IsoFIT-BP Study

Feasibility study to assess the delivery of a novel isometric exercise intervention for people with Stage 1 hypertension in the NHS

This is a study in partnership with:

Background and study aims

High blood pressure affects many people in the UK. People with raised blood pressure (140-159/90-99 mmHg) are recommended to make changes in their lifestyle (e.g. smoking/alcohol/diet/exercise) and/or medication in order to reduce their blood pressure. Current knowledge suggests that a particular type of exercise - isometric exercise - can lower blood pressure. Isometric exercise involves holding a fixed body position for a short period of time.

As most of the information about the benefits of this type of exercise comes from laboratory-based studies, researchers want to find out if it is possible for GP practices, and other healthcare providers, to offer NHS patients with clinically high blood pressure an isometric exercise plan to do at home and how it might affect their blood pressure over 6 months. They will also find out the experiences of those doing this type of exercise and whether it can be done consistently at home over time.

Interested in taking part?

Thank you for your interest. Recruitment for this study is now closed.

The data is currently being analysed and a summary of the study results will be published here in due course.If you would still like to contact the study team, please e-mail: IsoFIT-BP@canterbury.ac.uk

Research sites

A list of the participating research sites and their contact details can be found here

Participant frequently asked questions

How often should I do my Isometric exercise training?

Please complete your training three times a week. Ideally, training should be separated by at least 24 hours and you should try to stick to training on the same days each week. The exercise will involve completing 4 lots of 2 minutes of isometric wall squat, with 2 minutes rest in between. This will total 8 minutes of exercise on each training day.

How often will I be collecting my Blood pressure measurements?

You will be asked to collect your blood pressure at the start of the study- after your screening assessment. Then again at week 4, week 12 and week 24. The blood pressure protocol will involve taking 5 days’ worth of measurements with 2 measurements in the AM and 2 measurements in the PM. You will receive a reminder message to prompt you to take your blood pressure at the start of weeks 4, 12 and 24.

What equipment will I need to take part in the study?

After your screening assessment you will be posted an Omron Blood pressure monitor to use during the study. You will also be provided with an isometric wall squat measuring device, known as a ‘Bend and squat’, which you should use for your isometric training and a heart rate monitor which will record your heart rate throughout the training and help you to keep time of the exercise and rest bouts. You will be given the Bend and squat, heart rate monitor and a paper study diary, to collect your results, at your Exercise Plan Visit.

What should I record in my Study Diary?

In your study diary you should collect your resting heart rate before the training session, and your heart rate and rating of perceived exertion (RPE) immediately after each exercise bout, i.e. four bouts per session Also, at week 4, 12 and 24 you will also be asked to measure your blood pressure for 5 days, this should also go into your diary. Please record your results as displayed on your blood pressure and heart rate monitors, without rounding up or changing the numbers.

How should I use the Hypertension leaflet included in the Diary?

The document on Page 4 of the diary is there to remind you of the standard care / lifestyle advice given to you by your GP or health care professional at the Baseline Assessment.

Why do I need to avoid caffeine before my training sessions?

Caffeine is a stimulant that increases heart rate. As we are using your heart rate measurements to see how you are responding to your training, any changes to this will affect the validity of the results. For this reason, we ask you not to consume caffeine in the 4 hours before your training sessions. It’s fairly well known that Coffee and Tea contain caffeine, however it should also be noted that fizzy drinks and chocolate also contain caffeine, as such your heart rate and blood pressure could be affected by this which could then adversely affect your physical responses to your training session..

Why should I avoid physical exercise that I am unaccustomed to, or that would be exhausting for 24 hours before a session?

There are a few reasons for this, one is that our body functions differently in the short term after exercise whilst it recovers, so your heart rate and blood pressure could be affected by this. Additionally, when we are physically exhausted or do high intensity exercise or exercise, we are not used to- our body can need longer to recover from this. The rest period is important for recovery and should help ensure your body is prepared to do the next training session.

Why do I need to avoid eating in the 2 hours before a training session?

After you eat there is a potential effect upon metabolic rate and thus heart rate. This is undesirable when we are collecting your heart rate values to measure your response to training. Furthermore, it will also make you feel uncomfortable and nauseous whilst you exercise as your body takes a long time to digest certain foods.

Why do I need to avoid drinking alcohol for 12 hours before a training session?

There are a few reasons for this, the first is the same as for the other requirements, i.e. that alcohol affect your heart rate and blood pressure. The second, is that alcohol is also likely to affect how well hydrated you are and it is important to be hydrated when you are exercising.

What should I do if I don’t follow the pre training requirements?

Please try to adhere to these requirements where possible. If you forget or don’t follow them exactly, please still try to complete your training (if you feel you can), but record the deviation in your study diary, in the ‘notes’ box under the training record table.

If I can’t complete the whole 2 minutes of exercise what should I do?

Please try to hold the squat position until the 2-minute bout is complete, isometrics exercise has the most positive effects on your body when you can maintain the exercise continuously. However, it may be that by the 4^th bout of a training session, you start feeling fatigued more quickly.

If you really need to stop, stand up momentarily to ease of the load, but return to the squat position to finish the exercise bout as soon as you can. For example, if you stop after 13:10, make a mental note to complete the last 40 seconds of wall squat after your break. You should find yourself getting fitter the more isometric exercise training you do and as a result you will gradually need to take fewer or even any additional rests. .

Do I need to write down my heart rate and Rating of Perceived Exertion (RPE) value straight after each isometric exercise bout?

Yes, it’s important to capture your HR at the end of the exercise bout before your heart rate starts to return to resting. To aid with the timing of this, keep an eye on your watch as it gets close to 2 minutes. Remember the number shown as your heart rate when the watch indicates the end of the bout and write this into your training diary immediately. Then using the RPE scale, think about what your RPE score was at the end of the exercise and write this down as well. This can be done seated and will be part of the two minutes of rest.

How do I use the Rating of Perceived exertion (RPE) scale?

The RPE scale is made up of the rating scale of 0- 10, the description words and the TTF (Time to Failure). The description words and TTF are only included to help you to more easily select which number from the rating scale you are. If you find it easier to simply refer to the rating scale that’s also okay.

Can I leave my Bend and squat set up for training?

You may choose to leave the arms set to your measurements if you can store the device safely without bending it this way. However, to avoid unnecessary damage, you may prefer to put it back to its original state in order to store it in its box. Either way is fine, as long as you set up the arms of the Bend and squat to the correct measurements you were provided with in your study diary.

How much should I wet the electrodes on the Heart Rate monitor chest strap?

Try to cover the electrodes with a thin layer of water, its best to put your finger under a tap then spread the water on this way. The strap is water resistant but should not be put directly into a stream of running water, this may soak it and damage the device.

Can I get a new Bend and squat if mine has broken or worn?

Yes, please contact the help line 01227 923357 or email IsoFIT-BP@canterbury.ac.uk if you need a new Bend and squat device. This will then be sent in the post to you. However, please try to keep yours in good condition, e.g. don’t at any point allow your body weight to rest on the device when you’re doing the exercise and store it away safely after use.