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频繁的、短时间的低强度站立运动可降低收缩压:中风后打破久坐时间(BUST-Stroke)试验。

Frequent, short bouts of light-intensity exercises while standing decreases systolic blood pressure: Breaking Up Sitting Time after Stroke (BUST-Stroke) trial.

机构信息

1 School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia.

2 Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia.

出版信息

Int J Stroke. 2018 Dec;13(9):932-940. doi: 10.1177/1747493018798535. Epub 2018 Sep 17.

Abstract

BACKGROUND

Stroke survivors sit for long periods each day. Uninterrupted sitting is associated with increased risk of cardiovascular disease. Breaking up uninterrupted sitting with frequent, short bouts of light-intensity physical activity has an immediate positive effect on blood pressure and plasma clotting factors in healthy, overweight, and type 2 diabetic populations.

AIM

We examined the effect of frequent, short bouts of light-intensity physical activity on blood pressure and plasma fibrinogen in stroke survivors.

METHODS

Prespecified secondary analyses from a three-armed randomized, within-participant, crossover trial. Participants were 19 stroke survivors (nine female, aged 68 years old, 90% able to walk independently). The experimental conditions were sitting for 8 h uninterrupted, sitting with 3 min bouts of light-intensity exercise while standing every 30 min, or sitting with 3 min of walking every 30 min. Blood pressure was measured every 30 min over 8 h and plasma fibrinogen at the beginning, middle, and end of each day. Intention-to-treat analyses were performed using linear mixed models including fixed effects for condition, period, and order, and a random intercept for participant to account for repeated measures and missing data.

RESULTS

Sitting with 3 min bouts of light-intensity exercise while standing every 30 min decreased systolic blood pressure by 3.5 mmHg (95% CI 1.7-5.4) compared with sitting for 8 h uninterrupted. For participants not taking antihypertensive medications, sitting with 3 min of walking every 30 min decreased systolic blood pressure by 5.0 mmHg (95% CI -7.9 to 2.0) and sitting with 3 min bouts light-intensity exercise while standing every 30 min decreased systolic blood pressure by 4.2 mmHg (95% CI -7.2 to -1.3) compared with sitting for 8 h uninterrupted. There was no effect of condition on diastolic blood pressure (p = 0.45) or plasma fibrinogen levels (p = 0.91).

CONCLUSION

Frequent, short bouts of light-intensity physical activity decreases systolic blood pressure in stroke survivors. However, before translation into clinical practice, the optimal duration and timing of physical activity bouts needs to be determined.

CLINICAL TRIAL REGISTRATION

Australian and New Zealand Clinical Trials Registry http://www.anzctr.org.au ANZTR12615001189516.

摘要

背景

中风幸存者每天长时间坐着。不间断的坐姿与心血管疾病风险增加有关。在健康、超重和 2 型糖尿病人群中,频繁的、短暂的低强度身体活动可以打断不间断的坐姿,对血压和血浆凝血因子产生即时的积极影响。

目的

我们研究了频繁的、短暂的低强度身体活动对中风幸存者的血压和血浆纤维蛋白原的影响。

方法

这是一项三臂随机、参与者内交叉试验的预设次要分析。参与者为 19 名中风幸存者(9 名女性,年龄 68 岁,90%能够独立行走)。实验条件为不间断坐 8 小时、每隔 30 分钟坐 3 分钟轻度运动、每隔 30 分钟坐 3 分钟散步。在 8 小时内每 30 分钟测量一次血压,并在每天开始、中间和结束时测量血浆纤维蛋白原。采用线性混合模型进行意向治疗分析,包括条件、周期和顺序的固定效应,以及参与者的随机截距,以考虑重复测量和缺失数据。

结果

与不间断坐 8 小时相比,每隔 30 分钟坐 3 分钟轻度运动站立的坐姿使收缩压降低了 3.5mmHg(95%置信区间 1.7-5.4)。对于未服用抗高血压药物的参与者,每隔 30 分钟坐 3 分钟散步使收缩压降低了 5.0mmHg(95%置信区间 -7.9 至 2.0),每隔 30 分钟坐 3 分钟轻度运动站立使收缩压降低了 4.2mmHg(95%置信区间 -7.2 至 -1.3)与不间断坐 8 小时相比。条件对舒张压(p=0.45)或血浆纤维蛋白原水平(p=0.91)没有影响。

结论

频繁的、短暂的低强度身体活动可降低中风幸存者的收缩压。然而,在将其转化为临床实践之前,还需要确定身体活动的最佳持续时间和时间安排。

临床试验注册

澳大利亚和新西兰临床试验注册中心 http://www.anzctr.org.au 注册号 ANZTR12615001189516。

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