Sara Thompson – M.Sc. in Exercise Science

The Workout

4 Essential Activities:

  1. Aerobic

  2. High-intensity

  3. Strength

  4. Balance

4 Specific Exercises:

  1. Daily living (such as moving a weight from one place to another)

  2. Balance 

  3. Proprioceptive exercises

  4. Upper body resistance exercises

*Each exercise was performed for one minute, followed by two minutes of walking and one minute of rest.

 

The Research

group walkingHypertension is a chronic condition in which there is elevated blood pressure in the arteries. While it is not usually associated with discomfort, there are consequences associated with chronically high blood pressure such as risk of stroke and myocardial infarction (Go et al., 2014). Additionally, hypertension has been suggested to exacerbate the physical and cognitive impairment associated with aging such as balance control (Acar et al., 2015).

Multicomponent Exercise Programs

Multicomponent exercise programs (MCEP) consist of activities that incorporate various forms of exercise into one workout.

  1. Aerobic

  2. High-intensity

  3. Strength

  4. Balance – try a stability ball

This allows individuals to obtain the benefits of various exercise regimes, while keeping the time requirement to a minimum. It has been suggested that hypertensive (HTS) patients have impaired physical function due to vascular damage, however there is limited research on the effects of MCEP on HTS patients.

Recently, a group of researchers in Brazil aimed to test the effects of 6 months of MCEP on physical and cognitive function in normotensive (NTS) and HTS older adults (Junior et al., 2017). The researchers aimed to compare the response to an exercise stimulus in NTS versus HTS patients, while testing if age is a confounding factor for this response.

The Study

101 NTS (individuals who have normal blood pressure) and 117 HTS patients were recruited from nearby healthcare centers.

Requirements

  1. 60 years of age or older

  2. Without any other physical or psychological ailment

The program consisted of two exercise sessions per week, carried out over 6 months.

Twelve exercises were performed during each exercise session.

The exercises consisted of activities of:

  1. Daily living (such as moving a weight from one place to another)

  2. Balance 

  3. Proprioceptive exercises

  4. Upper body resistance exercises

Each exercise was performed for one minute, followed by two minutes of walking and one minute of rest.

Physical and Cognitive Assessments

Before and after the 6-month intervention, participants performed physical and cognitive assessments.

The physical assessment consisted of a battery of tests aimed to assess their ability to perform activities of daily living.

These tests included:

  1. Sit-to-stand (participants required to stand and sit from a chair as fast as possible five times)

  2. The one-leg stand (amount of time participants could balance on one leg) 

  3. Usual walking speed

  4. Maximal walking speed

  5. Timed up and go test (time required to get up from a chair, walk three meters, turn around and sit back down)

  6. Executive function was also assessed with the timed up and go (TUG), with an added cognitive component.

 

To perform this task, participants completed the usual TUG test, however they were given a cognitive task to perform at the same time such as naming as many animals as they could.

Related Article: 16-Week Training Program To Help Promote Health

Results

Results of the physical assessments revealed that following the 6-month intervention, both NTS and HTS patients improved in the one-leg stand test, as well as usual and maximal walking speed.

Additionally, the improvements were similar in NTS and HTS patients, and did not differ between the younger (<75 years) and older (≥75) participants. Surprisingly, there were no improvements in the sit-to-stand test, timed up and go test, or the cognitive test in either group.

The researchers suggest that there might not have been enough emphasis on resistance training to elicit improvements in muscle strength.

Similarly, the authors speculate that the program might not have been the appropriate stimulus to improve executive function, however the mechanism behind this is not well understood.

More research is needed to conclude which type of exercise is optimal for improved cognition.

stability ball

Takeaway

This study is important for three reasons:

  1. There was 100% adherence, suggesting that a multicomponent exercise program is a realistic and time-manageable option for individuals with hypertension

  2. HTS patients can improve physical function, specifically balance and mobility, to the same degree as NTS patients

  3. Improvements were similar in the younger and older age group, indicating that age is not a limiting factor for improved performance

Therefore, a multicomponent exercise program such as the current one can be used to improve balance and mobility for individuals with hypertension, regardless of age.

Future studies are warranted to optimize the MCEP protocol such that improvements can also be obtained in muscle strength and cognitive function.

Related Article: 5 Ways To Exercise Your Heart

References

Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., et al. (2014). Heart disease and stroke statistics – 2014 update: a report from the American Heart Association. Circulation, 129(3), 399-410.

Acar, S., Demirbuken, I., Algun, C., Malkoc¸ M., & Tekın, N. (2015). Is hypertension a risk factor for poor balance control in elderly adults? Journal of Physical Therapy Science, 27(3), 901–904.

Junior, H. J. C., Rodrigues, B., Feriani, D. J., Gonçalves, I., Asano, R. Y. et al. (2017).  Effects of Multicomponent Exercise on Functional and Cognitive Parameters of Hypertensive Patients: A Quasi-Experimental Study. Journal of Aging Research, Mar 19 [Epub ahead of print].

You Might Like:

  • Training

Training Your Body and Brain

Contributed by Julia C. Basso, PhD, Post-doctoral Research Associate at the Center for Neural Science and New York University Training Your Body and Brain Many different forms of exercise exist.  At the gym, we are given

Get in the Zone: Heart Rate Monitoring

Dayton Kelley The Fast Twitch Grandma readers are well-informed individuals after having explored our website. Our readers know that exercise offers a bounty of physical and mental benefits including extended life expectancy (Lee, et

  • woman doing exercise for heart health

5 Ways To Exercise Your Heart

Julia Basso Did you know February is National Heart Month? Exercise beneficially affects the body in a surprising number of ways.  I am excited to be writing a series based on the effects of

Combat Heart Problems and Diabetes with HIIT

Evan Stevens Exercise can be used to treat (if not cure) type 2 diabetes mellitus. We know from past studies that endurance exercise can increase insulin sensitivity  up to three times it normally is

  • Riding for Charity

Carpe Diem, The Series: Riding for Charity

Paul Stevens Carpe Diem (but in a relaxed sort of way) Summer Daze We’re into August already?! The summer has been moving quickly probably because the schedule has been pleasantly full. We recently had my

  • Rowing Ergometer

The Perfect Catch

Dayton Kelly Looking for a change of pace? Why the Rowing Ergometer should be on your radar. Perhaps one of the most misunderstood and under-utilized exercise machines in the gym is the rowing ergometer.