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Published in: Trials 1/2018

Open Access 01-12-2018 | Study protocol

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

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

Published in: Trials | Issue 1/2018

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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.
Appendix
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Literature
1.
go back to reference WHO. Global health risks: mortality and burden of disease attributable to selected major risks. Bull. World Health Organ. 2009;87:646–646. WHO. Global health risks: mortality and burden of disease attributable to selected major risks. Bull. World Health Organ. 2009;87:646–646.
2.
go back to reference 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.CrossRef 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.CrossRef
3.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
4.
go back to reference 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.CrossRef 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.CrossRef
5.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
6.
go back to reference 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.CrossRef 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.CrossRef
7.
go back to reference Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):1–9. Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):1–9.
8.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
9.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
10.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
11.
go back to reference 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. 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.
13.
go back to reference Bang LE. Hypertensio arterialis—behandlingsvejledning. Hypertension. 2015;1–6. Bang LE. Hypertensio arterialis—behandlingsvejledning. Hypertension. 2015;1–6.
14.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
15.
go back to reference Craig CL, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.CrossRefPubMed Craig CL, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.CrossRefPubMed
16.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
17.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
18.
19.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
20.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
21.
go back to reference Dannecker EA, Koltyn KF. Pain during and within hours after exercise in healthy adults. Sport Med. 2014;44(7):921–42.CrossRef Dannecker EA, Koltyn KF. Pain during and within hours after exercise in healthy adults. Sport Med. 2014;44(7):921–42.CrossRef
Metadata
Title
Twenty weeks of isometric handgrip home training to lower blood pressure in hypertensive older adults: a study protocol for a randomized controlled trial
Authors
Martin Grønbech Jørgensen
Jesper Ryg
Mathias Brix Danielsen
Pascal Madeleine
Stig Andersen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Trials / Issue 1/2018
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-018-2441-x

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