The Effects of Interrupting Prolonged Sitting With Frequent Bouts of Light-Intensity Standing Exercises on Blood Pressure in Stroke Survivors: A Dose Escalation Trial

Abstract

Background: Interrupting prolonged sitting acutely lowers blood pressure in nonstroke populations. However, the dose–response effect in stroke survivors is unknown. The authors investigated different doses of light-intensity standing exercises that interrupt prolonged sitting and reduce blood pressure immediately and over 24 hours in stroke survivors. Methods: Within-participant, laboratory-based, dose escalation trial. Conditions (8 h) were prolonged sitting and 2 experimental conditions of standing exercises with increasing frequency (3 cohorts, 2 × 5 min to 6 × 5 min). The primary outcome is the mean systolic blood pressure. Results: Twenty-nine stroke survivors (aged 66 [12] y) participated. Frequent bouts of standing exercises lowered the mean systolic blood pressure following the 4 × 5-minute (−2.1 mm Hg; 95% confidence interval [CI], −3.6 to −0.6) and 6 × 5-minute conditions (−2.3 mm Hg; 95% CI, −4.2 to −0.5) compared with prolonged sitting. Diastolic blood pressure was lowered following the 6 × 5-minute condition (−1.4 mm Hg; 95% CI, −2.7 to −0.2). The 24-hour systolic blood pressure increased following the 2 × 5-minute condition (6.9 mm Hg; 95% CI, 3.1 to 10.6). Conclusions: Interrupting prolonged sitting with more frequent bouts of standing exercises lowers systolic and diastolic blood pressure in stroke survivors. However, reductions may only be short term, and investigations on sustained effects are warranted.

Post‐discharge sedentary behavior and light‐intensity physical activity‐associated stroke recurrence in patients with minor ischemic stroke: A preliminary retrospective observational study

“…Reportedly, many factors influence stroke recurrence including age, sex, history of hypertension and diabetes, severity of neurological symptoms, ankle‐brachial index, interleukin‐37 levels, post‐stroke depression, smoking, alcohol consumption, and physical activity level (Han et al., 2021; Hobeanu et al., 2022; Kariasa et al., 2019; Kono et al., 2015; Liu et al., 2020; Skajaa et al., 2022; Wu et al., 2019; Zhang et al., 2021). Additionally, previous studies have shown that sedentary behavior affects stroke recurrence through factors such as arterial stiffness and blood pressure (Batacan et al., 2015; Evans et al., 2019; Hartman et al., 2021; Mackie et al., 2021; Paterson et al., 2020), and guidelines for stroke recurrence recommend reducing sedentary behavior. Therefore, the results of this study indicating that patients engaging in fewer sedentary behaviors have fewer recurrent strokes are well‐supported by the existing literature.…”

“…Details of previous randomized controlled trials have been reported (Mackie et al., 2021). Participants were hospitalized for ischemic stroke at an acute care hospital between December 2019 and June 2021.…”

“…Guidelines for stroke prevention state that reducing sedentary behavior and increasing physical activity may be crucial to prevent recurrence (Kleindorfer et al., 2021). Furthermore, reducing sedentary behaviors and increasing physical activity levels may improve factors associated with stroke recurrence such as arterial stiffness (Evans et al., 2019; Theofilis et al., 2022), peripheral vascular function (O’Brien et al., 2018; Paterson et al., 2020), cerebral blood flow (Bangen et al., 2023; Hartman et al., 2021), blood pressure (Batacan et al., 2015; Mackie et al., 2021), glucose metabolism (Peddie et al., 2021; Sjöros et al., 2020), and lipid metabolism (Grace et al., 2017; Sjöros et al., 2020).…”