An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension and clinical implications

Table 4 Translation of IRT into clinical practice: model of exercise prescription for BP management

Variable	Recommended for nonclinical and (supervised) clinical populations^a)
Variable	Upper limb	Lower limb
Mode	Handgrip; unilateral of bilateral	Wall squat (leg press)
Frequency	3 times/wk	3 times/wk
Intensity	30% MVC^b)	15%–25% MVC^c)
Time	4 × 2-min contractions (handgrip squeeze); separated by 3-min rest periods	4 × 2-min contractions (hold); separated by 2-min rest periods
Special consideration	Session should be initially supervised by an exercise professional, and progressed to a HEP when feasible Breathe normally (to avoid Valsalva pressor response) Do not exceed 30% MVC (counterproductive) Individuals unable to sustain the 2 min at 30% MVC should commence with 15%–20% MVC	Session should be initially supervised by an exercise professional, and progressed to a HEP when feasible Breathe normally (to avoid Valsalva pressor response) Monitoring of HR, BP, and training dose Do not exceed 30% MVC (counterproductive) Individuals unable to sustain the 2 min should commence with 10%–15% MVC

IRT Isometric resistance training, BP Blood pressure, MVC Maximal voluntary contraction, HEP Home-based exercise program, HR Heart rate
^a)As with the commencement of any exercise program, individuals should be adequately screened and cleared by a suitable qualified exercise professional
^b)The 30% MVC should be established prior to the beginning of each session by completing two to three MVC to establish correct MVC value to be used for the session
^c)Wall squat exercise are performed at a participant-specific knee joint angle relative to a target HR of 95% peak HR. Isometric wall squat exercise intensity can be reliably adjusted by manipulating knee joint angle [50, 51]

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