Intervenção cinesioterapêutica associada a exergame como agente modulador de marcadores epigenéticos e aspectos cognitivos em mulheres idosas

Human aging is a natural process, which is accompanied by several changes, such as decreased muscle strength, balance deficit, changes in cognitive functions and imbalance of epigenetic markers. A kinesiotherapeutic exercise program can minimize or recover the effects of these changes, especially if associated with the use of exergames, however, the molecular mechanisms associated with this response are not elucidated. Therefore, the objective of this thesis was to evaluate the effects of a kinesiotherapeutic intervention protocol with the use of an exergame on the modulation of peripheral epigenetic markers: global histone H3 acetylation levels, global histone H4 acetylation levels, factor levels Brain-derived neurotrophic factors (BDNF) and cognitive aspects in elderly women. The specific objectives were: i) Develop an intervention protocol; ii) Assist in proposing an exergame for the kinesiotherapeutic intervention protocol; iii) To verify the effect of the association of kinesiotherapeutic exercise with the use of exergame on the modulation of epigenetic markers and BDNF in peripheral blood; iv) Evaluate pre- and post-intervention cognitive aspects with kinesiotherapeutic exercises associated with the use of exergame and with conventional therapy; and v) Compare the results between the control group and the intervention group before, after the first session and after the intervention. To answer the objectives, two scientific productions were developed, both presented in the form of scientific articles. The first production, Chapter 3, presents the protocol of the intervention, specific objective I. The second production, Chapter 4, presents the general objective and the specific objectives III, IV and V. To respond to these objectives, a randomized controlled clinical trial was conducted. , not blind. The sample consisted of 22 elderly women, aged 60 years or older, with preserved cognitive appearance, ability to walk, who did not have heart or neurological diseases and who had a eutrophic Body Mass Index (BMI). Participants were stratified into two groups: the control group (n=10), which performed the kinesiotherapy intervention protocol and the intervention group (n=12), which performed the kinesiotherapy intervention protocol using an exergame. The instruments used for the evaluation were: peripheral blood collection, to measure epigenetic markers; Montreal Cognitive Assessment (MoCa) scale, to assess cognitive functions; geriatric depression scale (GDS-15) for tracking mood disorders and the Borg Scale for subjective rating of effort. Both interventions were performed at a frequency of 02/week for 06 weeks and occurred individually. Before and after each session, the vital signs of the participants were measured. Both exergame and conventional interventions improved cognitive performance, improved the inflammatory profile, increased BDNF levels, and induced histone H4 and H3 hyperacetylation state in elderly women. The results showed that both interventions can be considered important strategies capable of promoting cognitive improvement in healthy elderly women, which seems to be associated with peripheral increases in histone and BDNF acetylation levels.

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