Basquete em cadeira de rodas, melhora no tratamento da infecção das vias urinárias em pessoas com deficiência motora : ensaio clinico

Abstract

People with disabilities (PCD) especially those who use mobility aids in a wheelchair (CR), orthotics or prostheses have a high chance of developing several pathologies, including chronic episodes of urinary tract infection (UTI) . Objectives: To investigate the effect of wheelchair basketball (BCR) intervention and clinical follow-up on UTI and to analyze biochemical, immunological and microbiological biomarkers in motor PCD. Design: Experimental follow-up study of 12 months of BCR practice, twice a week, with 48 male individuals aged 18 years to 55 years, allocated in a control group (CG; n=21) and an experimental group (EG; n=27) Location: The study was developed (NP-TIMES-UFMT), carried out by the Júlio Muller University Hospital, both from the Federal University of Mato Grosso (UFMT) and technical and logistical support from the Health and Sports Departments. Participants: Participants (n=48) were male, aged from at least 18 to 55 years, divided into a control (CG) and experimental (EG) group. Urine collections were made in 2 pots, one for abnormal elements and sediments (EAS) and the other for urine culture with antibiogram, as well as blood collection for quantification of biomarkers. Results: In the CG, spinal cord trauma (SCI) 68% (n=15), and traumatic brain injury associated with SCI and transverse myelitis 18% (n=4) and other etiological factors 18.2% (n=4). In EG, the highest incidence of poliomyelitis was 21% (n=9), followed by TRM 21% (n=8). The CG had a prevalence of 40% (n=8) of the Escherichia coli bacteria and 30% (n=6) EG in the moments before and after the intervention. In the intragroup analysis, the EG showed improvement (X2=0.835) in the pre- and post-intervention moments, showing greater chances of protection when the 12-month intervention was performed by the BCR. Regarding this same analysis, in the CG there was an improvement in the moments before and after the intervention (X2=1.154; X2=1.187; X2=1.187) for the bacteria Escherichia coli, Morganellla morgani, Citrobacter frendi, respectively; thus demonstrating greater chances of risks and reinfection when they were not in BCR training associated with a risk factor in 51% in the CG in the development of UTI. In the intergroup comparison, there was an improvement in the EAS and urine culture, in addition to the antibiogram before (p=0.004), and after the intervention (p=0.011), respectively. Also in the intergroup comparison, there was a decrease in the infection caused by the bacterium Klebsiella pneumoniae (p=0.027), as well as an increase in the variable partially activated thromboplastin time (p=0.046), HCM (p=0.032), CHCM (p=0.021) and platelets (p=0.022). In EG, there was an increase in hematimetric markers of hemoglobin (p=0.01) and hematocrit (p=0.005), as well as a reduction in glycated hemoglobin (p=0.000). In the intragroup comparison, there was a reduction in T3 (p=0.01), IL-6 (p=0.006) before and in C-reactive protein (p=0.035) after the intervention, both in the EG and in the CG. Conclusion: In this clinical trial, there was a reduction in UTI and improvement in biochemical, immunological and microbiological biomarkers assessed through the practice of physical exercise by BCR, as well as due to multidisciplinary monitoring and health education in the studied population.