Effects of arm swing exercise training on cardiac autonomic modulation, cardiovascular risk factors, and electrolytes in persons aged 60–80 years with prehypertension: A randomized controlled trial

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Prehypertension (n=50). Intervention: Arm swing exercise (ASE) training vs. Daily routine activities without additional regular exercise. Primary outcome: Systolic blood pressure (SBP, mmHg) after 3-month intervention (p=<0.05).

Q: What does this research mean for the field?

Arm swing exercise training significantly lowers resting systolic blood pressure and improves cardiac autonomic modulation and cardiovascular risk factors in older adults with prehypertension. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Piyapong Prasertsri; Sanita Singsanan; Chirapond Chonanant; Orachorn Boonla; Petcharat Trongtosak

doi:10.1016/j.jesf.2018.11.002

November 16, 2018Journal of Exercise Science & FitnessOpen Access

Effects of arm swing exercise training on cardiac autonomic modulation, cardiovascular risk factors, and electrolytes in persons aged 60–80 years with prehypertension: A randomized controlled trial

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Key result

Arm swing exercise training for 3 months lowered resting systolic blood pressure compared to control in older adults with prehypertension.

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Why the study?

The effects and carry-over effects of arm swing exercise training on cardiac autonomic modulation, cardiovascular risk factors, and blood electrolytes in older individuals with prehypertension were not well known.

Does a 3-month home-based arm swing exercise training program improve blood pressure, cardiac autonomic modulation, cardiovascular risk factors, and serum electrolytes in sedentary older adults aged 60-80 years with prehypertension?

Key Points

To examine the immediate effects and 1-month carry-over effects of arm swing exercise training on cardiac autonomic modulation, cardiovascular risk factors, and blood electrolytes in older individuals with prehypertension.
Randomized controlled trial of 50 individuals aged 60–80 years with prehypertension (mean age 66.90 ± 5.50 yr, BMI 23.84 ± 3.65 kg/m2) randomly assigned to an arm swing exercise (ASE) group (n = 25) or control group (n = 25).
The ASE group completed a 3-month training program consisting of 30 min/day, 3 days/week, while the control group maintained normal daily routines without regular exercise.
Outcomes including blood pressure, heart rate variability (RMSSD and HF power), cardiovascular risk factors (blood glucose, lipids, hsCRP), and serum electrolytes were evaluated at baseline, post-intervention (3 months), and 1 month after intervention cessation.
Following 3 months of training, systolic blood pressure (114.47 ± 7.57 vs 120.62 ± 11.83 mmHg) and serum hsCRP (1.51 ± 0.37 vs 1.98 ± 0.31 mg/L) were significantly lower in the ASE group compared to controls (p < 0.05).
Post-intervention serum HDL-cholesterol (56.16 ± 10.28 vs 50.42 ± 9.08 mg/dL), potassium (4.29 ± 0.30 vs 4.13 ± 0.28 mmol/L), magnesium (2.43 ± 0.18 vs 2.33 ± 0.16 mg/dL), RMSSD, and HF power were significantly higher in the ASE group than in controls (p < 0.05).
At 1-month follow-up, systolic blood pressure (119.20 ± 8.97 vs 125.92 ± 14.91 mmHg) and hsCRP remained significantly lower, while HDL-cholesterol (54.47 ± 9.71 vs 48.86 ± 9.12 mg/dL) and potassium remained significantly higher in the ASE group compared to controls (p < 0.05).

Study Design

Type

RCT (n=50)

Blinding

Open-label

Randomization

1:1 randomization using random number table (odd numbers to ASE group, even numbers to control group)

Multicenter

No

Structured PICO

Does a 3-month home-based arm swing exercise training program improve blood pressure, cardiac autonomic modulation, cardiovascular risk factors, and serum electrolytes in sedentary older adults aged 60-80 years with prehypertension?

P

Population

50 sedentary older adults (mean age 66.9 years, 78% female) in Thailand with untreated prehypertension, free of cardiovascular, renal, or metabolic disease, followed for 3 months of intervention plus 1 month post-intervention.

I

Intervention

Home-based arm swing exercise (ASE) training program for 3 months at a frequency of 30 minutes/day, 3 days/week (swinging arms forward to ~30° and backward to ~60° at a rate of ~42 cycles/minute, average intensity 55-60% of maximal HR), in addition to maintaining daily routine activities, followed by 1 month of exercise cessation.

C

Comparator

Maintenance of daily routine activities (such as housekeeping, gardening, and cooking) without any additional regular exercise for 3 months, followed by 1 month of continued daily routine activities.

O

Outcome

Systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiac autonomic modulation (heart rate variability parameters including RMSSD and HF power), cardiovascular risk factors (fasting blood glucose, lipid profile, hsCRP), and serum electrolytes (Na+, K+, Cl-, Ca2+, Mg2+, phosphorus) evaluated after the 3-month intervention and at 1-month post-intervention follow-up.surrogate

Main Result

Absolute Event Rate: 114.47% vs 120.62%

p-value: p=<0.05

A 3-month low-intensity arm swing exercise program improves systolic blood pressure, parasympathetic tone, HDL-cholesterol, hsCRP, and serum potassium and magnesium in older adults with prehypertension, with carry-over benefits on blood pressure, lipids, inflammation, and potassium lasting 1 month after stopping exercise.

Limitations

Open-label trial where all subjects were aware of grouping and assessment
Exercise compliance was determined via self-reporting
Small sample size (50 subjects total) from a single center/district
Open-label design where all subjects were aware of grouping and assessment
Compliance to home-based exercise training was determined via self-reporting
Small sample size (n=50) from a single community setting in Thailand

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Implication

Supports arm swing exercise to lower SBP in older adults with prehypertension; extends RCT evidence for accessible low-intensity training.

Abstract

This study aimed to investigate the effect and carry-over effect of arm swing exercise (ASE) training on cardiac autonomic modulation, cardiovascular risk factors, and blood electrolytes in older persons with prehypertension. Subjects were 50 individuals with prehypertension (aged 66.90 ± 5.50 yr, body mass index 23.84 ± 3.65 kg/m2). They were randomly assigned into ASE group and control group. Subjects in the ASE group underwent an ASE training program for 3 months at a frequency of 30 min/day, 3 days/week. Subjects in the control group maintained their daily routine activities minus regular exercise. Blood pressure, heart rate variability (HRV), cardiovascular risk factors including blood glucose, lipid profile, high-sensitive C-reactive protein (hsCRP), and electrolytes were evaluated on 3 occasions: before and after the 3-month intervention, and 1 month after intervention ended. Following the 3-month intervention, systolic blood pressure (SBP) and serum hsCRP concentration were significantly lower, while serum high-density lipoprotein (HDL)-cholesterol, potassium (K+), magnesium (Mg2+) concentrations, standard deviation of normal R-R intervals (RMSSD) and high frequency (HF) power values were higher in the ASE group when compared with the control group (p < 0.05). At the 1-month follow-up interval, SBP and serum hsCRP concentration remained lower while serum HDL-cholesterol and K+ concentrations remained higher in the ASE group as compared to the control group (p < 0.05). ASE training decreased SBP and serum hsCRP concentration, increased serum HDL-cholesterol, K+, and Mg2+ concentrations and increased RMSSD and HF power values in older persons with prehypertension. In addition, there were carry-over effects of ASE training i.e. decreased SBP and serum hsCRP concentration as well as increased serum HDL-cholesterol and K+ concentrations.

Discussion

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Cite This Study

Prasertsri et al. (2018) conducted an RCT in Prehypertension (n=50). Arm swing exercise (ASE) training vs. Daily routine activities without additional regular exercise was evaluated on Systolic blood pressure (SBP, mmHg) after 3-month intervention (p=<0.05). Arm swing exercise training for 3 months lowered resting systolic blood pressure compared to control in older adults with prehypertension.

synapsesocial.com/papers/6a7d8f4c968fa26fcacb4a80 https://doi.org/10.1016/j.jesf.2018.11.002

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Effects of arm swing exercise training on cardiac autonomic modulation, cardiovascular risk factors, and electrolytes in persons aged 60–80 years with prehypertension: A randomized controlled trial

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Effects of arm swing exercise training on cardiac autonomic modulation, cardiovascular risk factors, and electrolytes in persons aged 60–80 years with prehypertension: A randomized controlled trial

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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