Comparison of the Effects of Unilateral and Bilateral Resistance Training on Heart Rate Variability, Muscle Strength, and Functional Capacity in Individuals With Hypertension: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 54
- 试验地点
- 1
- 主要终点
- Muscle Strength
研究概览
简要总结
Hypertension is associated with autonomic nervous system dysfunction, reduced muscle strength, and impaired functional capacity, all of which contribute to increased cardiovascular risk and decreased quality of life. Resistance training is recommended as a non-pharmacological intervention for hypertension; however, it remains unclear whether unilateral and bilateral resistance training produce different physiological adaptations, particularly regarding cardiac autonomic function.
This randomized controlled trial aims to compare the effects of unilateral and bilateral resistance training on heart rate variability (HRV), muscle strength, and functional capacity in adults with hypertension. Eligible participants aged 40-75 years with a confirmed diagnosis of hypertension will be randomly allocated to one of three groups: a unilateral resistance training group, a bilateral resistance training group, or a control group. Randomization will be performed using a computer-generated block randomization procedure with sex stratification to ensure balanced group allocation.
Participants in the two intervention groups will complete a supervised 12-week resistance training program, performed twice weekly at an intensity of 60-70% of one-repetition maximum (1RM). The unilateral training group will perform exercises using one limb at a time, whereas the bilateral training group will perform the same exercises simultaneously with both limbs. The control group will receive no structured exercise intervention during the study period but will receive general information regarding the benefits of physical activity.
Assessments will be conducted at baseline and after the 12-week intervention. The primary outcome will be heart rate variability measured using a Polar H10 heart rate sensor and Elite HRV software. Secondary outcomes will include peripheral muscle strength assessed by one-repetition maximum testing, functional capacity assessed using the Six-Minute Walk Test and the Glittre Activities of Daily Living Test, and blood pressure measured using a sphygmomanometer.
The findings of this study are expected to provide evidence regarding the optimal resistance training strategy for improving autonomic function and physical performance in individuals with hypertension, thereby supporting the development of safer and more individualized exercise prescriptions.
详细描述
Hypertension is one of the leading modifiable risk factors for cardiovascular disease and is strongly associated with autonomic nervous system dysfunction. Increased sympathetic activity and reduced parasympathetic activity contribute to impaired cardiovascular regulation, which can be assessed non-invasively through heart rate variability (HRV). Reduced HRV has been associated with increased cardiovascular morbidity and mortality. In addition to autonomic dysfunction, individuals with hypertension frequently exhibit reduced muscle strength, impaired functional capacity, and limitations in daily physical activities.
Resistance training is widely recommended as a safe and effective non-pharmacological intervention for hypertension because it improves blood pressure control, muscular fitness, and overall physical function. Although both unilateral and bilateral resistance training are commonly prescribed, their physiological effects may differ. Unilateral resistance exercises generally involve a smaller active muscle mass, potentially resulting in lower cardiovascular stress while maintaining local muscular adaptations. In contrast, bilateral resistance exercises recruit a larger muscle mass and may induce greater cardiovascular and hemodynamic responses. Despite these theoretical differences, evidence directly comparing their effects on cardiac autonomic regulation in individuals with hypertension remains limited.
The primary objective of this randomized controlled trial is to compare the effects of unilateral and bilateral resistance training on cardiac autonomic function assessed by HRV in adults with hypertension. Secondary objectives include evaluating changes in peripheral muscle strength, functional capacity, activities of daily living, and blood pressure following a supervised resistance training program.
Adults aged 40 to 75 years with a physician-confirmed diagnosis of hypertension who are able to participate safely in resistance exercise will be recruited from Munzur University and Tunceli State Hospital. After providing written informed consent, eligible participants will be randomly assigned to one of three groups using a computer-generated block randomization procedure with sex stratification:
Unilateral Resistance Training Group Bilateral Resistance Training Group Control Group
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 40 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Adults aged 40 to 75 years.
- •Physician-confirmed diagnosis of hypertension.
- •Medically stable and able to safely participate in a supervised resistance training program.
- •Able to understand the study procedures and provide written informed consent.
排除标准
- •Presence of cardiovascular diseases other than hypertension.
- •Neurological disorders.
- •Psychiatric disorders.
- •Orthopedic conditions limiting participation in resistance exercise.
- •Any other systemic disease that may interfere with study participation.
- •Cognitive impairment or psychological conditions preventing completion of the assessments.
- •History of recent surgery or medical conditions contraindicating exercise.
- •Inability or unwillingness to comply with the study protocol.
研究组 & 干预措施
Unilateral Resistance Training Group
Participants will receive a supervised unilateral resistance training program twice weekly for 12 weeks. Training intensity will be set at 60-70% of one-repetition maximum (1RM). Exercises will include leg press, knee extension, leg curl, seated row, and chest press, performed separately with the right and left limbs. Each session will consist of 2-3 sets of 8-12 repetitions with at least 1 minute of rest between sets. Training load will be progressively increased according to participants' performance and perceived exertion.
干预措施: Unilateral Resistance Training (Other)
Bilateral Resistance Training Group
Participants will receive a supervised bilateral resistance training program twice weekly for 12 weeks. Exercise intensity will be prescribed at 60-70% of one-repetition maximum (1RM). The training program will include leg press, knee extension, leg curl, seated row, and chest press performed simultaneously with both limbs. Each exercise will be completed for 2-3 sets of 8-12 repetitions with at least 1 minute of rest between sets. Training intensity will be progressively increased according to participants' performance and perceived exertion.
干预措施: Bilateral Resistance Training (Other)
Control Group
Participants assigned to the control group will not receive supervised resistance training during the 12-week study period. They will receive standardized education regarding the health benefits of regular physical activity. After study completion, participants will be offered the exercise program if the intervention is shown to be beneficial.
结局指标
主要结局
Muscle Strength
时间窗: Baseline and Week 12
Muscle strength will be assessed using one-repetition maximum (1RM) testing for leg press, knee extension, leg curl, seated row, and chest press exercises.
Functional Capacity
时间窗: Baseline and Week 12
Functional capacity will be evaluated using the Six-Minute Walk Test (6MWT). Walking distance and physiological responses will be recorded before and after the intervention.
RMSSD
时间窗: Baseline and Week 12
Change in the root mean square of successive differences (RMSSD) measured using heart rate variability analysis. RMSSD is reported in milliseconds (ms). Minimum value: 0 ms. There is no fixed maximum value. Higher values indicate greater parasympathetic activity and improved cardiac autonomic function (better outcome).
SDNN
时间窗: Baseline and Week 12
Change in the standard deviation of normal-to-normal intervals (SDNN) measured using heart rate variability analysis. SDNN is reported in milliseconds (ms). Minimum value: 0 ms. There is no fixed maximum value. Higher values indicate greater overall heart rate variability and improved cardiac autonomic function (better outcome).
pNN50
时间窗: Baseline and Week 12
Change in the percentage of successive normal-to-normal intervals differing by more than 50 ms (pNN50). The outcome is expressed as a percentage (%). Minimum value: 0%. Maximum value: 100%. Higher values indicate greater parasympathetic activity (better outcome).
Mean RR Interval
时间窗: Baseline and Week 12
Change in mean RR interval measured using heart rate variability analysis. The outcome is expressed in milliseconds (ms). Minimum value: 0 ms. There is no fixed maximum value. Higher values generally indicate a lower resting heart rate and improved autonomic regulation (better outcome).
Total Power
时间窗: Baseline and Week 12
Change in total power measured using heart rate variability analysis. The outcome is expressed in milliseconds squared (ms²). Minimum value: 0 ms². There is no fixed maximum value. Higher values indicate greater overall heart rate variability (better outcome).
LF Power
时间窗: Baseline and Week 12
Change in low-frequency (LF) power measured using heart rate variability analysis. The outcome is expressed in milliseconds squared (ms²). Minimum value: 0 ms². There is no fixed maximum value. Higher values generally indicate greater autonomic modulation.
HF Power
时间窗: Baseline and Week 12
Change in high-frequency (HF) power measured using heart rate variability analysis. The outcome is expressed in milliseconds squared (ms²). Minimum value: 0 ms². There is no fixed maximum value. Higher values indicate greater parasympathetic activity (better outcome).
LF Peak
时间窗: Baseline and Week 12
Change in low-frequency peak (LF Peak) measured using heart rate variability analysis. The outcome is expressed in hertz (Hz). Minimum value: 0 Hz. There is no fixed maximum value.
HF Peak
时间窗: Baseline and Week 12
Change in high-frequency peak (HF Peak) measured using heart rate variability analysis. The outcome is expressed in hertz (Hz). Minimum value: 0 Hz. There is no fixed maximum value.
次要结局
- Activities of Daily Living(Baseline and Week 12)
- Blood Pressure(Baseline and Week 12)