Isometric wall squat training as an adjuvant to blood pressure control. A Multicentric study in Latin America

Before the intervention will be necessary determine the level of training which is given in degrees of knee flexion. To the initial test, participant will stand up straight with feet separated to the hip width with a wall positioned behind, then walk forward extending the shoulders until hands can remain touching the wall, then will lean the back and buttocks against the wall and slide down the wall until reach a 95 degrees angle of knees flexion. Ensuring back and buttocks remain in contact with the wall all the time. The angle of the joint will be measured with a wooden goniometer, previously adjusted to the subject's leg with Velcro strips. The lateral epicondyle of the femur and the greater trochanter will be taken as a reference for one arm of the goniometer and the other in the lateral midline of the fibula using the lateral malleolus and the head of the fibula as a reference. Immediately the subject is in position, 2 minutes will begin to be counted. If the participant does not pass the initial test at 95°, he/she must start at Level 1 (135º) of the training, if he/she pass it, they will start at Level 2 (125º). After defining the level at which the participant starts, the training take place 3 times a week, maintaining the position for 2 minutes until completing 4 sets, leaving 2 minutes between sets. The length of the weeks will depend on each level. The hands should be placed crossed on the chest and the angle of each level will be measured with the wooden goniometer fixed at the same reference points as the initial evaluation. Levels 1 (135º), 2 (125º) and 3 (115º) will be done for 2 weeks each, while levels 4 (105º) and 5 (95º) will be done for 3 weeks each for a total of 12 weeks. The next 12 weeks, once a week at level 5 (95º). LEVELS OF TRAINING If participant pass initial test: Week 1: 125º Week 2, 3: Between 125º - 115º Week 4 - 6: Between 115º - 105º Week 7 – 9: Between 105º - 95º Week 10 – 24: 95º If participant do not pass initial test: Week 1: 135º Week 2: 135º - 125º Week 3, 4: Between 125º - 115º Week 5 - 6: Between 115º - 105º Week 7 – 9: Between 105º - 95º Week 10 – 24: 95º Initial test and intervention training will be delivered by physical therapists, nurses, and physicians (not experience is required), who will be previously training in the evaluation and intervention procedures. After the initial test, participants will be trained in the intervention plan, and they do it in an independent way at home or in the job place. To monitor adherence to the intervention the patient will be virtually supervised by the evaluators once a week to make sure the intervention is doing in a right way Initial test and training, besides they will be ask to register the days when they do the training.