Isometric arm tensing before standing significantly reduced the proportion of elderly patients remaining with orthostatic hypotension compared to leg tensing (20% vs 77.8%; P=0.023).
RCT (n=19)
parallel
No
Does simple isometric arm tensing exercise compared to leg tensing exercise reduce orthostatic fall in blood pressure in elderly patients with orthostatic hypotension?
Simple isometric arm tensing exercises performed just prior to standing significantly ameliorate the orthostatic fall in blood pressure in elderly patients with orthostatic hypotension compared to leg exercises.
Absolute Event Rate: 20% vs 77.8%
p-value: p=0.023
Objective: Orthostatic hypotension (OH), an important cause of falls in the elderly, is grossly underdiagnosed. Our study aimed to determine the prevalence and associated factors of OH among the elderly attending a secondary care hospital. Furthermore, we assessed and compared the effectiveness of simple arm and leg tensing exercises, performed just prior to standing, to mitigate the orthostatic fall in blood pressure (BP) in elderly OH patients. Materials and Methods: A cross-sectional study screened elderly patients (≥65 years) for OH and recruited them into a randomized controlled trial (CTRI/2020/08/027182) of two parallel groups performing either arm tensing or leg tensing exercises just before standing up. We performed an interim analysis of the ongoing trial using paired t -test for within-group comparisons. Patients identified to have OH based on systolic or diastolic fall in BP were analyzed separately. Chi-square analysis compared the improvement in OH status between the two groups. Results: Nineteen out of 186 screened elderly patients were diagnosed with OH (10.21%, 95% CI: 7.99–12.43). Arm exercise significantly reduced the orthostatic-induced fall in systolic and diastolic BP, while leg exercise effectively reduced only the systolic fall in BP among patients with OH. The proportion of patients with OH after arm exercise (20%) was significantly lower than after leg exercise (77.8%) ( P = 0.023, Fischer's exact test). Conclusion: We found a 10.21% prevalence of OH in our elderly population. Furthermore, we found that simple isometric arm tensing exercise ameliorates the fall in BP on standing up in OH patients.
Tephilla et al. (Wed,) conducted a rct in Orthostatic hypotension (n=19). Isometric arm tensing exercises vs. Isometric leg tensing exercises was evaluated on Proportion of patients with orthostatic hypotension after exercise (p=0.023). Isometric arm tensing before standing significantly reduced the proportion of elderly patients remaining with orthostatic hypotension compared to leg tensing (20% vs 77.8%; P=0.023).
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