005); one assessed a vigorous aerobic exercise program in a population with depression and reported higher percentage of abstinent participants in the test group at the end of treatment, compared to the control (n=30 EOT: 73% vs 33%, p=0.028); two investigated a Yoga program and reported that the pilot group was more likely to be abstinent at the end of treatment, compared to the control (n=55, EOT: OR =4.56, 95% CI 1.1-18.6, p=0.034; n=227, EOT: OR = 1.37, 95% CI 1.07-2.79, p=0.05). Conclusion: Promising benefits were found in the association of physical exercise with a smoking cessation program, but shortcomings in current knowledge were also revealed. Thus, it is not possible to recommend this intervention in clinical practice and further studies are needed.
Introduction: Smoking is an important cause of illness and the effectiveness of current treatments does not exceed 45% after one year of abstinence. Several clinical trials have been carried out to evaluate the complementation of smoking cessation programs with physical exercise. However, it is yet to be established what types of exercise programs are effective. Objective: Determine the effectiveness of physical exercise programs as a complement to conventional smoking cessation treatments in abstinence rates. Methods: A search was conducted at PubMed for randomized clinical trials. The risk of bias was assessed. The main outcome was the difference in the percentage of abstinent participants between intervention groups. Other outcomes were daily smoking consumption, weight gain and adverse events. Results: 17 clinical trials were included (4 had a low risk of bias, 1 had some concerns about the risk of bias, 12 had high risk of bias) involving 3166 participants (experimental: n=1581 vs control: n=1543; one study did not discriminate this distribution, n=42), of which 14 evaluated an aerobic exercise program, 1 evaluated a strength training program and 2 evaluated a Yoga program. 5 studies revealed significant results in the main outcome: two evaluated a vigorous aerobic exercise program and showed that the experimental group had higher proportion of abstinent individuals at the end of treatment and follow-up, compared to the control (n=281, EOT: 19.4% PE vs 10.8% C p=0.03, follow-up: 11.9% PE vs 53.4% C p=0.05; high anxiety sensitivity subpopulation, EOT: 25.6% PE vs 11.6% C p=0.005; follow-up: 23.3% PE vs 10.2% C p=0.005); one assessed a vigorous aerobic exercise program in a population with depression and reported higher percentage of abstinent participants in the test group at the end of treatment, compared to the control (n=30 EOT: 73% vs 33%, p=0.028); two investigated a Yoga program and reported that the pilot group was more likely to be abstinent at the end of treatment, compared to the control (n=55, EOT: OR =4.56, 95% CI 1.1-18.6, p=0.034; n=227, EOT: OR = 1.37, 95% CI 1.07-2.79, p=0.05). Conclusion: Promising benefits were found in the association of physical exercise with a smoking cessation program, but shortcomings in current knowledge were also revealed. Thus, it is not possible to recommend this intervention in clinical practice and further studies are needed.
Description
Keywords
Adição de Nicotina Atividade Física Cessação Tabágica Exercício Perturbação Por Uso de Tabaco