Breaking up sitting time after stroke

Sep 18 2018

Author: Associate Professor Coralie English 

BUST study

We found that when stroke survivors stood up every 30 minutes and performed three minutes of light intensity exercises, their blood pressure was lower, compared to when they sat continuously for eight hours. Here is why this matters.

We have all heard the media stories about the dangers of sitting time - ‘beware the chair’, ‘sitting is the new smoking’ and other such sensationalised headlines. Is there any truth to such statements? What, if anything, is the relevance to stroke recovery?

Firstly, yes, there is some truth to the headlines. While comparisons to the health risks of smoking are nonsensical, we do know that spending long periods of time sitting down each day is not good for you, particularly if you are also not getting enough exercise of the ‘huffing and puffing’ type. In fact, a large meta-analysis of data from over 1 million adults published in The Lancet in 2016 showed that amongst those people with the lowest levels of ‘huffing and puffing’ exercise, higher levels of sitting time were associated with a very large increase in the risk of cardiovascular disease. This is relevant for people with stroke for two reasons. Firstly, people with stroke are at particularly high risk for recurrent stroke and other cardiovascular diseases. Secondly, we know that people with stroke fit this profile of very low levels of physical activity and high sitting time.

So, what can we do about it?

Breaking up sitting time with frequent, short bouts of light intensity activity (eg exercises while standing or walking) may help. Studies in other population groups have found beneficial effects for this approach. My group has just completed the first ever study of this approach in people with stroke. We conducted a trial under very tight experimental conditions and found that when stroke survivors stood up every 30 minutes and performed three minutes of light intensity exercises (mini-squats, toe raises and marching on the spot), they had lower blood pressure over the day, compared to sitting continuously for eight hours. Most importantly, this benefit occurred even in people who were taking blood pressure lowering medications.

This is an important finding, because high blood pressure is the leading risk factor for stroke, and every small reduction in blood pressure reduces risk. Of course, doing standing exercises strictly for three minutes every half-hour each and every day is not feasible. Our group is now testing more practicable doses of exercises and their effects on blood pressure. In the meantime, ‘move more, sit less’ is a good mantra to live by for all of us!

To take part in the current BUST-BP-Dose study, (Newcastle) contact our team by emailing strokeregister@hmri.org.au.