Estimating the efficacy of isometric handgrip training to lower resting blood pressure in patients with stage 1 hypertension in Eastern Uganda compared to standard of care: study protocol for a randomized controlled trial
Bibliographic record
Abstract
BACKGROUND: Hypertension (HTN) is a major non-communicable disease worldwide, including in Uganda. Studies have estimated HTN prevalence in Uganda between 19 and 33% among adults, with only 7-9% controlled within clinical target ranges. Isometric handgrip training (IHT), a form of resistance training that consists of performing multiple static forearm contractions separated by brief rest periods on a handgrip dynamometer or stress ball, is a promising simple, time-efficient, and low-cost intervention. This randomized controlled trial (RCT) aims to determine the efficacy of 12 weeks of IHT compared to standard of care on resting blood pressure (BP) levels in a population of hypertensive patients at the Soft Power Mukagwa Allan Stone Community Health Clinic (Kyabirwa, Uganda). METHODS: This study consists of a two-arm, parallel, randomized controlled, superiority trial. Patients having (1) a diagnosis of stage 1 HTN (BP > 140-159/90-99 mmHg), (2) not currently taking HTN medication, (3) not having been on HTN medication in the past 3 months, and (4) aged ≥18 years will be recruited. A total of 250 participants will be randomized with equal allocation to intervention and control arms. The control arm will receive standard care for HTN for a duration of 12 weeks, as per clinic standard practice. In addition to standard care, the intervention arm will perform IHT sessions three times a week for a duration of 12 weeks. IHT sessions will consist of four 2-min isometric handgrip contractions, using alternate hands with 1-min rest periods between contractions (total: 12 min). The primary outcome is the mean resting systolic BP at 12 weeks. Data collection will be conducted at baseline, 1, 2, and 3 months and will include measurements of BP levels and administration of questionnaires. DISCUSSION: This RCT will provide evidence on the efficacy of IHT, a promising and cost-efficient therapy for blood pressure control in a Ugandan context. We anticipate that our results will inform treatment strategies for hypertensive patients in Uganda and in other high-burden LMIC contexts. TRIAL REGISTRATION: Retrospectively registered. ISRCTN Registry; ISRCTN46005092 ; 31/10/2024.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.029 | 0.029 |
| Meta-epidemiology (narrow) | 0.006 | 0.003 |
| Meta-epidemiology (broad) | 0.014 | 0.007 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.003 | 0.004 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.007 | 0.007 |
| Insufficient payload (model declined to judge) | 0.053 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".