Twenty weeks of isometric handgrip home training to lower blood pressure in hypertensive older adults: a study protocol for a randomized controlled trial

Martin Grønbech Jørgensen, Jesper Ryg, Mathias Brix Danielsen, Pascal Madeleine, Stig Andersen, Martin Grønbech Jørgensen, Jesper Ryg, Mathias Brix Danielsen, Pascal Madeleine, Stig Andersen

Abstract

Background: Hypertension markedly increases the risk of cardiovascular diseases and overall mortality. Lifestyle modifications, such as increased levels of physical activity, are recommended as the first line of anti-hypertensive treatment. A recent systematic review showed that isometric handgrip (IHG) training was superior to traditional endurance and strength training in lowering resting systolic blood pressure (SBP). The average length of previous IHG training studies is approximately 7.5 weeks with the longest being 10 weeks. Therefore, presently it is unknown if it is possible to further lower blood pressure levels beyond the 10-week mark. Recently, we developed a novel method for monitoring handgrip intensity using a standard Nintendo Wii Board (Wii). The primary aim of this study is to explore the effects of a 20-week IHG home training facilitated by a Wii in hypertensive older adults (50 + years of age) on lowering SBP compared to usual care. Secondary aims are to explore if/when a leveling-off effect on SBP will occur during the 20-week intervention period in the training group and to explore adherence and potential harms related to the IHG home training.

Methods/design: Based on previous evidence, we calculated that 50 hypertensive (SBP between 140 and 179 mmHg), older adults (50 + years of age) are needed to achieve a power of 80% or more. Participants will be randomly assigned to either an intervention >group (IHG home training + hypertension guidelines on lifestyle changes) or to a control group (hypertension guidelines on lifestyle changes). Participants in the intervention group will perform IHG home training (30% of maximum grip strength for a total of 8 min per day per hand) three times a week for 20 weeks. Resting blood pressure and maximal handgrip strength will be obtained by a blinded outcome assessor in both groups at specific time points (baseline, follow-up at 5, 10, 15, and 20 weeks) throughout the study.

Discussion: This assessor-blinded, randomized controlled trial will explore the effect of a 20-week IHG home training intervention on resting blood pressure in hypertensive older adults. In addition, the trial will report adherence and potential harms related to the IHG home training.

Trial registration: ClinicalTrials.gov, ID: NCT03069443 . Registered on 3 March 2017.

Keywords: Home training; Hypertension; Isometric handgrip training; Older adults.

Conflict of interest statement

Ethics approval and consent to participate

The Ethics Committee of the North Denmark Region (N-20160077) and the Danish Data Protection Agency (2016–204, 17 November 2016) has approved the study. The study has been registered at www.ClinicalTrials.gov (NCT03069443, 13 January 2017). Written informed consent will be obtained from each participant.

Consent for publication

Consent for publication has been obtained from involved parties.

Competing interests

MGJ is a shareholder of FysioMeter and will, therefore, not take part in either the data collection or data processing. The authors MBD, JR, PM, and SA declare that they have no competing interests

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of the POTENT study. IHG isometric handgrip training
Fig. 2
Fig. 2
Illustration of the target line and the “live” applied muscle force participants will be seeing during an isometric handgrip (IHG) training session
Fig. 3
Fig. 3
Schedule of enrollment, interventions, and assessments

References

    1. WHO. Global health risks: mortality and burden of disease attributable to selected major risks. Bull. World Health Organ. 2009;87:646–646.
    1. Lawrence MM, Cooley ID, Huet YM, Arthur ST, Howden R. Factors influencing isometric exercise training-induced reductions in resting blood pressure. Scand J Med Sci Sport. 2015;25(2):131–42. doi: 10.1111/sms.12225.
    1. Kelley GA, Kelley KS. Isometric handgrip exercise and resting blood pressure: a meta-analysis of randomized controlled trials. J Hypertens. 2010;28(3):411–8. doi: 10.1097/HJH.0b013e3283357d16.
    1. Mancia G, et al. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) J Hypertens. 2013;31(10):1925–38. doi: 10.1097/HJH.0b013e328364ca4c.
    1. Chobanian AV, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206–52. doi: 10.1161/01.HYP.0000107251.49515.c2.
    1. Eckel RH, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:25 Suppl 1. doi: 10.1161/01.cir.0000437740.48606.d1.
    1. Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):1–9.
    1. Carlson DJ, Dieberg G, Hess NC, Millar PJ, Smart NA. Isometric exercise training for blood pressure management: a systematic review and meta-analysis. Mayo Clin Proc. 2014;89(3):327–34. doi: 10.1016/j.mayocp.2013.10.030.
    1. Inder JD, Carlson DJ, Dieberg G, Hess NC, Smart NA. Isometric exercise training for blood pressure management: a systematic review and meta-analysis to optimize benefit. Hypertens Res. 2016;39(2):88–94. doi: 10.1038/hr.2015.111.
    1. Blomkvist AW, Andersen S, de Bruin ED, Jorgensen MG. Isometric hand grip strength measured by the Nintendo Wii Balance Board—a reliable new method. BMC Musculoskelet Disord. 2016;17(1):56. doi: 10.1186/s12891-016-0907-0.
    1. Jorgensen MG, Andersen S, Ryg J, Masud T. Novel use of the Nintendo Wii Board for measuring isometric lower limb strength: a reproducible and valid method in older adults. PLoS One. 2015;10(10):1–8.
    1. Chan A-W, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346(9):e7586. doi: 10.1136/bmj.e7586.
    1. Bang LE. Hypertensio arterialis—behandlingsvejledning. Hypertension. 2015;1–6.
    1. Badrov MB, Horton S, Millar PJ, Mcgowan CL. Cardiovascular stress reactivity tasks successfully predict the hypotensive response of isometric handgrip training in hypertensives. Psychophysiology. 2013;50(4):407–14. doi: 10.1111/psyp.12031.
    1. Craig CL, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95. doi: 10.1249/01.MSS.0000078924.61453.FB.
    1. Appel LJ, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997;336(16):1117–24. doi: 10.1056/NEJM199704173361601.
    1. Svendsen JH, Madeleine P. Amount and structure of force variability during short, ramp and sustained contractions in males and females. Hum Mov Sci. 2010;29(1):35–47. doi: 10.1016/j.humov.2009.09.001.
    1. Aagaard P. Training-induced changes in neural function. Exerc Sport Sci Rev. 2003;31(2):61–7. doi: 10.1097/00003677-200304000-00002.
    1. Bird M-L, Callisaya ML, Cannell J, Gibbons T, Smith ST, Ahuja KD. Accuracy, validity, and reliability of an electronic Visual Analog Scale for pain on a touch screen tablet in healthy older adults: a clinical trial. Interact J Med Res. 2016;5(1):e3. doi: 10.2196/ijmr.4910.
    1. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. doi: 10.1016/j.jbi.2008.08.010.
    1. Dannecker EA, Koltyn KF. Pain during and within hours after exercise in healthy adults. Sport Med. 2014;44(7):921–42. doi: 10.1007/s40279-014-0172-z.

Source: PubMed

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