1 School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia.
2 Centre for Research Excellence in Stroke Recovery and Rehabilitation, Florey Institute of Neuroscience, Melboure, Australia.
Int J Stroke. 2018 Dec;13(9):921-931. doi: 10.1177/1747493018801222. Epub 2018 Sep 18.
People with stroke sit for long periods each day, which may compromise blood glucose control and increase risk of recurrent stroke. Studies in other populations have found regular activity breaks have a significant immediate (within-day) positive effect on glucose metabolism. We examined the effects of breaking up uninterrupted sitting with frequent, short bouts of light-intensity physical activity in people with stroke on post-prandial plasma glucose and insulin.
Randomized within-participant crossover trial. We included people between 3 months and 10 years post-stroke, ambulant with minimal assistance and not taking diabetic medication other than metformin. The three experimental conditions (completed in random order) 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. Meals were standardized and bloods were collected half- to one-hourly via an intravenous cannula.
A total of 19 participants (9 female, mean [SD] age 68.2 [10.2]) completed the trial. The majority ( n = 12, 63%) had mild stroke symptoms (National Institutes of Stroke Scale score 0-13). There was no significant effect of experimental condition on glucose (mean [SD] positive incremental area [+iAUC] mmol·L·h-1 under the curve during sitting 42.3 [29.5], standing 47.4 [23.1], walking 44.6 [26.5], p = 0.563) or insulin (mean + iAUC pmol·L·h-1 sitting 14,161 [7,560], standing 14,043 [8,312], walking 14,008 [8,269], p = 0.987).
Frequent, short bouts of light-intensity physical activity did not have a significant effect on post-prandial plasma glucose and insulin in this sample of people with stroke. Further studies are needed to identify strategies that improve inactivity-related glucose metabolism after stroke.
患有中风的人每天长时间坐着，这可能会影响血糖控制并增加中风复发的风险。其他人群的研究发现，有规律的活动休息对葡萄糖代谢有显著的即时（当天内）积极影响。我们研究了在中风患者中，通过频繁的短暂低强度体力活动打断不间断坐姿对餐后血浆葡萄糖和胰岛素的影响。
这是一项随机自身交叉试验。我们纳入了中风后 3 个月至 10 年、在最小辅助下能走动但除了服用二甲双胍之外没有服用其他糖尿病药物的患者。三个实验条件（随机顺序完成）为：连续 8 小时不间断坐着、每隔 30 分钟坐着时进行 3 分钟的低强度运动、或每隔 30 分钟坐着时进行 3 分钟的散步。通过静脉插管每半小时至一小时采集标准化的餐食前后的血液样本。
共有 19 名参与者（9 名女性，平均[标准差]年龄 68.2[10.2]岁）完成了试验。大多数患者（n = 12，63%）有轻度中风症状（国立卫生研究院中风量表评分 0-13）。实验条件对血糖没有显著影响（曲线下连续坐着时的葡萄糖正增量面积[+iAUC]mmol·L·h-1为 42.3[29.5]，站立时为 47.4[23.1]，行走时为 44.6[26.5]，p = 0.563）或胰岛素（+iAUC pmol·L·h-1坐着时为 14161[7056]，站立时为 14043[8312]，行走时为 14008[8269]，p = 0.987）。
在这个中风患者样本中，频繁的短暂低强度体力活动对餐后血浆葡萄糖和胰岛素没有显著影响。需要进一步的研究来确定改善中风后与不活动相关的葡萄糖代谢的策略。
