RESUMO
Programas de intervenção, voltados aos transtornos psicóticos, têm investido em melhorar a qualidade do cuidado ofertado aos jovens na fase inicial da psicose, na tentativa de garantir um melhor prognóstico. Assim, a prática de exercícios físicos tem sido incentivada e elencada como estratégia essencial para o processo de recovery. Porém, alguns desafios têm sido identificados para a prática de exercício físico por esses indivíduos como, principalmente, a falta de motivação e o engajamento. Desse modo, faz-se fundamental a elaboração de programas de exercícios físicos que incorporem estratégias para o enfrentamento destes desafios. O presente estudo teve como objetivo desenvolver um programa de exercícios físicos digital para indivíduos na fase inicial da psicose e seus familiares. Assim, o estudo metodológico qualitativo realizado considerou as recomendações para o primeiro estágio, desenvolvimento, da versão revisada do Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare (CReDECI2) e, para auxiliar na descrição de todos os componentes da intervenção, foi adotado os 16 itens aprovados pelo Consensus on Exercise Reporting Template (CERT). O programa foi desenvolvido por um profissional de educação física em parceria com docentes e profissionais da saúde, especialistas em saúde mental. Os resultados descreveram o desenvolvimento do Mental Move - vinculado ao Centro de Ciência, Cuidado e Apoio na Psicose (CiCAP) que propõe uma intervenção combinada com sessões de treino disponíveis no formato digital para indivíduos na fase inicial da psicose e seus familiares. Para auxiliar nas orientações e na motivação para realização do programa foram elaborados um manual em formato de ebook e outros materiais de apoio. Todo o conteúdo do programa foi inserido em uma Plataforma digital que confere acesso livre aos participantes. O programa incorporou estratégias para motivar o público-alvo para iniciar a prática de exercício físico em sua rotina semanal; ser de fácil execução; podendo ser realizado de forma individual, ou com a presença de um familiar ou grupo; ser gerenciado pelos participantes e/ou ao mesmo tempo por profissionais de saúde de forma indireta ou direta; ser de fácil acesso; ser viável para ser oferecido em diferentes cenários, como o domicílio, serviços de saúde, entre outros; e com baixo custo financeiro. Outros estudos serão necessários para que sejam percorridas as etapas de validação e avaliação previstas para a sua disponibilização. Espera-se que programas desta natureza possam ser incorporados às ações de cuidado em saúde mental pelos profissionais de saúde e contribuir para a promoção de saúde mental e melhora da qualidade de vida dos indivíduos na fase inicial da psicose e seus familiares
Intervention programs focused on psychotic disorders have invested in improving the quality of care offered to young people in the early stages of psychosis in an attempt to ensure a better prognosis. Thus, the practice of physical exercises has been encouraged and listed as an essential strategy for the recovery process. However, some challenges have been identified for the practice of physical exercise by these individuals, mainly the lack of motivation and engagement. Therefore, it is essential to develop exercise programs that incorporate strategies to face these challenges. The present study aimed to develop a digital physical exercise program for individuals in the initial phase of psychosis and their families. Thus, the qualitative methodological study conducted considered the recommendations for the first stage, development, of the revised version of the Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare (CReDECI2) and, to assist in the description of all components of the intervention, the 16 items approved by the Consensus on Exercise Reporting Template (CERT) were adopted. The program was developed by a physical education professional in partnership with faculty and health professionals who specialize in mental health. The results described the development of Mental Move - linked to the Center for Science, Care and Support in Psychosis (CiCAP) which proposes a combined intervention with training sessions available in digital format for individuals in the early stages of psychosis and their families. To assist in the orientation and motivation for carrying out the program, a manual in ebook format and other support materials were prepared. All the content of the program was inserted in a digital platform that gives free access to the participants. The program incorporated strategies to motivate the target audience to start practicing physical exercise in their weekly routine; to be easy to implement; to be carried out individually, or with the presence of a family member or group; to be managed by the participants and/or at the same time by health professionals indirectly or directly; to be easily accessible; to be feasible to be offered in different settings, such as home, health services, among others; and with low financial cost. Further studies will be necessary to go through the validation and evaluation stages foreseen for its availability. It is hoped that programs of this nature can be incorporated into mental health care actions by health professionals and contribute to the promotion of mental health and improvement in the quality of life of individuals in the initial phase of psychosis and their families
Assuntos
Humanos , Exercício Físico/psicologia , Saúde Mental , Transtornos Mentais/reabilitação , Serviços de Saúde MentalRESUMO
The current manuscript reviews the literature on the health effects of resistance training (RT) for individuals with Down syndrome (DS), focusing on this training modality's methodology, application, and safety. The literature has mentioned that early aging in this population is associated with loss of muscle strength, lower lean and bone mass, and increased obesity. It is necessary to propose non-pharmacological measures for prevention and health promotion. Thus, this review suggests a current research-based RT guide for individuals with DS. This review is divided into three sections: Section 2 briefly reviews DS and the effects on structural and functional decline and how exercise and physical activity can influence health aspects in this population; Section 3 summarizes the evidence for RT prescription; Section 4 briefly reviews the health and potential benefits of RT in individuals with DS. The findings from this review suggest that most individuals with DS should engage in moderate-intensity RT at least 2 days a week and perform RT on the major muscle groups and include balance training. The RT program should be modified and adapted according to individuals' characteristics and limitations. RT promotes positive, health-related benefits such as increasing strength, improving body composition, improving functional capacity and balance, reducing inflammatory status and oxidative stress, and improving the immune system. The RT protocols summarized in this current review provide guidance, critical conclusions, and novel research settings, which could be useful to coaches, clinicians, and researchers to effectively design RT program for individuals with DS.