None listed
Conditions
Brief summary
People who have had a stroke and are living at home spend 75% of their waking hours sitting down, which is much higher than people of a similar age without stroke. Spending long periods of time sitting down each day increases the risk of cardiovascular disease, including stroke, putting this population at particularly high risk. About a third of people who have had one stroke will have a second or third stroke, so it is important that we look for ways to reduce this risk. In studies of people without stroke, breaking up prolonged sitting time with regular activity breaks (walking or simple strengthening exercises) leads to significant reductions in cardiovascular disease risk factors such as glucose metabolism and blood pressure. The effects of breaking up sitting time in people with stroke, and the optimal type of activity break for this group is not known. Not getting enough physical activity is the second highest risk factor for stroke, but achieving the recommended amount of daily physical activity, particularly for those people who find it difficult to walk, is near impossible for many stroke survivors. Therefore, reducing sitting time is a promising, innovative, low cost intervention to reduce the risk of having another stroke. We will conduct a study that will help us to understand the impact of prolonged sitting time on stroke risk factors, and will assess the effectiveness of two ways of regularly breaking up sitting time in people with stroke. We will recruit 19 stroke survivors who have difficulty walking. Each survivor will complete all 3 experimental conditions in a random order, under the direct supervision of research staff at HMRI. The 3 conditions will be (1) prolonged sitting without breaks (control), (2) breaking up sitting time by walking at a comfortable speed overground (ie not on a treadmill) for 3 minutes every 30 minutes, and (3) breaking up sitting time with 3 minutes of simple exercises in standing every 30 minutes. Participating stroke survivors will have blood samples taken at regular intervals throughout the duration of the study, and will have their blood pressure continually monitored. Our study outcome measures will include glucose and insulin measures (primary), blood pressure, plasma fibrinogen (secondary) as well as safety and feasibility indicators. This study will be first to assess the effects of breaking up prolonged sitting time in people with stroke. We aim to build on this work in the future by testing different types of activity breaks (eg standing only, seated exercises) at varying frequencies and durations in different sub-groups of stroke survivors (eg people who walk well, and those that cannot walk at all). BUST-Stroke will also inform future research to assess the effect of reducing daily sitting time in people both early (in hospital) and later after stroke.
Interventions
Two different experimental conditions:
1. Prolonged sitting (8 hours) during which every 30mins participants will perform exercises in standing for 3 minutes (ie. calf raises, knee lifts semi-squats).
2. Prolonged sitting (8 hours) during which every 30mins participants will walk for 3 minutes.
Activities, time on task during the activity bouts, toilet breaks and any deviations from protocol for each condition will be recorded in the participant's Case Report Form by the research assistant.
The
Two different experimental conditions: 1. Prolonged sitting (8 hours) during which every 30mins participants will perform exercises in standing for 3 minutes (ie. calf raises, knee lifts semi-squats). 2. Prolonged sitting (8 hours) during which every 30mins participants will walk for 3 minutes. Activities, time on task during the activity bouts, toilet breaks and any deviations from protocol for each condition will be recorded in the participant's Case Report Form by the research assistant. There will be a 6 day wash out period between each conditions. Breakfast will be provided for each participant at approx 8.30am and lunch approx 4 hours later. Each meal provided will contain approximately one third of the participant’s energy requirements and the full day’s meals combined will have a macronutrient profile in line with the Acceptable Macronutrient Distribution Ranges as recommended by the Nutrient Reference Values for Australians and New Zealanders. Carbohydrate contribution will constitute approximately 55% of energy in order to elicit an adequate glucose and insulin response.
Sponsors
University of Newcastle
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Stroke survivors who are: *Greater than or equal to 6 months post-stroke with moderate walking disability as defined as *score of =2 on the Functional Ambulation Classification (ie. require the assistance of less than or equal to 1 person to safely walk) AND *walking speed between 0.4 to 0.8m/s *able to toilet independently and *able to stand from sitting from a lounge chair independently or with minimal assistance of less than or equal to 1 person
Exclusion criteria
*employment in a non-sedentary occupation (ie. non-office based occupation), *self-reported < 4 hours/day sitting *regularly engaged in physical activity (ie. greater than or equal to 150min/week) as assessed by self-report *BMI > 45kg/m2 *current smoker *pregnant *clinically diagnosed with acute/chronic illness or other condition which has known physical activity contraindications or limits their ability to complete the each experimental condition (ie. chronic low back pain aggravated by prolonged sitting) *urinary frequency and or urinary urgency or requiring assistance with toileting (other than to mobilise to the toilet) and *insulin dependent diabetes or who are taking diabetes medication other than metformin.
Outcome results
None listed