Respostas do pilates em dupla tarefa sobre parâmetros cognitivos e funcionais de mulheres pós-menopáusicas

Abstract

Aging may cause morphological and functional changes that may lead to decrease on physical functional and cognitive performance throughout aging, particularly on post-menopausal women. The performance in situations of divided attention (dual-task) may be reduced with advancing age, favoring the risk of falls and limiting functionality. The Pilates method is a form of physical exercise that combines strength and balance training and promotes improvement on these physical fitness variables in older adults. Considering the available evidence that dual- task training may promote additional benefits to the exercises performed isolated, including the prevention and/or improvement of cognitive decline associated with age, this study aimed to propose and evaluate the effects of a dual-task protocol composed of mat Pilates and Cognitive stimulation (PILATES-COG) on healthy, community-dwelling post-menopausal older women, compared to a group that received health education related materials. This is a non-randomized controlled trial, 47 women participated in this study (PILATES-COG =22; Control= 22), with amenorrhea for at least 12 months, and performance on the Mini-Mental State Examination compatible with normality, adjusted for schooling. Twenty-four sessions of solo Pilates were held, 2x week, during approximately 50 minutes, in classes, involving mat exercises and simultaneous cognitive tasks. Memory assessment (Word List, Delayed Recall and Recognition of the CERAD battery - Consortium to Establish a Registry for Alzheimer's Disease), language (Semantic and Phonological Verbal Fluency), balance (mini-BESTest), lower-limb muscle strength (Chair Sit-to-Stand Test), functional mobility (Timed Up and Go test – TUG; TUG with dual-task – TUG DT) and Dual-Task Cost (DT Cost). Two-way mixed ANOVA was used for data analysis, and Bonferroni was used as post-hoc to perform intra- and inter-group comparisons. Effect sizes were described with partial eta squared. Our results show that the main effects of Time were found for both Semantic Fluency (p = 0.002) and Phonological Fluency (p = 0.002), Immediate memory (p < 0.001) and Evocation Memory (p < 0.001), lower- limb muscle strength (p<0.001), balance (p<0.001) dual-task gait speed (p=0.023) and DT cost (p=0.012). Main effects of Group were found for lower-limb muscle strength, balance, TUG, TUG DT, speed in one and dual-task (p<0.001). There was interaction between Time and Group for language (p=0.017) as well as Balance and Lower-limb muscle strength (p=0.015; p=0.008). In the intragroup comparison, the participants on the Pilates group showed improvement after the intervention for the assessment of Language (p<0.001), Memory (p=0.001), Lower-limb muscle strength (p<0.001), balance (p<0.001) and DT Cost (p<0.05). The dual-task intervention, composed of mat Pilates exercises and cognitive stimulation, improved language, memory, lower limb muscle endurance and balance in postmenopausal women. We suggest this protocol may be a viable and effective strategy to reduce age-related cognitive decline and improve physical functional performance in healthy postmenopausal women.