Abstract
Background
Increased physical activity has been recommended as an important lifestyle modification for the prevention and control of hypertension. Walking is a low‐cost form of physical activity and one which most people can do. Studies testing the effect of walking on blood pressure have revealed inconsistent findings.
Objectives
To determine the effect of walking as a physical activity intervention on blood pressure and heart rate.
Search methods
We searched the following databases up to March 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 2), Ovid MEDLINE, Ovid Embase, CINAHL, PsycINFO, SPORTDiscus, PEDro, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched the following Chinese databases up to May 2020: Index to Taiwan Periodical Literature System; National Digital Library of Theses and Dissertation in Taiwan; China National Knowledge Infrastructure (CNKI) Journals, Theses & Dissertations; and Wanfang Medical Online. We contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions.
Selection criteria
Randomised controlled trials of participants, aged 16 years and over, which evaluated the effects of a walking intervention compared to non‐intervention control on blood pressure and heart rate were included.
Data collection and analysis
We used standard methodological procedures expected by Cochrane. Where data were not available in the published reports, we contacted authors. Pooled results for blood pressure and heart rate were presented as mean differences (MDs) between groups with 95% confidence intervals (CIs). We undertook subgroup analyses for age and sex. We undertook sensitivity analyses to assess the effect of sample size on our findings.
Main results
A total of 73 trials met our inclusion criteria. These 73 trials included 5763 participants and were undertaken in 22 countries. Participants were aged from 16 to 84 years and there were approximately 1.5 times as many females as males. The characteristics of walking interventions in the included studies were as follows: the majority of walking interventions was at home/community (n = 50) but supervised (n = 36 out of 47 reported the information of supervision); the average intervention length was 15 weeks, average walking time per week was 153 minutes and the majority of walking intensity was moderate. Many studies were at risk of selection bias and performance bias.
Primary outcome
We found moderate‐certainty evidence suggesting that walking reduces systolic blood pressure (SBP) (MD ‐4.11 mmHg, 95% CI ‐5.22 to ‐3.01; 73 studies, n = 5060). We found moderate‐certainty evidence suggesting that walking reduces SBP in participants aged 40 years and under (MD ‐4.41 mmHg, 95% CI ‐6.17 to ‐2.65; 14 studies, n = 491), and low‐certainty evidence that walking reduces SBP in participants aged 41 to 60 years (MD ‐3.79 mmHg, 95% CI ‐5.64 to ‐1.94, P < 0.001; 35 studies, n = 1959), and those aged 60 years of over (MD ‐4.30 mmHg, 95% CI ‐6.17 to ‐2.44, 24 studies, n = 2610). We also found low certainty‐evidence suggesting that walking reduces SBP in both females (MD ‐5.65 mmHg, 95% CI ‐7.89 to ‐3.41; 22 studies, n = 1149) and males (MD ‐4.64 mmHg, 95% CI ‐8.69 to ‐0.59; 6 studies, n = 203).
Secondary outcomes
We found low‐certainty evidence suggesting that walking reduces diastolic blood pressure (DBP) (MD ‐1.79 mmHg, 95% CI ‐2.51 to ‐1.07; 69 studies, n = 4711) and heart rate (MD ‐2.76 beats per minute (bpm), 95% CI ‐4.57 to ‐0.95; 26 studies, n = 1747). We found moderate‐certainty evidence suggesting that walking reduces DBP for participants aged 40 years and under (MD ‐3.01 mmHg, 95% CI ‐4.44 to ‐1.58; 14 studies, n = 491) and low‐certainty evidence suggesting that walking reduces DBP for participants aged 41 to 60 years (MD ‐1.74 mmHg, 95% CI ‐2.95 to ‐0.52; 32 studies, n = 1730) and those aged 60 years and over (MD ‐1.33 mmHg, 95% CI ‐2.40 to ‐0.26; 23 studies, n = 2490). We found moderate‐certainty evidence that suggests walking reduces DBP for males (MD ‐2.54 mmHg, 95% CI ‐4.84 to ‐0.24; 6 studies, n = 203) and low‐certainty evidence that walking reduces DBP for females (MD ‐2.69 mmHg, 95% CI ‐4.16 to ‐1.23; 20 studies, n = 1000). Only 21 included studies reported adverse events. Of these 21 studies, 16 reported no adverse events, the remaining five studies reported eight adverse events, with knee injury being reported five times.
Authors' conclusions
Moderate‐certainty evidence suggests that walking probably reduces SBP. Moderate‐ or low‐certainty evidence suggests that walking may reduce SBP for all ages and both sexes. Low‐certainty evidence suggests that walking may reduce DBP and heart rate. Moderate‐ and low‐certainty evidence suggests walking may reduce DBP and heart rate for all ages and both sexes.
Plain language summary
The effect of walking on blood pressure control
Review question
Can walking lower blood pressure?
Background
Hypertension or elevated blood pressure is a major risk factor for cardiovascular diseases, such as coronary heart disease, stroke, and heart failure. Lowering blood pressure to normal levels is effective in reducing the risks of these diseases. Many of the risk factors relating to hypertension, such as physical inactivity, a diet high in salt and fat, or cigarette smoking, are related to lifestyle. Physical activity is recognised as an essential component of a healthy lifestyle. However many people may find it difficult to undertake exercise that fits into their daily lives. Walking is a low‐cost activity and one which many people can do. Previous studies have shown inconsistent results of the effect of walking on blood pressure control.
Study characteristics
We included 73 trials involving 5763 participants from 22 countries, published up to March 2020. These trials included both males and females; with an age range from 16 to 84 years with approximately half aged over 60 (51%) and 39% aged 41 to 60 years with various health conditions. The types of walking activity varied, including home‐, community‐, school‐, or gym‐based walking several times a week with different intensity levels.
Key results
We found moderate‐certainty evidence suggesting that walking reduces systolic blood pressure (SBP). We found moderate‐certainty evidence suggesting that walking reduces SBP in participants aged 40 years and under and low‐certainty evidence that walking reduces SBP in participants aged 41 and over. We also found low certainty‐evidence suggesting that walking reduces SBP in females and males. We found low‐certainty evidence suggesting that walking reduces diastolic blood pressure (DBP) and heart rate. Only 21 studies reported a total of eight adverse events, with knee injury reported five times as an adverse event. Many studies did not report how participants were allocated to the walking and control groups and whether those who assessed outcomes knew to which group a participant belonged. However, our outcomes of blood pressure and heart rate are objective measures and thus are less likely to be influenced by knowledge of whether a participant was in a walking or control group. Our findings suggest that moderate‐intensity walking, three to five times per week, of 20 to 40 minutes duration, and 150 minutes per week for approximately three months could have an effect on lowering blood pressure.
Summary of findings
Background
Description of the condition
Hypertension is responsible for approximately nine million deaths worldwide each year (Lim 2012) and an estimated 1.13 billion people globally have hypertension, with two‐thirds living in low‐ and middle‐income countries (WHO 2019). The premature death and disability caused by hypertension can have a considerable financial toll on families, health services, and national finances (WHO 2013). Hypertension is also a risk factor for various health problems, such as myocardial infarction, heart failure, chronic kidney disease, stroke, peripheral artery disease, and atrial fibrillation (Qamar 2018). Epidemiologic studies show that cardiovascular disease (CVD) events, such as coronary heart disease, stroke, and heart failure, are associated with elevated blood pressure levels (Amici 2009; Pini 2008; Rodriguez 2014). Observational studies document a progressive increase in heart disease risk as blood pressure rises above 115/75 mmHg ( Lawes 2008; Lewington 2002). A recent meta‐analysis of prospective cohort studies demonstrates that even just a stage I hypertension (systolic blood pressure (SBP) 130 to 139 mmHg or diastolic blood pressure (DBP) 80 to 89 mmHg) is associated with those CVD events and its morbidity and mortality (Han 2019).
Lowering blood pressure to standard targets has been found to be effective in reducing the risks of coronary artery disease and stroke (Lewington 2002; Staessen 2001; Vargas‐Urocoechea 2019), and effective control of stage 1 hypertension was found to prevent more than 10% of CVD (Han 2019). The report to the Eighth Joint National Committee for Detection, Evaluation, and Treatment of High Blood Pressure (JNC‐8) recommends that individuals achieve a target SBP <140 mmHg and DBP lower than 90 mmHg (James 2014; Lawes 2008; Lewington 2002). SBP is suggested as a better predictor of adverse health events than DBP (Ettehad 2016; Haider 2003).
Hypertension control through pharmacological treatment has led to substantial benefits in the primary prevention of morbidity and mortality from cardiovascular diseases (Ettehad 2016; Law 2009; Li 2019; Musini 2019; Blood Pressure Lowering Treatment Trialists 2000; Blood Pressure Lowering Treatment Trialists 2008; Wright 2018). Given some of the drawbacks to the pharmacological treatment of hypertension, such as discontinuation of the drug treatment due to potential adverse effects and the level of adherence with prescribed medication, non‐pharmacological interventions play an important role in controlling hypertension (Bonilla Ocampo 2018; Hagberg 2000).
There are several non‐modifiable risk factors for hypertension including a family history of hypertension, age over 65 years and co‐existing diseases (e.g. kidney disease and diabetes), but modifiable risk factors for hypertension include use of tobacco and consumption of alcohol, high fat diet, excessive salt consumption, physical inactivity and obesity (WHO 2002; WHO 2019). These modifiable risk factors for hypertension are related to lifestyle.
As hypertension is associated with lifestyle factors, all of the current guidelines highlight the role of non‐pharmacological interventions in hypertension management (James 2014; Whelton 2002; WHO 2003; Williams 2004). When most people with hypertension fall into the categories of high‐normal to stage 1 blood pressure elevations, which are lower than the level at which physicians often begin to prescribe antihypertensive medications (Wang 2004), lifestyle modifications maybe even more important than pharmacological treatment to control blood pressure.
Description of the intervention
Lifestyle physical activity interventions have been recommended as a way of lowering blood pressure and reducing the risk of heart disease (James 2014; Williams 2004). Some randomised controlled trials have provided evidence of the benefits of physical activity on reduction in SBP (Duru 2010; Murphy 2006), however, other studies found no such benefits (Elley 2003; Lawton 2008; Liira 2014). These contradictory data could result from methodological differences in the type of physical activity used in the intervention (frequency, duration, intensity, mode of supervision), target population, or overall study design. In addition, many people may find it difficult to fit physical exercise into their daily lives. Walking is one of the easiest forms of low‐cost physical activity and one which many people can do.
How the intervention might work
Evidence from randomised and non‐randomised trials suggests that walking may lead to improvements in SBP and DBP (Kelley 2001; Lee 2006). Walking, as an everyday activity for most people, is likely to be the most relevant low‐to‐moderate‐intensity activity, and brisk walking is a common and feasible form of sustainable dynamic aerobic exercise (Mabire 2017; Tschentscher 2013). For adults aged 18 and over, walking is the most popular physical activity (Afonso 2001; Australian Bureau of Statistics 2003; National Institutes of Health 1996), and the most common leisure activity among both men and women (Australian Bureau of Statistics 2003; Crespo 1996; Office for National Statistics 2003).
Why it is important to do this review
Results from previous studies examining the effect of walking interventions on blood pressure have been inconsistent. A meta‐analysis of walking programs for blood pressure management found beneficial effects either from various study designs (Kelley 2001); limited in a specific population, such as inactive adults (Oja 2018) or those with type 2 diabetes (Cai 2014); complex interventions, such as combining walking, jogging and/or running (Nieman 2013, Shabaaninia 2017, Sijie 2012); or compared a walking intervention with participants in the control group who also received an intervention, such as active pedometer‐based walking intervention (Vetrovsky 2018) or lifestyle modification, such as health education (Zhang (張舒) 2012) or salt reduction (Subramanian 2011). More evidence from randomised controlled trials in the general population and investigation of the effect of walking alone on blood pressure is needed. The purpose of this review is to examine whether walking is effective in controlling blood pressure.
Objectives
To determine the effect of walking as a physical activity intervention on blood pressure and heart rate.
Methods
Criteria for considering studies for this review
Types of studies
We included individually‐randomised parallel group controlled trials. We excluded cluster‐randomised studies due to the risk of contamination and we did not include cross‐over trials due to possible carry‐over effects of the intervention.
Types of participants
Both hypertensive and normotensive adults aged 16 years and over.
Types of interventions
Walking interventions including community, laboratory‐based (e.g. treadmill), or non‐stair and non‐uphill treadmill walking were included. Mixed interventions of walking with other modes of physical activity, such as jogging, or other forms of lifestyle modification, such as dietary salt reduction, were excluded.
The comparison was non‐exercising and non‐intervention controls.
Types of outcome measures
All outcome measures of: systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) as continuous data.
Primary outcomes
Systolic blood pressure (SBP) (continuous): measured by any standard devices, such as electronic or traditional mercury sphygmomanometer, or 24 hours ambulatory blood pressure measurement in millimetres of mercury (mmHg) pressure units.
Secondary outcomes
Diastolic blood pressure (DBP) (continuous): measured by any standard devices, such as electronic or traditional mercury sphygmomanometer, or 24 hours ambulatory blood pressure measurement in mmHg.
Heart rate (HR) (continuous): measured by any standard devices in beats per minute (bpm).
Search methods for identification of studies
Electronic searches
The Cochrane Hypertension Information Specialist conducted systematic searches in the following databases for randomised controlled trials without language, publication year, or publication status restrictions:
Cochrane Hypertension Specialised Register via the Cochrane Register of Studies (CRS‐Web) (searched 8 March 2020);
Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Register of Studies (CRS‐Web) (2020, Issue 2);
MEDLINE Ovid (from 1946 onwards), MEDLINE Ovid Epub Ahead of Print, and MEDLINE Ovid In‐Process & Other Non‐Indexed Citations (searched 7 March 2020);
Embase Ovid (searched 7 March 2020);
CINAHL EBSCO (searched 9 March 2020);
SPORTDiscus EBSCO (searched 11 March 2020);
PsycINFO EBSCO (searched 9 March 2020);
Physiotherapy Evidence Database (PEDro) (searched 11 March 2020);
ClinicalTrials.gov (www.clinicaltrials.gov) (searched 11 March 2020);
World Health Organization International Clinical Trials Registry Platform (https://apps.who.int/trialsearch) (searched 11 March 2020).
Databases were searched from the date of inception. The Information Specialist modelled subject strategies for databases on the search strategy designed for MEDLINE. Where appropriate, they were combined with subject strategy adaptations of the sensitivity‐ and precision maximising search strategy designed by Cochrane for identifying randomised controlled (as described in Chapter 4 of the Cochrane Handbook for Systematic Reviews of Interventions Version 6 (Lefebrve 2019). We present the search strategies for major databases in Appendix 1.
The review authors also searched the following databases from the date of inception:
Index to Taiwan Periodical Literature System (searched 18 May 2020);
National Digital Library of Theses and Dissertations in Taiwan (searched 18 May 2020);
China National Knowledge Infrastructure (CNKI)‐Journals, Theses & Dissertations (searched 18 May 2020);
Wanfang Medical Online (searched 18 May 2020).
Searching other resources
The Cochrane Hypertension Information Specialist searched the Hypertension Specialised Register segment (which includes searches of MEDLINE and Epistemonikos for systematic reviews) to retrieve existing systematic reviews relevant to this systematic review, so that we could scan their reference lists for additional trials. The Specialised Register also includes searches of CAB Abstracts & Global Health, CINAHL, ProQuest Dissertations & Theses and Web of Knowledge.
We checked the bibliographies of included studies and any relevant systematic reviews identified for further references to relevant trials. Where necessary, we contacted authors of key papers and abstracts to request additional information about their trials. We did not perform a separate search for adverse effects of interventions used for the treatment of hypertension. We considered adverse effects described in the included studies only.
Data collection and analysis
Selection of studies
All titles and abstracts identified through the searches were scanned by two review authors (LLL and HHL) independently for eligibility of inclusion. Abstracts that did not meet all the inclusion criteria were rejected. Any discrepancies were discussed and resolved by a third review author (CM). Full‐text articles for all included titles and abstracts were then retrieved and assessed by two review authors (LLL and HHL) to determine whether they met the inclusion criteria. Uncertainties concerning the appropriateness of studies for inclusion in the review were discussed and resolved through consultation with a third review author (CM). We have produced a PRISMA flow chart (Figure 1) showing how we selected our studies for inclusion in the review.
1.
Data extraction and management
A data extraction form was used to extract data on population, study methods, intervention, and outcomes. Two review authors independently extracted data (CM and LLL; EC and YW) and then compared the data. Any discrepancies were identified and resolved via discussion. We extracted data on study aim, inclusion and exclusion criteria, description of the intervention and control, and outcomes of interest. Special care was taken to avoid the inclusion of multiple reports pertaining to the same individuals, for example in trials reporting outcomes over multiple time periods. Where data were not available in the published trial reports, we contacted authors requesting missing information, and studies were excluded when data were not available.
Assessment of risk of bias in included studies
Using the Cochrane 'Risk of bias' tool (RoB1), two review authors (CM and LLL; EC and YW) independently assessed each study by examining randomisation procedure; allocation concealment; blinding of participants, intervention providers, and outcome assessors; incomplete outcome and losses to follow‐up. Discrepancies were resolved by discussion between the two review authors and, if needed, by consulting a third review author.
Measures of treatment effect
The mean blood pressure and heart rate differences from baseline to follow‐up in the intervention and control groups were compared and pooled using the weighted mean difference (WMD) approach (see Cochrane Collaboration: http://www.epi.bris.ac.uk/cochrane/stats3.html). The appropriateness of conducting meta‐analysis was checked by assessing clinical, methodological, and statistical homogeneity. Where insufficient information about the variance has been provided in trial reports, we calculated variances and took the correlation of baseline and final blood pressure measurements (Follmann 1992) into account. We contacted trial authors to collect the data insufficiently reported in the original trial, such as systolic or diastolic blood pressure readings at either baseline or follow‐up, and trials were excluded when the requested data were not available.
Unit of analysis issues
The unit of analysis was each participant. For studies with more than two arms, we included only arms that met the inclusion criteria of the review.
Dealing with missing data
We addressed the issue of missing data by requesting information from the original study authors. Where such attempts were unsuccessful and data could not be obtained, or estimates had to be derived by making further assumptions, the robustness of the overall findings was assessed through sensitivity analyses.
Assessment of heterogeneity
We used forest plots, Chi2 tests, and I²to test for heterogeneity between the results of the studies in the review. We regarded a level of heterogeneity above 50% as substantial or high, as explained in the Cochrane Handbook for Systematic Reviews of Interventions, Section 9.5.2 (Higgins 2011). Where significant heterogeneity existed, explanations were sought for the sources of heterogeneity such as differences in the design or methodological characteristics.
Assessment of reporting biases
The possibility of publication bias was examined using funnel plots. If there was evidence that publication bias did exist, the trim‐and‐fill method (Duval 2000; Peters 2007) was used. This method estimates and adjusts for the numbers and outcomes of studies estimated as being missing and provides a sensitivity analysis to assess the robustness of the results to the likely degree of publication bias in the literature.
Data synthesis
We checked the appropriateness of conducting meta‐analysis by assessing for clinical and design homogeneity and presented the pooled results of SBP and DBP, and heart rate as mean differences (MDs) between groups and 95% Confidence Intervals (CIs). Random‐effects models were used to take account of statistical heterogeneity between combinable studies. We used Cochrane Review Manager 5.4 (RevMan 2014 [Computer program]) for data synthesis.
Subgroup analysis and investigation of heterogeneity
Subgroup analyses according to age and sex were carried out among the studies with sufficient information. Pooled results for SBP and DBP and heart rate were presented as MDs between groups and 95% CIs. Statistical heterogeneity was quantified by I². Random‐effects models were used to allow for statistical heterogeneity present between studies.
Sensitivity analysis
We performed sensitivity analyses to assess the effect of walking on blood pressure in studies we assessed at low risk of overall bias. We also performed a sensitivity analysis for studies assessed at low risk of attrition bias.
Summary of findings and assessment of the certainty of the evidence
We used the GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation) (Guyatt 2011) to assess the certainty of the evidence for each estimate of intervention effect (Schünemann 2019a; Schünemann 2019b). We rated the certainty of the evidence by assessing the 'Risk of bias' evaluation, indirectness of evidence, inconsistency (considering I² and P value), imprecision of effect estimates (95%CI or small size of effect), and potential publication bias. We rated the certainty of the evidence as high, moderate, low or very low. We downgraded the evidence from 'high certainty' by one level for serious limitations or by two levels for very serious study limitations. We present key findings of the review in the 'Summary of findings' tables, including a summary of the amount of data, the magnitude of the effect size and the overall certainty of the evidence.
Results
Description of studies
Results of the search, included and excluded studies are described as follows.
Results of the search
Our initial searches identified 51,195 potentially relevant papers. After the removal of duplicates and initial screening, 7565 records remained. After conducting a further assessment on the basis of title and abstract, we excluded 7166 records and obtained the full text of 399 studies. After screening the full text of these 399 studies, 73 studies remained (Figure 1). Three studies are ongoing and will be considered in updates of this review when needed (Characteristics of ongoing studies).
Included studies
Seventy‐three randomised controlled trials involving 6473 participants met our inclusion criteria and were included in the review. Of the 6473 participants randomised into the 73 trials, 5763 received the eligible intervention and 5060 were analysed. The details of the methods, participants, intervention, comparison group, and outcome measures for each of the included trials are shown in the Characteristics of included studies. Further study details are presented in Table 4. The trials were published over a 30‐year period between 1991 and 2020, with 10 published during the 1990s, 23 during the 2000s, and 40 in 2010 to 2020.
1. Baseline characteristics of included studies.
Study ID | Participants randomised n | Country | Study population | Mean age (SD) or range | Male/total (%) | Mean baseline SBP (SD)(mmHg) | Mean baseline DBP (SD)(mmHg) | Mean baseline HR (SD)(beats/min) |
Araiza 2006 | 30 | USA | type 2 diabetes mellitus, free from advanced secondary complications of diabetes. | Range 33 to 69; IG: 49 (SD 11); CG:51 (SD 10) | NR | IG: 140.6 (SD 21.4); CG: 136.6 (SD 19.3) | IG: 80.7 (SD 12.2); CG: 77.6 (SD 8.9) | NR |
Arija 2017 | 419 | Spain | Older primary health‐care patients (attending primary health care facilities) | IG: 64.5 (SD 9.2); CG: 66.99 (SD 10.28) | 84/364 (23.2%) | IG: 131.06 (SD 15.94); CG: 135.32 (SD 16.62) | IG: 76.75 (SD 9.09); CG: 75.96 (SD 9.86) | NR |
Baker 2008 | 80 | UK | Sedentary general population | Range 18 to 65; IG: 47.3 (SD9.3); CG: 51.2 (SD7.9) | 16/79 (20.3%) | IG: 118.2 (SD 17.9); CG: 119.9 (SD 15.9) | IG: 75.1(SD 11.4); CG: 75.5 (SD 11.8) | IG: 68.6 (SD 7.2); CG: 67.9 (SD 8.6) |
Bang 2016 | 60 | Korea | General population (Office workers) | IG: 42.22 (SD 11.44); CG: 37.37 (SD 9.32) | 3/45 (6.67%) | IG: 121.39 (SD 16.02); CG: 112.52 (SD 12.49) | IG: 79.00 (SD 9.37); CG: 72.85 (SD 9.35) | NR |
Baross 2017 | 24 | UK | Sedentary young adults | IG: 20.9 (SD 2.0); CG: 21.3 (SD 2.0) | 13 (54%) | IG: 126.7 (SD 3.7); CG: 127.9 (SD 4.2) | IG: 77.7 (SD 3.0); CG: 77.0 (SD 1.8) | IG: 66.0 (SD 3.1); CG: 67.4 (SD 2.7) |
Bayat 2018 | 120 | Iran | Woman with Type 2 Diabetes | IG: 53.77 (SD 6.52); CG: 52.06 (SD 6.28) | 0 (0%) | IG: 126.04 (SD 16.69), CG: 130.9 (SD 15.64) | IG: 74.9 (SD 10.85); CG: 85.0 (SD 10.0) | |
Bell 2010 | 140 | Canada | Sedentary general population | Male: 49 (SD 11); Female: 50 (SD 9) | NR | IG: 124 (SD 14); CG: 125 (SD 13) | IG: 78 (SD 9); CG: 80 (SD 9) | IG: 73 (SD 9); CG: 76 (SD 11) |
Braith 1994 | 30 | USA | Normotensive elderly adults | Range 60 to 79; IG: 66 (SD 5); CG: 66 (SD 5) | NR | IG: 121 (SD 10); CG: 121 (SD 12) | IG: 72 (SD 8); CG: 74 (SD 5) | IG: 71 (SD 8); CG: 65 (SD 8) |
Brandon 2006 | 52 | USA | Obese sedentary adults | (total: 37.93; AAE: 34.0 (SD 7.2); AAC: 36.0 (SD 8.4); WE: 40.5 (SD 7.1); WC: 42.0 (SD 9.7) | 0 (0%) | AAE: 110.0 (SD 11.9); AAC: 103.9 (SD 15.6); WE: 111.0 (SD 14.9); WC: 115.0 (SD 18.1) | AAE: 69.7 (SD 8.9); AAC: 63.8 (SD 14.6) WE: 67.0 (SD 10.3); WC: 68.5 (SD 10.2) | NR |
Brenner 2020 | 48 | Canada | Patients with vascular problems | IG 68.6 (SD 6.87); CG 63.7 (SD 8.47) | 21/33 (63.6%) | IG: 124 (SD 15); CG: 132 (SD 14) | IG: 67 (SD 8); CG: 69 (SD 11) | IG: 63 (SD 12); CG: 66 (SD 13) |
Brown 2014 | 94 | UK | General population (Office workers) | IG1: 46.3 (SD 9.4); IG2: 39.3 (SD 10.3); CG: 40.2 (SD 11.0) | 74 (78.7%) | IG1: 135.1 (SD 12.3); IG2: 128.9 (SD 15.1); CG: 133.3 (SD 10.5) | IG1: 86.0 (SD 7.6); IG2: 81.5 (SD 11.9); CG: 79.5 (SD 7.1) | IG1: 67.1 (SD 10.0); IG2: 63.6 (SD 10.1); CG: 64.6 (SD 12.5) |
Chan 2018 | 164 | Hong Kong | Hypertensive patients | IG: 63.22 (SD 11.11); CG: 65.13 (SD 10.22) | 80 (48.8%) | IG: 138.15 (SD17.39); CG: 142.49 (SD19.12) | IG: 79.74 (SD 10.51); CG: 82.59 (SD 10.68) | NR |
Chiang 2019 | 32 | Taiwan | College students with obesity | IG1: 19.17 (SD 1.03); IG2: 20.64 (SD 1.80); CG: 19.36 (SD 1.12) | NR | IG1: 121.92 (SD 15.70); IG2: 121.36 (SD 11.48); CG: 127.00 (SD 17.18) | IG1: 76.92 (SD 12.06); IG2: 79.55 (SD 8.85); CG: 74.33 (SD 11.06) | IG1: 75.92 (SD 10.13) IG2: 78.3 (SD 10.02) CG: 79.78 (SD 7.85) |
Coghill 2008 | 67 | UK | Hypercholesterolaemic men | Range 45 to 65 | 67 (100%) | IG: 138.04 (SD 15.61); CG: 140 (SD 15.63) | IG: 89.90 (SD 9.93); CG: 88.32 (SD 9.52) | NR |
Cooper 2000 | 90 | UK | Sedentary adults with unmedicated hypertension 150‐180 mmHg | Range 25 to 63; IG: 46.2 (SD 9.4); CG: 49.4 (SD 8.9) | 72 (80%) | IG: 139.8 (SD 12.7); CG: 135.7 (SD 9.3) | IG: 89.5 (SD 9.6); CG: 87.6 (SD 8.5) | NR |
Dong 2007 | 120 | China | Patients with chronic heart failure | IG: 61.7 (SD 12.3); CG: 61.9 (SD 12.1) | 66 (55%) | IG: 149.10 (SD 44.50); CG: 147.2 (SD 44.1) | NR | IG: 104 (SD 25); CG: 105 (SD 21) |
Dong 2012 | 51 | China | White coat hypertension patients | Range 45 to 71; IG: 53.75 (SD 16.42); CG: 54.26 (SD 17.18) | 29 (56.9%) | IG: 129.51 (SD 25.42); CG: 127.96 (SD 23.13) | IG: 82.09 (SD 17.23); CG: 83.46 (SD 18.52) | NR |
Duncan 1991 | 102 | USA | Sedentary pre‐menopausal women | Range 20 to 40 | 0 (0%) | IG1: 105 (SD 8); IG2: 109 (SD 9); IG3: 108 (SD 6); CG: 108 (SD 8) | IG1: 70 (SD 7); IG2: 74 (SD 8); IG3: 73 (SD 9); CG: 74 (SD 7) | NR |
Dureja 2014 | 10 | India | Young adults (post‐graduate students) | Range 19 to 25 | 10 (100%) | IG: 116 (SD 5.47); CG: 123 (SD 10.36) | IG: 79 (SD 8.94); CG: 82.0 (SD 11.51) | NR |
Foulds 2014 | 90 | Canada | General population | Range 20 to 65; total: 44 (SD 13) | 21/58 (36.2%) | IG1: 116 (SD 16.11); IG2: 111.22 (SD 11.39); IG3: 108.28 (SD 11.58); IG4: 115.15 (SD 11.31);CG: 114.6 (SD 16.97) | IG1: 75.2 (SD 10.3); IG2: 72.3 (SD 7.14); IG3: 68.2 (SD 9.17); IG4: 74.9 (SD 11);CG: 69.2 (SD 8.6) | NR |
Fritz 2013 | 213 | Sweden | Overweight general population, & individuals with IGT or T2DM | Range 45 to 69; total: 60 (SD 5.3) | 95 (44.6%) | IG1_NGT: 138 (SD 12.5); IG2_IGT: 141 (SD 14.0); IG3_T2DM: 143 (SD 13.2);CG1_NGT: 137 (SD 15.0); CG2_IGT: 141 (SD 13.0); CG3_T2DM: 144 (SD 12.6) | IG1_NGT: 85 (SD 7.9); IG2_IGT: 84 (SD 7.8); IG3_T2DM: 85 (SD 7.6);CG1_NGT: 84 (SD 8.8); CG2_IGT: 86 (SD 9.4); CG3_T2DM: 83 (SD 7.4) | NR |
Geddes 2009 | 15 | USA | Multiple sclerosis adults | IG: Range 40 to 64; CG: Range 22 to 50 | 3/12 (25%) | NR baseline SBP | NR baseline DBP | NR |
Gilson 2007 | 70 | UK | General population (University employees office workers) | Male: 41 (SD 11); Female: 42 (SD 11) | 7 (10%) | IG1: 121.7 (SD 17.3); IG2: 119.0 (SD 7.4); CG: 121.6 (SD 9.9) | IG1: 85.6 (SD 12.1); IG2: 85.7 (SD 10); CG: 82.9 (SD 7.3) | NR |
Gradidge 2018 | 132 | South Africa | Obese women (university staff) | IG: 44.4 (SD 11.5); CG: 37.4 (SD 8.78) | 0 (0%) | IG: 127 (SD 14.7); CG: 122 (SD 15.6) | NR | NR |
Hamdorf 1999 | 49 | Australia | Elderly sedentary women | Range 79 to 91; IG: 82.4 (SEM 0.66); CG: 83.1 (SEM 0.69) | 0 (0%) | IG: 144.6 (SEM 4.9); CG: 149.3 (SEM 5.1) | IG: 72.6 (SEM 2.2); CG: 77.7 (SEM 2.5) | IG: 74.4 (SEM 2.1) CG: 72.7 (SEM 1.7) |
Headley 2017 | 49 | USA | Stage 3 chronic kidney disease adults | IG: 58 (SD 8.0); CG: 57.1 (SD 9.0) | 30/46 (65.2%) | IG: 126.4 (SD 17.8); CG: 133.7 (SD 19.2) | IG: 79.5 (SD 10.2); CG: 79.1 (SD 10.7) | IG: 64.3 (SD 8.9); CG: 65.5 (SD 12.3) |
Herzig 2014 | 78 | Finland | Impaired fasting glucose/ glucose tolerance adults | IG: 58.1 (SD 9.9); CG: 59.5 (SD 10.8) | 18/68 (26.5%) | IG: 138.5 (SD 16.4); CG: 150.4 (SD 20.2) | IG: 83.8 (SD 8.0); CG: 85.4 (SD 9.5) | NR |
Higashi 1999b | 27 | Japan | Essential hypertensive adults | IG: 53 (SD 10); CG: 51 (SD 8) | 20 (74%) | IG: 155.0 (SD 6.6); CG: 155.4 (SD 8.3) | IG: 96.0 (SD 4.9); CG: 97.6 (SD 4.3) | IG: 71.8 (SD 9.7); CG: 73.1 (SD 6.4) |
Holloway 1997 | 102 | USA | Sedentary middle‐aged | Range 20 to 50 | unknown | IG1_XS: 113.6 (SD 9.8); IG2_T: 113.4 (SD 11.1); IG3_S: 116.7 (SD 10.0); CG: 114.5 (SD 12.3) | IG1_XS: 80.0 (SD 7.3); IG2_T: 81.9 (SD 9.1); IG3_S: 83.5 (SD 8.7); CG: 82.7 (SD 6.0) | IG1_XS: 76.4 (SD 9.0) IG2_T:77.0 (SD 8.8) IG3_S: 75.9 (SD 6.3) CG:78.6 (SD 10.1) |
Hua 2006 | 47 | Canada | Hypertensive adults | IG‐Male:55.8 (SD 9.5); IG‐Female: 56.3 (SD 9.6) CG‐Male: 55.9 (SD 10.2) CG‐Female:58.5 (SD 11.3) | 20/40 (50%) | IG‐Male: 140 (SD 11); IG‐Female: 141 (SD 16); CG‐Male: 142 (SD 15); CG‐Female: 141 (SD 17) | IG‐Male: 92 (SD 7); IG‐Female: 87 (SD 9); CG‐Male: 91 (SD 11); CG‐Female: 88 (SD 9) | IG‐Male: 69 (SD 7); IG‐Female: 75 (SD 12); CG‐Male: 75 (SD 15); CG‐Female: 70 (SD 12) |
Karstoft 2013 | 34 | Denmark | Type 2 diabetes adults | IG_CWT: 60.8 (SD 2.2); IG_IWT: 57.5 (SD 2.4); CG: 57.1 (SD 3.0) | 20/32 (62.5%) | IG_CWT: 155 (SD 5.4); IG_IWT: 138 (SD 3.3); CG: 142 (SD 4.3) | IG_CWT: 90.0 (SD 1.8); IG_IWT: 85.0 (SD 2.8); CG: 86.6 (SD 3.5) | NR |
Khalid 2013 | 30 | Egypt | Hypertensive post‐menopausal women | Range 40 to 50; IG: 52.9 (SD 2.6); CG: 52.7 (SD 2.2) | 0 (0%) | IG: 148 (SD 5.6); CG: 154 (SD 6.7) | ||
Koh 2010 | 43 | Australia | Long‐term haemodialysis patients | IG: 52.1 (SD 13.6); CG: 51.3 (SD 14.4) | 19/31 (61.3%) | IG: 143 (SD 32) CG: 145 (SD 18) | IG: 78 (SD 16); CG: 80 (SD 9) | IG: 73 (SD 9); CG: 74 (SD 10) |
Kukkonen‐Harjula 1998 | 116 | Finland | Healthy middle‐aged adults | Range 30 to 55; IG: 42.1 (SD 5.1); CG: 40.3 (SD 4.5) | 55 (47.4%) | IG: 118 (SD 12) | CG: 75 (SD 11) | NR |
Kurban 2011 | 60 | Turkey | Type 2 diabetes adults | IG: 53.77 (SD 8.2); CG: 53.57 (SD 6.6) | 29 (48%) | IG: 129.17 (SD 12.1); CG: 124.83 (SD 14.59) | IG: 78.83 (SD 6.78); CG: 77.88 (SD 10.53) | NR |
Lee 2007 | 202 | Taiwan | Hypertensive adults (mild / moderate) | IG: 71.3 (SD 6.4); CG: 71.3 (SD 5.7) | 118 (58.4%) | IG: 152.0 (SD 10.5); CG: 152.4 (SD 11.1) | IG: 83.5 (SD 11.2); CG: 80.6 (SD 8.8) | NR |
Li 2018 | 100 | China | University teachers | IG: 42.26 (SD 8.63); CG: 42.39 (SD 8.35) | 48/100 (48%) (22+26) | IG: 112.69 (SD 13.74); CG: 118.95 (SD 14.99) | NR | NR |
Li 2003 | 48 | USA | Elderly sedentary adults | Range 60 and above; IG: 72 (SD 6.4); CG: 73.3 (SD 7.3) | 9/40 (22.5%) | IG: 133.64 (SD 9.68); CG: 132.17 (SD 13.62) | IG: 81.5 (SD 9.41); CG: 81.22 (SD 8.59) | NR |
Lin 2000 | 22 | Taiwan | Borderline hypertensive adolescents / students | Range 16 to 18 | 22 (100%) | IG1: 140 (SD 11.14); IG2: 137.75 (SD 6.69); CG: 145.67 (SD 10.33) | IG1: 92.25 (SD 3.45); IG2: 91.75 (SD 4.06); CG: 93.67 (SD 4.27) | NR |
Ming 2018 | 64 | China | Elderly patients with Coronary Heart Disease and Hypertension | IG: 63.18 (SD 5.42); CG: 62.76 (SD 5.54) | 40 (62.5%) | IG: 136.79 (SD 7.03); CG: 137.32 (SD 7.44) | IG: 95.88 (SD 4.10); CG: 96.30 (SD 4.52) | IG: 83.18 (SD 8.14); CG: 83.55 (SD 8.09) |
Moreau 2001 | 24 | USA | Postmenopausal women with borderline stage 1 hypertension | IG: 53 (SE 2); CG: 55 (SE 1) | 0 (0%) | IG: 142 (SE 3); CG: 142 (SE 3) | IG: 84 (SE 1); CG: 86 (SE 2) | IG: 77 (SE 3); CG: 77 (SE 3) |
Murphy 1998 | 47 | UK | Sedentary middle‐aged women | IG1: 44.8 (SD 8.4); IG2: 48.0 (SD 5.5); CG: 47.3 (SD 4.1) | 0 (0%) | IG1_short bout: 125.5 (SD10.8); IG2_long bout: 124.2 (SD11.1); CG: 128.6 (SD13.3) | NR | NR |
Murphy 2006 | 37 | UK | Sedentary general population (civil servants) | IG: 41.4 (SD 7.5); CG: 40.8 (SD 10.0) | 13 (35%) | IG: 120.4 (SD 19.7); CG: 116.5 (SD 1 3) | IG: 77.2 (SD 9.4); CG: 74.6 (SD 9.0) | NR |
Murtagh 2005 | 48 | UK | Sedentary general population (university staff/students) | 45.7 (SD 9.4) | 17 (35%) | IG1_single bout: 117.9 (SD 12.0); IG2_accumulated bout: 121.7 (SD 11.2); CG: 117.5 (SD 18.1) | IG1_single bout: 74 (SD 9.8) IG2_accumulated bout: 75.4 (SD 6.6); CG: 73.1 (SD 10.6) | NR |
Nemoto 2007 | 246 | Japan | General population adults | Range 44 to 78; 63 (SD 6) | 60 (24%) | Wcnt_male: 141 (SE 2); Wcnt_female: 135 (SE 3); Wint_male: 146 (SE 2); Wint_female: 140 (SE 3); CG_male: 143 (SE 2); CG_female: 142 (SE 3) | Wcnt_male: 85 (SE 2); Wcnt_female: 81 (SE 2); Wint_male: 87 (SE 3); Wint_female; 85 (SE 2); CG_male: 84 (SE 2); CG_female: 83 (SE 2) | Wcnt_male: 81 (SE 3); Wcnt_female: 78 (SE 1); Wint_male: 75 (SE 3); Wint_female; 81 (SE 2); CG_male: 80 (SE 3); CG_female: 79 (SE 1) |
Neumann 2006 | 25 | USA | Older adults with Silent Myocardial Ischaemia | Range 56 to 83; IG: 71 (SE 2); CG: 63 (SE 2) | 17 (68%) | IG: 134 (SE 3); CG: 140 (SE 6) | IG: 76 (SE 3); CG: 80 (SE 2); | IG: 71 (SE 3); CG: 71 (SE 3) |
Pagonas 2014 | 72 | Germany | Hypertensive outpatients | IG: Range 42 to 79CG: Range 43 to 77 | 31 (43.1%) | IG: 137.9 (SD 12.3); CG: 133.1 (SD 12.1) | IG: 78.1 (SD 8.9); CG: 73.8 (SD 6.4) | NR |
Palmer 1995b | 27 | USA | Sedentary middle‐aged premenopausal women | Range 29 to 50; 37.4 | 0 (0%) | IG: 117.1 (SD 14); CG: 122.6 (SD 13.8) | IG: 80.9 (SD 10.6); CG: 77.6 (SD 11.2) | IG: 74 (SD 10.8); CG: 71 (SD 6.5) |
Pernar 2017 | 41 | Sweden | Prostate cancer patients | Range 54.5 to 81.7 | 41 (100%) | IG: 170; CG: 162 | IG: 93; CG: 89 | NR |
Pospieszna 2017 | 39 | Poland | Postmenopausal women (healthy volunteers) | Range 52 to 72; IG: 62 (SD 3.79); CG: 62 (SD 1.12) | 0 (0%) | IG: 134.7 (SD 21.23); CG: 132.16 (SD 3.8) | IG: 75.8 (SD 7.06); CG: 78.58 (SD 1.96) | NR |
Ready 1996 | 79 | Canada | Sedentary postmenopausal women | Range 50 and above; 61.3 (SD 5.8) | 0 (0%) | IG1_3D: 134 (SD 18); IG2_5D: 131 (SD 20); CG: 131 (SD 16) | IG1_3D: 77 (SD 11); IG2_5D: 76 (SD 9) CG: 77 (SD 10) | NR |
Romero 2019 | 55 | USA | Sedentary elderly female | Range 60 to 75 | 0 (0%) | IG: 143.67 (SD 21.91); CG: 146.07 (SD 24.18) | IG: 84.41 (SD 15.19); CG: 82.96 (SD 10.29) | NR |
Sakuragi 2006 | 20 | Japan | Sedentary general population (female college students) | Range 20 to 22; IG: 19.4 (SD 1.4); CG: 20.1 (SD 1.2) | 0 (0%) | IG:93.324(SD17.55);CG:100.13(SD18.09) | IG:43.779(SD14.18);CG:50.054(SD11.72) | Figure 2 |
Salesi 2014 | 32 | Iran | Elderly women | Range 50 to 55 | 0 (0%) | IG: 136.0 (SD 12.1); CG: 131.1 (SD 8.7) | IG: 83.1 (SD 10.1); CG: 80.3 (SD 3.8) | NR |
Saptharishi 2009 | 58 | India | Confirmed hypertensive / pre‐hypertensive patients | IG: 22.4 (SD 1.3); CG: 22.5 (SD 1.4) | 39 (67.2%) | IG: 128.6 (SD 7.7); CG: 123.1 (SD 10.2) | IG: 87.4 (SD 4.8); CG: 82.9 (SD 7.1) | NR |
Serwe 2011 | 60 | USA | Sedentary office women | Range 18 to 50; IG1: 37.1 (SD 7.2); IG2: 38.2 (SD 7.3); CG: 36.3 (SD 8.1) | 0 (0%) | IG1: 115.1 (SD 10.5); IG2: 117.7 (SD 12.1); CG: 120.9 (SD 9.2) | IG1: 73.4 (SD 8.1); IG2: 73.2 (SD 8.7); CG: 72.7 (SD 7.2) | IG1: 68.4 (SD 10.4); IG2: 65.8 (SD 6.0); CG: 72.7 (SD 9.5) |
Shenoy 2010 | 40 | India | T2DM patients | Range 40 to 70; IG: 53.15 (SD 4.4); CG: 51 (SD 5.4) | 29 (73%) | IG: 122 (SD 13.8); CG: 131 (SD 12.7) | IG: 85.6 (SD 16.1); CG: 86.0 (SD 7.2) | IG: 82.7 (SD 10.6); CG: 81.0 (SD9.7) |
Stanton 1996 | 102 | New Zealand | Sedentary, essential hypertension volunteers | IG: 55.2 (SE 1.4); CG:53.8 (SE 1.5) | 42/89 (47.2%) | IG: 142.9 (SE 2.5); CG: 145.3 (SE 2.6) | IG: 88.4 (SE 1.4); CG: 94.0 (SE 1.4) | NR |
Stutzman 2010 | 25 | Canada | Sedentary normal & overweight 20 weeks pregnant women | IG_normal weight: 30.4 (SD 4.2); IG_overweight: 28.8 (SD 6.9); CG_normal weight: 25.8 (SD 3.0); CG_overweight: 26.2 (SD 5.6) | 0 (0%) | IG_normal weight: 111 (SD 12); IG_overweight: 114 (SD 14); CG_normal weight: 109 (SD 7); CG_overweight: 107 (SD 8) | IG_normal weight: 76 (SD 11); IG_overweight: 75 (SD 10); CG_normal weight: 74 (SD 4); CG_overweight: 72 (SD 4) | NR |
Tudor‐Locke 2004 | 60 | Canada | Sedentary overweight T2DM patients | Range 40 to 60; total: 52.7 (SD 5.2); IG: 52.8 (SD 5.7) CG: 52.5 (SD 4.8) | 26/47 (55.3%) | IG: 138.2 (SD 17.2); CG: 130.1 (SD 15.9); | IG: 81.5 (SD 9.5); CG: 78.9 (SD 8.0) | IG: 76.4 (SD 11.8) CG: 77.0 (SD 9.7) |
Tudor‐Locke 2020 | 120 | USA | Sedentary overweight/obese and postmenopausal women | Range 45 to 75; IG1: 62.6 (SD 6.5); IG2: 61.7 (SD 6.2); CG: 58.4 (SD 5.8) | 0 (0%) | IG1: 127.6 (SD 16.6); IG2: 125.2 (SD 12.7); CG: 122.5 (SD 13.9) | IG1: 78.7 (SD 8.0); IG2: 75.5 (SD 7.6); CG: 77.3 (SD 7.3) | NR |
Tully 2005 | 31 | UK | Sedentary middle‐aged adults | Range 50 to 65; IG: 55.52 (SD 3.99); CG: 57.75 (SD 4.64) | 13 (42%) | IG: 129.94 (SD 8.61); CG: 125.78 (SD 14.02) | IG: 78.47 (SD 4.16); CG: 77.22 (SD 7.74) | NR |
Tully 2007a | 106 | UK | Sedentary middle‐aged adults (civil servants) | Range 40 to 61; IG1_3D: 47.8 (SD 5.97); IG2_5D: 46.37 (SD 4.76); CG: 49.05 (SD 6.31) | 42 (39.6%) | IG1_3‐Day: 134 (SD 15); IG2_5‐Day: 133 (SD 15); CG: 128 (SD 15) | IG1_3‐Day: 87 (SD 11); IG2_5‐Day: 87 (SD 11); CG: 83 (SD 10) | IG1_3‐Day: 69 (SD 12); IG2_5‐Day: 72 (SD 10); CG: 75 (SD 11) |
Tully 2011 | 12 | UK | Sedentary university students | 21.16 (SD 6.17) | 2 (16.7%) | IG: 120 (SD 15.62); CG: 131.67 (SD 11.85) | IG: 79.00 (SD 8.23); CG: 86.33 (SD 8.50) | NR |
Venturelli 2011 | 24 | Italy | Late stage Alzheimer's disease patients | Range 65 and above; IG: 83 (SD 6); CG: 85 (SD 5); | 0 (0%) | IG: 132 (SD 10); CG: 133 (SD 6) | IG: 84 (SD 5); CG: 84 (SD 3) | NR |
Wallis 2017 | 46 | Australia | Severe OA patients rated as grade III or IV affecting at least one of the tibiofemoral compartments | Range 50 to 84; IG: 68 (SD 8); CG: 67 (SD 7) | 26 (56.5%) | IG: 142 (SD 10); CG: 138 (SD 24) | IG: 82 (SD 10); CG: 81 (SD 11.1) | NR |
Wang (王正斌) 2014 | 62 | China | Patients with hypertension and Diabetes Mellitus | Range 40 to 70; IG: 55.8 (SD 9.3); CG: 57.4 (SD 8.9) | 39 (62.9%) | IG: 143 (SD 11); CG: 141 (SD 14) | IG: 81 (SD 11); CG: 88 (SD 9) | NR |
Wang 2014 | 53 | Taiwan | Sedentary postmenopausal women | Range 45 to 70; IG: 56.9 (SD 6.2) CG: 55.1 (SD 7.8) | 0 (0%) | IG: 124.6 (S D9.2); CG: 127 (SD 10.1) | IG: 76.8 (SD 8.1) CG: 79 (SD 9.4) | NR |
Wang 2016 | 61 | China | Hypertensive coal miners | Range 18 to 64; IG: 49.61 (SD 4.91); CG: 48.50 (SD 6.31) | 31/48 (64.6%) | IG: 134.83 (SD 17.43); CG: 143.97 (SD 20.91) | IG: 82.39 (SD 12.94); CG: 87.63 (SD 10.48) | NR |
Westhoff 2007 | 54 | Germany | Sedentary Isolated Systolic Hypertension elderly patient | Range 60 and above; IG: 67.2 (SD 4.8); CG: 68.9 (SD 5.2) | 26 (48.1%) | IG: 136.6 (SD 12.7); CG: 134.8 (SD 11) | IG: 76.3 (SD 7.3); CG: 72.8 (SD 7.2) | Figure 2 |
Xiao 2010 | 124 | China | Elderly Type 2 Diabetes Mellitus patients | IG: 65.84 (SD 6.32); CG 65.82 (SD 6.39) | 36/112 (32.1%) | IG: 141.82 (SD 16.23); CG 141.05 (SD 20.06) | IG: 82.91 (SD 9.94); CG 84.04 (SD 10.15) | NR |
Yan 2010 | 418 | China | Patients with Congestive Heart Failure | IG: 61.2 (SD 11.8); CG: 62.5 (SD 11.6) | 261 (62.4%) | IG: 123.1 (SD 21.9); CG: 125.6 (SD 20.2) | IG: 68.6 (SD 10.8); CG: 68.5 (SD 10.6) | IG: 74.2 (SD 15.7) CG: 77.1 (SD 15.2) |
Yu 2018 | 231 | China | Elderly patients with Isolated Systolic Hypertension | IG1: 82.96 (SD 2.06); IG2: 83.01 (SD 2.09); CG: 83.44 (SD 1.99) | 139/211 (65.9%) | IG1: 141.67 (SD 5.95); IG2: 140.87 (SD 6.45); CG: 141.94 (SD 5.22) | IG1: 63.2 (SD 3.59); IG2: 62.36 (SD 2.84); CG: 63.43 (SD 3.11) | NR |
CG: control group; CWT: continuous walking training; IG: intervention group; IGT: impaired glucose tolerance; IWT: intermittent walking training; NGT: normal glucose tolerance; NR: not reported; OA: Osteoarthritis; SD: standard deviation; SE: standard error; T2DM: type 2 diabetes mellitus; Wcnt: moderate‐intensity continuous walking training group; Wint: high‐intensity interval walking training group
Study and participant characteristics
The mean age of participants ranged from 16 to 84 years; and there were approximately 1.5 times as many female participants as male ones (3122 versus 2075). Among the trials that reported data about sex, the majority recruited both male and female participants (n = 49 trials), 20 recruited only women and four only men. Hua 2006 and Nemoto 2007 recruited both male and female participants and provided outcome data for each. Sample sizes ranged from 10 to 396. The majority of the trials were conducted in the USA (n = 14) and the UK (n = 12); with nine in China; seven in Canada; four in Taiwan; three each in Australia, India, and Japan; two each in Finland, Germany, Iran, and Sweden; and one each in Denmark, Egypt, Iran, Italy, Korea, Poland, New Zealand, Poland, Spain, and Turkey (Table 4). Among the 73 trials included in the current review, nearly one quarter (n = 17, 23%) reported that they recruited hypertensive participants, while 15 reported that they recruited non‐hypertensive participants (21%).
Interventions and comparators
Among the trials that clearly stated the setting of their interventions (n = 71), the walking interventions were mainly carried out at home/in the community (n = 50) (such as indoor or outdoor walking, nature/city/campus walking, or daily walking), or in the laboratory with the treadmill or stepper (n = 16). There was a total of 36 trials conducting supervised walking programs among the 47 trials reported the information of supervision. The prescription of walking interventions varied widely in the 73 included trials, and included treadmill walking (n = 18), outdoor walking (n = 17), brisk walking (n = 16), and Nordic walking (n = 6). Participants in the control groups received no intervention. In order to be able to compare the length of time of each intervention, we decided to present the time of the intervention in weeks and thus when the length of the intervention was presented as months, we calculated months into weeks using the following formula: number of months*4.33 weeks. On the basis of this calculation, the intervention length ranged from four to 64 weeks, including 12 to 13 weeks in 26 trials and 24 to 26 weeks in 13 trials. Moreau 2001 conducted two outcome measures at both 12 and 24 weeks, respectively and Chan 2018 conducted three at three, six, and nine months, respectively, and we conservatively used the data obtained at the shortest intervention length, which is 12 weeks (three months). The average length of the intervention among all studies was 15 weeks. In terms of frequency and duration of walking, most trials prescribed walking three to five sessions per week and 20 to 40 minutes per session. Among the 77 walking intervention groups that clearly stated the prescription for weekly walking frequency and duration of walking per session, the walking time per week ranged widely from 10 to 845 minutes. The average walking duration per week was 153 minutes (range 150 to 180) prescribed by 22 studies. The second and third most frequently prescribed duration were a walking duration of 90 to 100 minutes per week prescribed by 13 studies and 120 to 149 minutes prescribed by 12 studies.
Among the walking groups that provided information for classifying measures of the walking intensity, 27 intervention groups used maximum heart rate (in the form of either a percentage or calculated heart rate); 24 each reported a walking intensity as VO2max (in the form of either a percentage or calculated VO2max) and walking distance per hour (e.g. 6.5km/hour), per day (e.g. 3 km/day) or per second (e.g. 1.6 to 1.8 metres/second), respectively. Fourteen studies reported the ratings of perceived exertion using the Borg Scale of Perceived Exertion (Borg 1982), and eight used the percentage of heart rate reserve. Of these, 14 walking group intensities were measured using mixed methods, such as walking distance per hour plus the percentage of the maximum heart rate. The intensity of walking varied from minor to high and the majority of the walking groups were moderate intensity (n = 62), with 13 low intensity, 11 self‐paced, and five high intensity.
Funding sources
More than one‐third of the trials included in the current review failed to report their funding sources (n = 32) and studies that clearly reported the funding support received funding from governments (n = 24), private sector (n = 11), both (n = 3), or were self‐funded (n = 3).
Excluded studies
The reasons for study exclusion are mainly due to non randomisation, not just walking but multiple interventions, intervention control groups, or the unavailability of outcome data (see Characteristics of excluded studies).
Risk of bias in included studies
We have summarised our judgments of the risks of bias in Figure 2 and Figure 3. Full details of our judgments of risk of bias are presented in Characteristics of included studies tables.
2.
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3.
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Allocation
Random sequence generation
Of the 73 included studies, 27 described a method of random sequence generation that we judged to be at low risk of bias. In most studies, researchers used a computerised random number generator. We judged 45 studies to be at unclear risk of random sequence generation due to insufficient information available to make a judgment. We judged one study (Nemoto 2007) to be a high risk of bias because there were reassignments after randomisation and it was not defined how many participants were reassigned.
Allocation concealment
Only 13 studies described a method of allocation concealment that we judged to be at low risk of bias. For the majority of studies (n = 59), we were unable to judge the risk of allocation bias as these studies failed to report sufficient information on which to make a judgment. We judged one study (Nemoto 2007) to be a high risk of allocation bias because some participants were moved from their allocated group to be in the same group as their partner or to a more convenient administrative centre.
Blinding
Blinding of participants and personnel
Given the nature of the intervention, it was difficult to blind participants and personnel and thus we judged 42 of the 73 included to be at high risk of performance bias. We judged five studies to be at low risk of performance bias. The authors for the remaining 26 studies failed to provide sufficient information regarding blinding of participants and personnel and we, therefore, judged these studies to be at unclear risk of performance bias.
Blinding of outcomes assessors
Fifty‐two studies failed to report information on the blinding of outcomes assessors and therefore we judged the risk of detection bias to be unclear. Blinding of outcome assessment was deemed appropriate in 19 trials and we judged these trials to be at low risk of bias for this domain. We judged the remaining two trials (Cooper 2000; Koh 2010) to be at high risk of detection bias as both authors clearly stated that outcome assessors were not blinded to group assignment.
Incomplete outcome data
The majority of the included studies provided information regarding withdrawals or losses to follow‐up (n = 64). Among the studies that provided sufficient information, the dropout rate varied substantially from 0 to 37% in the 73 included studies. We judged 21 studies to have a high risk of bias due to incomplete outcome data, i.e. the dropout rate was equal to or greater than 20%. There are 45 studies using per‐protocol (PP) analysis, 17 studies using intention‐to‐treat (ITT), and two studies reported both ITT and PP. In addition, there are three studies that performed more than one randomisation in their trial (Nemoto 2007; Neumann 2006; Stutzman 2010). In Karstoft 2013, a total of three randomisations was carried out and there were five participants entering the trial twice firstly into the control and then into the intervention group.
Selective reporting
We judged all 73 included studies to be at low risk of selective reporting bias because they either reported the data of the primary outcome and/or secondary outcomes in the published paper or provided the outcome data we needed when we contacted them. Ten studies were prospectively registered with a clinical trial registry, and therefore the majority of studies (n = 63) were not.
Other potential sources of bias
In the study by Brenner 2020, participants in both the intervention and control groups received follow‐up phone calls after the first week of the program, and at two‐week intervals during the 12‐week intervention period. Also, in the study by Chan 2018, the participants in all trial arms were encouraged or invited to participate in weekly non‐exercised based community socialisation activities during the three‐month intervention period (Chan 2018). For both studies, these activities are likely to have highlighted the issue regarding the importance of lifestyle modification and thus may have resulted in contamination of the control group participants. This may lead to a dilution in any observed difference between the intervention and control groups in both studies.
To check for publication bias, we produced a funnel plot using the mean difference (MD) for the effects of walking on SBP and DBP against the standard error (SE). An inspection of the two funnel plots shows symmetrical plots, with the effect estimate equally distributed around the mean (Figure 4; Figure 5). This suggests that publication bias is not an issue for this review.
4.
Funnel plot of comparison: 1 Walking versus non‐intervention control (overall), outcome: 1.1 systolic blood pressure [mmHg].
5.
Funnel plot of comparison: 1 Walking versus non‐intervention control (overall), outcome: 1.2 diastolic blood pressure [mmHg].
Effects of interventions
See: Table 1; Table 2; Table 3
Summary of findings 1. Walking compared to no intervention (overall) for control of blood pressure.
Walking compared to no intervention (overall) for hypertension | |||||
Patient or population: adults with or without hypertension Setting: general population Intervention: walking Comparison: no intervention (overall) | |||||
Outcomes | Anticipated absolute effects* (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
Effect with no intervention mmHg |
Effect with Walking mmHg |
||||
Systolic blood pressure | The mean systolic blood pressure was ‐1.30 | MD 4.11 lower (5.22 lower to 3.01 lower) | 5060 (73 RCTs) | ⊕⊕⊕⊝ MODERATE 1 2 | Walking interventions probably reduce systolic blood pressure. |
Diastolic blood pressure | The mean diastolic blood pressure was ‐0.73 | MD 1.79 lower (2.51 lower to 1.07 lower) | 4711 (69 RCTs) | ⊕⊕⊝⊝ LOW 2 3 | Walking interventions may reduce diastolic blood pressure. |
Heart rate [beats/min] | The mean heart rate [beats/min] was ‐0.41 beats/min | MD 2.76 beats/min lower (4.57 lower to 0.95 lower) | 1747 (26 RCTs) | ⊕⊕⊝⊝ LOW 2 4 | Walking interventions may reduce heart rate. |
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; DBP: diastolic blood pressure; MD: mean difference; RCT: randomised controlled trial; SBP: systolic blood pressure. | |||||
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. |
1 Not downgraded one level for risk of bias even though more than half of included studies failed to report details of randomisation and allocation concealment. This is because a sensitivity analysis based on trials judged as being at low risk of bias also showed a statistically significant reduction of SBP: Weighted Mean Difference= ‐4.31, 95% CI: ‐7.99 to ‐0.63, P = 0.02, I2 = 0%, n = 235.
2 Downgraded one level for inconsistency on the basis of statistically significant heterogeneity.
3 Downgraded one level for risk of bias; More than half of the included studies failed to report details of randomisation and allocation concealment. The sensitivity analysis based on trials judged as being at low risk of bias failed to show a statistically significant reduction of DBP: Weighted Mean Difference = ‐0.47, 95% CI: ‐2.54 to 1.61, P = 0.66, I2 = 18%, n = 235.
4 Downgraded one level for risk of bias; More than half of included studies failed to report details of randomisation and allocation concealment and there is no data for further sensitivity analysis.
Summary of findings 2. Walking compared to no intervention by age for control of blood pressure.
Patient or population: adults with or without hypertension Setting: general population Intervention: walking Comparison: no intervention, by age | |||||
Outcomes | Anticipated absolute effects* (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
Effect with no intervention mmHg |
Effect with Walking mmHg |
||||
SBP age <=40 |
The mean SBP was 1.71 | MD 4.41 lower (6.17 lower to 2.65 lower) | 491 (14 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | Walking interventions probably reduce systolic blood pressure in adults aged equal to or less than 40 years. |
SBP age 41‐60 |
The mean SBP was ‐1.88 | MD 3.79 lower (5.64 lower to 1.94 lower) | 1959 (35 RCTs) | ⊕⊕⊝⊝ LOW 1 2 | Walking interventions may reduce systolic blood pressure in adults aged 41 to 60 years. |
SBP age >60 |
The mean SBP was ‐2.21 | MD 4.30 lower (6.17 lower to 2.44 lower) |
2610 (24 RCTs) | ⊕⊕⊝⊝ LOW 1 2 | Walking interventions may reduce systolic blood pressure in adults aged over 60 years. |
DBP age <=40 |
The mean DBP was ‐0.24 | MD 3.01 lower (4.44 lower to 1.58 lower) | 491 (14 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | Walking interventions probably reduce diastolic blood pressure in adults aged equal to or less than 40 years. |
DBP age 41‐60 |
The mean DBP by age 41‐60 was ‐0.87 | MD 1.74 lower (2.95 lower to 0.52 lower) | 1730 (32 RCTs) | ⊕⊕⊝⊝ LOW 1 2 | Walking interventions may reduce diastolic blood pressure in adults aged 41 to 60 years. |
DBP age >60 |
The mean DBP was ‐0.86 | MD 1.33 lower (2.40 lower to 0.26 lower) | 2490 (23 RCTs) | ⊕⊕⊝⊝ LOW 1 2 | Walking interventions may reduce diastolic blood pressure in adults aged over 60 years. |
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; DBP: diastolic blood pressure; MD: mean difference; RCT: randomised controlled trial; SBP: systolic blood pressure. | |||||
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect |
1 Downgraded one level for risk of bias; the majority of included studies failed to report details of randomisation and allocation concealment.
2 Downgraded one level for inconsistency; there was statistically significant heterogeneity.
Summary of findings 3. Walking compared to no intervention by sex for control of blood pressure.
Patient or population: adults with or without hypertension Setting: general population Intervention: walking Comparison: no intervention, by sex | ||||||
Outcomes | Anticipated absolute effects* (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | ||
Effect with no intervention mmHg |
Effect with Walking mmHg |
|||||
SBP in males | The mean SBP was ‐1.22 | MD 4.64 lower (8.69 lower to 0.59 lower) | ‐ | 203 (6 RCTs) | ⊕⊕⊝⊝ LOW 1 2 | Walking interventions may lower systolic blood pressure in male adults. |
SBP in females | The mean SBP was ‐0.48 | MD 5.65 lower (7.89 lower to 3.41 lower) | ‐ | 1149 (22 RCTs) | ⊕⊕⊝⊝ LOW 2 3 | Walking interventions may reduce systolic blood pressure in female adults. |
DBP in males | The mean DBP was ‐1.81 | MD 2.54 lower (4.84 lower to 0.24 lower) | ‐ | 203 (6 RCTs) | ⊕⊕⊕⊝ MODERATE 2 | Walking interventions probably reduce diastolic blood pressure in male adults. |
DBP in females | The mean DBP was 0.53 |
MD 2.69 lower (4.16 lower to 1.23 lower) | ‐ | 1000 (20 RCTs) | ⊕⊕⊝⊝ LOW 2 3 | Walking interventions may reduce diastolic blood pressure in female adults. |
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; | ||||||
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect |
1 Large 95% confidence intervals.
2 Downgraded one level for risk of bias; the majority of included studies failed to report details of randomisation and allocation concealment.
3 Downgraded one level for inconsistency; there was statistically significant heterogeneity.
See Table 1; Table 2; Table 3.
Primary outcome
Overall, we found that walking reduced systolic blood pressure (SBP) compared to the non‐intervention control groups (mean difference (MD) ‐4.11 mmHg, 95% confidence interval (CI) ‐5.22 to ‐3.01, P < 0.00001, I² = 53%) on the basis of 73 trials, 5060 participants (Analysis 1.1). The funnel plot for SBP did not show serious small‐study bias (Figure 4). Using GRADE to assess the certainty of the evidence, we downgraded the evidence by one level for inconsistency because there was significant heterogeneity (moderate‐certainty evidence). We did not downgrade one level for risk of bias even though more than half of the included studies failed to report details of randomisation and allocation concealment. This is because a sensitivity analysis based on trials judged as being at low risk of overall bias showed a reduction of SBP (MD ‐4.31 mmHg, 95% CI ‐7.99 to ‐0.63, P = 0.49, I² = 0%).
1.1. Analysis.
Comparison 1: Walking vs non‐intervention control, Outcome 1: systolic blood pressure
Our analyses showed that walking statistically and significantly lowered SBP in participants in all three age groups. Thus, when comparing participants who received the intervention with those in the control groups, participants aged 40 years and under showed a MD of ‐4.41 mmHg (95% CI ‐6.17 to ‐2.65, P < 0.00001, I² = 0%; 14 studies, n = 491), participants aged 41 to 60 years showed a MD of ‐3.79 mmHg (95% CI ‐5.64 to ‐1.94, P < 0.001, I² = 61%; 35 studies, n = 1959), and those aged 60 years of over showed a MD of ‐4.30 mmHg (95% CI ‐6.17 to ‐2.44, P < 0.001, I² = 60%; 24 studies; n= 2610) (Analysis 2.1). We graded the evidence in the age group of less than or equal to 40 years as moderate due to the concern of risk of bias as the majority of included studies failed to report details of randomisation and allocation concealment; we graded the certainty of the evidence as low in the age groups of 41 to 60 and over 61 due to the two concerns of risk of bias when the majority of included studies failed to report details of randomisation and allocation concealment, and inconsistency when there was statistically significant heterogeneity.
2.1. Analysis.
Comparison 2: Walking vs non‐intervention control: subgroup analysis by age, Outcome 1: SBP by Age
Regarding sex, the outcome data of the subgroup analysis showed that walking interventions statistically lowered SBP in both females (MD ‐5.65 mmHg, 95% CI ‐7.89 to ‐3.41, P < 0.00001, I² = 44%; 22 studies, n = 1149) and males (MD ‐4.64 mmHg, 95% CI ‐8.69 to ‐0.59, P = 0.02, I² = 29%; 6 studies, n = 203) (Analysis 3.1). We graded the evidence for males and females with low certainty as there were risks of bias, imprecision (large 95% confidence interval), and inconsistency, i.e. significant heterogeneity.
3.1. Analysis.
Comparison 3: Walking vs non‐intervention control: subgroup analysis by sex, Outcome 1: SBP by Sex
Regarding intervention characteristics, when we consider only the trials with a statistically significant reduction in SBP in the current review, the average walking duration per week (mean = 151 minutes/week. range: 60 to 220 minutes) was similar to the walking duration per week in the trials with negative results (mean = 157 minutes/week. range: 10 to 845 minutes). In terms of intensity of walking, moderate walking is the major prescription (n = 14 intervention groups) in the trial with a significant reduction in SBP, five were self‐paced; one each was high and low intensity.
Secondary outcomes
Overall, compared to the non‐intervention control group, we found that walking reduced both diastolic blood pressure (DBP) (MD ‐1.79 mmHg, 95% CI ‐2.51 to ‐1.07, P < 0.00001, I² = 53%; 69 studies, n = 4711) (Analysis 1.2) and heart rate (HR) (MD ‐2.76 bpm, 95% CI ‐4.57 to ‐0.95, P = 0.003, I² = 65%; 26 studies, n = 1747) (Analysis 1.3). We graded the evidence for changes in DBP and HR as low certainty as there were concerns of both inconsistency (statistically significant heterogeneity) and risk of bias as more than half of included studies failed to report details of randomisation and allocation concealment.
1.2. Analysis.
Comparison 1: Walking vs non‐intervention control, Outcome 2: diastolic blood pressure
1.3. Analysis.
Comparison 1: Walking vs non‐intervention control, Outcome 3: heart rate [beats/min]
We found that walking reduced DBP according to subgroup analyses for all three age groups. Our analysis for study participants aged 60 years and over showed an MD of ‐1.33 mmHg (95% CI ‐2.40 to ‐0.26; 23 studies, n = 2490) while our analysis of participants in the age group 41 to 60 years showed an MD of ‐1.74 mmHg (95% CI ‐2.95 to ‐0.52; 32 studies, n = 1730), and participants aged 40 years and under showed a MD of ‐3.01 mmHg (95% CI ‐4.44 to ‐1.58; 14 studies, n = 491) (Analysis 2.2). While these reductions in DBP were statistically significant, the reduction in DBP for each age group was smaller than that seen for reductions in SBP for the corresponding age groups. We graded the certainty of evidence for the analysis for participants aged 40 years and under as moderate because we downgraded one level for risk of bias as the majority of included studies failed to report details of randomisation and allocation concealment. For the analyses of DBP and participants aged 41 to 60 years and 60 years and over we graded the evidence as low because we downgraded one level for risk of bias as the majority of included studies failed to report details of randomisation and allocation concealment and we downgraded one level for inconsistency.
2.2. Analysis.
Comparison 2: Walking vs non‐intervention control: subgroup analysis by age, Outcome 2: DBP by Age
As with SBP, we found that walking reduced DBP for both males and females, however, the reductions in DBP were not as great as those seen in SBP. Thus, walking interventions saw a statistically significant reduction in DBP among females (MD ‐2.69 mmHg, 95% CI ‐4.16 to ‐1.23, P = 0.0003, I² = 43%; 20 studies, n = 1000) and males (MD ‐2.54 mmHg, 95% CI ‐4.84 to ‐0.24, P = 0.03, I² = 0%; 6 studies, n = 203) when compared to females and males in control groups (Analysis 3.2). We graded the evidence for DBP and men as moderate; we downgraded the evidence one level for risk of bias due to the majority of included studies failing to report details of randomisation and allocation concealment. We graded the evidence for DBP and women as low; we downgraded the evidence one level for risk of bias due to the majority of included studies failing to report details of randomisation and allocation concealment and one level for inconsistency as there was statistically significant heterogeneity.
3.2. Analysis.
Comparison 3: Walking vs non‐intervention control: subgroup analysis by sex, Outcome 2: DBP by Sex
We found that walking significantly reduced the HR of participants in the walking groups compared to those in control groups (‐2.76 bpm, 95% CI ‐4.57 to ‐0.95, P < 0.001, I² = 65%).
Sensitivity analyses
Sensitivity analyses were undertaken to assess the effect of walking in high‐quality studies only, where high‐quality studies were defined as those with a low risk of overall bias. Only four studies met our definition of low risk of bias (Baker 2008; Stanton 1996; Venturelli 2011; Wallis 2017). Walking was still found to be effective in lowering SBP by a statistically significant mean of 4.31 mmHg (95% CI ‐7.99 to ‐0.63, P = 0.02, I² = 0%; 4 studies, n = 235) (Analysis 4.1), but did not significantly lower DBP (MD ‐0.43 mmHg, 95% CI ‐2.78 to 1.92, P = 0.72, I² = 18%) (Analysis 4.2).
4.1. Analysis.
Comparison 4: Walking vs non‐intervention control: sensitivity analysis for studies at low risk of overall bias, Outcome 1: systolic blood pressure
4.2. Analysis.
Comparison 4: Walking vs non‐intervention control: sensitivity analysis for studies at low risk of overall bias, Outcome 2: diastolic blood pressure
A sensitivity analysis was also performed to evaluate the effect of the walking interventions in 41 studies (n = 3480) with a low risk of attrition bias. Walking was found to lower SBP by a mean of 4.67 mmHg (95% CI: ‐6.25 to ‐3.09, P < 0.001, I² = 65%) (Analysis 5.1) and significantly lower DBP by a mean of 2.23 mmHg (95% CI ‐3.20 to ‐1.26, P < 0.001, I² = 64%) (Analysis 5.2).
5.1. Analysis.
Comparison 5: Walking vs non‐intervention control: sensitivity analysis for studies at low risk of attrition bias, Outcome 1: systolic blood pressure
5.2. Analysis.
Comparison 5: Walking vs non‐intervention control: sensitivity analysis for studies at low risk of attrition bias, Outcome 2: diastolic blood pressure
Adverse events
Of the 73 included trials, only 21 reported adverse events. Of this 21, 16 reported no adverse events and a total of eight events was reported by the remaining five studies with Kukkonen‐Harjula 1998 reporting two events (one participant with a stress fracture and another one with a knee injury); Li 2003 reporting one participant with a bruised foot; Tudor‐Locke 2020 reporting one participant with knee pain; Wallis 2017 reporting two participants with knee pain and one participant who tripped; and Westhoff 2007 reporting one participant with knee pain and two participants with events considered unrelated to the intervention, namely, acute cholecystitis and a change in medication. Thus, while few studies specifically reported adverse events, knee pain seemed to be the most common adverse event. (see Characteristics of included studies). Several studies reported incidences that occurred during the intervention period. Brenner 2020 reported that two participants dropped out due to hip fracture; one dropped out from the study by Chan 2018 due to health problems, 60 dropped out of the Yan (嚴華) 2010a study due to hospitalisation, and several participants were reported as injured in the studies by Baker 2008 and Karstoft 2013.
Additional analyses
Sample size may impact trial outcomes at different levels. We examined the impact of the study sample size on the effects of walking on blood pressure in the current review. We undertook a post hoc subgroup analysis that entailed comparing studies having a sample size greater than 30 participants with studies having a sample size equal to or less than 30 for the outcomes of SBP and DBP. The analyses showed a statistically significant reduction in SBP in both sample sizes. The group with a study sample size of less than or equal to 30 saw a mean reduction in SBP of 7.06 mmHg (95% CI ‐9.47 to ‐4.66, P < 0.00001, I² = 35%), while the group with trial sample sizes over 30 showed a smaller mean reduction of 3.48 mmHg (95% CI ‐4.69 to ‐2.27, P < 0.00001, I² = 54%) (Analysis 6.1). Similarly, the analyses showed a statistically significant reduction in DBP in both sample sizes. The group with a study sample size of less than or equal to 30 saw a mean reduction in DBP of 2.92 mmHg (95% CI ‐5.02 to ‐0.82, P = 0.006, I² = 61%) while the group with trial sample sizes over 30 showed a smaller mean reduction of 1.57 mmHg (95% CI ‐2.32 to ‐0.82, P < 0.0001, I² = 50%) (Analysis 6.2).
6.1. Analysis.
Comparison 6: Walking vs non‐intervention control: sample size per trial ≦30 vs. >30, Outcome 1: SBP
6.2. Analysis.
Comparison 6: Walking vs non‐intervention control: sample size per trial ≦30 vs. >30, Outcome 2: DBP
We carried out subgroup analyses using baseline SBP and DBP to classify participants into two sets of comparison groups, one is normotensives compared to high normal and hypertensive participants and the other is normotensives compared to hypertensives only. The classification was based on two current hypertension guidelines, American Heart Association (Unger 2020) and European Society of Cardiology (Williams 2018), which defined SBP as normotensives <130 mmHg, high normal ≥130 mmHg, and hypertension ≥140 mmHg; DBP as normotensives <85 mmHg, high normal ≥85 mmHg, and hypertension ≥90 mmHg. Geddes 2009 did not provide baseline SBP and DBP data for us to be able to carry out the classification and therefore was not included in these subgroup analyses.
We found a similar magnitude of walking effect on both normotensive SBP compared to either higher than high normal (MD ‐4.14 mmHg, 95% CI ‐5.28 to ‐3.00, P = 0.45; 72 studies, n = 5048, Analysis 7.1) or higher than hypertensive (MD ‐4.24 mmHg, 95% CI ‐5.52 to ‐2.97, P = 0.29; 54 studies, n = 3630, Analysis 8.1). This is similar when compared normotensive to higher than high normal DBP (MD ‐4.06 mmHg, 95% CI ‐5.24 to ‐2.88, P = 0.65; 68 studies, n = 4699, Analysis 7.2), and compared to higher than hypertensive DBP (MD ‐4.39 mmHg, 95% CI ‐5.67 to ‐3.10, P = 0.03; 60 studies, n = 4223, Analysis 8.2). There was a similar reduction between the two DBP subgroup analyses (‐4.39 versus ‐4.24) but the reduction in DBP comparing normotensive with higher than hypertensive was a statistically significant difference. Additionally, there was significant heterogeneity between the subgroups of normotensive and higher than hypertensive DBP (Chi² = 4.50, df = 1, P = 0.03, I² = 77.8%, n = 4223, Analysis 8.2), but not in other subgroup analyses to this purpose.
7.1. Analysis.
Comparison 7: Walking vs non‐intervention control: subgroup analysis (normotensive vs. high normal), Outcome 1: SBP
8.1. Analysis.
Comparison 8: Walking vs non‐intervention control: subgroup analysis (normotensive vs. hypertensive), Outcome 1: SBP
7.2. Analysis.
Comparison 7: Walking vs non‐intervention control: subgroup analysis (normotensive vs. high normal), Outcome 2: DBP
8.2. Analysis.
Comparison 8: Walking vs non‐intervention control: subgroup analysis (normotensive vs. hypertensive), Outcome 2: DBP
We carried out further statistical analyses to test the association between baseline and change SBP and so for DBP. The association is weak (SBP: r= ‐0.142; DBP: r= ‐0.285) and not statistically significant in the association of baseline and change SBP (P = 0.23) but statistically significant in DBP (P = 0.02).
Discussion
Summary of main results
Our review aimed to determine the effect of a walking intervention on blood pressure. We included 73 randomised controlled trials in the meta‐analysis and revealed that walking alone can lower both systolic and diastolic blood pressure (SBP/DBP) statistically and clinically, regardless of age, sex, or baseline blood pressure. We also found that the effect of walking on lowering blood pressure exists after undertaking sensitivity analyses with just high‐quality studies or those not at risk of attrition bias. Among the four high‐quality studies, which were defined as no risk of biases regarding allocation, performance, attrition, and measurement, our findings suggest that walking can lower SBP by 4.31 mmHg (P = 0.02), but less likely to effectively lower DBP (WMD = ‐0.43, P = 0.71). The effect of walking on lowering blood pressure is also evidenced even when we omitted the studies with a dropout rate greater than 20%. It was found that a walking intervention could significantly lower SBP by 4.67 mmHg (P < 0.00001) and DBP by 2.23 mmHg (P < 0.00001).
Previous research has shown that a reduction in blood pressure is associated with the management of the mortality of the cardiovascular disease. Lowering SBP by 2 mmHg of SBP is related to approximately a 10% decrease in stroke mortality and a 7% decrease in mortality from vascular risks in adults (Lewington 2002). A more recent paper by Ettehad 2016 showed that a reduction in SBP of 10 mmHg reduced the risk of major cardiovascular disease (CVD) events by 20%, coronary heart disease (CHD) by 17%, stroke by 27% and all‐cause mortality by 13%. Our review found that walking interventions could lower SBP from 3.01 to 5.22 mmHg (MD ‐4.11) and DBP from 1.07 to 2.51 (MD ‐1.79), which were of greater magnitude than the reduction of 2 mmHg SBP and could be considered clinically significant. These small reductions in blood pressure are similar to those reported by previous systematic reviews which investigated interventions of walking among the younger population (Hanson 2015; Tschentscher 2013). Walking may also serve as an effective, useful adjunct to pharmacological therapy for controlling hypertension. For those who are normotensive, walking interventions may be useful in further reducing or preventing an increase in blood pressure.
The age of the study participants may mediate the effect of walking on blood pressure reduction (Lee 2010a). It is noteworthy that the result of subgroup analysis by different age groups showed that walking intervention demonstrated a similar reduction of SBP in the age group of over 60 to that observed in the age group of equal to or less than 40. Though previous studies found a tendency of an association between older people and a greater reduction in SBP and DBP (Burt 1995; Lee 2010a), this effect of walking on blood pressure reduction may result from higher baseline blood pressure levels among older adult participants. In the current review, we found a similar effect of walking on both normotensive SBP and DBP compared to either higher than high normal or higher than hypertensive.
When there are no sex differences on the effect of walking on lowering blood pressure, we found that females have slightly more reduction and more precisely than males in both SBP and DBP. This finding is inconsistent with those of previous studies (Carpio‐Rivera 2016; Christou 2005) that have suggested that males appeared to have a greater reduction in blood pressure than females. The menstrual cycle and menopausal impact might confound the acute‐ and long‐term effects of physical activity on the changes in blood pressure among the female population (Christou 2005). This inconsistency might also be due to that, in the current review, the total number of female participants is around 1.5 times compared to that of males. Previous studies argued that researchers have usually neglected adult females (Carpio‐Rivera 2016), but this did not appear to be the case in walking trials. In general, this review supports the finding that age and sex are less likely to change blood pressure response to physical activity.
The sample size could impact the research outcome widely and adequate sample sizes are required to provide sufficient power to generate robust results. According to our post hoc subgroup analyses using sample sizes greater and less than 30 participants per trial for the outcomes of SBP and DBP, there was a statistically significant reduction of both SBP and DBP in the two different sample sizes, whereby the studies with sample sizes equal to or less than 30 showed a much larger effect but less precisely, i.e. wider 95% confidence intervals than those in the studies with sample sizes greater than 30. This differs from a previous systematic review that found that walking interventions are likely to be effective according to studies with larger sample sizes (Lee 2010a). Most of the included studies in the current review did not report the power calculation for estimating adequate sample size. A small sample size could result in greater bias due to variations in the participants or contribute towards a positive result when the observed effects are far larger than the true differences between the groups (Altman 1997). Small sample size could also make the generalisability of the results challenging. Therefore, a proper sample size calculation is crucial for the robust interpretation and generalisation of the effect of the intervention.
There are insufficient data to examine the long‐term effect of walking on blood pressure. As only three studies reported follow‐up data on blood pressure in the months after the intervention ceased, it is unclear whether the benefits can persist or if further intervention is needed to maintain the benefit. The evidence showed that the cessation of exercise may lead to a rapid loss of benefit with regard to blood pressure (Moker 2014). The previous research revealed that the application of behaviour modification theories, such as increased exercise self‐efficacy among older participants might prolong the ongoing benefits of walking with regard to blood pressure management (Chiu 2015).
Overall completeness and applicability of evidence
We searched and screened relevant databases carefully to identify all relevant randomised controlled trials that investigated the effect of walking intervention on blood pressure control compared with a non‐intervention control group. Our searches were carried out across multiple databases and we screened carefully all reference lists of the included studies and relevant systematic reviews, together with a hand search of all articles citing the included studies to enhance the completeness of the systematic review.
We identified 73 studies that met our inclusion criteria and included data from 5060 participants in the meta‐analysis for our primary outcome of change in SBP. We included data from 69 studies and 4711 participants in the meta‐analysis for the secondary outcome of change in DBP. Fewer studies (n = 26) and participants (n = 1747) provided data for the meta‐analysis of the secondary outcome of change in heart rate (HR). These 73 studies included walking interventions only and thus other modes of activity such as jogging or lifestyle modifications such as dietary salt reduction were excluded. There were sufficient participants to undertake subgroup analyses of changes in SBP and DBP by age and sex. Our findings that walking can result in a statistically and clinically significant reduction in SBP and DBP were robust to subgroup analysis according to age and sex.
Walking is the activity that the majority of the population can do and is seen as a low cost, low risk, common and feasible mode of physical activity in different age groups for decades (Asikainen 2004; Kraus 2019; Morris 1997; Mutrie 2004). Therefore, walking is often recommended by healthcare professionals as a form of exercise for health promotion and preventing health problems (Kraus 2019; Pate 1995). The findings from the current meta‐analysis are applicable to blood pressure management among both normotensive and hypertensive populations.
Quality of the evidence
We judged the certainty of the evidence of the effect of walking on SBP as moderate rather than high because of lack of clarity around randomisation procedures, allocation concealment and blinding of participants, study personnel, and outcome assessors. There was also some inconsistency across trials, which was related in part to differences in study populations and to differences in walking interventions. In this circumstance, we decided not to downgrade the certainty of this evidence because that sensitivity analysis on the basis of low risk of bias trials showed a significant reduction of SBP. However, we judged the certainty of the evidence of the effect of walking on DBP and HR as low because of the inconsistency across trials and the lack of clarity around randomisation procedures, allocation concealment, and blinding of participants, study personnel, and outcome assessors. A sensitivity analysis on the basis of low risk of bias trials showed a non‐significant reduction of DBP and there were data for us to carry out a similar sensitivity analysis on HR. While we assessed many of the studies at risk of performance bias, it should be noted that the outcomes of interest for this review are objective so even if participants and assessors are aware of group assignment, this knowledge is less likely to influence the outcome data than if we were analysing subjectively‐assessed outcomes.
Potential biases in the review process
Approximately one quarter (n = 19, 26%) of the 73 included trials were multi‐arm trials. An example is a study by Brown 2014, where one intervention consisted of a nature walking group with participants following a walking route through trees and parks while a second intervention comprised a built walking group(BW) following a route through housing estates, and a third control arm followed normal activities. With such studies, where the walking intervention groups met our inclusion criteria, we combined them and calculated a mean change in outcome measures for the combined group, thus creating a single‐pair wise comparison with the control group. In some multi‐arm trials, one or more of the intervention groups did not meet our inclusion criteria and thus we excluded those findings from our analyses. Where we did combine groups, we were cautious to ensure that combining groups did not result in double‐counting of participants. A number of studies, for example, Chan 2018 and Moreau 2001 collected outcome data at a number of time points. We used the data collected at the shortest intervention period so that the data collection was most similar for the majority of studies. However, our findings may have changed if we used data from the last time period of data collection as it may be that fewer participants continued with the intervention as time went on. For those studies that did not provide sufficient data, we contacted study authors and received responses from approximately 10%. Some study details and data remain missing which may influence the findings of our review.
Agreements and disagreements with other studies or reviews
Our meta‐analysis investigated the effect of a walking intervention compared to a non‐intervention control group on blood pressure control using randomised controlled trials and revealed that walking significantly lowered both systolic and diastolic blood pressure, and heart rate among the adult participants, regardless of their age or sex. The results of the current meta‐analysis support the findings of earlier reviews that a walking intervention can lower either SBP (Bravata 2007) or DBP (Murphy 2007; Qui 2014), or both (Hanson 2015; Herrod 2018; Kelley 2001; Oja 2018; Tschentscher 2013). These findings are also consistent with a previous systematic review, which found that group walking could cause a statistically significant reduction in both SBP (3.72 mmHg, P < 0.001) and DBP (3.14 mmHg, P < 0.001) (Hanson 2015). Herrod 2018 reported that undertaking aerobic exercise regularly over at least three months can lead to 5 mmHg to 6 mmHg reduction in SBP and 2 mmHg to 3.5 mmHg in DBP among participants aged over 65 years (Herrod 2018).
However, one systematic review found no effect of walking on SBP and DBP control (Cai 2014), and two did not find a statistically significant reduction in SBP (Murphy 2007; Qui 2014). One systematic review using standardised mean differences and a random‐effects model found a small but statistically significant reduction in both SBP (‐0.213 mmHg, P = 0.001) and DBP (‐0.166 mmHg, P = 0.006) (Oja 2018). The systematic review undertaken by Bravata 2007 found that the use of pedometers has a similar effect on SBP reduction (‐3.8 mmHg, P < 0.001) as our finding, but a relatively small reduction in DBP (‐0.3 mmHg, P = 0.001). This slightly differs from the findings of Cai 2014 that the use of a pedometer was not statistically effective in reducing neither SBP (‐1.13 mmHg, P = 0.18) nor DBP (‐1.49 mmHg, P = 0.25). Among patients with type 2 diabetes, a recent meta‐analysis by Qui 2014 found that walking was associated with DBP reduction but not a significant reduction in SBP.
Walking prescriptions in the included studies of the current review mainly followed the general recommendations of physical activity for adults (ACSM 2018; US Dept of Health & Human Sciences 2018; US Dept of Health & Human Sciences 2018; Bull 2020), which involved participating in moderate‐intensity aerobic physical activity for a minimum of 30 minutes on five days per week or vigorous‐intensity exercise for a minimum of 20 minutes on three days per week. Walking can be considered as either a low‐intensity activity (e.g. walking at an easy or moderate pace) or moderate exercise (e.g. brisk or very brisk walking) (Hamilton 2008; Tanasescu 2002; US Dept of Health & Human Sciences 2018), and occasionally greater than moderate‐intensity (Murtagh 2002; Tanasescu 2002).
The previous review (Brown 1995) and guideline (ACSM 2018) pointed out that low‐ to moderate‐intensity exercise could have a similar effect on blood pressure reduction as does high‐intensity training among hypertensive people, while low‐ to moderate‐intensity exercise may even have a greater impact on SBP (Hagberg 2000). Among the trials that found a statistically significant reduction in SBP (n = 21 trials) with clearly stated intensity prescription (n = 16 intervention groups), the present review observed that moderate‐intensity walking is the major prescription of walking (n = 14 groups), with only one trial prescribing high‐intensity walking, and one trial prescribing low‐intensity walking. Consistent with this finding, previous studies found a greater, longer‐lasting blood pressure reduction after reaching exercise intensity of 75% VO2max (Quinn 2000; Huang 2006; Cox 2001), which were seen as the moderate‐intensity level of exercise.
Previous studies have found that higher baseline blood pressure was associated with a greater reduction in blood pressure (Lee 2007; Nemoto 2007). Given the similar reduction in BP we saw among normotensive and hypertensive people and the weak association between baseline and change in blood pressure, we conclude that the effect of walking is similarly beneficial to those defined as normotensive and hypertensive. This is consistent with a later study (Rahman 2019) that found the benefits of medicinal blood pressure treatment, regardless of baseline blood pressure.
Authors' conclusions
Implications for practice.
We found moderate‐ to low‐certainty evidence that walking can lower systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR). Our findings suggest that these findings are relevant for all adults of any age, for both men and women and for those defined as normotensive and hypertensive according to baseline blood pressure levels. World Health Organization (WHO) guidelines recommend that aerobic physical activity should be undertaken in moderate‐intensity for 150 to 300 minutes per week; with muscle‐strengthening activities twice a week to have additional health benefits (Bull 2020). Findings from this review suggest that walking of moderate‐intensity, undertaken three to five times per week, of 20 to 40 minutes duration, and 150 minutes per week for approximately three months may lower blood pressure.
Walking is an attractive intervention for the prevention, control, and management of high blood pressure, representing both a cheaper treatment alternative to medication and one with less risk of adverse events and side effects for patients. Furthermore, the consequent reduction in the risk of cardiovascular diseases as a result of controlling blood pressure represents substantial savings in the treatment costs of chronic diseases and relieving the burden of national and global health expenditures.
Implications for research.
Future studies should focus on the impact on blood pressure control of different walking environments, such as walking in the laboratory or gymnasium, and walking in the countryside or city. The neighbourhood, place of work, or peer pressure may also play a crucial role in motivation regarding physical activity. Finding alternatives or phased walking interventions for those who are less able to take up a walking activity are also warranted. Furthermore, studies that focus on those with different co‐morbidity or those with poorly controlled hypertension where medications may have limited effect, are required. Given that we found few studies that had collected data on adverse events, and from those studies that did, knee pain was the most common adverse event, it is essential that future studies collect data on adverse events that might be related to the walking intervention. The long‐term benefits of walking interventions on blood pressure reduction require further research. In terms of study design, future studies should adopt rigorous trial designs aim to reduce the risk of bias by using transparent methods of random sequence generation and allocation concealment, ensuring study attrition is minimised and blinding outcome assessors where possible and then report those properly. Only then, the quality and certainty of published evidence on this topic can be raised.
What's new
Date | Event | Description |
---|---|---|
8 March 2021 | Amended | Corrected minor typos in the text |
History
Protocol first published: Issue 11, 2010 Review first published: Issue 2, 2021
Notes
An earlier version of this review was funded by the Tzu Chi College of Technology (TCCT‐971B31 2007.08.01‐2008.07.31). It was carried out without meta‐analysis and was published in the International Journal of Nursing Studies (New Reference).
Acknowledgements
We are extremely grateful to Cochrane Hypertension Managing Editor, Ciprian Jauca, for his consistent support and assistance throughout the whole process of this review; the assistance from the Cochrane Hypertension Information Specialist, Douglas Salzwedel, for his design and update of the English reference search, and his support in this field; the searches of the English references of Stephen Adams and Chinese ones of Ching‐Ju Fang (方靜如). We would also like to thank the Cochrane Hypertension Group editors for their input; the peer reviewers for their thorough and constructive comments and the Copy Editor, Heather Maxwell, for her effort on the draft of this review.
Appendices
Appendix 1. Search strategies
Database: Ovid MEDLINE(R) and Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations, Daily and Versions(R) <1946 to March 06, 2020> Search Date: 7 March 2020 1 exp walking/ 2 (walk$ or gait or locomot$ or stride$ or stroll$ or treadmill$).tw,kf. 3 or/1‐2 4 exp hypertension/ 5 essential hypertension/ 6 (antihypertens$ or hypertens$ or prehypertens$).tw,kf. 7 exp blood pressure/ 8 (blood pressur$ or bloodpressur$).tw,kf. 9 ((arterial adj2 pressur$) or (diastolic adj2 pressur$) or (systolic adj2 pressur$)).tw,kf. 10 (bp or dbp or sbp).tw,kf. 11 or/4‐10 12 randomized controlled trial.pt. 13 controlled clinical trial.pt. 14 randomized.ab. 15 placebo.ab. 16 clinical trials as topic/ 17 randomly.ab. 18 trial.ti. 19 or/12‐18 20 animals/ not (humans/ and animals/) 21 ((ocular or portal or pulmonary) adj (arterial or hypertens$)).ti. 22 (eclamp$ or preeclampsi$ or pregnan$).ti. 23 or/20‐22 24 19 not 23 25 3 and 11 and 24
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: Cochrane Hypertension Specialised Register via Cochrane Register of Studies (CRS‐Web) Search Date: 8 Search Date: March 2020 #1 (walk* OR gait OR locomot* OR stride* OR stroll* OR treadmill*) AND INSEGMENT #2 RCT:DE A ND INSEGMENT #3 Review:ODE AND INSEGMENT #4 (#2 OR #3) AND INSEGMENT #5 #1 AND #4 AND INSEGMENT
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: Cochrane Central Register of Controlled Trials (Issue 2, 2020) via Cochrane Register of Studies (CRS‐Web) Search Date: 8 March 2020 #1 MESH DESCRIPTOR Walking EXPLODE ALL AND CENTRAL:TARGET #2 (walk* OR gait OR locomot* OR stride* OR stroll* OR treadmill*) AND CENTRAL:TARGET #3 (#1 OR #2) AND CENTRAL:TARGET #4 MESH DESCRIPTOR Hypertension AND CENTRAL:TARGET #5 MESH DESCRIPTOR Essential Hypertension AND CENTRAL:TARGET #6 (antihypertens* OR hypertens* OR prehypertens*) AND CENTRAL:TARGET #7 (blood OR arterial OR diastolic OR systolic) NEAR2 pressur* AND CENTRAL:TARGET #8 (bp OR dbp OR sbp) AND CENTRAL:TARGET #9 (#4 OR #5 OR #6 OR #7 OR #8) AND CENTRAL:TARGET #10 #3 AND #9 AND CENTRAL:TARGET
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: Embase <1974 to 2020 March 05> Search Date: 7 March 2020 1 exp walking/ 2 (walk$ or gait or locomot$ or stride$ or stroll$ or treadmill$).tw. 3 or/1‐2 4 exp hypertension/ 5 (antihypertens$ or hypertens$ or prehypertens$).tw. 6 exp blood pressure/ 7 (blood pressur$ or bloodpressur$).tw. 8 ((arterial adj2 pressur$) or (diastolic adj2 pressur$) or (systolic adj2 pressur$)).tw. 9 (bp or dbp or sbp).tw. 10 or/4‐9 11 randomized controlled trial/ 12 crossover procedure/ 13 double‐blind procedure/ 14 (randomi?ed or randomly).tw. 15 (crossover$ or cross‐over$).tw. 16 placebo.ab. 17 (doubl$ adj blind$).tw. 18 assign$.ab. 19 allocat$.ab. 20 or/11‐19 21 (exp animal/ or animal.hw. or nonhuman/) not (exp human/ or human cell/ or (human or humans).ti.) 22 ((ocular or portal or pulmonary) adj (arterial or hypertens$)).ti. 23 (eclamp$ or preeclampsi$ or pregnan$).ti. 24 or/21‐23 25 20 not 24 26 3 and 10 and 25
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: EBSCO CINAHL (1982 to Present)
Search Date: 9 March 2020
S21 S3 AND S12 AND S20 S20 (S13 OR S14 OR S15 OR S16 OR S17 OR S18 OR S19) S19 (MH "Quantitative Studies") S18 (MH "Random Assignment") S17 TI (randomi* OR randomly) OR AB (randomi* OR randomly) S16 ( TI (singl* blind*) OR (doubl* blind*) ) OR ( AB (singl* blind*) OR (doubl* blind*) ) S15 TI (clinic* trial*) OR AB (clinic* trial*) S14 PT Clinical Trial S13 (MH "Clinical Trials+") S12 (S4 OR S5 OR S6 OR S7 OR S8 OR S9 OR S10 OR S11) S11 TI (bp OR dbp OR sbp) OR AB (bp OR dbp OR sbp) S10 TI (diastolic N1 pressur*) OR (systolic N1 pressur*) OR AB (diastolic N1 pressur*) OR (systolic N1 pressur*) S9 TI (arterial N1 pressur*) OR AB (arterial N1 pressur*) S8 TI (blood pressur* OR bloodpressur*) OR AB (blood pressur* OR bloodpressur*) S7 MJ Blood Pressure S6 (MH "Blood Pressure+") S5 (TI (antihypertens* OR hypertens* OR prehypertens*) ) OR ( AB (antihypertens* OR hypertens* OR prehypertens*) ) S4 (MH "Hypertension+") S3 S1 OR S2 S2 TI ( (walk* OR gait OR locomot* OR stride* OR stroll* OR treadmill*) ) OR AB ( (walk* OR gait OR locomot* OR stride* OR stroll* OR treadmill*) ) S1 (MH "Walking+")
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: EBSCO PsycINFO (1950 to Present)
Search Date: 9 March 2020 S20 S3 AND S11 AND S19 S19 (S12 OR S13 OR S14 OR S15 OR S16 OR S17 OR S18) S18 TI blind* OR AB blind* S17 AB allocat* S16 AB assign* S15 TI trial* OR AB trial* S14 AB control group* S13 TI controlled OR AB controlled S12 TI (randomi* OR randomly) or AB (randomi* OR randomly) S11 (S4 OR S5 OR S6 OR S7 OR S8 OR S9 OR S10) S10 TI (bp OR dbp OR sbp) OR AB (bp OR dbp OR sbp) S9 TI ( (diastolic N1 pressur* OR systolic N1 pressur*) ) AND AB ( (diastolic N1 pressur* OR systolic N1 pressur*) ) S8 TI (arterial N1 pressur*) OR AB (arterial N1 pressur*) S7 TI blood pressur* OR AB blood pressur* S6 SU Blood pressure S5 (TI (antihypertens* OR hypertens* OR prehypertens*) ) or ( AB (antihypertens* OR hypertens* OR prehypertens*) ) S4 SU Hypertension S3 S1 OR S2 S2 TI ( (walk* OR gait OR locomot* OR stride* OR stroll* OR treadmill*) ) or AB ( (walk* OR gait OR locomot* OR stride* OR stroll* OR treadmill*) ) S1 SU Walking ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: EBSCO SPORTDiscus (1949 to Present)
Search Date: 11 March 2020
S20 (S3 AND S11 AND S19) S19 (S12 OR S13 OR S14 OR S15 OR S16 OR S17 OR S18) S18 TI blind* OR AB blind* S17 AB allocat* S16 AB assign* S15 TI trial* OR AB trial* S14 AB control group* S13 TI controlled OR AB controlled S12 TI (randomi* OR randomly) OR AB (randomi* OR randomly) S11 (S4 OR S5 OR S6 OR S7 OR S8 OR S9 OR S10) S10 TI (bp OR dbp OR sbp) OR AB (bp OR dbp OR sbp) S9 TI (diastolic N1 pressur*) OR (systolic N1 pressur*) OR AB (diastolic N1 pressur*) OR (systolic N1 pressur*) S8 TI (arterial N1 pressur*) OR AB (arterial N1 pressur*) S7 TI (blood pressur*) OR AB (blood pressur*) S6 SU Blood pressure S5 TI (antihypertens* OR hypertens* OR prehypertens*) OR AB (antihypertens* OR hypertens* OR prehypertens*) S4 SU Hypertension S3 S1 OR S2 S2 TI ( (walk* or gait or locomot* or stride* or stroll* or treadmill*) ) or AB ( (walk* or gait or locomot* or stride* or stroll* or treadmill*) ) S1 SU Walking
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: PEDro <1929 to Present>
Search Date: 11 March 2020
Abstract & Title: antihypertens* Therapy: fitness training Method: clinical trial OR systematic review Score of at least 7/10
Abstract & Title: blood pressure Therapy: fitness training Method: clinical trial OR systematic review Score of at least 7/10
Abstract & Title: hypertens* Therapy: fitness training Method: clinical trial OR systematic review Score of at least 7/10
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: ClinicalTrials.gov
Search Date: 11 March 2020
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ Other terms: randomized Study type: Interventional Studies (Clinical Trials) Study Results: All Studies Intervention/treatment: treadmill OR walking Outcome Measure: blood pressure
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: WHO International Clinical Trials Registry Platform (ICTRP)
Search Date: 11 March 2020
blood pressure AND randomi* AND walk* hypertens* AND randomi* AND walk* blood pressure AND randomi* AND treadmill hypertens* AND randomi* AND treadmill
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: Index to Taiwan Periodical Literature System
Search Date: 18 May 2020
#1 (健走 + 健步 + 踏步 + 快走 + 快步 + 跑走 + 慢走 + 慢步 + 走路 + 步行 + 腳踏 + 滑步 + 跑步機 + 漫步機 + 橢圓機) * (收縮壓 + 舒張壓 + 血壓 + 心跳 + 心律 + 心率 + 心肺) * (實驗 + 試驗 + 隨機 + 對照 + random* + controlled + trial) [Search Fields: Article Title, Keywords, Author, Abstract]
#2 (walking + tread* + “running machine” + “running machines” + “Pedlar inexpensive ergometer” + "elliptical trainer" + "elliptical trainers" + gait* + locomot* + stride*) * (SBP + DBP + BP + pressure + hypertens* + antihypertens* + heart* + HR + rhythm* + cardi*) * (random* + controlled + trial) [Search Fields: Article Title, Keywords, Author, Abstract]
#3 #1 or #2
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: National Digital Library of Theses and Dissertations in Taiwan
Search Date: 18 May 2020
(健走.ti,kw or 健步.ti,kw or 踏步.ti,kw or 快走.ti,kw or 快步.ti,kw or 跑走.ti,kw or 慢走.ti,kw or 慢步.ti,kw or 走路.ti,kw or 步行.ti,kw or 腳踏.ti,kw or 滑步.ti,kw or 跑步機.ti,kw or 漫步機.ti,kw or 橢圓機.ti,kw or walking.ti,kw or tread*.ti,kw or "running machine".ti,kw or "running machines".ti,kw or "Pedlar inexpensive ergometer".ti,kw or "elliptical trainer".ti,kw or "elliptical trainers".ti,kw or stride*.ti,kw) and (收縮壓.ti,kw,ab or 舒張壓.ti,kw,ab or 血壓.ti,kw,ab or 心跳.ti,kw,ab or 心律.ti,kw,ab or 心率.ti,kw,ab or 心肺.ti,kw,ab or SBP.ti,kw,ab or DBP.ti,kw,ab or BP.ti,kw,ab or pressure.ti,kw,ab or hypertens*.ti,kw,ab or antihypertens*.ti,kw,ab or heart*.ti,kw,ab or HR.ti,kw,ab or rhythm*.ti,kw,ab or cardi*.ti,kw,ab) and (實驗.ti,kw,ab or 試驗.ti,kw,ab or 隨機.ti,kw,ab or 對照.ti,kw,ab or random*.ti,kw,ab or controlled.ti,kw,ab or trial.ti,kw,ab)
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: China National Knowledge Infrastructure (CNKI): Journals, Theses & Dissertations
Search Date: 18 May 2020
(TI=(健走+健步+踏步+快走+快步+跑走+慢走+慢步+走路+步行+腳踏+滑步+跑步機+漫步機+橢圓機+跑台+跑臺+平板+踏車+walking+ tread+"running machine"+"running machines"+"Pedlar inexpensive ergometer"+"elliptical trainer"+"elliptical trainers"+stride) or KY=(健走+健步+踏步+快走+快步+跑走+慢走+慢步+走路+步行+腳踏+滑步+跑步機+漫步機+橢圓機+跑台+跑臺+平板+踏車+walking+ tread+treadmill+treadmills+"running machine"+"running machines"+"Pedlar inexpensive ergometer"+"elliptical trainer"+"elliptical trainers"+stride)) and (SU=(收縮壓+舒張壓+血壓+心跳+心律+心率+心肺+SBP+DBP+BP+pressure+hypertension+hypertensive+antihypertensive+antihypertension+heart+HR+rhythm+rhythms+cardiopulmonary)) and (SU=(隨機+對照+控制組+random+randomly+randomized+randomised))
(This interface does not support truncation queries)
‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐
Database: Wanfang Med Online: Journals, Theses & Dissertations
Search Date: 18 May 2020
((題名=健走 OR 健步 OR 踏步 OR 快走 OR 快步 OR 跑走 OR 慢走 OR 慢步 OR 走路 OR 步行 OR 腳踏 OR 滑步 OR 跑步機 OR 漫步機 OR 橢圓機 OR 跑台 OR 跑臺 OR 平板 OR 踏車) OR (關键词=健走 OR 健步 OR 踏步 OR 快走 OR 快步 OR 跑走 OR 慢走 OR 慢步 OR 走路 OR 步行 OR 腳踏 OR 滑步 OR 跑步機 OR 漫步機 OR 橢圓機 OR 跑台 OR 跑臺 OR 平板 OR 踏車)) AND (收縮壓 OR 舒張壓 OR 血壓 OR 心跳 OR 心律 OR 心率 OR 心肺) AND (隨機 OR 對照 OR 控制組)
Data and analyses
Comparison 1. Walking vs non‐intervention control.
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1.1 systolic blood pressure | 73 | 5060 | Mean Difference (IV, Random, 95% CI) | ‐4.11 [‐5.22, ‐3.01] |
1.2 diastolic blood pressure | 69 | 4711 | Mean Difference (IV, Random, 95% CI) | ‐1.79 [‐2.51, ‐1.07] |
1.3 heart rate [beats/min] | 26 | 1747 | Mean Difference (IV, Random, 95% CI) | ‐2.76 [‐4.57, ‐0.95] |
Comparison 2. Walking vs non‐intervention control: subgroup analysis by age.
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
2.1 SBP by Age | 73 | 5060 | Mean Difference (IV, Random, 95% CI) | ‐4.12 [‐5.22, ‐3.01] |
2.1.1 Age <=40 | 14 | 491 | Mean Difference (IV, Random, 95% CI) | ‐4.41 [‐6.17, ‐2.65] |
2.1.2 Age 41‐60 | 35 | 1959 | Mean Difference (IV, Random, 95% CI) | ‐3.79 [‐5.64, ‐1.94] |
2.1.3 Age >60 | 24 | 2610 | Mean Difference (IV, Random, 95% CI) | ‐4.30 [‐6.17, ‐2.44] |
2.2 DBP by Age | 69 | 4711 | Mean Difference (IV, Random, 95% CI) | ‐1.79 [‐2.51, ‐1.07] |
2.2.1 Age <=40 | 14 | 491 | Mean Difference (IV, Random, 95% CI) | ‐3.01 [‐4.44, ‐1.58] |
2.2.2 Age 41‐60 | 32 | 1730 | Mean Difference (IV, Random, 95% CI) | ‐1.74 [‐2.95, ‐0.52] |
2.2.3 Age >60 | 23 | 2490 | Mean Difference (IV, Random, 95% CI) | ‐1.33 [‐2.40, ‐0.26] |
Comparison 3. Walking vs non‐intervention control: subgroup analysis by sex.
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
3.1 SBP by Sex | 26 | 1352 | Mean Difference (IV, Random, 95% CI) | ‐5.49 [‐7.43, ‐3.56] |
3.1.1 Male | 6 | 203 | Mean Difference (IV, Random, 95% CI) | ‐4.64 [‐8.69, ‐0.59] |
3.1.2 Female | 22 | 1149 | Mean Difference (IV, Random, 95% CI) | ‐5.65 [‐7.89, ‐3.41] |
3.2 DBP by Sex | 24 | 1203 | Mean Difference (IV, Random, 95% CI) | ‐2.67 [‐3.85, ‐1.48] |
3.2.1 Male | 6 | 203 | Mean Difference (IV, Random, 95% CI) | ‐2.54 [‐4.84, ‐0.24] |
3.2.2 Female | 20 | 1000 | Mean Difference (IV, Random, 95% CI) | ‐2.69 [‐4.16, ‐1.23] |
Comparison 4. Walking vs non‐intervention control: sensitivity analysis for studies at low risk of overall bias.
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
4.1 systolic blood pressure | 4 | 235 | Mean Difference (IV, Random, 95% CI) | ‐4.31 [‐7.99, ‐0.63] |
4.2 diastolic blood pressure | 4 | 235 | Mean Difference (IV, Random, 95% CI) | ‐0.43 [‐2.78, 1.92] |
Comparison 5. Walking vs non‐intervention control: sensitivity analysis for studies at low risk of attrition bias.
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
5.1 systolic blood pressure | 41 | 3480 | Mean Difference (IV, Random, 95% CI) | ‐4.67 [‐6.25, ‐3.09] |
5.2 diastolic blood pressure | 41 | 3480 | Mean Difference (IV, Random, 95% CI) | ‐2.23 [‐3.20, ‐1.26] |
Comparison 6. Walking vs non‐intervention control: sample size per trial ≦30 vs. >30.
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
6.1 SBP | 73 | 5040 | Mean Difference (IV, Random, 95% CI) | ‐4.12 [‐5.23, ‐3.02] |
6.1.1 sample size <= 30 | 15 | 321 | Mean Difference (IV, Random, 95% CI) | ‐7.06 [‐9.47, ‐4.66] |
6.1.2 sample size >30 | 58 | 4719 | Mean Difference (IV, Random, 95% CI) | ‐3.48 [‐4.69, ‐2.27] |
6.2 DBP | 69 | 4691 | Mean Difference (IV, Random, 95% CI) | ‐1.79 [‐2.51, ‐1.08] |
6.2.1 sample size <= 30 | 15 | 321 | Mean Difference (IV, Random, 95% CI) | ‐2.92 [‐5.02, ‐0.82] |
6.2.2 sample size >30 | 54 | 4370 | Mean Difference (IV, Random, 95% CI) | ‐1.57 [‐2.32, ‐0.82] |
Comparison 7. Walking vs non‐intervention control: subgroup analysis (normotensive vs. high normal).
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
7.1 SBP | 72 | 5048 | Mean Difference (IV, Random, 95% CI) | ‐4.14 [‐5.28, ‐3.00] |
7.1.1 Normotensive <130 | 33 | 2057 | Mean Difference (IV, Random, 95% CI) | ‐3.68 [‐5.12, ‐2.24] |
7.1.2 High normal and Hypertensive ≧130 | 39 | 2991 | Mean Difference (IV, Random, 95% CI) | ‐4.54 [‐6.23, ‐2.85] |
7.2 DBP | 68 | 4699 | Mean Difference (IV, Random, 95% CI) | ‐4.06 [‐5.24, ‐2.88] |
7.2.1 Normotensive <85 | 53 | 3920 | Mean Difference (IV, Random, 95% CI) | ‐3.91 [‐5.26, ‐2.55] |
7.2.2 High normal and Hypertensive ≧85 | 15 | 779 | Mean Difference (IV, Random, 95% CI) | ‐4.57 [‐7.07, ‐2.07] |
Comparison 8. Walking vs non‐intervention control: subgroup analysis (normotensive vs. hypertensive).
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
8.1 SBP | 54 | 3630 | Mean Difference (IV, Random, 95% CI) | ‐4.24 [‐5.52, ‐2.97] |
8.1.1 Normotensive <130 | 33 | 2057 | Mean Difference (IV, Random, 95% CI) | ‐3.68 [‐5.12, ‐2.24] |
8.1.2 Hypertensive ≧140 | 21 | 1573 | Mean Difference (IV, Random, 95% CI) | ‐5.21 [‐7.66, ‐2.76] |
8.2 DBP | 60 | 4223 | Mean Difference (IV, Random, 95% CI) | ‐4.39 [‐5.67, ‐3.10] |
8.2.1 Normotensive <85 | 53 | 3920 | Mean Difference (IV, Random, 95% CI) | ‐3.91 [‐5.26, ‐2.55] |
8.2.2 Hypertensive ≧90 | 7 | 303 | Mean Difference (IV, Random, 95% CI) | ‐7.82 [‐11.16, ‐4.47] |
Characteristics of studies
Characteristics of included studies [ordered by study ID]
Araiza 2006.
Study characteristics | ||
Methods |
Aim: quote: "To determine whether a recommendation to accumulate 10000 steps per day, as documented by use of a pedometer, would result in significant improvements in parameters of glycemic control, insulin sensitivity, cardiovascular risk, lipid profile, and oxidative stress in sedentary patients with type 2 diabetes mellitus." Design: parallel 2‐group RCT (1:1) matched Power/sample size calculation: yes (post hoc) |
|
Participants |
No. randomised:30 (15 in IG, 15 in CG) No. completers: 30 Country: USA Study population: Type 2 diabetes mellitus (free from advanced secondary complications of diabetes) Ethnicity: NR Gender: NR Age: mean 51 (SD 10) in IG, 49 (SD 11) in CG; range 33 to 69 Smokers: NR Hypertension: no Mean baseline BP: SBP = 140.6 (SD 21.4) in IG, 136.6 (SD 19.3) in CG; DBP = 80.7 (SD 12.2) in IG, 77.6 (SD 8.9) in CG . Inclusion criteria: participants with type 2 diabetes mellitus with oral therapy, but free from advanced secondary complications of diabetes. Exclusion criteria: pregnant or lactating women, anaemia (haemoglobin <11 g/100 mL for males, haemoglobin <10 g/100 mL for females), cardiovascular disease, hypertension (SBP >180 mmHg and/or DBP >110 mmHg), or orthopedic limitation for walking. |
|
Interventions |
IG: Active group: The protocol consisted of a 10‐day baseline period during which the participants were asked not to change their physical activity habits.
CG: Control group: quote: "The control group was instructed to maintain their normal activity habits throughout the 6‐week intervention." |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: BP (SBP/DBP) was measured with participant in the seated position with an automated monitor at study weeks 0 and 6. Primary/Main outcome of manuscript: BMI, percentage of body fat, BP, waist circumference, and resting energy expenditure (REE) Adherence: the active increased steps per day by an average of 69% to 10410 (SD 4162). Adverse event: NR |
|
Notes |
PARTICIPANT Trial registration: NR Funding sources: NIH NCRR GCRC grant 5M01‐RR00997 from the University of New Mexico GCRC. |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | No information |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | It is unlikely that the participants and investigators were blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | no dropout ITT analysis |
Selective reporting (reporting bias) | Low risk | 0nly 1 endpoint measurement at 6 weeks |
Other bias | Low risk | No other bias |
Arija 2017.
Study characteristics | ||
Methods |
Aim: to assess short‐ and medium‐term effectiveness of 9 months supervised physical activity programme including social cultural activities on CVD risk in adults accessing primary healthcare facilities Design: parallel 2‐group RCT (3:1) Power/sample size calculation: yes |
|
Participants |
No. randomised: 419 (305 in IG, 114 in CG) No. completers: 364 Country: Spain Study population: primary healthcare patients (attending primary healthcare facilities) Ethnicity: NR Gender: male 23.2% (only can roughly estimated from the following information: "76.8% women" in abstract) Age: mean 64.5 (SD 9.2) in IG, 66.99 (SD 10.28) in CG (mean age: 65.19) Smokers: 7.9% in IG, 4.20% in CG Hypertension: 54.2% in IG, 57.3% in CG Mean baseline BP: SBP = 131.06 (SD 15.94) in IG, 135.32 (SD 16.62) in CG; DBP = 76.75 (SD 9.09) in IG, 75.96 (SD 9.86) in CG, (see manuscript Table 4) Inclusion criteria: adults accessing the primary care facilities Exclusion criteria: Quote: "an episode of ischemic heart disease (<6 months previously), or an acute episode of arthritis which would limit the ability to walk, or having a lung or heart disease with dyspnea (mild to moderate effort dyspnea) which would limit the individual’s ability to undertake the proposed exercise regimen" |
|
Interventions |
IG: walking group: Walking itineraries and cultural activities were pre‐set. Walking itineraries were, on average, a five‐km circuit in and around the city. Group sizes ranged from 15 to 30 participants. Monthly socio‐cultural activities included: visits to museums and libraries, cultural exhibitions, tourist attractions and dance lessons.
CG: control group: received usual care from healthcare personnel, and were recommended to follow their habitual lifestyle. |
|
Outcomes |
Review outcomes reported: SBP, DBP; AEs (at 2 years) Measurement method : BP was measured with a manual sphygmomanometer with the participants resting for at least five minutes. Three recordings were taken and the average of the second and third readings was used in the statistical analyses. Primary/Main outcome of manuscript: overall CVD risk Adverse event: NR, cardiovascular event objective outcomes (hospital records) |
|
Notes |
Trial registration: NCT02767739 Funding sources: private sector (Department of Health of the Generalitat of Catalonia, the Catalan Society of Family and Community Medicine (CAMFIC) and the Nursing Association Family and Community (AIFICC)) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Computer‐generated random number table Table 1 in manuscript |
Allocation concealment (selection bias) | Unclear risk | No information Table 1 in manuscript |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | No other co‐interventions Closely supervised by healthcare professionals Closely monitored for adherence |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information about blood pressure assessor |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 13.1% in 9‐month follow‐up 45 out of 305 (14.8%) in IG and 10 out of 114 (8.8%) in CG refer to Figure 1 PP analysis |
Selective reporting (reporting bias) | Low risk | only 1 endpoint measurement at 9 months; only 1 analysis. AE: only 1 endpoint measurement at 2 years for CVD events; only 1 analysis. |
Other bias | Low risk | no other bias |
Baker 2008.
Study characteristics | ||
Methods |
Aim: to evaluate short‐term effects of a pedometer‐based walking programme on health outcomes in general population not meeting current physical activity guidelines. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised: 80 (1 withdrawn after randomisation, resulting 39 in IG, 40 in CG) No. completers: 79 Country: UK (Scotland) Study population: general population (from lowest socio‐economic groups surrounding community of a West of Scotland University) Ethnicity: NR Gender: male 20.3% (16/79) Age: mean 47.3 (SD 9.3) in IG, 51.2 (SD 7.9) in CG Smokers: NR Hypertension: NR Mean baseline BP: SBP = 118.2 (SD 17.9) in IG, 119.9 (SD 15.9) in CG; DBP = 75.1 (SD 11.4) in IG, 75.5 (SD 11.8) in CG; HR = 68.6 (SD 7.2) in IG, 67.9 (SD 8.6) in CG Inclusion criteria: independently ambulatory, English speaking, age 18 to 65, self‐classified as not meeting current physical activity recommendation, completed Physical Activity Readiness Questionnaires for readiness, and personal physician's approval of participation. Exclusion criteria: not meeting inclusion criteria |
|
Interventions |
IG: walking group: An initial semi‐structured physical activity consultation based on the Transtheoretical Model of exercise behavior change. Followed by a 12‐week walking programme involving a graduated increase in the participants' mean daily step‐count over the first six weeks to a target of 3,000 accumulated steps above their baseline value for 5 days/week. In the following six weeks, participants maintained this intensity for at least 5 days/week.
CG: Control group: maintain normal walking levels for 12 weeks. |
|
Outcomes |
Review outcomes reported: SBP, DBP, HR Measurement method: quite: "Blood pressure and HR was measured using an automated blood pressure monitor (Omron HEM‐907, Bannockburn, IL). On each visit blood pressure measurements were performed three times with a rest period of one minute between measurements. Three measurements of resting heart rate were also recorded simultaneously by the blood pressure monitor. The average of these measurements is reported in these results." Primary/Main outcome of manuscript: steps per day measured by Omron HJ‐109E Step‐O‐Meter and International Physical Activity Questionnaire (IPAQ). Compliance/Adherence: 64% (definition: 25 out of 39 participants achieved an increase of 15,000 steps per week) Adverse event: NR (5 were injured, 3 in TG and 2 in CG, but was not identified as adverse event) |
|
Notes |
Trial registration: NR note: study name was Walking for Well‐being in the West (WWW) Funding sources: Government(Walking for Well‐being in the West (WWW) study was funded by the Scottish Government (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518560/)) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Independent interactive voice response system (by phone) refer to Table 4 |
Allocation concealment (selection bias) | Low risk | Quote: "Randomization was carried out via an independent interactive voice response system (IVRS) which concealed all details of the randomization method from the end users." Independent interactive voice response system (by phone) refer to Table 4 |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | Quote: "Researchers who conducted the physical activity consultations were not blinded to group assignment in order to implement the physical activity intervention." "Additional researchers...were blinded to group assignment." refer to Table 3 and 4 |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Quote:"Additional researchers who performed physiological measurements were blinded to group assignment." |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Ddropout 19.0% (15 out of 79 dropouts) was acceptable 7 out of 39 (18%) in IG, 8 out of 40 (20%) in CG. ITT analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Bang 2016.
Study characteristics | ||
Methods |
Aim: to determine the physical and psychological effects of an urban forest‐walking program for office workers. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: yes (In order to test the difference between the two groups of the two sides, the significance level was .05, power .80, and the effect size was.80 using G * Power 3.1 program. As a result, the number of subjects required was 26 per group, A total of 52 patients.) |
|
Participants |
No. randomised: 60 (30 in IG, 30 in CG) No. completers: 45 Country: Korea Study population: sedentary office workers Ethnicity: NR Gender: male 0% Age: mean age 39.8 ( 42.22 (SD 11.44) in IG, 37.37 (SD 9.32) in CG) Smokers: NR Hypertension: 0% Mean baseline BP: SBP = 121.39 (SD 16.02) in IG, 112.52 (SD 12.49) in CG DBP = 79.00 (SD 9.37) in IG, 72.85 (SD 9.35) in CG Inclusion criteria: 60 school faculty and researchers who voluntarily submitted their application announcements to the campus from 6 September 26 2014 to 8 October 2014 and recruited on a first‐come‐first‐served basis. Exclusion criteria: NR |
|
Interventions |
IG: Forest walk: City centre forest walk program ‐ Forest walk at park in lunch time. Lunch of rice ball or sandwich was provided.
CG: Control (CON) group: Maintain normal daily routine |
|
Outcomes |
Review outcomes reported: SBP, DBP (Table 1 and 2) Measurement method: BP (no HR) was measured using an automated blood pressure monitor after 10‐minute rest. Primary/Main outcome of manuscript: SBP, DBP (no HR), body composition analysis, bone density, depression, quality of life Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Korean government |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Computerised randomisation procedure; refer to Table 1 (baseline information only from completer) ("low risk": because all participants were from a same hospital) |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Co‐interventions: lunch provided to intervention group participants No details provided |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 25% (15 out of 60 dropouts) 12 (36.4%) in TG and 3 (11.1%) in CG PP analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 2 years for CVD events Only 1 analysis |
Other bias | Low risk | No other bias |
Baross 2017.
Study characteristics | ||
Methods |
Aim: to compare the effects on resting SBP, DBP, and mean arterial pressure (MAP) of 6 weeks of training, involving either (i) simultaneous walking and isometric handgrip (WHG), (ii) walking only (WLK), (iii) isometric handgrip only (IHG), or (iv) control conditions (CON). Design: parallel 4‐group RCT (1:1:1:1) Power/sample size calculation: No |
|
Participants |
No. randomised: 24 (12 in IG, 12 in CG); (12 in WHG and12 in IHG groups excluded) No. completers: 24 Country: UK Study population: sedentary young adults Ethnicity: NR Gender: male 54% (13/24) Age: mean 20.7 (SD 1.6) for IG, 21.3 (SD 2.0) for CG Smokers: NR Hypertension: 0% Mean baseline BP: SBP = 126.7 (SD 3.7) for IG; 127.9 (SD 4.2) for CG; DBP = 77.7 (SD 3.0) for IG; 77.0 (SD 1.8) for CG Resting HR = 66.0 (SD 3.1) for IG; 67.4 (SD 2.7) for CG Inclusion criteria: healthy sedentary participants, who were university students who had not participated in regular exercise training (3 or more times per week) for 12 months prior to enrolment in our study. Exclusion criteria: if they reported any recent (6 months) history of medical treatment for serious illness such as high blood pressure, orthopaedic injury, viral illness, or surgical procedure, habitually active students |
|
Interventions |
IG: Walking (WLK) group: treadmill walking using a mains powered treadmill (GX100, Powerjog, Birmingham, UK).
CG: Control (CON) group: maintain normal daily routine Note: WHG (simultaneous walking and isometric handgrip exercise) and IHG (isometric handgrip exercise) groups excluded |
|
Outcomes |
Review outcomes reported: SBP, DBP, resting heart rate Measurement method: quote: "resting baseline measures (heart rate and blood pressure) were recorded using a heart rate monitor (Polar Beat, Polar Electro, Kempele, Finland) and an automatic blood pressure monitor (UA‐767 Plus, A&D Company, Ltd., Tokyo, Japan)." Primary/Main outcome of manuscript: Resting HR, SBP, DBP and mean arterial pressure (MAP) Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "were randomly allocated" but no details reported refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Participants not blinded. Quote:"All training sessions were carried out at the University of Northampton in a consistent laboratory environment under supervision." |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Dropout: NR refer to Table 1 |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | no other bias |
Bayat 2018.
Study characteristics | ||
Methods |
Aim: quote: "To evaluate the effect of regular walking for 3 months on some glycemic indexes and blood pressure in women with type 2 diabetes" Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 120 (60 in IG, 60 in CG) No. completers: 100 Country: Iran Study population: Type II diabetic women Ethnic: NR Gender: male 0% Age:mean 53.77 (SD 6.52) in IG, 52.06 (SD 6.28) in CG Smokers: no Hypertension: no Mean baseline BP: SBP = 126.04 (SD 16.69) in IG, 130.9 (SD 15.64) in CG; DBP = 74.9 (SD 10.85) in IG, 85.0 (SD 10.0) in CG. Inclusion criteria: women with type 2 diabetes, aged ranged 50 to 70, none of them used tobacco or drugs, had no history of stroke, heart, kidney disease, proteinuria, or neurological and lumbar disc disease. Exclusion criteria: not specified |
|
Interventions |
IG: Walking group:
CG: Control group: quote: "The control group did not have any physical activity during regular study, such as regular walking." "Both groups took 500 mg of metformin and 5 mg of glibenclamide daily." |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method : quote "A standard mercury brachial barometer was used to measure the blood pressure of type 2 diabetic patients." "Blood pressure of the subjects was taken in the sitting position after 10 minutes of rest, the legs were placed on the floor, and the hand was measured at the heart level. Blood pressure was measured twice in both pre‐test and post‐test, and the mean of these two was recorded as the patient's blood pressure at each turn." Primary/Main outcome of manuscript: glycaemic indexes and BP Compliace/Adherance: walking group completion rate 92% of prescribed walking steps/day Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Arabian government |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Qquote: "were randomly assigned" but no details reported refer to Table 1 and 2 |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 and 2 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | According to the information author provided: Dropout 20 out of 120 (16.7%) 10 out of 60 (16.7%) in IG and 10 out of 60 (16.7%) in CG drop outs PP analysis |
Selective reporting (reporting bias) | Low risk | SBP and DBP were reported at 3 months Only 1 analysis |
Other bias | Low risk | No other bias |
Bell 2010.
Study characteristics | ||
Methods |
Aim: to compare the improvements in fitness and health‐related parameters from aerobic fitness training program and pedometer‐based walking program in sedentary men and women. Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 140 (69 in IG and 71 in CG); (71 in Fitness training group excluded) No. completers: 88 Country: Canada Study population: general population from urban city Ethnic: NR Gender: NR Age:mean 49 (SD 11) in men, 50 (SD 9) in women Smokers: NR Hypertension: NR Mean baseline BP: SBP = 124 (SD 14) in IG, 125 (SD 13) in CG; DBP = 78 (SD 9) in IG, 80 (SD 9) in CG. HR = 73 (SD 9) in IG, 76 (SD 11) in CG Inclusion criteria: Quote: “a successful completion of a physical examination by a physician; between the ages of 25 and 65 years; no known cardiorespiratory or other disease (e.g. diabetes mellitus); sedentary (no regular physical activity and less than a mean of 5500 baseline steps per day for a 7‐day period); ability to walk and participate in a moderate physical activity program; and willingness to be randomly assigned to any of the experimental groups.” Exclusion criteria: Quote: “any blood parameter measured during pre‐testing was at a level considered to be clinically unhealthy, if their pre‐exercise heart rate was at or above 100 beat × minute–1, or their resting systolic or diastolic blood pressure was at or above 145 mmHg systolic and 95 mmHg diastolic.” |
|
Interventions |
IG: Walking (pedometer‐based walking) group: Accumulated walking steps, progressively overloaded every 3 weeks for the first 12 weeks followed by an additional 4‐ and 8‐week increase in steps over the final 12 weeks, resulting in a progressive increase in the number of steps until 10,000 steps per day were prescribed during the last 8 weeks of the 24‐week program. Participants in the walking group were counselled to attain the target number of daily steps by increasing their walking during the morning, afternoon or evening time periods or during breaks at work. No exercise intensity guidelines or heart‐rate monitors were provided.
CG: Control group: the control group was requested to not begin nor change their amount of daily physical activity while participating in the study and was offered an activity program after completion of the study as an incentive to adhere to these guidelines. Note: fitness training group excluded from this description. |
|
Outcomes |
Review outcomes reported: SBP, DBP, HR Measurement method : submaximal HR, BP, rating of perceived exertion, ventilatory threshold (VT), and peak oxygen uptake (VO2) were determined during a graded exercise test on a treadmill. Primary/Main outcome of manuscript: fitness (ventilatory threshold, peak oxygen uptake) and health‐related parameters (waist circumference, hip circumference, BMI, HR and BP) measured at baseline and week 24. Adverse event: NR |
|
Notes |
Trial registration: NR Note: study duration of 6 months was been clearly described as 24 weeks in the original article Funding sources: Governement (Grant from the Canadian Institutes of Health Research. Kerry S. Courneya (4th author) is supported by the Canada Research Chairs Program.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomly assigned to..." but no details reported. refer to Table 2 |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 2 |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Quote:"were blinded to the name of the subject and the time of the test" |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Oobjective outcomes Quote:"were blinded to the name of the subject and the time of the test" |
Incomplete outcome data (attrition bias) All outcomes | High risk | 26 out of 69 (37.7%) in IG and 26 out of 71 (36.6%) in CG refer to Figure 1 PP analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 24 weeks only 1 analysis |
Other bias | Low risk | No other bias |
Braith 1994.
Study characteristics | ||
Methods |
Aim: to determine the effects of 6 months of moderate‐ and high‐intensity walking exercise on resting BP in normotensive elderly subjects (60 to 79 years). Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 30 (19 in moderate intensity group, 11 in control group) (14 in high intensity group excluded) No. completers: 30 Country: USA Study population: general population (elderly volunteers) Ethnic group: NR Gender: male 45% (20/44*100%) included the group we excluded Age: mean 66 (SD 5) in IG, 66 (SD 5) in CG. Smokers: NR Hypertension: 0% Mean baseline BP: SBP = 121 (SD 10) in IG121 (SD 12) in CG; DBP = 72 (SD 8) in IG74 (SD 5) in CG; HR = 71 (SD 8) in IG65 (SD 8) in CG. Inclusion criteria: Quote: “male and female volunteers aged 60 to 79 years, sedentary but otherwise healthy persons with no contraindications to exercise.” Exclusion criteria: “(1) 2 consecutive resting systolic or diastolic BP measurements >140 or >90 mmHg, respectively; (2) >0.3 mV of horizontal or downsloping ST‐segment depression at 0.08 second from the J point; (3) significant arrhythmias; (4) angina pectoris; and (5) exercise‐induced bundle branch block.” |
|
Interventions |
IG: Walking (moderate intensity) group:
CG: Control group: control group participants were instructed to maintain their usual diet and salt intake during the study period. Note: IG2_high: high intensity walking group that trained with uphill treadmill jogging excluded according to the following description: "all subjects in the high‐intensity group trained by walking uphill on a treadmill." |
|
Outcomes |
Review outcomes reported: resting SBP, DBP Measurement method: quote: "subjects did not participate in strenuous physical activity for a minimum of 24 hours before these measurements. Heart rate and BP were measured after 20 minutes of seated rest in a quiet room.The same trained observer made all BP measurements by auscultation using a Hawksley random‐zero sphygmomanometer in the arm with the highest BP during the initial visit. Heart rate was measured by palpitation." Primary/Main outcome of manuscript: resting SBP, DBP (at baseline,week 13 and 26), HR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomly stratified to 1 of 3 groups" but no details reported. refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and personnel not blinded. refer to Table 2 |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | According to the outcome table 1 and 2, the dropout rate was 0% since the participant number was the same in two tables. ITT analysis |
Selective reporting (reporting bias) | Low risk | Measurement at 3 months and 6 months (all reported) Both 3‐month and 6‐month analysis reported |
Other bias | Low risk | No other bias |
Brandon 2006.
Study characteristics | ||
Methods |
Aim: the effects of a 16‐week dose if brisk walking on body composition and blood pressure in sedentary and obese African America and White women. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised: 52 (15 in AAE, 13 in WE, 12 in AAC, 12 in WC) No. completers: 36 Country: USA Study population: general population (from urban university and local government agencies.) Ethnicity: African American: 51.92% (27/52), white: 48.08% (25/52) Gender: male 0% (0/52) Age: mean 34.0 (SD 7.2) in AAE, 40.5 (SD 7.1) in WE, 36.0 (SD 8.4) in AAC, 42.0 (SD 9.7) in WC. (mean age 37.93) Smokers: NR Hypertension: NR Mean baseline BP: SBP = 110.0 (SD 11.9) in AAE, 111.0 (SD 14.9) in WE; 103.9 (SD 15.6) in AAC, 115.0 (SD 18.1) in WC; DBP = 69.7 (SD 8.9) in AAE, 67.0 (SD 10.3) in WE; 63.8 (SD 14.6) in AAC, 68.5 (SD 10.2) in WC. Inclusion criteria: Quote: “Sedentary (exercise less than twice a week for the past six months), weight stability, age 18 to 50 years, body fat (>27% body fat).” For the IG: able to successfully walk three miles per session after the first two weeks of orientation. Exclusion criteria: Quote: “past history of cardiovascular disease, present signs or symptoms of cardiovascular disease, resting SBP>160mmHg and resting DBP>100mmHg, or taking blood pressure or other medication that contraindicated exercise. Participants with two or more coronary heart disease risk factors obtained physical approval before participating in the study. Women who were on or had been on diets or weight loss medications affecting body weight within the last six months were excluded from the study.” |
|
Interventions |
IG: Walking group (AAE, WE) The first 2 weeks were used for conditioning and providing instruction on the brisk walking, training the ability of walking 3 miles for a session. The last 16 weeks constituted the training intervention. The walking sessions took place outside on courses, or on indoor track or treadmill on rainy day. The participants were instructed for making up and recording missed sessions within a week.
CG: Control group (AAC, WC): were asked not to exercise outside the program All study participants were instructed not to change their present lifestyle and dietary habit. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method : all BP values were measured with a calibrated sphygmomanometer and stethoscope on the right arm. The same technician and equipment were used for all BP measurements in this study. Primary/Main outcome of manuscript: body compositions (BMI, waist and hip circumferences, per cent body fat, bone marrow density, body density‐skinfold fatness) and blood pressure measured at baseline and week 18. Compliance/Adherence: 87.6+‐8.9% (Quote:"Only subjects that completed 75% of the training intervention were included in the data analyses.) Adverse event: NR |
|
Notes |
Trial registration: NR note: mean baseline BP in Table 1 and table 5 had some differences. Definition: 75% of the completion of the training interventions Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "The women were randomly assigned based on race…” Randomisation method was not clearly described. refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | High dropout rates: 16/52 = 30.8% there was no explanation regarding the high dropout rate in the article refer to Table 2 PP analysis |
Selective reporting (reporting bias) | Low risk | Only measurement at 18 weeks only 1 analysis |
Other bias | Low risk | No other bias |
Brenner 2020.
Study characteristics | ||
Methods |
Aim: to determine the circulatory and autonomic effects, as well as the effects on walking performance of a progressive, 12‐week, home‐based, low‐intensity (pain‐free walking) exercise program in patients with PAD. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised:48 (27 in IG, 21 in CG) No. completers: 33 Country: Canada Study population: patients with vascular problems (from a cohort study held at a vascular clinic at an acute care hospital) Ethnicity: NR Gender: male 63.6% (21/33), [66.7% (12/18) in IG, 60% (9/15) in CG] Age: mean 68.56 (SD 6.87) in IG, 63.67 (SD 8.47) in CG. Smokers: 48.5% (16/33) in total, [44.4% (8/18) in IG, 53.3% (8/15) in CG] Hypertension: NR Mean baseline BP: SBP = 124 (SD 15) in IG, 132 (SD 14) in CG. DBP = 67 (SD 8) in IG, 69 (SD 11) in CG HR = 63 (SD 12) in IG, 66 (SD 13) in CG Inclusion criteria:
Exclusion criteria:
|
|
Interventions |
IG: Walking group: Verbal and written instructions regarding Borg Ratings of Perceived Exertion (RPE) Scale and the Borg CR‐10 Pain Scale were offered. Logbooks rather than activity monitors were applied due to funding limitations. Both groups received follow‐up phone calls after the first week of the program and at 2‐week intervals to address any concerns. For members of the exercise group, to address any questions about the exercise intervention and to ensure compliance with the program.
CG: Control group: Continue with normal lifestyle and record in an activity log the type and amount of physical activity during the week, the duration of activity, and HR. |
|
Outcomes |
Review outcomes reported: HR and BP Measurement method: at rest in the supine position and during upright standing at baseline and after 12 weeks. Participants rested comfortably in the supine position in a quiet, dimly lit room. HR and BP were measured using a BpTRU machine (Model BPM‐300, VSM Medtech Ltd., Coqitlam, BC). The upright standing data were measured following an adaptation period of 3 minutes in the upright, free‐standing position. Primary/Main outcome of manuscript: HR, BP, heart rate variability (HRV), and heart rate reserve Compliance/Adherence: duration, mean 33.7 minute/session with 95 ± 11% compliance; frequency, mean 4.3 (SD 2.1) days/week with 97 ± 37% compliance; and walking distance, mean 74 + 9% compliance. Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Queen’s University, School of Nursing Freda Paltiel Award and a Southeastern Ontario Academic Health Sciences Innovation Grant |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Rrandom assignment, participants randomly selected a sealed envelope that contained an assignment to groups. However, quote: "for each participant who did not complete testing following the exercise program," a new participant was recruited. There is no information for how the new participant was recruited. |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants were not blinded and personnel was unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 31.3% (15 out of 48 dropouts) 9 out of 27 (33.3%) in IG, 6 out of 21 (28.6%) in CG refer to Table 1, 3, 4. PP analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 12 weeks Only 1 analysis |
Other bias | Unclear risk | The follow‐up phone calls to both intervention and control groups after the first week of the program and at 2‐week intervals during the 12‐week intervention period may increase the awareness of the need of lifestyle modification among participants in the control group and may cause the concern of information contamination. |
Brown 2014.
Study characteristics | ||
Methods |
Aim: to measure the impact of lunchtime walking on employee's physical activity levels and health markers. Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised: 94 (32 in IG1, 33 in IG2, 29 in CG) No. completers: 73 Country: UK Study population: general population (office workers) Ethnicity: white 98% (92/94), Indian 2% (2/94) Gender: male 78.7% (74/94) Age: mean 42 years (SD 10.6) Smokers: 0% Hypertension: NR Mean baseline BP: SBP = 135.1 (SD 12.3) in IG1, 128.9 (SD 15.1) in IG_built; 133.3 (SD 10.5) in CG; DBP = 86.0 (SD 7.6) in IG1; 81.5 (SD 11.9) in IG2, 79.5 (SD 7.1) in CG HR = 67.1 (SD 10.0) in IG1; 63.6 (SD 10.1) in IG_built; 64.6 (SD 12.5) in CG Inclusion criteria: 18 to 65 years office workers, consider themselves healthy and able to undertake fairly intense exercise. Exclusion criteria: Quote: "known cardiovascular and/or neurological conditions or taking of medication that affects these systems." |
|
Interventions |
IG1_nature : Nature Walking (NW) group: The walking route provided for the NW group consisted of trees, spaces of maintained grass, public footpaths, and country lanes. They are able to walk individually or with others.
IG2_built : built walking (BW) group: The walking route for the BW group primarily composed of paved footpaths adjacent to roads, housing estates, and industrial areas. They are able to walk individually or with others.
CG: Control (waiting) group: normal level of activities.
|
|
Outcomes |
Review outcomes reported: SBP, DBP, HR Measurement method : a Polar HR monitor (Polar Electro UK Ltd, Warwick, UK) was used to view HR throughout the testing procedure. Resting BP measurement was taken using an electronic BP monitor (MX3 basic, Omron, Lake Forest, IL, USA) with the cuff placed on the participant’s upper right arm. Primary/Main outcome of manuscript: HR and HR variability Adverse event: NR |
|
Notes |
Trial registration: ISRCTN005716448 Funding sources: Governement(The British Heart Foundation (non‐clinical PhD studentship FS/10/32/28204) and Economic and Social Research Council as part of UK Research and Innovation (project number RES‐064‐27‐0019) supported this study.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "Randomisation for the grouping of the participants was generated by a computer program" refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 21 out of 94 = 22.3% 5 out of 32 in Nature walking (15.6%), 6 out of 33 in Built walking (18.2%), 10 out of 29 in control group (34.5%) dropouts refer to Figure 1, Table 2 PP analysis |
Selective reporting (reporting bias) | Low risk | Only measurement at 8 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Chan 2018.
Study characteristics | ||
Methods |
Aim: to compare Tai Chi with brisk walking in effects of reducing cardiovascular disease risk factors and improving psychosocial well‐being. Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised: 164 (82 in IG, 82 in CG); (82 in Tai Chi group excluded) No. completers: 144 Country: Hong Kong Study population: hypertensive adults Ethnicity: NR Gender: male 48.8% ((42+38)/164) Age: mean 63.22 (SD 11.11) in IG, 65.13 (SD 10.22) in CG. Smokers: Yes, 11.0% (5+13)/164) Hypertension: 100% Mean baseline BP: SBP = 138.15 (SD 17.39) in IG, 142.49 (SD 19.12) in CG. DBP = 79.74 (SD 10.51) in IG, 82.59 (SD 10.68) in CG. Inclusion criteria:
Exclusion criteria: NR |
|
Interventions |
IG: Brisk walking group: To ensure intervention fidelity, a pulse oximeter was provided to each participant to measure HR during brisk walking. Self‐reported logbooks were provided for the participants to record heart rate, frequency and duration of brisk walking. The research assistant collected the logbooks weekly and encouraged the participants’ adherence to the intervention. Weekly non‐exercise community activities were arranged for 3 months as attention control activities to balance the socialiSation among groups.
CG: Control group: Usual activity without self‐report log books, but weekly non‐exercise community activities for 12 weeks as attention control activities to balance the socialisation among three groups. Note: Tai Chi group excluded |
|
Outcomes |
Review outcomes reported: SBP and DBP Measurement method: the participants were asked to sit for at least 10 minutes in a quiet location. BP was then measured twice at 5‐minute intervals using a digital BP monitor (CARESCAPEV100, GE Healthcare). The average of the two BP readings was used for analysis. Data were collected at baseline, 3, 6, and 9 months. Primary/Main outcome of manuscript: BP Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Health Medical Research Fund, Food and Health Bureau, Hong Kong SAR (No. 12130041). |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "The randomisation list was stored in a password‐protected computer only accessible by the research staff responsible for participant allocation." |
Allocation concealment (selection bias) | Low risk | Quote: "The randomisation list was stored in a password‐protected computer only accessible by the research staff responsible for participant allocation." |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Quote: "The research assistants responsible for data collection were blinded to group assignment." |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 12.2% (20 out of 164 dropouts) 6 out of 82 (7.3%) in IG, 14 out of 82 (17.1%) in CG refer to Fig. 1 GEE models used for accommodating missing data ITT analysis |
Selective reporting (reporting bias) | Low risk | only 1 endpoint measurement at 3 months only 1 analysis |
Other bias | Unclear risk | The participants in the brisk walking and control groups were arranged to participate in non‐exercise community socialisation activities weekly during the 3‐month intervention period. These activities may cause information contamination between groups and may increase awareness of lifestyle modification among control group participants. |
Chiang 2019.
Study characteristics | ||
Methods |
Aim: to investigate the differences in body composition and metabolic syndrome (MS) under a daily 12,000‐step strategy with or without moderate‐intensity walking exercise in college students with obesity Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised:32 (12 in IG1, 11 in IG2, 9 in CG) No. completers: 32 Country: China Study population: college students with obesity and did not regularly engage in physical activity (≥18 years) Ethnicity: NR Gender: NR Age: mean 19.17 (SD 1.03) in IG1, 20.64 (SD 1.80) in IG2, 19.36 (SD 1.12) in CG Smokers: NR Hypertension: NR Mean baseline BP: SBP = 121.92 (SD 15.70) in IG1, 121.36 (SD 11.48) in IG2, 127.00 (SD 17.18) in CG. DBP = 76.92 (SD 12.06) in IG1, 79.55 (SD 8.85) in IG2, 74.33 (SD 11.06) in CG. HR = 75.92 (SD 10.13) in IG1, 78.3 (SD 10.02) in IG2, 79.78 (SD 7.85) in CG Inclusion criteria: participants with obesity aged 18 years or older who did not regularly engage in physical activity were recruited. The inclusion criterion for participants were no diabetes or other chronic diseases. Exclusion criteria: NR |
|
Interventions | All three groups were required to attend a procedure instruction session on different day before the intervention and were issued a smartwatch (ZenWatch 3, ASUSTeK Computer Inc. Taipei, Taiwan) for step monitoring during the 8‐week intervention. Participants from WEG and WSG must report back to the lab weekly for verification of any missing or incorrect data recording on the exercise log. IG1: Walking Step Goal (WSG) group:
IG2: Walking Exercise (WEG) group:
CG: Control group: not given any instructions regarding exercise during the intervention and was asked to maintain a similar daily routine including diet. A smartwatch (ZenWatch 3, ASUSTeK Computer Inc., Taipei, Taiwan) was offered for step monitoring |
|
Outcomes |
Review outcomes reported: SBP and DBP, resting HR Measurement method: prior to measuring resting HR, SBP, DBP, and blood biomarkers, participants were asked to refrain from intense activity, smoking, caffeine consumption, and avoid the foods rich in sugar and fat for 24 hours and to fast for 12 hours before blood sampling. All resting values were obtained after a 10 minutes seated resting. Primary/Main outcome of manuscript: Weight (wt), BMI, body fat (FAT), visceral fat area (VFA), skeletal muscle mass (SMM), waist circumference (WC), hip circumference (HIP), HDL‐C, HR, DBP, SBP and blood biomarkers (fasting glucose (FG), and TG levels). Compliance/Adherence: WSG 94.5% (11340.46/12000*100%; mean 11340.46 (SD 743) steps per day. WEG 102.4% (12288/12000*100%; mean 12288 (SD 721) steps per day. Adverse event: NR |
|
Notes |
Trial registration: Australian New Zealand Clinical Trials Registry, (ACTRN12618001237279) Funding sources: Chinese Culture University and Ministry of Science and Technology, Republic of China (Taiwan) (No. 105–2815‐C‐034‐028‐H). |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Participants "were randomly assigned" but no details reported. |
Allocation concealment (selection bias) | Unclear risk | The "grouping methods" for assigning study groups "was confidential to the participants" but not sure what kind of methods has been confidential to study participants. |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | No information |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 8 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Coghill 2008.
Study characteristics | ||
Methods |
Aim: to investigate whether a home‐based physical activity program meeting current guidelines was effective in improving the lipid profile in hypercholesterolaemic men. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised:67 (38 in IG, 29 in CG) No. completers: 67 Country: UK Study population: middle‐aged hypercholesterolaemic men Ethnicity: NR Gender: male 100% Age: range 45 to 65 years Smokers: 0% Hypertension: NR Mean baseline BP: SBP = 138.04 (SD 15.61) in IG, 140 (SD 15.63) in CG; DBP = 89.90 (SD 9.93) in IG, 88.32 (SD 9.52) in CG Inclusion criteria: middle‐aged (45 to 65 years) male non‐smokers, with hypercholesterolaemia defined as TC6.2mmol/L (NCEP III, 2001) and/or a TC/HDLC ratio≥6; who were not receiving pharmacological treatment for hypercholesterolaemia or other conditions related to CHD, including both type 1 and 2 diabetes; sedentary (defined as no regular moderate or vigorous physical activity in excess of 30 minutes a day on at least five days a week over the last three months) and able to undertake a program of walking. Exclusion criteria: NR |
|
Interventions |
IG: Brisk Walking group: Wear times of accelerometer, total activity energy expenditure, and any bout of moderate activities ≥30 minutes or high intensity activity ≥20 minutes were recorded in a diary by participants.
CG: Control group: control group participants were requested to maintain their current activities of daily living |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: quote: "Blood pressure and resting heart rate were measured with a Spacelabs 90207 monitor." Primary/Main outcome of manuscript: SBP, DBP Adverse event: NR |
|
Notes |
Trialregistration: NR Funding sources: Private sector (Frenchay Hospital Trustees, Bristol funded the blood assays for this project.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "randomization group inside a sealed opaque envelope" |
Allocation concealment (selection bias) | Low risk | Quote:"Participants were allocated by a researcher blinded to the randomisation process who selected and opened each envelope with the participant at the point of randomisation." refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded. Personnel not blinded. refer to Figure 1 |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | No dropout refer to figure 1, table 1, 2 ITT analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Cooper 2000.
Study characteristics | ||
Methods |
Aim: Quote:“The effect of a six‐week programme of moderate intensity exercise on daytime ambulatory blood pressure (10.00am to 10.00pm) among unmedicated, sedentary adults aged 25 years to 63 years with office blood pressure of 150 mmHg to 180 mmHg systolic and/or 91 mmHg to 110 mmHg diastolic.” Hypertensive adults Design: Parallel 2‐group RCT (1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised: 90 (48 in IG, 42 in CG) No. completers: 86 Country: UK Study population: unmedicated hypertensive patients adults (recruited from general practices and workplaces of two large companies) Ethnicity: NR Gender: male 80% (72/90) Age: mean 46.2 (SD 9.4) in IG, 49.4 (SD 8.9) in CG. Smokers: NR Hypertension: 100% hypertensive patients (SBP 150 to 180, DBP 91 to 110) Mean baseline BP: SBP = 139.8 (SD 12.5) in IG, 137.0 (SD 10.9) in CG; DBP = 89.5 (SD 9.6) in IG, 88.4 (SD 9) in CG. Inclusion criteria: Quote:“be aged 18 years to 64 years, not be receiving pharmacological blood pressure or lipid lowering treatment, be sedentary, and have a resting office blood pressure of 150 mmHg to 180 mmHg (systolic) and/or 91 mmHg to 110 mmHg (diastolic).” Exclusion criteria: NR |
|
Interventions |
IG: Walking group: Participants were asked to expend a daily 150 kcal to 200 kcal in 30 minutes of physical activity (equivalent to 30 minutes of brisk walking) in addition to their normal levels of activity for at least 5 days a week.
CG: Control group: Participants were asked to maintain their usual levels of physical activity over the subsequent six weeks. All participants were requested not to change other aspects of their lifestyle during the intervention period. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method : daytime ambulatory blood pressure was measured using SpaceLabs 90207 monitors programmed to record a reading every 15 minutes between 9.00 am and 10.00 pm. Primary/Main outcome of manuscript: Office and ambulatory SBP, DBP, and weight measured at baseline and week‐6. Compliance/Adherence: 89% compliance 100% compliance was defined as recording that exercise was undertaken on 30 of 42 days Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Government (This study was funded by the NHS Executive South and West Research and Development Directorate. The Department of Social Medicine at the University of Bristol is the main centre for the MRC Health Services Research Collaboration.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote:"Block randomisation within strata defined by sex was used to generate the allocation, with six intervention and five control conditions within each block of 11." refer to Table 1 |
Allocation concealment (selection bias) | Low risk | Opaque envelope prepared by others Quote:"…, an opaque envelope with the treatment allocation was opened to reveal the participant’s treatment allocation. Randomisation envelopes were prepared by a member of the research team not involved in data collection and researchers collecting data were unaware of the allocation of participants until opening each envelope." refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded. Personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | High risk | "The researcher responsible for administering the collection of data at six‐week follow‐up was not blinded to treatment allocation." |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 4.4% (4 out of 90) 1 out of 48 (2.1%) in IG, 3 out of 42 (7.1%) in CG Planned ITT, but excluded dropouts in analysis refer to Table 2 PP analysis |
Selective reporting (reporting bias) | Low risk | Only measurement at 6 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Dong (董兆強) 2007.
Study characteristics | ||
Methods |
Aim: to investigate the effect of physical training on insulin resistance among the patients with chronic heart failure (CHF). Design: parallel 2‐group RCT (65:55) Power/sample size calculation: NR |
|
Participants |
No. randomised: 120 (65 in IG, 55 in CG) No. completers: 120 Country: China Study population: hospitalised congestive heart failure (CHF) patients (NYHA Ⅱ‐Ⅲ) Ethnicity: Chinese Gender: male 55% ((36+30)/120) Age: mean 61.7 (SD 12.3) in IG; 61.9 (SD 12.1) in CG Smokers: NR Hypertension: 20.8% (25 primary hypertension with 14 in IG and 11 in CG) Mean baseline BP: SBP = 149.10 (SD 44.50) in IG, 147.2 (SD 44.1) in CG. HR = 104 (SD 25) in IG, 105 (SD 21) in CG Inclusion criteria: ① Hospitalised NYHA Ⅱ‐Ⅲ CHF patients with stable condition for at least 2 months;
Exclusion criteria:
|
|
Interventions |
IG: Training group: Participants were encouraged to walk to and from on a relatively stable 40‐metre hallway for 6 minutes per session. Routine medication treatment and the 6‐minute walking distance exercise were continued till 20 weeks. HR, BP and EKG were monitored during each session.
CG: Routine therapy group: routine medication treatment |
|
Outcomes |
Review outcomes reported: meanBP and HR Measurement method: before and after the 20‐week intervention Primary/Main outcome of manuscript: homeostasis model assessment‐insulin resistance (HOMA‐IR), insulin resistance index (ISI), left ventricular ejection fraction (LEVF), left ventricular fractional shortening (LVFS), 6‐minute walking distance, HR and mean BP Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote:"randomly divided" using "random table" but no details reported |
Allocation concealment (selection bias) | Unclear risk | NR, study groups allocator |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Dropout: NR 65 completers in training group, 55 completers in control group refer to table 2, 3 Unsure ITT or PP analysis |
Selective reporting (reporting bias) | Unclear risk | Only 1 endpoint measurement at 20 weeks Only 1 analysis Only provided SBP but not DBP without reason, DBP data could not obtained from author contact |
Other bias | Low risk | no other bias |
Dong (董雅娟) 2012.
Study characteristics | ||
Methods |
Aim: to observe influence of aerobic exercise on blood pressure in patients with white coat hypertension (WCH). Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 51 (26 in IG, 25 in CG) No. completers: 51 Country: China Study population: white coat hypertensive patients Ethnicity: Chinese Gender: male 56.9% ((16+13)/51) Age: mean 53.75 (SD 16.42) in IG, 54.26 (SD 17.18) in CG Smokers: NR Hypertension: 100% (white coat hypertension) Mean baseline BP: 24 hours mean SBP (mSBP) = 129.51 (SD 25.42) in IG, 127.96 (SD 23.13) in CG; 24 hour mean DBP (mDBP) = 82.09 (SD 17.23) in IG, 83.46 (SD 18.52) in CG Inclusion criteria:
Exclusion criteria:
|
|
Interventions |
IG: Walking group: Adopted WHO recommendation of “mild hypertension exercise plan”: Exercise was done in the morning and evening.
CG: Control group: not undergoing exercise |
|
Outcomes |
Review outcomes reported: Office SBP (OSBP), Office DBP(ODBP), Ambulatory 24‐hour mean SBP (mSBP). Ambulatory 24‐hour mean DBP (mDBP), Ambulatory daytime SBP (dSBP) and Ambulatory daytime DBP (dDBP). We used mSBP and mDBP only. Measurement method: office BP: after resting for 30 minutes in sitting position, OSBP and ODBP were measured at right upper arm by mercury standard cuff sphygmomanometer. Ambulatory BP: non‐invasive portable (America type AMR4) ambulatory blood pressure monitor was used for measurement. Cuff (22 cm 12 cm) was tied to right upper arm of participant automatically aerated and measured every 30 minutes in daytime (6:00 to 22:00) and every 60 minutes at night (22:00 to 6:00 of second day), effective was de fined as recorded monitoring times ≥80% within 24 hours. Primary/Main outcome of manuscript: Office SBP(OSBP), Office DBP(ODBP), Ambulatory 24‐hour mean SBP (mSBP) DBP (mDBP), ambulatory daytime SBP (dSBP) and DBP (dDBP) Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote:"randomly divided" mentioned in abstract but no detail reported |
Allocation concealment (selection bias) | Unclear risk | NR |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 0% (0/51) 26 in exercise group, 25 in control group refer to table 1, 2 ITT analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 3 months Only 1 analysis |
Other bias | Low risk | No other bias |
Duncan 1991.
Study characteristics | ||
Methods |
Aim: the effects of a 24‐week walking program with different exercise intensity on the risk of cardiovascular disease in sedentary premenopausal women. Design: parallel 4‐group RCT (1:1:1:1) Power/sample size calculation: Yes |
|
Participants |
No. randomised: 102 (29 in IG1, 26 in IG2, 26 in IG3, 21 in CG) No. completers: 59 (16 in IG1, 12 in IG2, 18 in IG3, 13 in CG) Country:USA Study population: general population (premenopausal female volunteers) Ethnicity: 81% White, 17% black, and 2% Hispanic. Gender: male 0% (0/102) Age: range 20 to 40 Smokers: 0% Hypertension: NR Mean baseline BP: (data only reported for 59 study completers) SBP = 105 (SD 8) in IG1, 109 (SD 9) in IG2, 108 (SD 6) in IG3, 108 (SD 8) in CG; DBP = 70 (SD 7) in IG1, 74 (SD 8) in IG2, 73 (SD 9) in IG3, 74 (SD 7) in CG Inclusion criteria: 20 to 40 years of age, sedentary menopausal women with blood pressure below 160/90mmHg, total serum cholesterol levels below 6.59 mmol/L, and serum triglyceride levels below 2.25 mmol/L;"if they:
Exclusion criteria: NR |
|
Interventions |
IG1_aerobic: walking (aerobic walkers) group:
IG2_brisk: walking (brisk walkers) group:
IG3_stroller: walking (strollers) group:
Walking on a tartan‐surfaced 1.6‐km track, starting at 2.4 km, and gradually increasing to 4.8 km by the week 7, till the completion of the study. Subsequently from week 8 to 24, the walking intensity depends on the allocated group.
CG: Control group: remaining sedentary for the duration of the study and were not contacted except to schedule follow‐up testing. All groups advised not to change dietary, exercise (other than prescribed) or other life style habits |
|
Outcomes |
Review outcomes reported: resting BP (at baseline and week‐24) Measurement method: the same trained observer made all measurements with a mercury sphygmomanometer. The mean of the three readings on the third day was used as baseline and follow‐up values. SBP andDBP were recorded at the first and fifth phases of Korotkoffs sounds. Primary/Main outcome of manuscript:sSerum lipid and lipoprotein levels, maximal oxygen uptake (VO2 max), nude body weight, and percentage of body fat measured at baseline and week‐24. Adverse event: no |
|
Notes |
Trial registration: NR Funding sources: private sector (This study was supported by a grant from the Naturalizer division of Brown Shoe Co, St Louis, Mo) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote:"random assignment" but no details reported Table 1 results only from 59 completers, not all 102 randomised |
Allocation concealment (selection bias) | Unclear risk | No information Table 1 results only from 59 completers, not all 102 randomised |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded and personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | 0bjective outcomes Quote:"All baseline and posttest‐dependent variables (except percentage of body fat) were measured by personnel who were blinded to individual participant group assignments." |
Incomplete outcome data (attrition bias) All outcomes | High risk | 13 out of 29 (44.8%) in IG (aerobic), 14 out of 26 (53.8%) in IG (brisk), 8 out of 26 (30.8%) in IG (strollers), 8 out of 21 (38.1%) in CG. refer to Table 3 PP analysis |
Selective reporting (reporting bias) | Low risk | Only measurement at 24 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Dureja 2014.
Study characteristics | ||
Methods |
Aim: to investigate the effect of treadmill training on blood pressure among young post‐graduate students. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised:10 (5 in IG, 5 in CG) No. completers: 10 Country: India Study population: post graduate students Ethnicity: NR Gender: male 100% Age: range 19 to 25 years Smokers: NR Hypertension:NR Mean baseline BP: SBP = 116 (SD 5.47) in IG, 123 (Sd10.36) in CG DBP = 82.0 (SD 11.51) in IG, 79 (SD 8.94) in CG Inclusion criteria:19 to 25 years, college students Exclusion criteria:NR |
|
Interventions |
IG: Walking (experimental) group: treadmill walking with increasing intensity
CG: Control group: NR |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: not mentioned Primary/Main outcome of manuscript: Pre‐test, post‐test SBP, DBP Adverse event: NR |
|
Notes |
Trialregistration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "Participants were randomly assigned to" but no details reported |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | no dropout refer to Tables 2, 3, 4,5 ITT analysis |
Selective reporting (reporting bias) | Low risk | Only measurement at 4 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Foulds 2014.
Study characteristics | ||
Methods |
Aim: to examine the dose–response relationship between exercise volume and intensity with derived health benefits including volumes and intensity of activity well below international recommendations. Design: parallel 6‐arm RCT (1:1:1:1:1:1) (1 control + 4 brisk walking groups + 1 running group) Power/sample size calculation: NR |
|
Participants |
No. randomised:90 (75 in walking group, 15 in CG). (17 in running group excluded) No. completers: 58 Country: Canada Study population: general population (healthy and active) Ethnicity: NR Gender: male 36% (21/58) Age: mean 44 (SD13), range 20 to 65 years Smokers: NR Hypertension: 0% Mean baseline BP: NR Inclusion criteria: Quote: "participants represented a range of ages, from 20 to 65 years of age, who were not previously diagnosed with diabetes or cardiovascular disease. All participants were cleared using the Physical Activity Readiness Questionnaire for Everyone (PAR‐Q+) (Warburton et al. 2011). Participants in this training program include only individuals who responded ‘No’ to each of the PAR‐Q+ questions." Exclusion criteria: NR |
|
Interventions |
IG1: walking (10‐minute brisk walking once/week) group
IG2: Walking (10‐minute brisk walking 3 times/week) group
IG3: Walking (30‐minute brisk walking 3 times/week) group
IG4: Walking (60‐minute brisk walking 3 times/week) group
CG: Control group: control group prescribed no additional exercise training. Note: the group of 30‐minute running 3 times/week was excluded |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: resting BP was evaluated following 3 minutes of seated rest (BP‐TRU, VSM Medical, Vancouver, BC). Primary/Main outcome of manuscript: body composition and exercise capacity (VO2 max) Adverse event: No |
|
Notes |
Trialregistration: NR running group (N = 17) outcome was not extracted Funding sources :private sector (This research was supported by the Physical Activity Support Line, the Canada Foundation for Innovation, the BC Knowledge Development Fund, the Canadian Institutes of Health Research (CIHR), the Michael Smith Foundation for Health Research (MSFHR), and the Natural Sciences and Engineering Research Council of Canada (NSERC)) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote:"were assigned randomly" but no details reported refer to Table 1 (72 completers, 114 randomised) |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded. Personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | 7 out of 114 did not start 32 out of 90 drop outs (35.6%) (25% to 47% in each group) Quote:"Attrition rates (18 to 47 %)" no reasons given for drop outs PP analysis |
Selective reporting (reporting bias) | Low risk | Only measurement at 13 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Fritz 2013.
Study characteristics | ||
Methods |
Aim: The effects of Nordic walking on cardiovascular risk factors were determined in overweight individuals with normal or disturbed glucose regulation. Design: Parallel 6‐arm RCT Power/sample size calculation: Yes |
|
Participants |
No. randomised:213 [87 in IG (53 in NGT, 14 in IGT, 20 in T2DM),126 in CG (75 in NGT, 21 in IGT, 30 in T2DM)] No. completers: 203 Country: Sweden Study population: overweight individuals with IGT or T2DM, and normal OGTT Ethnicity: Caucasian Gender: male 44.6% (95/213) Age: mean 60 (SD 5.3), range 45 to 69 years. Smokers: NR Hypertension: NR Mean baseline BP: SBP = NGT: 138 (SD12.5) in IG, 137 (SD 15.0) in CG; IGT: 141 (SD 14.0) in IG, 141 (SD 13.0) in CG; T2DM: 143 (SD13.2) in IG, 144 (SD 12.6) in CG DBP = NGT: 85 (SD 7.9) in IG, 84 (SD 8.8) in CG: IGT: 84 (SD 7.8) in IG, 86 (SD 9.4) in CG; T2DM: 85 (SD7.6) in IG, 83 (SD 7.4) in CG Inclusion criteria: Quote: "age 45–69 years, body mass index (BMI) >25 kg/m2 and HbA1c for individuals with T2DM between 7.4% and 9.3% of the National Glycohemoglobin Standardization Program standard (57–78 mmol/mol of the International Federation of Clinical Chemistry standard)" Exclusion criteria: Quote: "physical impairments, symptoms of angina pectoris (i.e. chest pain on physical strain), atrial fibrillation determined by electrocardiogram, systolic blood pressure (SBP) or diastolic blood pressure (DBP) >160 or >100 mmHg, respectively, and insulin treatment." |
|
Interventions |
Intervention group: IG1_NGT: Walking (NGT) group: Normal glucose tolerance IG2_IGT:Walking (IGT) group: Impaired glucose tolerance IG3_T2DM:Walking (T2DM) group: type 2 diabetes mellitus
After 2 months, the participants in the intervention group received a supportive telephone call from an assisting nurse.
Control group:Quote: "The participants in the control group were instructed to maintain their habitual physical activity." CG1_NGT:Control (NGT) group CG2_IGT:Control (IGT) group CG3_T2DM:Control (T2DM) group Quote: "All participants were also instructed not to change their usual eating habits." |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: SBP and DBP (Speidell & Keller Tonometer) Primary/Main outcome of manuscript: BMI, waist circumference, blood pressure, glucose tolerance, clinical chemistry, maximal oxygen uptake (peak VO2) and self‐reported physical activity (questionnaire) Adverse event: No |
|
Notes |
Trialregistration: NR Funding sources: Government and private sector (This study was supported by the Strategic Research Programme in Diabetes at Karolinska Institutet, the Stockholm County Council, the Swedish Heart Lung Foundation and the Swedish Research Council, Stockholm) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote:"For the randomisation procedure, blinded labels with the participants' names were drawn from a box and assigned to either the control or intervention group " |
Allocation concealment (selection bias) | Low risk | Quote:"..drawn from a box and assigned to either the control or intervention group." refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded. Personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 4.7% (10 out of 213) 6 as 6.9% in TG and 4 as 3.2% in CG refer to Table 2 (ITT analysis) Quote:"Follow‐up data were missing for ten participants, and the principle of last‐observation‐carried‐forward was applied in those cases. Analysis was performed as intention‐to‐treat." |
Selective reporting (reporting bias) | Low risk | Only measurement at 4 months Only 1 analysis |
Other bias | Low risk | No other bias |
Geddes 2009.
Study characteristics | ||
Methods |
Aim: to investigate the effects of a 12‐week home walking program on cardiovascular parameters, fatigue perception, and walking distance in persons with multiple sclerosis (MS). Design: parallel 2‐group RCT (2:1) Power/sample size calculation: NR |
|
Participants |
No. randomised:15 (9 in IG, 6 in CG) No. completers: 12 Country: USA Study population: adult multiple sclerosis patients (18 to 65 years) Ethnicity: NR Gender: male 25% (3/12) Age: mean 51.3 in IG (range 40 to 64 years), 34.7 in CG (22 to 50 years) (mean age 45.83) Smokers: NR Hypertension: NR Mean baseline BP: NR Inclusion criteria: adults between the ages of 18 and 65 with a diagnosis of MS greater than 1 year, no history of exacerbation within 6 months prior to the study, no regular participation in an aerobic exercise program within 6 months prior to the study, the ability to walk independently 100 metres with or without resting (may use intermittent or constant unilateral assistance such as a cane, crutch, or a brace), and an Expanded Disability Status Score (EDSS) < 6.0. Exclusion criteria: if they had cardiovascular, pulmonary, or orthopaedic conditions that precluded them from participating in an aerobic conditioning program. |
|
Interventions |
IG: Walking group: home walking program; participants maintained weekly exercise log including RPE values and received biweekly telephone calls to monitor compliance.
For the first 2 weeks, the participants walked 5 minutes below the lower limits of their THR range, followed by 15 minutes of walking within their THR range, and then a 5‐minute cool down below their THR range. During weeks 3 through 12, participants increased their training time in the THR range to 20 to 30 minutes.
CG: Control group: the control group was asked to refrain from any regular exercise during the 12‐week period. Control group participants were offered the opportunity to participate in the home walking program with monitoring upon completion of the study. |
|
Outcomes |
Review outcomes reported: SBP, DBP, resting HR Measurement method: the sphygmomanometer cuff, Polar Fitwatch Heart Rate Monitor Primary/Main outcome of manuscript: 6 min walk test, Physiological Cost Index (PCI) Compliance/Adherence: NR Adverse event: no |
|
Notes |
Trialregistration: NR Funding sources: private sector (This study was partially supported by the New York Chapter Research Designated Fund) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Coin toss Table 1 is only for completers |
Allocation concealment (selection bias) | Unclear risk | Coin toss Table 1 is only for completers |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Quote: "Neither the researchers nor participants were blinded in the study." |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 20.0% (3 out of 15) 1 out of 9 (11.1%) in IG, 2 out of 6 (33.3%) in CG PP analysis,Three participants (2 control and 1 experimental) were excluded from data analysis due to poor compliance refer to p.3, Table 2 |
Selective reporting (reporting bias) | Low risk | Only measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Gilson 2007.
Study characteristics | ||
Methods |
Aim: the impact of two walking interventions, 15‐minute brisk walking and accumulated walking steps, on work day step counts and health status. Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 70 (23 in IG1, 23 in IG2, 24 in CG) No. completers: 64 Country: UK Study population: university employees (volunteers of the UK academic and administrative) Ethnicity: NR Gender: male 10% (7/70) Age: mean 42 (SD 11) in female, and 41 yrs (SD 11) in male Smokers: NR Hypertension: NR Mean baseline BP: SBP = 121.7 (SD 17.3) in IG1, 119.0 (SD 7.4) in IG2, 121.6 (SD 9.9) in CG; DBP = 85.6 (SD 12.1) in IG1, 85.7 (SD 10) in IG2, 82.9 (SD 7.3) in CG Inclusion criteria: NR (convenience sample) Exclusion criteria: NR (convenience sample) |
|
Interventions |
IG1_route: Walking ("working routes") group: Brisk and continuous walking; at least 15‐minute walking around campus; participants received detailed guidance of expectations and goals prior the study, and reinforced by weekly group emails through the intervention phase.
IG2_task: Walking ("walking in task") group: The accumulation of step counts through work day; participants received detailed guidance of expectations and goals prior the study, and reinforced by weekly group emails through the intervention phase.
CG: Control group: received no intervention and continued with normal behaviour. |
|
Outcomes |
Review outcomes reported: SBP, DBP were measured at baseline and week‐10 Measurement method: SBP/DBP (Accoson sphygmomanometer) Primary/Main outcome of manuscript: per cent body fat, waist circumference, and BP Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: “randomly assigned” “based on random number tables” |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Quote: "pretest and posttest measures were administered by trained instructors who …. were blind to the intervention status." |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 6 out of 70 (8.6%) 2 in working routes TG (8.7%), 2 in Walking in task TG (8.7%), 2 in CG (8.3%) dropout refer to Tables PP analysis |
Selective reporting (reporting bias) | Low risk | Only measurement at week 10 only 1 analysis |
Other bias | Low risk | No other bias |
Gradidge 2018.
Study characteristics | ||
Methods |
Aim: to determine if an intervention of walking, a primary form of physical activity amongst African populations, could influence the body composition and blood pressure of a cohort of African women employed at a rural‐based South African university. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 132 (66 in IG, 66 in CG) No. completers: 115 Country: South Africa Study population: obese women Ethnicity: NR Gender: male 0% Age: Mean 44.4 (SD 11.5) in IG, 37.4 (SD 8.78) in CG. Smokers: NR Hypertension: NR Mean baseline BP: SBP= 127 (SD 14.7) in IG, 122 (SD 15.6) in CG. Inclusion criteria: women aged ≥18 years and employed at the university. Exclusion criteria: pregnant, illiterate or injured women |
|
Interventions |
IG: Walking group: Using treadmills (Jkexer Sprint 9875A), the walking intervention took place during lunch breaks at the Human Movement Sciences gymnasium, University of Venda. Hydration with water was encouraged and the ambient room temperature was kept at 18 degrees Celsius.
CG: Control group: did not receive any treatment |
|
Outcomes |
Review outcomes reported: BP Measurement method: BP was measured on the right arm with the participant in a seated position using the Omron BP monitor (M6, Europe). The average of the latter two of three measurements was recorded after the participants had rested for at least 10 minutes Primary/Main outcome of manuscript:bBody mass, stature, waist and hip circumference, BP Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "distance randomisation", "49 of these participants were randomly selected into an intervention group" but not sure how the random sequence was generated |
Allocation concealment (selection bias) | Low risk | Quote: "the researchers were blinded to the assignment sequence, as the research assisstants allocated the participants into either the intervention or control group." |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 12.9% (17 out of 132 dropouts) 17 out of 66 (25.8%) in IG, 0 out of 66 (0%) in CG High dropout rate in intervention group without reason refer to Table 1 PP analysis |
Selective reporting (reporting bias) | Unclear risk | Only 1 endpoint measurement at 12 weeks Only 1 analysis DBP measured but not reported and could not obtained data from author contact |
Other bias | Low risk | No other bias |
Hamdorf 1999.
Study characteristics | ||
Methods |
Aim: investigate the effect of a progressive, twice‐weekly walking programme on habitual activity patterns, body composition and functional/social characteristics among previously sedentary 79‐ to 91‐year old females Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised:49 (25 in IG, 24 in CG) No. completers: 38 Country: Australia Study population: community dwelling women (sedentary yet participating in community life and not functionally impaired) Ethnicity: NR Gender: male 0% (0/49) Age: mean 82.4 (SEM 0.66) in IG, 83.1 (SEM 0.69) in CG Smokers: NR Hypertension: NR Mean baseline BP: SBP = 144.6 (SEM 4.9) in IG, 149.3 (SEM 5.1) in CG; DBP = 72.6 (SEM 2.2) in IG, 77.7 (SEM 2.5) in CG HR = 74.4 (SEM2.1) in IG, 72.7 (SEM1.7) in CG Inclusion criteria: sedentary women in their age of ninth decade; sedentary level determined from each participant's response to an activity questionnaire. Exclusion criteria: contraindications to the exercise testing, medication usage and ECG irregularities. |
|
Interventions |
IG: Walking (training) group: outdoor walking with free transportation for each session.
CG: Control group: asked not to engage in any physical activity outside the study |
|
Outcomes |
Review outcomes reported: SBP, DBP, HR Measurement method: Resting SBP and DBP were measured using a random zero sphygmomanometer after 10 minutes of rest in a seated position. Primary/Main outcome of manuscript: resting SBP/DBP, recovery SBP/DBP, spirometry, skinfolds, habitual activity profiles Adverse event: No |
|
Notes |
Trial registration: NR Funding sources: Government and private sector (This research was supported by grant No. 944042 from the National Health and Medical Research Council of Australia and from a Special Purposes fund from the Royal Adelaide Hospital.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Coin toss refer to Table 2 |
Allocation concealment (selection bias) | Unclear risk | Quote: "toss coin" and no other details refer to Table 2 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded. Personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 22.4% (11 out of 49) 7 out of 25 in IG (28%), 4 out of 24 in CG (16.7%) Completers only analysis Quote: "Two dropped out of the control group on medical advice while three withdrew due to family commitments. Drop out in the training group was due to medical reasons (n=2), overseas travel (n=1) and family commitments (n=3)" refer to Tables PP analysis |
Selective reporting (reporting bias) | Low risk | Measurement at 3 and 6 months Only 1 analysis |
Other bias | Low risk | No other bias |
Headley 2017.
Study characteristics | ||
Methods |
Aim: To determine whether a relationship exists between post‐exercise hypotension (PEH) prior to training and changes in resting blood pressure values following 16 weeks of training in stage 3 CKD patients. Design: Parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 49 (27 in IG, 22 in CG) No. completers; 46 Country: USA Study population: chronic kidney disease patients Ethnicity: NR Gender: male 65.2% (30/46) Age: 58 (SD 8.0) in IG; 57.1 (SD 9.0) inCG Smokers: 0% Hypertension: 95.7% Mean baseline BP: SBP = 126.4 (SD 17.8) in IG; 133.7 (SD 19.2) in CG DBP = 79.5 (SD 10.2) in IG; 79.1 (SD 10.7) in CG resting HR = 64.3 (SD 8.9) in IG; 65.5 (SD 12.3) in CG Inclusion criteria: ageD 35–70 years, had a glomerular filtration rate of 30–59 mL/minute per 1.73m2 and had either diabetes mellitus or hypertension as the primary cause of their kidney disease. Patients with both diabetes and hypertension were also included. Exclusion criteria:
|
|
Interventions |
IG: Walking group: participants who were randomised to T were asked to attend three supervised training sessions per week for 16weeks. Participants initially trained at 50% to 60% VO2peak for 15 to 30 minutes and then gradually increased to a total of 55 minutes.The average weekly duration of exercise was 129.2 ± 8.6 minutes. If a participant missed a session, they were given a 2‐week period during which they could make up that session.
CG: Control group: control group participants were told to continue as physician told them and not start any new exercise routine. |
|
Outcomes |
Review outcomes reported: SBP, DBP, HR Measurement method: Quote: "SBP and DBP blood pressure readings were taken with a calibrated automated sphygmomanometer (Tango; Sun Tech Medical, Morrisville, NC, USA)." "Subjects were fitted with a 24h ambulatory blood pressure monitor (ABPM; Spacelabs Healthcare, Issaquah, WA, USA) that they wore on the nondominant arm for the next 24h period." Primary/Main outcome of manuscript: BP, HR Compliance/Adherence: adherence to the programme was computed by taking the total number of sessions completed and dividing it by 48 sessions and expressing this as a percentage. Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Government(This study was supported by the National Heart, Lung and Blood Institute of grant no. 1R15HL096097‐01) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "... randomized to the treatment group (T) or to the control group (C) but no details reported. refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded. Personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | 0bjective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | 3 out of 49drop outs (6.1%) 2 in TG (7.4%) and 1 in CG (4.5%) drop outs PP analysis |
Selective reporting (reporting bias) | Low risk | Measurement at 16 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Herzig 2014.
Study characteristics | ||
Methods |
Aim: to investigate the effects of a 3‐month structured aerobic walking exercise on fasting and 2‐hour glucose and insulin concentrations and lipid homeostasis in sedentary overweight people with impaired fasting glucose and/or impaired glucose tolerance. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: Yes |
|
Participants |
No. randomised: 78 (38 in IG, 40 in CG) No. completers: 68 Country: Finland Study population: outpatients at high‐risk for T2DM Ethnicity: Caucasian Gender: male 26.5% (18/68) Age: mean 58.1 (SD 9.9) for IG; 59.5 (SD 10.8) for CG [68 completers only] Smokers: NR Hypertension: 52.9 % (36/68) Mean baseline BP: SBP = 138.5 (SD 16.4) for IG; 150.4 (SD 20.2) for CG; DBP = 83.8 (SD 8.0) for IG; 85.4 (SD 9.5) for CG Inclusion criteria: with the FINDRISC questionnaire for T2D scores >15 were selected for the study, the WHO criteria for impaired fasting glucose (>=5.6 and <7.0 and 2‐h glucose <7.8 mmol/L) or impaired glucose tolerance (fasting glucose <7.8 and 2‐h glucose >=7.8 and <11.1 mmol/L). Exclusion criteria: exclusion criteria were any functional limitation or chronic disease that might have limited the training and testing of the cardiovascular and respiratory systems, any medication for diabetes or current vigorous PA for more than 75 minutes per week as revealed by a questionnaire or physician’s examination. |
|
Interventions |
IG: Walking group: the training sessions of the intervention group were carried out in an indoor sports hall.
Walking was followed by a 5‐minute stretching and balance training, a 20‐minute walk and a 10‐minute stretching and balance exercise. After 1.5 months the 5‐minute stretching and balance training between the two 20‐minute walks were eliminated, and walking time was increased to 45 minutes.
CG: Control group: the control group participants met research assistants once a week for downloading the data from the accelerometers. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: Quote: "Heart rate was recorded using a heart rate monitor (M61, Polar Electro, Kempele, Finland)" "Blood pressure and blood lactic acid (Lactate Pro, Argray Inc., Kojo, Japan) were measured at each resistance level." Primary/Main outcome of manuscript: metabolic parameters (e.g. fasting glucose, total cholesterol, insulin etc) (see Table 2) Adverse event: NR |
|
Notes |
Trial registration: NCT01649219 Funding sources: Government and private sector(The Finnish Diabetes Foundation and EVO funds from Pohjois‐Pohjanmaa Hospital District and Oulu University Hospital) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Computerised random number generation refer to Table 1 (SBP imbalance) |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded. Personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 12.8% (10 out of 78) 5 out of 38 (13.2%) in IG & 5 out of 40 (12.5%) in CG dropouts 33/35 and 35/40 included in analysis PP analysis |
Selective reporting (reporting bias) | Low risk | Measurement at 12 weeks only 1 analysis |
Other bias | Low risk | No other bias |
Higashi 1999b.
Study characteristics | ||
Methods |
Aim: the effects of a 12‐week, 30‐minute brisk walking program on endothelial function and forearm haemodynamics in patients with essential hypertension Design: parallel 2‐group RCT (3:1) Used for sample size calculation: NR |
|
Participants |
No. randomised:27 (20 in IG, 7 in CG) No. completers: 27 Country: Japan Study population: mild to moderate hypertension patients Ethnicity: Japanese Gender: male 74% (20/27) Age: mean 53 (SD 10) in IG, 51 (SD 8) in CG Smokers: 29.6% (8/27) Hypertension: 100% Mean baseline BP: SBP = 155.0 (SD 6.6) in IG, 155.4 (SD 8.3) in CG; DBP = 96.0 (SD 4.9) in IG, 97.6 (SD 4.3) in CG Heart rate =71.8 (SD 9.7) in IG, 73.1 (SD 6.4) in CG Inclusion criteria: BP between 140 to 170 or 90 to 110mmHg. Quote: “No patient had a history of cardiovascular or cerebrovascular disease, diabetes mellitus, hypercholesterolemia, liver disease, or renal disease. All patients were essentially sedentary and did not exercise regularly.” Exclusion criteria: Quote: “alcohol intake greater than ethanol 30 mL/day.” |
|
Interventions |
IG: Walking (exercise) group: Participants were asked not to change their original behavioral and dietary habits, especially the intake of sodium, potassium, calories, and alcohol. Exercise performance sheet, recorded by the participants, and 24‐hour urinary excretion of sodium and potassium were checked by the investigators every four weeks during the interview.
CG: Control group: participants were asked not to engage in any physical activity outside the study. |
|
Outcomes |
Review outcomes reported: SBP, DBP, HR Measurement method: not mentioned Primary/Main outcome of manuscript: endothelial function Adverse event: NR |
|
Notes |
Trial registration: NR note: data from Protocol 2 only Funding sources: government This study was supported in part by a grant‐in‐aid for Scientific Research from the Ministry of Education, Science and Culture of Japan and Japan Heart Foundation grant for research on hypertension and vascular metabolism and a grant from Research Foundation for Community Medicine) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomised" but no details reported refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded. Personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Dropout: NR At start of study? Intervention arm n = 20, Control arm n = 7; At follow up? Intervention arm n = 20, Control arm n = 7 refer to table 2 Unsure ITT or PP analysis |
Selective reporting (reporting bias) | Low risk | Only 1 analysis |
Other bias | Low risk | No other bias |
Holloway 1997.
Study characteristics | ||
Methods |
Aim: to compare psychological state, resting heart rate, and resting blood pressure of sedentary adults among different walking intervention groups. Design: parallel 5‐group RCT (4 interventions + 1 control groups) Power/sample size calculation: No |
|
Participants |
No. randomised:83 (8 dropouts, resulting 58 in IG [22 in XC, 21 in T, 15 in S], 17 in CG) (19 in stationary bicycle excluded) No. completers: 75 Country: USA Study population: general population (volunteers) Ethnicity: NR Gender: male 47.9% [45/(45 + 49), 94 completers only] [this 94 include bicycle] Age: range 23 to 49 years (only in abstract), male range 20 to 40), female range 20 to 50 Smokers: NR Hypertension: NR Mean baseline BP SBP = 113.6 (SD 9.8) in IG1_XS, 113.4 (SD 11.1) in IG2_T, 116.7 (SD 10.0) in IG3_S, 114.5 (SD 12.3) in CG. DBP = 80.0 (SD 7.3) in IG1_XS, 81.9 (SD 9.1) in IG2_T, : 83.5 (SD 8.7) in IG3_S, 82.7 (SD 6.0) in CG HR = 76.4 (SD 9.0) in IG1_XS, 77.0 (SD 8.8) in IG2_T, 75.9 (SD 6.3) in IG3_S, 78.6 (SD 10.1) in CG Inclusion criteria: men between 20 and 40 years of age, women between 20 and 50 years Exclusion criteria: Quote: "anyone who responded NO to any of the PAR‐Q questions, or YES to 2 or more of the Major Coronary Risk Factors questions" "Those on mood altering or blood pressure altering medications, and those who had been regular exercises within the 6 months preceding the study" |
|
Interventions | Participants signed up for a practice session and orientation held at the LaCross YMCA, where training took place. The training site was chosen due to its convenience for accessibility, childcare, and open hours. In the last 4 weeks, interval training was added to add variety and further improve conditioning. Self‐selected intensity level (HR and 15‐points Borg scale) was recorded in personal exercise logs, which was used to verify attendance of unsupervised sessions.
IG1_XC: Walking (XC, Cross‐country ski simulator) group: participants exercised only on NordicTrack Achiever model (NordicTrack, Inc., Chaska, MN) and only at LaCrosse YMCA. IG2_T: Walking (T, Treadmill) group: participants exercised only on Trimline1100 motorised treadmill (Roadmaster Corporation, Irving, TX) and only at LaCrosse YMCA. IG3_S: Walking (S, Stepper) group: participants exercised only on Precor 721E hydraulic steepper (Precor, Inc., Bothell, WA) and only at LaCrosse YMCA. CG: Control group: not to alter activity levels or modify diet. Note: stationary bicycle excluded from analysis |
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Outcomes |
Review outcomes reported: SBP, DBP, resting HR Measurement method:quote: "Resting blood pressure was measured with the occluding cuff, auscultation method, all pressures were taken with a mercury sphygmomanometer..." Primary/Main outcome of manuscript: psychological state, resting heart rate, resting blood pressure. Compliance/Adherence: NR. Participants who missed more than 3 sessions were eliminated from the study. Adverse event: NR |
|
Notes |
Trial registration: No Funding sources: NR |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "...were randomly assigned to..." and no details reported completers only |
Allocation concealment (selection bias) | Unclear risk | Quote:"...were randomly assigned to..." and no details reported completers only |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded, research personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | 8 out of 102 drop outs (7.8%) Completers PP analysis |
Selective reporting (reporting bias) | Low risk | Measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Hua 2006.
Study characteristics | ||
Methods |
Aim: to determine the effects of a low‐intensity exercise conditioning programme on BP, HR, and cardiac autonomic function in men and women with mild hypertension Design: parallel 2‐group RCT Power/sample size calculation: yes |
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Participants |
No. randomised: 47 (7 dropouts, 20 in IG [male = 10, female = 10], 20 in CG [male = 10, female = 10]) No. completers: 40 Country: Canada Study population: sedentary hypertensive men and women Ethnicity: NR Gender: male 50% (20/40) Age: range 56 to 59 Smokers: non‐smokers Hypertension: hypertensive participants Baseline BP: SBP = 140 (SD 11) in IG1‐male, 141 (SD16) in IG2‐female, 142 (SD 15) in CG1‐male, 141(SD17) in CG2‐female; DBP = 92 (SD 7) in IG1‐male, 87 (SD 9) in IG2‐female, 91 (SD 11) in CG1‐male, 88 (SD 9) in CG2‐female;; resting HR = 69 (SD 7) in IG1‐male, 75 (SD 12) in IG2‐female, 75 (SD15) in CG1‐male, 70 (SD 12) in CG2‐female Inclusion criteria:
Exclusion criteria:
|
|
Interventions |
IG1_M / IG2_F: Walking group It was suggested that not to exercise within 2 hours of consuming a large meal, alcohol or caffeine, and not to make any dietary change, but encouraged to begin each walking session with a 5 to 10 minutes warm‐up and end with a 5 to 10 minute cool‐down. Participants were also instructed recording walking sessions and reasons from stopping in the exercise log. All the participants received a phone call or email from the researcher every 3 weeks to monitor their progress and to answer any questions. They returned to the lab by the end of week 12 for re‐assessment and logs were collected.
CG1_M / CG2_F: Control group: maintaining current level of activity. An activity log was used to obtain weekly activities. |
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Outcomes |
Review outcomes reported: SBP, HR Measurement method: Quote: "A BpTRU (Model BPM‐300, VSM MedTech Ltd., Coquitlam, BC) automated, non‐invasive BP monitor was used to measure BP and HR." Primary/Main outcome of manuscript: BP, HR, cardiac autonomic function Compliance/Adherence: Quote:"3.75 sessions/week, a minimum of three sessions per week were considered compliance" IG1_M: Walking (male) group
IG2_F: Walking (female) group
Compliance/Adherence: a minimum of three sessions per week were considered compliance Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote:"... were randomized to ... " (p.29) but no details reported refer to Table 4 in thesis (p.42) |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | dropout 14.9% (7 out of 47) 6 in TG (23.1%) and 1 in CG (4.8%) drop outs refer to Table 5 (p.45) PP analysis |
Selective reporting (reporting bias) | Low risk | Measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Karstoft 2013.
Study characteristics | ||
Methods |
Aim: to test the feasibility of free‐living walking training in patients with type 2 diabetes Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: a priori power calculations indicated that n = 12 in each training group would be sufficient to detect significant changes in glycaemic control. |
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Participants |
No. randomised: 32 (total 3 rounds of randomisation; final 12 in IG1, 12 in IG2, 8 in CG) No. completers: 32 Country: Denmark Study population:T2DM patients Ethnicity: NR Gender: male 62.5% (20/32) Age: mean 60.8 (SD 2.2) in IG1; 57.5 (SD 2.4) in IG2; 57.1 (SD 3.0) in CG Smokers: NR Hypertension: NR Mean baseline BP: SBP = 155 (SD 5.4) in IG1; 138 (SD 3.3) in IG2; 142 (SD 4.3) in CG; DBP = 90.0 (SD 1.8) in IG1; 85.0 (SD 2.8) in IG2, 86.6 (SD 3.5) in CG Inclusion criteria: confirmed T2DM by OGTT and sedentary Exclusion criteria: Quote: “The use of exogenous insulin, weight instability (>2 kg/6 months), physical activity (>150 min/week), and evidence of liver, renal, and cardiopulmonary disease and diseases contraindicating physical activity.” |
|
Interventions |
IG1_CWT: Walking (continuous‐walking training) group: Walking above the target intensity, obtained from VO2 peak test.
IG2_IWT: Walking (interval‐walking training) group: Walking cycles of 3 minutes of the fast walking (above the target intensity) and 3 minutes of slow walking (below the target intensity).
CG: Control group: continue habitual lifestyle for 4 months and had their JD Mate pedometer data uploaded monthly. |
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Outcomes |
Review outcomes reported: SBP, DBP Measurement method: not mentioned Primary/Main outcome of manuscript: physical activities and energy intake expenditure parameters (Table 1 and 2) Adverse event: NR (one participant in continuous walking group dropped out due to a knee injury was reported but not identified as adverse event) |
|
Notes |
Trial registration: NR Funding sources: Government(This study was primarily funded by DD2 (The Danish Centre for Strategic Research in Type 2 Diabetes, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469283/) supported by the Danish Agency for Science (grants 09‐067009 and 09‐075724 to B.K.P.).) |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | A total 3 randomisations done, first 24 to 8/8/8, then the 5 out of 8 from control randomised to 2 IG, then additional randomisation of 5 to the 2 IG. There were five participants entering the trial twice as control then intervention. refer to Table 1 (SBP difference between IG and CG) |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Nature of intervention cannot be blinded 5 participants contributed to both CG and IG. Quote: "Subjects in the CON group were offered re‐randomisation into a training group after the CON period. Five subjects accepted, adding n = 3 to the CWT group and n = 2 to the IWT group." |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Dropout 6.9% (2 out of 29) 2 in TG and 0 in CG A total 3 randomisation done: first 24 to 8/8/8, then the 5 out of 8 from control randomised to 2 IG, then additional randomisation of 5 to the 2 IG. There were five participants entering the trial twice as control then intervention. PP analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 12 weeks only 1 analysis |
Other bias | Low risk | No other bias |
Khalid 2013.
Study characteristics | ||
Methods |
Aim: to investigate the effects of moderate exercise training on nitric oxide levels in postmenopausal hypertension. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: no |
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Participants |
No. randomised: 30 (15 in IG, 15 in CG) No. completers: 25 Country: Egypt Study population: postmenopausal, hypertensive & overweight/obese women Ethnicity: NR Gender: male 0% (0/25) Age: mean 52.9 (SD 2.6) in IG, 52.7 (SD 2.2) in CG, range 40 to 50. Smokers: NR Hypertension: 100% (SBP 140 to 160 mmHg, DBP over 90 to 100 mmHg) Mean baseline BP: SBP = 148 (SD 5.6) in IG; 154 (SD 6.7) in CG; DBP = 94 (SD 4.1) in IG; 95 (SD 4.2) in CG Inclusion criteria: experienced at least one year of postmenopausal hypertension, their ages ranged from 40 to 50 years; Body Mass Index (BMI) ranged from 30 to 36 Kg/m2, their Blood Pressure (BP) ranged from 140 to 160 mmHg (systolic ‐ SBP) over 90 to 100 mmHg (diastolic ‐ DBP) Exclusion criteria: on any postmenopausal hormone therapy such as oestrogen, previous history of hypertension or receiving any anti‐hypertensive drugs, history of diabetes or any other pathology within the spectrum of metabolic syndrome, orthopedic or neuromuscular disorders that could have interfered with the training program. |
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Interventions |
IG: Walking group: electric treadmill walking. The program consisted of three phases followed by a relaxation period. These phases were: 1‐warming up phase, 2‐ conditioning stimulus phase, 3‐cooling down phase.
CG: Control group: NR |
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Outcomes |
Review outcomes reported: SBP, DBP Measurement method: not mentioned Primary/Main outcome of manuscript: SBP, DBP, NO Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "A computer‐generated, simple randomisation procedure was used" refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Quote: "the medics who measured the blood pressure and all other variables incorporated in this study were blinded as to the allocation of the participants to both groups (exercise and control)." |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 16.7% (5 out of 30) 3 out 15 (20%) in IG, 2 out of 15 (13.3%) in CG dropouts PP analysis on completers only (Figure 1) |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 8 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Koh 2010.
Study characteristics | ||
Methods |
Aim: to compare the effects of 6 months of supervised intradialytic or unsupervised home‐based exercise training and usual care on physical function, arterial stiffness, and self‐reported health. Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: yes |
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Participants |
No. randomised:43 (21 in IG, 22 in CG ) (27 in Intradialytic‐exercise group trained on a cycle ergometer excluded) No. completers: 31 Country: Australia Study population: adult haemodialysis patients Ethnicity: NR Gender: male: 61.3% (19/31) Age: mean 52.1 (SD 13.6) in IG; 51.3 (SD 14.4) in CG Smokers: NR Hypertension: 38.7% (12/31) (Table 2) Mean baseline BP: SBP = 143 (SD 32) in IG, 145 (SD 18) in CG; DBP = 78 (SD 16) in IG, 80 (SD 9) in CG; HR = 73 (SD 9) in IG, 74 (SD 10) in CG. Inclusion criteria: “Patients aged >18 years on stable adequate dialysis therapy with urea reduction ratio >70% for >3 months”. Exclusion criteria: Quote:“Patients with unstable angina, those with lower‐limb amputation, or those who met or exceeded the exercise recommendation of 120 minutes of moderate intensity physical activity per week”. |
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Interventions |
IG: Walking (home‐based exercise) group: Fortnightly telephone contacts were given by investigators to provide encouragement and allow feedback.
CG: Control (Usual care) group: brochures about exercise benefits were given while participants were requested to maintain usual lifestyle. Note: intradialytic‐exercise group trained on a cycle ergometer excluded |
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Outcomes |
Review outcomes reported: SBP, DBP, HR Measurement method: central blood pressures and AIx were estimated using radial applanation tonometry performed on the non‐fistula arm using customized software (SphygmorCor 7.01). Primary/Main outcome of manuscript: physical function (6‐minute walk distance) and arterial stiffness (aortic pulse wave velocity) and self‐reported health Adverse event: No |
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Notes |
Trial registration: ACTRN12608000247370 Intrdialytic‐exercise group (ID) is excluded in this analysis (n = 27) because intervention is not walking Funding sources: private sector (This project was funded by the Clifford Craig Medical Research Trust.) |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote:"...unrestricted computer‐generated random numbers." refer to Table 1 (completers only) |
Allocation concealment (selection bias) | Low risk | Assigned by staff not associated with trial |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Quote:"It was not possible to blind participants or researchers to group assignment." refer to Table 1 (some did not receive home‐base exercise) |
Blinding of outcome assessment (detection bias) All outcomes | High risk | 0bjective outcomes Quote:"It was not possible to blind participants or researchers to group assignment." |
Incomplete outcome data (attrition bias) All outcomes | High risk | dropout 27.9% (12 out of 43) Start of study: home‐based exercise n = 21, Control n = 22; At follow up: home‐based exercise n = 15/21 = 71.4%, Control n = 16/22 = 72.7% PP analysis (completers only) |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 26 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Kukkonen‐Harjula 1998.
Study characteristics | ||
Methods |
Aim: to study the effects of walking training on maximal aerobic power, serum lipoproteins, and plasma fibrinogen as indicators of health‐related fitness in healthy middle‐aged men and women. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: Yes |
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Participants |
No. randomised: 117 (1 excluded after randomisation, 58 in IG, 58 in CG) (one woman in the exercise group was excluded because of arrhythmia during maximal exercise testing, n = 116.) No. completers: 108 Country: Finland Study population: healthy middle‐aged adults Ethnicity: NR Gender: male 47.4% (55/116)*100%; completers only Age: mean 42.1 (SD 5.1) in IG, 40.3 (SD 4.5) in CG; range 30‐55 years. Smokers: 0% Hypertension: 0% Mean baseline BP: SBP = 118 (SD 12) in IG, DBP = 75 (SD 11) in IG Inclusion criteria: 30 to 55 years old, non‐smokers, premenopausal (women), and clinically healthy with no disabilities precluding exercise training. Exclusion criteria:
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|
Interventions |
IG: Walking group: the target intensity of exercise for 50 minutes was 74% to 81% of HRmax, which is equivalent to 65% to 75% of VO2max.
CG: Control group: were told not to change their eating or physical activity habits. |
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Outcomes |
Review outcomes reported: exercise heart rate, (SBP, DBP ‐> pending from author) Measurement method: blood pressure measurements were taken after the participants had been resting in a sitting position for 5 minutes, using a random zero sphygmomanometer (Hawksley & Sons Ltd, Lancing, Sussex, England). Primary/Main outcome of manuscript: exercise capacity, lipid biomarkers Adverse event: 2 (one stress fracture and one knee injury leading to surgery) Quote:"Two severe injuries resulted from the training (one stress fracture and one knee injury leading to surgery). Other reasons for discontinuation were not related to training." |
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Notes |
Trial registration: NR Funding sources: Government. The study was supported by grants from the Finnish Ministry of Education and Polar Electro Oy (Kempele, Finland). |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "Randomization was stratified according to sex and submaximal oxygen consumption (divided into thirds)" but no details of randomisation refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 6.8% (8 out of 116) 5 out of 58 in IG (8.6%), 3 out of 58 (5.2%) in CG dropouts PP analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 15 weeks oOnly 1 analysis |
Other bias | Low risk | No other bias |
Kurban 2011.
Study characteristics | ||
Methods |
Aim: to determine the effect of chronic regular exercise on ischaemia‐modified albumin levels and oxidative stress in T2DM. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: no |
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Participants |
No. randomised:60 (30 in IG, 30 in CG) No. completers: 60 Country: Turkey Study population: T2DM patients Ethnicity: NR Gender: male 48% (29/60) Age: mean 53.77 (SD8.2) in IG; 53.57 (SD 6.6) in CG. Smokers: NR Hypertension: NR Mean baseline BP: SBP = 129.17 (SD 12.1) in IG, 124.83 (SD 14.59) in CG; DBP = 78.83 (SD 6.78) in IG, 77.88 (SD 10.53) in CG. Inclusion criteria: sedentary, T2DM patients with blood pressure ≧ 140/90mmHg. None of the patients had macro‐ or microvascular complication including retinopathy and proteinuria. Exclusion criteria: Quote:“Malignant disease, infectious disease, chronic obstructive lung disease, liver disease, kidney disease, and patients with joint or muscle disease.” |
|
Interventions |
IG: Walking group:
CG: Control group: participants remained sedentary throughout the study period. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: not reported Primary/Main outcome of manuscript: ischaemia‐modified albumin levels and oxidative stress (total antioxidant status and total oxidant status) Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote:"randomly divided" but no details reported refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Unlikely that research personnel and participants blinded |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Dropout: NR Start of study? Intervention n = 30, Control n = 30; At follow up, no mention of dropouts; not sure if Intervention n = 30/30 = 100%? Control n = 30/30 = 100%? refer to Table 1 Unsure ITT or PP analysis |
Selective reporting (reporting bias) | Low risk | Only measurement at 3 months Only 1 analysis |
Other bias | Low risk | No other bias |
Lee 2007.
Study characteristics | ||
Methods |
Aim: the effect of a community‐based walking intervention on blood pressure among older people aged 60. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: yes |
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Participants |
No. randomised:202 (102 in IG, 100 in CG) No. completers: 184 Country: Taiwan Study population: elderly mild‐to‐moderate hypertensive patients (60+ years) Ethnicity: NR Gender: male 58% (118/202) Age: mean 71.3 (SD 6.4) in IG, 71.3 (SD 5.7) in CG Smokers: 21.8% (44/202) Hypertension: 100% Mean baseline BP: SBP = 152.0 (SD 10.5) in IG, 152.4 (SD 11.1) in CG; DBP = 83.5 (SD 11.2) in IG, 80.6 (SD 8.8) in CG Inclusion criteria: Quote:“Being resident in a local township, aged 60 years and over and with a resting systolic blood pressure between 140 mmHg and 179 mmHg and thereby classified as having mild to moderate hypertension” Exclusion criteria: NR |
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Interventions |
IG: Walking (community‐based walking intervention) group: based on the self‐efficacy theory, participants were telephone‐contacted or in‐person interviewed by one of the research members to reinforce motivation and solve barriers to promote increased walking. A median of 6 contacts was given, it was more frequent in the first 3 months than the last 3 months.
CG: Control (usual care) group: participants received usual primary health care involving self‐initiated contact with health services as required. |
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Outcomes |
Review outcomes reported: SBP, DBP Measurement method: BP measured quote:"using a traditional mercury sphygmomanometer Primary/Main outcome of manuscript: change in SBP, exercise self‐efficacy score, self reported walking frequency, DBP Adverse event: NR |
|
Notes |
Trial registration: no Funding sources: self‐funded |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "A series of numbered, opaque, sealed envelopes were used to randomly allocate participants to one of the two arms of the trial. To prevent an imbalance in size of study groups, blocks of 12 were used. The randomisation list and the block size were concealed..." refer to Table 1 |
Allocation concealment (selection bias) | Low risk | Quote:" A series of numbered, opaque, sealed envelopes were used to randomly allocate participants to one of the two arms of the trial. To prevent an imbalance in size of study groups, blocks of 12 were used. The randomisation list and the block size were concealed..." refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and personnel were not blinded |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Quote: "All outcome measures were recorded during face‐to‐face interviews by four trained interviewers who were blinded to study group allocation and trained in questionnaire administration and blood pressure measurement." |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 8.9% (18 out of 202) 11 out of 102 in IG (10.8%), 7 out of 100 in CG (7%) dropouts refer to Table 2 and figure 1 PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 6 months Only 1 analysis |
Other bias | Low risk | no other bias |
Li (李虎) 2018.
Study characteristics | ||
Methods |
Aim: to investigate the effect of long‐term walking on health status. Design: Parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
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Participants |
No. randomised:100 (50 in IG, 50 in CG) No. completers: 80 Country: China Study population: university teachers Ethnicity: Chinese Gender: male 48% (22+26) Age: mean 43.63 (SD 8.26) in IG; 43.24 (8.67) in CG Smokers: NR Hypertension: yes Mean baseline BP: SBP = 118.95 (SD 14.99) in IG, 112.69 (SD 13.74) in CG (DBP was not reported.) Inclusion criteria:
Exclusion criteria: NR |
|
Interventions |
IG: Walking group:health seminar with positive feedback each month.
CG: Control group: no bracelet for step count, neither seminars nor feedback; measurement for health profile twice before and after intervention. |
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Outcomes |
Review outcomes reported: SBP Measurement method: SBP was obtained from regular health examination data from belonged universities. Primary/Main outcome of manuscript: questionnaire including height, BMI, waist‐hip ratio, sleeping condition, perceived pressure level, and history with hypertension, diabetes mellitus and hyperlipidaemia. Health profile measured SBP, blood sugar, LDL, cholesterol, TG, and HDL. Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Office of Research, Beijing Jiaotong University (016JB00050), National Natural Science Foundation of China(81641175), Peking University People's Hospital(RDB2015—10, RDY2016—15), 2015 Osteoarthritis Research Society International (OARSI), 2016 International Cartilage Regeneration & Joint Preservation Society (ICRS), 2016 Beijing love Joint Health Community Foundation |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote:"randomly divided" but no detail reported |
Allocation concealment (selection bias) | Unclear risk | NR |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 20% (20 out of 100 dropouts) 42 completers in walking group, 38 completers in control group refer to table 1 PP analysis |
Selective reporting (reporting bias) | Unclear risk | Only 1 endpoint measurement at 450 days Only 1 analysis Only provided SBP but not DBP without reason, DBP data could not obtained from author contact |
Other bias | Low risk | no other bias |
Li 2003.
Study characteristics | ||
Methods |
Aim: to evaluate the efficacy of cobblestone‐mat walking as a physical activity to improve selected health‐related outcomes. Design: Parallel 2‐group RCT (1:1) Power/sample size calculation: yes |
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Participants |
No. randomised: 48 (24 in IG, 24 in CG) (2 did not receive intervention, 6 declined, leaving 40 in study) No. completers; 40 Country: USA Study population: sedentary elderly adult (60+ years, general population) Ethnicity: white 90% (36/40) Gender: male 22.5% (9/40) Age: mean 72 (SD 6.4) in IG, 73.3 (SD 7.3) in CG Smokers: NR Hypertension: NR Mean baseline BP: SBP = 133.64 (SD 9.68) in IG, 132.17 (SD 13.62) in CG; DBP = 81.5 (SD 9.41) in CG, 81.22 (SD 8.59) in CG Inclusion criteria: Quote:“being 60 years of age or older, not participating in regular physical activity (i.e., in the previous 2 months, no more than 90 min of structured group exercise per week), being an independent ambulator able to walk without the use of aids, having no progressive or debilitating conditions that would limit participation in moderate‐intensity exercise, having a physician’s approval for participation, and having no severe foot or ankle problems.” Exclusion criteria: NR |
|
Interventions |
IG: walking (cobblestone‐mat walking) group: Walk on cobblestone mat for 12 to 25 minutes/session over the 8‐week study period. Foot‐rolling activity was provided between sets, and each participant was also given a pair of cotton socks to be worn
CG: Control group: participants were instructed to continue their usual physical activities and were also invited to four meetings to meet one another. A cobblestone‐mat walking program was provided at the end of the study. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: a trained and experienced research assistant used an aneroid sphygmomanometer to measure resting SBP and DBP. Primary/Main outcome of manuscript: HRQoL (SF‐12 IADL) and self‐care activities Compliance/Adherence: n = 18 (79%), compliance was defined by attending 15 or more sessions (24 sessions in total). 22/24 IG & 18/24 CG received intervention Adverse event: 1 (oOne had a bruise on the ball of her foot and Cobblestone‐Mat Walking subsequently dropped out of the study) |
|
Notes |
Trial registration: NR Funding sources: Government(Preparation of this manuscript was supported in part by Grant No. AG18394 from the National Institute on Aging.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "computer program to generate random numbers " refer to Table 1 & 2 |
Allocation concealment (selection bias) | Low risk | Quote:"Before enrolment of the first study participant, a research statistician not working on the study used a computer program to generate random numbers for group assignment." |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Participants not blinded. Quote:"The principle investigators were blinded to the assignment" |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes Quote:"The principle investigators were blinded to the assignment" but not use if it included outcome assessor(s). |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout: not in final analysis 16.7% (8 out of 48) 2 out of 24 in TG (8.3%) and 6 out of 24 in CG (25.0%) dropout Dropout: non completer 27.1% (13 out of 48) 7 out of 24 in IG (29.2%) & 6 out of 24 in CG (25%) dropout refer to Figure 1 PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 8 weeks Only 1 analysis |
Other bias | Low risk | no other bias |
Lin 2000.
Study characteristics | ||
Methods |
Aim: to examine the effects of brisk walking on blood pressure in teenagers with higher blood pressure. Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: no |
|
Participants |
No. randomised:22 (8 in IG1, 8 in IG2, 6 in CG) No. completers: 22 Country: Taiwan Study population: borderline hypertensive adolescents (students) Ethnicity: Chinese Gender: male 100% (22/22) Age: range 16 to 18 years Smokers: NR Hypertension: 100% borderline Mean baseline BP: SBP = 140 (SD 11.14) in IG1, 137.75 (SD 6.69) in IG2, 145.67 (SD 10.33) in CG; DBP = 92.25 (SD 3.45) in IG1, 91.75 (SD 4.06) in IG2, 93.67 (SD 4.27) in CG Inclusion criteria: 16 to 18 male teenagers with resting SBP≥140 mmHg and resting DBP≥90 mmHg. Deny use of anti‐hypertensives. Exclusion criteria: NR |
|
Interventions |
IG: Walking group:
IG: Walking group:
CG: Control group:maintaining current activity and dietary habit |
|
Outcomes |
Review outcomes reported:SBP, DBP Measurement method: resting blood pressure assessed by Sanken model SM‐301, Tokyo Japan Primary/Main outcome of manuscript: blood pressure and blood composition (refer to Table 1) Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote:"randomised" but no details reported refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes no information |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Dropout: NR refer to Table 1 |
Selective reporting (reporting bias) | Low risk | Reported measurement at 12 weeks only 1 analysis |
Other bias | Low risk | No other bias |
Ming (明輝) 2018.
Study characteristics | ||
Methods |
Aim: to examine the effect of long‐distance brisk walking on haemodynamics and cardiopulmonary function in elderly patients with coronary heart disease complicated with hypertension. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 64 (32 in IG, 32 in CG) No. completers: 64 Country: China Study population: hospitalised patients with percutaneous coronary intervention (PCI) Ethnicity: Chinese Gender: male 62.5% ((21+19)/64) Age: mean 63.18 (SD 5.42) in IG; 62.76 (SD 5.54) in CG Smokers: No Hypertension: 100% Mean baseline BP: SBP = 136.79 (SD 7.03) in IG, 137.32 (SD 7.44) in CG. DBP = 95.88 (SD 4.10) in IG,96.30 (SD 4.52) in CG. HR=83.18 (SD 8.14) in IG, 83.55 (SD 8.09) in CG Inclusion criteria:
Exclusion criteria:
|
|
Interventions |
IG: Walking group: During the long‐distance brisk walking, participants were asked to keep head up high and straight, open arms and keep shoulders and hips in vertical line along with the ground, and breathe in accordance with steps.
CG: Control group: routine medication treatment. |
|
Outcomes |
Review outcomes reported: SBP, DBP, mean arterial pressure, and heart rate Measurement method: before and after 40 weeks. Primary/Main outcome of manuscript: SBP, DBP, mean arterial pressure, heart rate, left ventricular ejection fraction, mitral velocity and late flow velocity ratio, cardiopulmonary function and life quality. Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "random‐number method" but no details reported |
Allocation concealment (selection bias) | Unclear risk | NR |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Dropout: NR 32 completers in walking group, 32 completers in control group This study requested elderly patients with coronary heart disease to walk briskly 20 to 140 steps for 30 to 70 minutes per session and 7 to 14 sessions/week for around 10 months. There is not sufficient information to judge the attrition. refer to table 1 to 3 Unsure ITT or PP analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 10 months Only 1 analysis |
Other bias | Low risk | No other bias |
Moreau 2001.
Study characteristics | ||
Methods |
Aim: the effects of daily walking on lowering blood pressure in postmenopausal women with borderline to stage 1 hypertension. Design: parallel 2‐group RCT (3:2) Power/sample size calculation: NR |
|
Participants |
No. randomised: 24 (15 in IG, 9 in CG) No. completers: 24 Country: United States Study population: postmenopausal women with borderline stage 1 hypertension Ethnicity: NR Gender: male: 0% (0/24) Age: mean 53 (SE 2) in IG; 55 (SE 1) in CG Smokers: 0% Hypertension:100% borderline Mean baseline BP: SBP = 142 (SE 3) in IG, 142 (SE 3) in CG; DBP = 84 (SE 1) in IG, 86 (SE 2) in CG HR = 77 (SE 3) in IG, 77 (SE 3) in CG Inclusion criteria: postmenopausal (for at least 1 year) women with borderline to stage 1 hypertension (SBP of 130 to 159 mmHg and/or DBP of 85 to 99 mmHg, determined on the basis of repeated seated BP recordings at rest on two separate days), were not participating in regular physical activity (< 2 days/week ) within the past year. Non‐smokers, had no orthopaedic limitations to walking, and were absent of known CVD as assessed with a health history questionnaire. Exclusion criteria: NR |
|
Interventions |
IG: Walking (exercise) group: self‐reported daily log sheets with any additional physical activity was collected biweekly. Participants were asked not to change any lifestyle activity other than walking.
CG: Control group: not to change daily activity and subsequently wore a pedometer 1 week each month to document their walking. |
|
Outcomes |
Review outcomes reported: SBP, DBP, resting HR Measurement method: blood pressure was measured in the left arm by brachial artery sphygmomanometer with at least 3 minutes separating each measurement. Primary/Main outcome of manuscript: blood pressure Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: private sector(research was supported by an American College of Sports Medicine Foundation Research Grant.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote:"randomised" but no details reported refer to Figure 1 and 2 |
Allocation concealment (selection bias) | Unclear risk | no information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants not blinded. Personnel not blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | objective outcomes Quote:"Blood pressure and heart rate were measured at rest in triplicate by the same trained observer who was blinded to the group assignment as previously described" |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Dropout: NR At start of study: Intervention n = 15, Control arm n = 9; At follow up: data not reported? Intervention n = 15/15 = 100%?, Control arm n = 9/9 = 100%? refer to table 1 Unsure ITT or PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 24 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Murphy 1998.
Study characteristics | ||
Methods |
Aim: to compare the effects of short and long bouts of brisk walking in sedentary women Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised:47 (16 in IG1, 16 in IG2, 15 in CG) No. completers: 34 Country: UK Study population: sedentary middle‐aged women Ethnicity: NR Gender: male 0% (0/47) Age: mean 44.4 (SD 6.2); 44.8 (SD 8.4) in IG1, 48.0 (SD 5.5) in IG2, 47.3 (SD 4.1) in CG Smokers: NR Hypertension: 0% Mean baseline BP: SBP = 125.5 (SD 10.8) in IG1_SB; 124.2 (SD 11.1) in IG2_LB; 128.6 (SD 13.3) in CG Inclusion criteria: Quote: "None was employed in manual work and none had engaged in regular physical activity (defined as more than one 20‐min bout per week) during the preceding 6 months. " Exclusion criteria: Quote: "history of cardiovascular disease; resting arterial blood pressure >150 mmHg systolic or >95 mmHg diastolic; body mass index >= 30 kg·m‐2; diabetes; musculoskeletal condition or injury; taking any pharmacotherapeutic drug." |
|
Interventions |
IG_SB: walking (Short‐bout: 3*10 minutes) group: participants in the short‐bout group split this into three 10‐minutes sessions at intervals of ≧4 hours. Training was performed outdoors on the campus of the University of Ulster.
IG_LB: Walking (long‐bout: 30minutes) group: participants in the long‐bout group were free to select the time of day at which they did their one 30‐minute bout. Training was performed outdoors on the campus of the University of Ulster.
CG: Control group: usual lifestyle |
|
Outcomes |
Review outcomes reported: SBP only Measurement method: blood pressure measured by mercury‐in‐glass sphygmomanometer Primary/Main outcome of manuscript: exercise capacity, SBP, anthropometric variables Adverse event: 0 |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomly assigned" but no details reported refer to Table 1 (completers only) |
Allocation concealment (selection bias) | Unclear risk | No information Completers only |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | no information |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Quote: "Duplicate measurements of arterial blood pressures were made by an observer who was blinded to subjects' group assignment " |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 27.7% (13 out of 47) 4 out of 16 long IG (25%), 4 out of 16 short IG (25%), 5 out of 15 CG (33.3%) dropouts PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 10 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Murphy 2006.
Study characteristics | ||
Methods |
Aim: to examine the effects of 45 minutes walking, 2 days/week on fitness, BP, body composition, lipids and C‐reactive protein (CRP). Design: parallel 2‐group RCT (3:2) Power/sample size calculation: NR |
|
Participants |
No. randomised: 37 (23 in IG, 14 in CG) No. completers: 33 Country: UK Study population: general population adults (sedentary civil servants) Ethnicity: NR Gender: male 35% (13/37) Age: mean 41.5 (SD 9.3); 41.4 (SD 7.5) in IG, 40.8 (SD 10.0) in CG Smokers: 0% Hypertension: 0% Mean baseline BP: SBP=120.4 (SD 19.7) in IG, 116.5 (SD 13) in CG; DBP=77.2 (SD 9.4) in IG, 74.6 (SD 9.0) in CG Inclusion criteria: NR Exclusion criteria: Quote: "physically active lifestyle, age > 65 years, resting BP > 159/99 mmHg, total cholesterol > 6.2 mmol· L‐1, fasting blood glucose > 7.0 mmol· L‐1, body mass index (BMI) > 34.9 kg· m‐2, current cigarette smokers, individuals with cardiovascular, pulmonary or metabolic disease, pain or discomfort in the chest, dizziness or heart murmur. In addition, individuals taking medication known to interfere with lipid metabolism, and females who were pregnant or planning to become pregnant in the following five months were excluded from taking part in the study." |
|
Interventions |
IG: Walking group: single bout and outdoors walking; Only 12 walkers wore pedometer to record steps in week 0, 4 and 8.
CG: Control group: wore pedometer to record steps in weeks 0, 4 and 8. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: duplicate measurements of BP were taken two minutes apart using an automated device (Omron 705 CP; Omron Matsusaka Co. Ltd., Japan) Primary/Main outcome of manuscript: blood pressure, lipids, CRP and body composition Compliance/Adherence: % of prescribed sessions (16 sessions in total) were completed. Compliance was high with walkers completing 83.9 ± 18.9% of prescribed sessions. Adverse event: 0 |
|
Notes |
Trial registration: NCT00284479 Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | C‐reactive protein "randomised controlled study" but no details reported refer to Table 1 (completers only) |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 (completers only) |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 10.8% (4 out of 37) 2 out of 23 IG (8.7%), 2 out of 14 CG (14.3%) dropouts refer to Table 3 Quote: "Four individuals dropped out of the study due to: illness (1 control), moving job (1 control), family circumstances (1 walker) and lack of interest (1 walker)." PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 8 weeks only 1 analysis |
Other bias | Low risk | No other bias |
Murtagh 2005.
Study characteristics | ||
Methods |
Aim: to evaluate the effectiveness of instructing sedentary individuals to undertake 20‐minute brisk walking (in one continuous bout or two 10‐minute bouts) 3 days per week, on fitness and other cardiovascular disease (CVD) risk factors in previously sedentary adults. Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 48 (19 in IG1_Single bout, 18 in IG2_Acumulated bout, 11 in CG) No. completers: 32 Country: UK Study population: sedentary general population (University staff or students) Ethnicity: NR Gender: male 35% (17/48) Age: mean 45.7 (SD 9.4) Smokers: NR Hypertension: 0% Mean baseline BP: SBP = 117.9 (SD 12.0) in IG1_Single bout, 121.7 (SD 11.2) in IG2_Acumulated bout, and 117.5 (SD 18.1) in CG; DBP = 74 (SD 9.8) in IG1_Single bout, 75.4 (SD 6.6) in IG2_Acumulated bout, and 73.1 (SD 10.6) in CG. Inclusion criteria: NR Exclusion criteria: Quote: "History of cardiovascular or metabolic disease, resting blood pressure > 140/90 mmHg, body mass index > 30 kg m‐2, musculoskeletal condition or injury, taking medications known to interfere with lipid metabolism, or a physically active lifestyle (Defined as engaging in more than 20 min of planned exercise per week during the preceding 4‐week period)." |
|
Interventions |
IG_SB: Walking (single‐bout) group: Treadmill walking: treadmills at the university were free of use. During one session each week, walking was supervised and heart rate and walking speed were monitored continuously. A self‐reported training diary recoding walking duration, speed, distance and all walking notes was collected in week 12.
IG_AB: walking (accumulated‐bout) group: Treadmill walking: treadmills at the university were free of use. During one session each week, walking was supervised and heart rate and walking speed were monitored continuously. A self‐reported training diary recoding walking duration, speed, distance and all walking notes was collected in week 12.
CG: Control group: no training |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: blood pressure measured by validated automated device (Omron 705CP; Omron Matsusaka Co. Ltd., Japan) Primary/Main outcome of manuscript: body composition, blood pressure and lipids Compliance/Adherence: compliance was defined as completing at least 60% of prescribed sessions [7] and, as a result, two subjects were excluded (1 single‐bout walker, 1 accumulated‐bout walker) Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomised" but no details reported refer to Results (32 completers only) |
Allocation concealment (selection bias) | Unclear risk | No information refer to Results (32 completers only) |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 33.3% (16 out of 48) 4 out of 19 single IG (21%), 9 out of 18 accumulated IG (50%), 3 out of 11 CG (27.3%) dropouts Quote: "Fourteen subjects dropped out of the study due to: time pressures with work/study (2 single‐bout walkers, 3 accumulated‐bout walkers); personal circumstances (1 single‐bout walker, 2 accumulated‐bout walkers, 1 control); lack of interest (1 accumulated‐bout walker); starting medication (1 accumulated‐bout walker); moving job (1 accumulated‐bout walker); and starting a personal exercise programme (2 control)." Quote: "Compliance was defined as completing at least 60% of prescribed sessions [7] and, as a result, two subjects were excluded (1 single‐bout walker, 1 accumulated‐bout walker)." Data are therefore presented for 32 subjects (17 women) who completed the study. Data were from completers only refer to Result PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Nemoto 2007.
Study characteristics | ||
Methods |
Aim: whether the high‐intensity interval walking training increased thigh muscle strength and peak aerobic capacity and reduced blood pressure more than moderate‐intensity continuous walking training. Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: the statistical power to detect their significant changes after training in the continuous and interval walking groups was >0.8 at α of 0.05 except for SBP in men from the continuous walking group (0.74) and DBP in men from the interval walking group (0.53). |
|
Participants |
No. randomised: 246 (16 in Wcnt_male, 59 in Wcnt_female, 19 in Wint_male, 68 in Wint_female, 25 in CG_male, 59 in CG_female.) Wint: high‐intensity interval walking training group Wcnt: moderate‐intensity continuous walking training group No. completers: 139 Country: Japan Study population: general population adults Ethnicity: NR Gender: male: 24% (60/246) Age: mean 63 (SD 6), range 44 to 78 Smokers: 0% Hypertension: 0% Mean baseline BP: SBP=141 (SE 2) in Wcnt_male, 135 (SE 3) in Wcnt_female, 146 (SE 2) in Wint_male, 140 (SE 3) in Wint_female, 143 (SE 2) in CG_male, 142 (SE 3) in CG_female; DBP=85 (SE 2) in Wcnt_male, 81 (SE 2) in Wcnt_female, 87 (SE 3) in Wint_male, 85 (SE 2) in Wint_female; 84 (SE 2) in CG_male, 83 (SE 2) in CG_female. HR=81 (SE 3) in Wcnt_male, 78 (SE 1) in Wcnt_female, 75 (SE 3) in Wint_male, 81 (SE 2) in Wint_female, 80 (SE 3) in CG_male, 79 (SE 1) in CG_female. Inclusion criteria: Quote: “Nonsmoking middle‐aged and older adults (44 to 78 years) with no history of cardiovascular or pulmonary diseases” Exclusion criteria: NR |
|
Interventions |
WCNT: walking (continuous moderate‐intensity training) group: Participants were instructed to walk more than 8000 steps per day for a minimum of 4 days a week. Pedometers were given and returned to administration centre once a month to review the compliance. Only 18 participants in this group wore accelerometer to monitor intensity and steps.
WINT: walking (high‐intensity interval walking) group: Participants were divided into 5 subgroups and invited to a community office near their homes. Instruction of repeating the following regimen 4 or more times per week: 5 or more sets of 2 to 3‐minute low‐intensity walking intervals (at approximately 40% of the pre‐training VO2peak), followed by a 3‐minute interval of high‐intensity walking (70% to 85% VO2peak for walking) was given. Participants were instructed to reach target levels every 2 weeks, and needed to return to local office to review compliance and load the pedometer/accelerometer data.
CG: Control (no walking training) group: Remaining sedentary life. |
|
Outcomes |
Review outcomes reported: SBP, DBP, resting HR Measurement method: SBP and (DBP were measured by auscultation after the participant had been sitting for 10 minutes in a room Primary/Main outcome of manuscript: VO2peak (by graded cycling exercise and by graded walking exercise), isometric knee extension and flexion forces were measured at baseline and week‐20. Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Government (This study was supported in part by grants from the Ministry of Health, Labor, and Welfare (Comprehensive Research on Aging and Health), the Japan Society for Promotion of Science, and the Ministry of Economy, Trade, and Industry of Japan.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | High risk | Quote: "a few of the participants were married couples and wanted to join the same group, and others, who lived a distance from an administrative center, wished to be assigned to the interval walking group so that they could visit a local community office nearer their homes. For these reasons, minor reassignments were made..." There were "minor" reassignments after randomisation and it was not defined how many participants were reassigned. refer to Table 4 |
Allocation concealment (selection bias) | High risk | Quote: "a few of the participants were married couples and wanted to join the same group, and others, who lived a distance from an administrative centre, wished to be assigned to the interval walking group so that they could visit a local community office nearer their homes. For these reasons, minor reassignments were made..." In this case, the information of allocation is unlikely to be concealed. refer to Table 4 |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | High dropout (total 107 out of 246 randomised, 43.5%) 24 out of 75 (32.0%) in Moderate intensity TG, 45 out of 87 (51.7%) in High intensity TG, and 38 out of 84 (45.2%) in CG drop outs refer to Figure 1 PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 5 months Only 1 analysis |
Other bias | Low risk | No other bias |
Neumann 2006.
Study characteristics | ||
Methods |
Aim: the potential attenuating effects of 6 months of walking (aerobic exercise) versus control on cardiovascular reactivity (CVR) to anger‐provoking stressors in sedentary older adults who manifest exercise‐induced silent myocardial ischaemia (SI) and have no history of overt coronary artery disease (CAD). Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 25 (14 in IG, 11 in CG) No. completers: 20 (9 dropouts, 4 CG re‐enter as IG) Country:USA Study population: adults with Silent Myocardial Ischemia (Baltimore‐Washington metropolitan area and the Charlestown Retirement Community) Ethnicity: NR Gender: male 68% (17/25) Age: mean 71 (SE 2) in IG, 63 (SE 2) in CG Smoker: 0% Hypertension: NR Mean baseline BP: SBP = 134 (SE 3) in IG, 140 (SE 6) in CG; DBP = 76 (SE 3) in IG, 80 (SE 2) in CG; resting HR = 71 (SE 3) in IG, 71(SE 3) in CG Inclusion criteria: older (age 56–83 years), nonsmokers with at least a high school education and without a history of symptomatic CAD. Exclusion criteria: Quote: “history of overt CAD, resting‐ECG evidence of CAD as defined by significant Q waves, major ST segment abnormalities, left‐bundle‐branch block, complex arrhythmias, poorly controlled hypertension (blood pressure >180/105 mmHg), stroke, peripheral arterial disease, poorly controlled hyperlipidaemia (low‐density lipid concentrations >190 mg/dl or plasma triglycerides >400mg/dl), diabetes mellitus, dementia (Mini‐Mental State Examination score <24), history of psychiatric disorders, current smoking, history of heavy alcohol consumption (>14 drinks per week), or other comorbid diseases that would interfere with the ability to participate in the study. Participants were also excluded if they had severe hypertension requiring multiple antihypertensive medications (3+) because of potential safety concerns of temporarily discontinuing their medications during the measurements of CVR.” |
|
Interventions |
IG: Walking (exercise) group: The duration and intensity of sessions were gradually increased until participants were walking for 40 minutes at 70% of their heart rate reserve or at their ischaemic threshold as determined during their exercise‐treadmill test.
CG: Control (wait‐list) group: the wait‐list controls received no further contact for 6 months before post‐control testing. |
|
Outcomes |
Review outcomes reported: SBP, DBP, resting HR Measurement method: all BP and HR data were collected oscillometrically at 60‐s intervals during rest and task periods with an automated vital‐signs monitor (Dinamap Model # 1846SX, Critikon, Tampa, FL). Primary/Main outcome of manuscript: cardiovascular reactivity (SBP, DBP, HR), Spielberger’s State‐Trait Personality Inventory questionnaires, lipoprotein lipids and glucose levels Compliance/Adherence: attended >75% of the exercise sessions Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Government (This work was supported by National Institute on Aging (NIA) K24 AG 00930, NIA R29 AG15112, a Department of Veteran Affairs Geriatric Research, Education and Clinical Center Grant (GRECC), a VA Merit Grant, and the University of Maryland Claude D.Pepper Older Americans Independence Center (P60‐AG12583).) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomised" but no details reported a total of two randomisation performed: 25 randomised to 14/11, the 6 and 3 lost, then the controls randomised again to become intervention (+4). Turn out become 12 in IG and 8 in CG. refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 36.0% (9 out of 25) 6 out of 14 in IG (42.9%), 3 out of 11 in CG (27.3%) dropouts refer to Figure 1 Quote: "Four participants dropped out of the exercise‐training protocol because of time conflicts, and 2 participants experienced adverse health events not associated with study participation but precluding them from further participation. During the 6‐month waiting period, 1 participant from the control group experienced an adverse health event not associated with study participation but precluding the individual from further participation in the study, and 2 participants refused to return for post‐control assessment." PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 6 months Only 1 analysis |
Other bias | Low risk | No other bias |
Pagonas 2014.
Study characteristics | ||
Methods |
Aim: to investigates the impact of an aerobic exercise program on BPV Design:Parallel 2‐group RCT (1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised:72 (36 in IG, 36 in CG) No. completers: 66 Country: Germany Study population: hypertensive outpatients (hypertension clinic or press) Ethnicity: NR Gender: male 43.1% (31/72) Age: mean 65.3 (range 42 to 79) in IG, 67.7 (range 43 to 77) in CG Smokers: ex‐smokers 15.3% (11/72) Hypertension: 100% Mean baseline BP: daytime ambulatory SBP = 137.9 (SD 12.3) in IG, 133.1 (SD 12.1) in CG daytime ambulatory DBP = 78.1 (SD 8.9) in IG, 73.8 (SD 6.4) in CG Inclusion criteria: current antihypertensive treatment with at least one antihypertensive drug and/or office blood pressure >=140/90 mmHg. Exclusion criteria: Quote: "regular engagement in physical exercise training in the past 4 weeks prior to inclusion in the study, symptomatic peripheral arterial occlusive disease, aortic insufficiency or stenosis >stage I, hypertrophic obstructive cardiomyopathy, congestive heart failure (>NYHA II), uncontrolled cardiac arrhythmia with haemodynamic relevance, systolic office BP >=180mmHg, signs of acute ischemias in exercise ECG, change of antihypertensive medication in the past 4 weeks prior to inclusion in the study or during follow‐up period." |
|
Interventions |
IG: Walking (exercise) group: Walking on a treadmill according to an interval‐training pattern; training was performed in the hospital. Training sessions were carried out with a target‐lactate concentration of 2.0±0.5 mmol/L in capillary blood slightly above the aerobic threshold.
CG: Control (sedentary) group: NR |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: assessment of 24‐hour‐ABP monitoring and physical performance were conducted before and after the observation period. 24‐hour‐ABP monitoring was performed using Spacelabs 90 207 monitors (Spacelabs, Redmond, WA, USA). Primary/Main outcome of manuscript: a change in systolic BPV measured as the CV of systolic daytime ABP. Compliance/Adherence: minimum of 8 weeks Adverse event: NR |
|
Notes |
Trial registration: NR Note: included Dimeo study participants, not separately analysed resistant hypertension subset. Funding sources: private sector (The study was supported by the Gertrud und Hugo Adler Stiftung, Georgensgmu¨ nd, Germany.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "Participants were randomly assigned to an exercise program or sedentary control." Quote: "A total of 72 patients, who met the inclusion criteria, were randomized by lot to either the exercise group (36 patients) or the control group (36 patients, Figure 1)." No details about the randomisation procedure refer to Table 1 & 2 |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Quote: "The aerobic exercise program consisted of walking on a treadmill according to an interval‐training pattern. Training was performed in the hospital. Patients were supervised during training by a study nurse and a physician." Insufficient information about control group and not sure if the nurse and physician had any opportunity to care participants in control group. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Measurement of 24‐hour ambulatory blood pressure was used. |
Incomplete outcome data (attrition bias) All outcomes | Low risk | dropout 8.3% (6 out of 72) 3 out of 36 in IG (8.3%) & 3 out of 36 in CG (8.3%) dropouts refer to Figure 1 (dropout) PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 8 to 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Palmer 1995b.
Study characteristics | ||
Methods |
Aim: the psychological effects of an 8‐week walking program on attributional style, scores of depression, self‐esteem, and physical fitness in females. Design: Parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 27 (16 in IG, 11 in CG) No. completers: 27 Country: USA Study population: non‐exercising, premenopausal, female volunteers (recruited from the general public via radio and newspaper) announcements. Ethnicity: NR Gender: male 0% (0/27) Age: mean 37.4; range 29 to 50 Smokers: NR Hypertension:0% Mean baseline BP: SBP = 117.1 (SD 14) in IG, 122.6 (SD 13.8) in CG; DBP = 80.9 (SD 10.6) in IG, 77.6 (SD 11.2) in CG; HR = 74 (SD 10.8) in IG, 71 (SD 6.5) in CG Inclusion criteria: non‐exercising, premenopausal women Exclusion criteria: Quote: "history of heart disease or other significant health problems and those who reported having been highly fit in the past 3 years were not eligible for participation." |
|
Interventions |
IG: Walking group: walking in university coliseum.
CG: Control group: non walking, wait‐list |
|
Outcomes |
Review outcomes reported: SBP, DBP, resting heart rate Measurement method: resting heart rate and blood pressure were measured by digital blood‐pressure cuff Primary/Main outcome of manuscript: psychological outcomes Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "Participants were randomly assigned to either a walking group...... or nonwalking, ......" and no other details about randomisation. refer to Table 2 |
Allocation concealment (selection bias) | Unclear risk | No information There is no information about control group participants. |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | No dropout refer to table 2 ITT analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 8 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Pernar 2017.
Study characteristics | ||
Methods |
Aim: the feasibility of a randomised walking group intervention to improve quality of life, circulating biomarkers, and morbidity among men with newly diagnosed prostate cancer. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised:41 (21 in IG, 20 in CG) No. completers: 36 Country: Sweden Study population: newly diagnosed prostate cancer patients Ethnicity: NR Gender: male 100% (41/41) Age: range 61.7 to 81.7 years in IG; 54.5 to 81.6 years in CG Smokers: 48% in IG; 50% in CG Hypertension: NR Mean baseline BP: SBP = 170 in IG, 162 in CG; DBP = 93 in IG, 89 in CG Inclusion criteria: histological diagnosis of prostate cancer without evidence of distant metastases, had completed initial treatment at least 1 month prior to study enrolment, and had a life expectancy of at least 5 years, the ability to speak Swedish and be mentally and physically able to complete the questionnaires and clinical exam and to participate in group walking sessions. Exclusion criteria: physical or mental impairment |
|
Interventions |
IG: Walking group: participants were assigned to groups of 6 to 8 men, based on the participants’ availability for walking on specific times of the day. For the 11‐week intervention, the men walked together weekly in their groups for 1 hour along with a research nurse who answered patients’ questions about prostate cancer and led discussions. On other days, the men were instructed to wear pedometers to monitor the number of steps they took on a given day. In addition, they recorded their daily number of steps in a diary.
CG: Control (usual care) group: received no intervention other than their usual medical care |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: not mentioned, only physical exam by research nurse Primary/Main outcome of manuscript: quality of life and circulating biomarker Compliance/Adherence: walked within 1000 steps of the study goal of 10,000 steps per day on average over the 11 weeks Adverse event: NR |
|
Notes |
Trial registration: NR 1. Convert % Difference in mean change in column 7 of Table 2 into Difffference in mean change score by dividing by 100. E.g. for SBP ‐8.51 = ‐8.51/100 = ‐0.0851 = mean difference of change scores = MD 2. Similarly covert 95%CI limits i.e. ‐21.23 and 4.21 become ‐0.2123 and 0.0421 3. Now use Revman Claculator, enter N, MD and 95%CI limits into the bottom set of boxes to get the SE of the mean diff of change score. 4. Use the MD and this SE to enter into GIV data type for meta‐analysis. 5. For SBP, MD = ‐0.085, SE (MD) = 0.0638 6. For DBP, MD = ‐0.0002, SE (MD) = 0.0321 Funding sources: Private sector(C.H. Pernar and S.C. Markt are supported by National Institutes of Health (NIH) training grants (T32 ES 007069, T32 CA 09001). This project was supported in part by funding from the Prostate Cancer Foundation (PCF). L.A. Mucci and J.R. Rider are PCF Young Investigators.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "randomised to the study through a random number generator... " |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 12.2% (5 out of 41) 4 out of 21 (19.0%) in walking group, 1 out of 20 usual care group (5.0%) dropouts refer to Figure 1 and author provided information PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 11 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Pospieszna 2017.
Study characteristics | ||
Methods |
Aim: to test if Nordic walking training would be increased endothelial nitric oxide synthase (eNOS) activity and, consequently, greater capacity for nitric oxide (NO) formation in the vascular endothelium. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: no |
|
Participants |
No. randomised: 39 (20 in IG, 19 in CG) No. completers: 39 Country: Poland Study population: healthy postmenopausal women (recruited through public advertisement) Ethnicity: NR Gender: male 0% (0/39) Age: mean 62 (SD 3.79) in IG, 62 (SD 1.12) in CG; range: 52 to 72 Smokers: data collected but NR Hypertension: no Mean baseline BP: SBP = 134.7 (SD 21.23) in IG, 132.16 (SD 3.8) in CG; DBP = 75.8 (SD 7.06) in IG, 78.58 (SD 1.96) in CG. Inclusion criteria: postmenopausal volunteers; good health status; aged between 52 and 72. Exclusion criteria: Quote: "exclusion criteria for volunteers included inflammatory disorders, recent infections, renal or hepatic insufficiency, active coronary artery disease, diabetes, hypertension (>160/100 mmHg), heart failure, the use of hormonal replacement therapy, and supplementation with antioxidants within 3 months prior to enrolment." |
|
Interventions |
Training group: Nordic walking
Control group: were asked to continue their daily routines, without any major changes, especially in the level of everyday physical activity |
|
Outcomes |
Review outcomes reported: SBP, DBP, HR Measurement method: after the participants spent a further 5 minutes resting in the supine position, the level of blood pressure and heart rate at rest were measured. Primary/Main outcome of manuscript: endothelial NOS activity, TAC and oLAb concentration Compliance/Adherence: quote: "Participants in the training group performed a 12‐week supervised NW training, preceded by individual demonstrations of the proper walking technique. Each physical workout took place outdoors and consisted of 60‐minute sessions of exercise (50 minutes of walk with 90% of ventilatory threshold [VT]intensity, 5‐minute warm‐up, and 5‐minute stretching), repeated three times per week." Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Government (This work was partially financed by the City of Poznan as part of the "Academic and Scientific Poznari" strategy) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomly divided into a training group ... and a control group" "Both groups were similar with regard to anthropometric parameters, such as body mass, BMI, or height. None of the accepted women changed their nutritional approach during the analysed 12‐week period. In particular, the levels of salt and alcohol intake were unchanged. Women assigned to the control group were asked to continue their daily routines, without any major changes, especially in the level of everyday physical activity." No other details about randomisation |
Allocation concealment (selection bias) | Unclear risk | Quote: "randomly divided into a training group ... and a control group" "Both groups were similar with regard to anthropometric parameters, such as body mass, BMI, or height. None of the accepted women changed their nutritional approach during the analysed 12‐week period. In particular, the levels of salt and alcohol intake were unchanged. Women assigned to the control group were asked to continue their daily routines, without any major changes, especially in the level of everyday physical activity." No other details about allocation concealment |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | 39 randomised but the number of participants at outcome measures was not reported Unsure ITT or PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Ready 1996.
Study characteristics | ||
Methods |
Aim: the effect of walking volume on aerobic fitness, serum lipids, and body composition in women post‐menopause, a population at risk for coronary artery disease. Design: Parallel 3‐group RCT (1:1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised: 79 (27 in IG1_3D, 27 in IG2_5D, 25 in CG) No. completers: 56 Country: Canada Study population: sedentary postmenopausal women (50+) Ethnicity: NR Gender: male 0% (0/79) Age: mean 61.3 (SD 5.8) (56 completers) Smokers: 0% Hypertension: NR Mean baseline BP: SBP = 134 (SD 18) in IG1_3D, 131 (SD 20) in IG2_5D, 131 (SD 16) in CG; DBP = 77 (SD 11) in IG1_3D, 76 (SD 9) in IG2_5D, 77 (SD 10) in CG. Inclusion criteria: Quote: “post‐menopausal status (no menstrual periods in the past 12 months), over 50 yrs of age, absence of hormone replacement therapy or medication to lower serum cholesterol, nonsmoker status, a sedentary lifestyle (exercising less than 30 min/wk), physical ability to exercise, and a body mass index of 34 or less. Total serum cholesterol levels less than 8.0 mmol/l and serum triglyceride less than 4.2 mmol/l" Exclusion criteria: Quote: "of these 30 were screened out for medical reasons, including medications that interfere with serum lipids, or presence of disease that would preclude unsupervised walking (e.g., known heart disease)." |
|
Interventions |
IG_3D: Walking (3 days/week) group:
IG_5D: Walking (5 days/week) group:
Participants were instructed to walk a complete 60 minutes first, and then gradually increased the intensity thereafter. Walkers were requested to attend at least 4 supervised session at the university track (5 times per week) in the first 2 week, and at least one per week thereafter. Unsupervised sessions took place in a variety of settings including community tracks, fitness facilities, parks, and public roads.
CG: Control group: participants were asked to maintain sedentary lifestyle |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: no mention on blood pressure measurement. Heart rate was monitored with an ECG (Cardio Tracer, Birtcher Medical Systems) using a CM5lead. Primary/Main outcome of manuscript: aerobic fitness, serum lipids, and body composition Compliance/Adherence:walkers must walk an average of at least 150 minutes/week and 240 minutes/week to successfully complete the study. Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: private sector (This study was supported by the Canadian Fitness and Lifestyle Research Institute (https://www.cflri.ca/who‐we‐are, project #931R014), the Manitoba Medical Service Foundation, and the Centre on Aging at the University of Manitoba.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomly assigned" but no details reported Completers only |
Allocation concealment (selection bias) | Unclear risk | No information Completers only |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 29.1% (23 out of 79) 8 out of 27 (29.6%) in 3‐day walking, 10 out of 27 5‐day walking (37.0%), 5 out of 25 (20.0%) in CG dropouts Unspecific reasons for each group refer to Figure 1 PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 24 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Romero 2019.
Study characteristics | ||
Methods |
Aim: to investigate the effects of a pedometer on motivating Mexican‐American female participants, ages sixty to seventy‐five years old, to increase their physical activity to lower weight and /or blood pressure. Design: Parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 55 (27 in IG, 28 in CG) No. completers: 55 Country: USA Study population: general population (women) Ethnicity: Mexican‐American Gender: male 0% Age: range 60 to 75 Smokers: NR Hypertension: NR Mean baseline BP: SBP = 143.67 (SD 21.91) in IG. 146.07 (SD 24.18) in CG; DBP = 84.41 (SD 15.19) in IG, 82.96 (SD 10.29) in CG. Inclusion criteria: Mexican‐American females aged 60 to 75 years Exclusion criteria: NR |
|
Interventions |
IG: Walking group: the treatment group participants completed simple entry logs to record the number of steps and facilitate the evaluation of the program. Each participant in the treatment group was contacted once a week via telephone to remind recording daily steps.
CG: Control group: participants did not receive a pedometer or entry logs, only education on the importance of diet and exercise on the pretest meeting. They were instructed to return at the end of the twelve weeks to complete a posttest. |
|
Outcomes |
Review outcomes reported: BP Measurement method: weight, systolic and diastolic blood pressure were measured at baseline and a follow‐up meeting 12 weeks later. Primary/Main outcome of manuscript: weight, systolic and diastolic blood pressure Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Randomly assigned but no detailed information provided |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 0% (0/55) refer to Table 3 ITT analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Sakuragi 2006.
Study characteristics | ||
Methods |
Aim: the effects of daily walking on subjective symptoms as well as on mood and autonomic nervous function in people who take no medication but have some general physical complaints. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: no |
|
Participants |
No. randomised: 20 (12 in IG,8 in CG) No. completers: 15 Country: Japan Study population: healthy college students from general population Ethnicity: NR Gender: male 0% (0/20) Age: range 20 to 22 Smokers: 0% Hypertension: 0% Mean baseline BP: figure 2. Inclusion criteria: normotensive nonsmokers Exclusion criteria: Quote: "exercised regularly two or more times per week for at least 30 min during the preceding 12 months and those who took medication on a regular basis" |
|
Interventions |
IG: Walking group: without altering other habitual activities during the study period
CG: Control group: wore lifestyle record machine from the previous week to the end of the study to ensure a level of daily activity. |
|
Outcomes |
Review outcomes reported: SBP, DBP, HR Measurement method: an occlusion cuff of appropriate size was attached to the left arm with a tonometry sensor on the radial artery at the wrist to measure blood pressure (BP) waveform (Colin, Japan). Primary/Main outcome of manuscript: psychological indices (Cornell medical index questionnaire, profile of mood states, and frontal alpha laterality ratio) and autonomic indices (Blood pressure and ECG variance under orthostatic condition) measured at baseline and week 4. Compliance/Adherence: walkers whose average amount of exercise calculated from the Lifecorder data did not increase by more than 1.2 kcal/kg/day would be excluded. Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | No information ‐ Quote: "All subjects were normotensive non‐smokers and were randomly assigned into two groups: a walking group (n=12) and a control group (n=8)." Completers only |
Allocation concealment (selection bias) | Unclear risk | Completers only |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 25% (5 out of 20) Completer‐only analysis refer to table 1 PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 4 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Salesi 2014.
Study characteristics | ||
Methods |
Aim: to investigate the effect of 8‐week walking program on metabolic syndrome indexes in non‐athlete menopausal women Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 32 (16 in IG, 16 in CG) No. completers: 32 Country: Iran Study population : elderly women Ethnicity: NR Gender: male 0% Age: range 50 to 55 years Smokers: NR Hypertension: NR Mean baseline BP: SBP=136.0 (SD 12.1) in IG, 131.1 (SD 8.7) in CG; DBP = 83.1 (SD 10.1) in IG, 80.3 (SD 3.8) in CG Inclusion criteria: aged 50 to 55, healthy inactive, fulfilling at least three criteria of ATPIII, at least 2 years of menopause, physical health, no regular exercise (at least 3 sessions a week) over the last 6 months before the study, not using hormone therapy Exclusion criteria: NR |
|
Interventions |
IG: walking group: walking with 60% heart rate reserve and for 30 minutes for the first two weeks. From the third week, every 2‐week sessions increased by 10 minutes and intensity increased by 5%. So that the session was with 75% heart rate reserve and 60 minutes at last week. Walking at own time (not treadmill)
CG: Control group: everyday normal activities with no physical exercise |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method:. measure by sphygmomanometer Primary/Main outcome of manuscript: SBP, DBP Compliance/Adherence: completed all session Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Egyptain government |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | The randomisation method was not described, the sample size is equal at the two groups. Based on Table 1, weight, BMI, fat% and waist to hip ratio seems to be comparable at the two groups before the program. |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | There was no missing value for the outcomes before and after the program at the two groups. refer to table 1, 2 According to the outcome table 1 and 2, the dropout rate was 0% since the participant number was the same in tables. ITT analysis |
Selective reporting (reporting bias) | Low risk | Only 1 analysis |
Other bias | Low risk | No other bias |
Saptharishi 2009.
Study characteristics | ||
Methods |
Aim: to measure the efficacy of physical exercise, reduction in salt intake, and yoga, in lowering BP among young (20 to 25) pre‐hypertensives and hypertensives, and to compare their relative efficacies. Design: parallel 4‐group RCT (1:1:1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised:58 (28 in IG, 30 in CG); (27 in Yoga group and 28 in Salt intake reduction excluded) No. completers: 56 Country: India Study population: confirmed hypertensives/pre‐hypertensives Ethnicity: NR Gender: male 69.6% ((20+19)/56) Age: mean 22.4 (SD 1.3) in IG; 22.5 (SD 1.4) in CG Smokers: NR Hypertension: 100% pre‐hypertensive and hypertensive Mean baseline BP: SBP = 128.6 (SD 7.7) in IG, 123.1 (SD 10.2) in CG; DBP = 87.4 (SD 4.8) in IG, 82.9 (SD 7.1) in CG Inclusion criteria: pre‐hypertensives (SBP130 to 139 mmHg and/or DBP 85 to 89 mmHg) and hypertensives. Exclusion criteria: severe hypertension |
|
Interventions |
IG: walking (physical exercise) group:
CG: Control group: NR Note: yoga and salt intake reduction groups excluded |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: blood pressure was measured using the mercury sphygmomanometer. Primary/Main outcome of manuscript: SBP, DBP Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Government (This study was sponsored by the Indian Council of Medical research (ICMR), New Delhi under the Short Term Studentship scheme (STS‐2007).) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "using a standardized randomization process, with a random number generator (SPSS 13.0)." refer to Table 1 (completers only) |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 3.4% (2 out of 58) 1 out of 28 in walking group (3.6%) & 1 out of 30 in control group (3.3%) dropouts refer to Table 1 Both ITT and PP done |
Selective reporting (reporting bias) | Low risk | Reported measurement at 8 weeks only 1 analysis |
Other bias | Low risk | No other bias |
Serwe 2011.
Study characteristics | ||
Methods |
Aim: to compare changes in PA between participants assigned to walk daily in accumulated shorter bouts, one continuous session and control group. Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: Yes |
|
Participants |
No. randomised: 60 (20 in IG_LB, 20 in IG_SB, 20 in CG) No. completers: 53 Country: USA Study population: sedentary office women Ethnicity: NR Gender: male: 0% (0/60) Age: mean 37.1 (SD 7.2) in IG_LB, 38.2 (SD 7.3) in IG_SB, 36.3 (SD 8.1) in CG; range 18 to 50 Smokers: NR Hypertension: 0% Mean baseline BP: SBP = 115.1 (SD 10.5) in IG_LB, 117.7 (SD 12.1) in IG_SB, and 120.9 (SD 9.2) in CG; DBP = 73.4 (SD 8.1) in IG_LB, 73.2 (SD 8.7) in IG_SB, 72.7 (SD 7.2) in CG Resting HR = 68.4 (SD 10.4) in IG_LB, 65.8 (SD 6.0) in IG_SB,72.7 (SD 9.5) in CG Inclusion criteria: Quote: “premenopausal healthcare workers between the ages of 18 and 50 years, inactive (i.e., did not engage in ≥30 minutes of daily physical activity either continuous or accumulated on >2 days/week for the past 3 months, per self‐report), free of cardiovascular, pulmonary, neurological, metabolic, or orthopedic disorders that could interfere with safe walking without an assistive device.” Exclusion criteria: participants who averaged >7500 steps/day, postmenopausal, taking medication known to affect blood pressure or being pregnant. |
|
Interventions |
IG_LB: walking (long bout) group:
IG_SB: Walking (short bout) group:
CG: Control group: maintaining normal physical activity levels and diet during the 8‐week intervention period. |
|
Outcomes |
Review outcomes reported: SBP, DBP, resting HR Measurement method: participants measures of resting blood pressure with a mercury sphygmomanometer and stethoscope. Primary/Main outcome of manuscript: physical activity assessed via steps=day obtained by pedometer. Fitness (6MWT) Compliance/Adherence: completed ≥80% of the prescribed walking bouts Adherence to prescribed intensity: Quote: "During week 8 of the walking program, 51.6% of the participants were in the recommended heart rate range of 60%–70% HRR, 38.7% of participants averaging below the recommended range and 9.7% of participants averaging above the recommended heart rate range. Average heart rate from week 4 of the intervention was not significantly different from the week 8 average heart rate (t=‐0.481, p=0.636). Week 4 and week 8 heart rate averages were positively correlated (r=0.564, p=0.015). The LB group followed recommended heart rate ranges with greater consistency than did the SB group (Table 3)." Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Government (This work was supported by funding from a College of Health Sciences Research Award and from a Career Development Award from the National Institute on Aging (K01AG025962)) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "participants deemed eligible were randomized to one of three study groups (control, LB, or SB group) and underwent initial pre‐intervention assessments." but no other details. refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Quote: "All educational materials, assessments, and follow‐up calls were scripted to have each participant receive the same information and treatment." but Unlikely that research personnel and participants blinded |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 11.7% (7 out of 60) Quote: "Of the 60 women enrolled, 53 completed the study" "Of the 7 who did not complete the study, 1 was from the control group" (1/20, 5%), "3 were from the Short Bout group" (3/20, 15%), "and 3 were from the Long Bout group." (3/20, 15%) refer to Table 1 ITT analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 8 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Shenoy 2010.
Study characteristics | ||
Methods |
Aim: to analyse the effects of 8 weeks of aerobic walking using a heart rate monitor (HRM) and pedometer for monitoring exercise intensity on glycaemic outcomes, fasting blood glucose (FBG), cardiovascular fitness and well‐being in type 2 diabetes patients. Design: Parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 40 (20 in IG, 20 in CG) No. completers: 40 Country: India Study population: T2DM patients Ethnicity: NR Gender: male 73% (29/40) Age: mean 53.15 (SD 4.4) in IG; 51.00 (SD 5.4) in CG Smokers: NR Hypertension: excluded if uncontrolled hypertension Mean baseline BP: SBP = 122 (SD 13.8) in IG, 131 (SD 12.7) in CG; DBP = 85.6 (SD 16.1) in IG, 86.0 (SD 7.2) in CG; Resting HR = 82.7 (SD 10.6) in IG; 81.0 (SD 9.7) in CG Inclusion criteria: Quote: “Diagnosed with type 2 diabetes, aged between 40 and 70 years, not taking insulin, without physical limitation, were not enrolled in other physical activity program previously or simultaneously and with the duration of diabetes between 1 and 10 years.” Exclusion criteria: Quote: "Evidence of coronary artery disease, uncontrolled hypertension, advanced retinopathy or neuropathy, severe orthopedic/cardiovascular/respiratory conditions restricting physical activity" |
|
Interventions |
IG: Walking group: a pilot study was conducted to estimate an average steps they could walk at 50% to 60% of maximum heart rate in 30 minutes, counted for 3000 steps for most participants. Participants were informed and trained to be familiar with the intensity and the body work until they can self‐monitor the exercise intensity.A self‐recorded diary log reported steps count and RHR. Participants were asked to maintain their diet habit during the program and advised regarding eating 1 to 2 hours before exercise avoiding hypoglycaemia and maintaining hydration level.
CG: Control group: no training but continued with medication as before and not engaged in any kind of active exercise intervention during the entire study period |
|
Outcomes |
Review outcomes reported: SBP, DBP, resting HR Measurement methods: blood pressure: Sphygmomanorneter‐Lifecare (N and B Medical Products Co.). Heart rate: Polar S410™ heart rate monitor (CE0537, Finland). Primary/Main outcome of manuscript: glycaemic outcomes, fasting blood glucose, cardiovascular fitness parameters and general well‐being Adverse event: NR |
|
Notes |
Trial registration: NCT01293253 Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomly assigned to one of the following two groups by a random lottery approach: the experimental group (group A) or control group (group B)" but no further details |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Unlikely that research personnel and participants blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | No dropout ITT analysis; Start of study: Intervention n = 20, Control n = 20; At follow‐up: Intervention n = 20/20 = 100%, Control n = 20/20 =100% refer to Table 2 |
Selective reporting (reporting bias) | Low risk | Reported measurement at 8 weeks Only 1 analysis ITT analysis |
Other bias | Low risk | No other bias |
Stanton 1996.
Study characteristics | ||
Methods |
Aim: the effect of moderate exercise (three 40‐minute sessions of brisk walking a week for 6 months) on mood state in sedentary, mildly hypertensive volunteers. Design: parallel 4‐group RCT Power/sample size calculation: yes (Thesis 7.1.10 Statistical Power) |
|
Participants |
No. randomised: 102 (53 in IG, 49 in CG); (55 in exercise + salt restriction and 51 in Salt restriction only excluded) No. completers: 89 Country: New Zealand Study population: mild hypertensive adults (recruited through participants’ general practitioners and through advertisements in community newspapers) Ethnicity: European (n = 179, 99%), Pacific Island (n = 1, 1%), Chinese (n = 1, 1%) (from Thesis Table 8.3) Gender: male: 52% (95/181; 181 refers to the overall completers only from four groups) Age: mean 55.2 (SE 1.4) in IG, CG:53.8 (SE 1.5) in CG, range 26 to 71) Smokers: 13/181 (181 refers to the overall completers from four groups; from thesis Table 8.3) Hypertension: 100% essential hypertension Mean baseline BP: (From Thesis Table 8.8) SBP = 142.9 (SE 2.5) in IG, 145.3 (SE 2.6) in CG; DBP = 88.4 (SE 1.4) in IG, 94.0 (SE 1.4) in CG. Inclusion criteria: Quote: “Essential hypertension, aged between 20 and 69 inclusive, a sedentary lifestyle, and being managed by a primary care doctor.” Exclusion criteria: Quote: “Symptomatic coronary heart disease, immobility that restricted walking, current diastolic blood pressure greater than 105 mmHg or a systolic blood pressure greater than 180 mmHg, and currently performing regular moderate activity. This excluded persons who were involved in more than 2 hours of moderate leisure time activity per week other than housework or gardening.” |
|
Interventions |
Extracted from Thesis: IG: Walking (exercise) group (Group B): brisk walking. A weekly diary was used to note health problems experienced during the week as well as compliance with medication.
CG: Control group (Group D) Note: Group A Exercise + salt restriction and Group C Salt restriction excluded |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement methods: blood measured with Hawksley random zero sphygmomanometer Primary/Main outcome of manuscript: mood state (measured at baseline and week‐26) Adverse event: NR |
|
Notes |
Trial registration: Auckland Blood Pressure Control Study Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "Participants were randomised at the time of the baseline interview..." Thesis section 7.1.3 Randomisation Balance baseline characteristics in Thesis Table 8.8 |
Allocation concealment (selection bias) | Low risk | Quote: "Participants were randomised at the time of the baseline interview..." Thesis section 7.1.3 Randomisation Balance baseline characteristics in Thesis Table 8.8 |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | Quote: "Therefore the doctors were unblinded ..." Thesis 7.1.3 Randomisation "The participants in the four intervention sub‐groups were thus blind to each other's intervention." p.152 |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes BP measured blindly |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 12.7% (13 out of 102) 181 (87%) completed the study, 177 (85%) completed the primary outcome measurement Group B. Exercise only: 46/53, 87% completed Group D. Control: 43/49, 88% completed refer to thesis and table I, II PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 26 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Stutzman 2010.
Study characteristics | ||
Methods |
Aim: to measure the effects of a 16‐week low‐intensity walking program in healthy, normal weight, and overweight/obese pregnant women on BP, heart rate variability (HRV), and BRS. Design: Parallel 2‐group RCT Power/sample size calculation: Yes |
|
Participants |
No. randomised: 25 (2 excluded & 1 withdraw after randomisation; 11 in IG [normal = 5, overweight = 6], 11 in CG [normal = 5, overweight = 6]) No. completers: 22 Country: Canada Study population: healthy women who were 20 weeks pregnant Ethnicity: NR Gender: male 0% (0/22) Age: mean 30.4 (SD 4.2) in IG_norm, 28.8 (SD 6.9) in IG_overweight; 25.8 (SD 3.0) in CG_norm, 26.2 (SD 5.6) in CG_overweight, ranged between 20 and 69 inclusive Smokers: non‐smoker during pregnancy Hypertension: 0% Mean baseline BP: SBP = 111 (SD 12) in IG_norm, 114 (SD 14) in IG_overweight; 109 (SD 7) in CG_norm, 107 (SD 8) in CG_overweight, DBP = 76 (SD 11) in IG_norm, 75 (SD 10) in IG_overweight; 74 (SD 4) in CG_norm, 72 (SD 4) in CG_overweight Inclusion criteria: healthy pregnant women at 20 (+ 2) weeks gestational age met the inclusion criteria of: (a) singleton pregnancy, (b) sedentary lifestyle (defined as ≤ 2 sessions of aerobic exercise per week, and (c) approval of the attending physician. Exclusion criteria: "(a) alcohol or drug dependence, (b) hypertension, diabetes, or comorbid medical conditions, or reasons that contraindicated exercise, (c) cigarette smoking during pregnancy, and (d) medical reasons or treatments that would confound the measurement of HRV and BRS." |
|
Interventions |
1. Walking group: IG_overweight: overweight, IG_norm: Normal weight Walking groups received verbal and written instructions for a 16‐week, progressive, low‐intensity walking program, an walking log, and the Borg 15‐point (6 to 20) RPE scale. Single bout. Activity log was collected at completion of the 16‐week period, and biweekly call or email from the researcher was provided to answer any questions and to assess/promote compliance.
2. Control group: CG_overweight : overweight CG_norm: normal weight An activity log to record daily physical activity was given and collected at completion of the 16‐week period. Biweekly call or email from the researcher was provided to answer any questions and to assess/promote compliance. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: maternal BP (arm) and HR were measured using a BpTRU (Model BPM‐300, VSM MedTech Ltd., Coquitlam, BC, Canada) BP monitor. Primary/Main outcome of manuscript: BP pressure, HRV, and baroreflex sensitivity (BRS) Compliance/Adherence: at least three exercise sessions per week. Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: None |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | By minimization method: quote: "Participants were assigned to one of four groups based on exercise group and BMI category. The first two subjects within each weight group, normal or overweight/obese, were randomized by coin toss to either an exercise (walking) group or a non‐exercise control group. Subsequent participants were then assigned to either the exercise (walking) group (n=11) or the non‐exercise control group (n=11) based on BMI so that the weight categories were equally represented in each exercise group." refer to Table 1 |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Unlikely that research personnel and participants blinded |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 12% (3 out of 25) refer to table 1, 2 PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 16 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Tudor‐Locke 2004.
Study characteristics | ||
Methods |
Aim: examining the effectiveness of the FSP (First Step Program) with a larger sample and a control group, also examining whether increased PA (Physical activity) was related to improvements in cardiovascular health, glycaemic control and lipid profiles. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised:60 (30 in IG, 30 in CG) No. completers: 47 Country: Canada Study population: sedentary overweight T2DM patients Ethnicity: NR Gender: male 55% (26/47) Age: range 40 to 60; mean 52.7 (SD 5.2); 52.8 (SD 5.7) in IG, 52.5 (SD 4.8) in CG Smokers: 68% quote: "17% of the participants smoked cigarettes regularly, 13% smoked occasionally, 38% were former smokers " Hypertension: quote: "55% of total sample" Mean baseline BP: SBP = 138.2 (SD 17.2) in IG, 130.1 (SD 15.9) in CG; DBP = 81.5 (SD 9.5) in IG, 78.9 (SD 8.0) in CG; Resting HR = 76.4 (SD 11.8) in IG, 77.0 (SD 9.7) in CG. (n = 47 completers) Inclusion criteria: “(1) aged 40 to 60 years; (2) minimum 3 months post diagnosis of type II diabetes; (3) treated by diet alone or by oral hypoglycaemic medications (not insulin); (4) no PA limitations or documented heart conditions; (5) not currently in an exercise program; and (6) < 8800 steps/day (defined as insufficiently active determined via a 3‐day, blinded pedometer protocol)” Exclusion criteria: NR |
|
Interventions |
IG: walking (FSP) group: Four weekly group meetings were held during the adoption phase (initial 4 weeks), participants were given pedometers and the program manual containing goal‐setting and problem‐solving exercises, as well as calendars for self‐monitoring steps/day. During the adherence phase (subsequent 12 weeks), participants were asked to use their pedometers and calendars for goal‐setting and self‐monitoring. No specific advise concerning diet or glycerol control was given. Thanking postcards were mailed at 6 and at 10 weeks. Pedometers and calendars were returned at the 16‐week assessment. Accumulated walking steps per day were calculated.
CG: Control group: wait‐list control group |
|
Outcomes |
Review outcomes reported: resting HR, SBP, DBP Measurement method: resting HR and BP were measured by a registered nurse. (method not mentioned) Primary/Main outcome of manuscript: daily PA assessed by pedometer (steps/day). Adverse event: quote: "No FSP participants reported having noteworthy musculoskeletal pain or problems during the intervention." |
|
Notes |
Trial registration: NR note: adoption phase (week 1 to 4), adherence phase (week 5 to 16) Funding sources: private sector (This project was supported by a grant from the Canadian Diabetes Association. Additional support for the development of First Step Program educational resources was provided by a Canadian Diabetes Association Award supported by Bayer Corporation.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "Those individuals who agreed to participate were randomly assigned to either the First Step Program (FSP) group or the wait‐list control group (CONTROL)" but no further details about randomisation. |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Blinding of participants and personnel not possible |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 21.7% in 16‐week follow‐up (13 out of 60), 6 as 20.0% in TG and 7 as 23.3% in CG Dropout 36.7% in 24‐week follow‐up (22 out of 60), 14 as 46.7% in TG and 8 as 26.7% in CG 47 completers analysis only 47/60 = 78.3% randomised (baseline/outcome) PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 16 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Tudor‐Locke 2020.
Study characteristics | ||
Methods |
Aim: to evaluate these potential effects in sedentary/low‐active postmenopausal women randomised to a usual behaviour control group or one of the 2 lifestyle step‐counting walking interventions (basic vs enhanced; differing only on their discrepant emphases on physical activity intensity) Design: parallel 3‐group RCT (50:50:20) Power/sample size calculation: yes |
|
Participants |
No. randomised: 120 (50 in IG1, 50 in IG2, 20 in CG) No. completers: 115 Country: USA Study population: non‐exercising, overweight/obese and postmenopausal women (45 to 75 years) Ethnicity: white 75.5% in IG1, 76.6% in IG2, and 52.6% in CG. Black 22.5% in IG1, 19.2% in IG2, and 47.4% in CG. Other 2.0% in IG1, 4.3% in IG2, and 0% in CG Gender: male 0% Age: mean 62.6 (SD 6.5) in IG1, 61.7 (SD 6.2) in IG2, 58.4 (SD 5.8) in CG Smokers: yes (0% in IG1, 6.4% in IG2, and 0% in CG) Hypertension: yes (26.5% in IG1, 12.8% in IG2, and 15.8% in CG.) Mean baseline BP: SBP = 127.6 (SD 16.6) in IG1, 125.2 (SD 12.7) in IG2, 122.5 (SD 13.9) in CG. DBP = 78.7 (SD 8.0) in IG1,75.5 (SD 7.6) in IG2, 77.3 (SD 7.3) in CG Inclusion criteria:
Exclusion criteria: significant cardiovascular disease/disorders (including diabetes) or other significant medical conditions considered life‐threatening, potentially interfering with or being aggravated by exercise, donating blood before 6 weeks of study, losing ≥ 20 kg in the previous year of study, having been hospitalised for mental illness within the previous 5 years of study, or planning to be out of the area for more than 3 weeks over the next 3 months after study commenced. |
|
Interventions | All intervention participants monitored their daily step counts and walking behaviour using the NL‐1000 accelerometer (New Lifestyle Inc, Lee's Summit, MO) and calendars (to record steps per day). Steps per day and active minutes derived from the NL‐1000 are reported as process variables for both intervention arms, indicative of program adherence. IG1: Basic walking group: In addition to the walking step goal, participants also attended weekly meetings to engage in intervention‐supported behavioural feedback, reflection, and goal setting for the subsequent week.
IG2: Enhanced walking group: Participants were instructed on how to count their cadence while walking a set time and experience what walking at a cadence of at least 100 steps per minute felt like.
CG: Control group: continued with normal routines and lifestyle, and participated to the baseline and 3‐month assessments. |
|
Outcomes |
Review outcomes reported: SBP and DBP Measurement method: NR, outcomes were measured at baseline and after 12‐week intervention. Primary/Main outcome of manuscript: BP, anthropometric measurements (height, weight, and waist circumference), fasting blood glucose and insulin, flow‐mediated dilation and gait speed. Compliance/Adherence: defined by average weekly values for steps per day and/or active minutes. 96.0% (9,602/10,000*100%) in basic walking group and 100.0% (10,508/10,000*100%) in enhanced walking group. Adverse event: 1 dropout due to knee pain, in Consort chart |
|
Notes |
Trial registration: ClinicalTrials.gov (NCT01519583) Funding sources: American Heart Association and National Institutes of Health (center grants: P30 DK072476 and U54 GM104940) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "Enrolled participants were randomly assigned" on the basis of "computer‐generated program". A biostatistician oversees the computer‐generated program that were used to randomly assign participants to groups. |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | The Principal Investigator were blinded to participants' randomised allocation status but participants were unlikely to be blinded to their allocation status. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | The assessment staff were blinded to participants' randomised allocation status. |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 4.2% (5 out of 120 dropouts) 4 out of 100 (4.0%) in IG, 1 out of 20 (5%) in CG refer to Table 1 PP analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 3 months Only 1 analysis |
Other bias | Low risk | No other bias |
Tully 2005.
Study characteristics | ||
Methods |
Aim: to examine the effects of 30‐minute self‐paced, non‐supervised, brisk walking, 5 days per week on traditional cardiovascular risk factors (BP, BMI, cholesterol), Framingham risk score, and fitness in people aged 50–65 years. Design: parallel 2‐group RCT (2:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 31 (21 in IG, 10 in CG) No. completers: 26 Country: UK Study population: sedentary middle‐aged adults from urban GP Ethnicity: NR Gender: male 42% (13/31) Age: mean 55.52 (SD 3.99) in IG; 57.75 (SD 4.64) in CG; range 50 to 65. Smokers: NR Hypertension: no quote:"severe, uncontrolled hypertension" Mean Baseline BP: SBP = 129.94 (SD 8.61) in IG,125.78 (SD 14.02) in CG; DBP = 78.47 (SD 4.16) in IG, 77.22 (SD 7.74) in CG Inclusion criteria: quote:“Individuals aged between 50 and 65 years, with no history of (1) coronary heart disease, (2) peripheral vascular disease, (3) musculoskeletal disease, (4) pulmonary disease, (5) diabetes mellitus, or (6) severe, uncontrolled hypertension.” Exclusion criteria: Quote:“Individuals who were currently prescribed lipid lowering medication, had a body mass index (BMI) over 35 kg/m2, or blood pressure (BP) greater than 140/90 mmHg were excluded. Females who were postmenopausal (no menstrual period in the last 12 months) and had begun taking hormone replacement therapy in the previous 3 months were excluded.” |
|
Interventions |
IG: Brisk walking group:
CG: Control group: participants were asked to maintain their habitual lifestyle and not change their activity. They were also given a diary and asked to record any exercise they performed over the 12 weeks. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: blood pressure was measured using a standardised auscultation procedure Primary/Main outcome of manuscript: body composition, blood pressure, functional capacity, blood lipids, and Framingham risk score. Compliance/Adherence: defined by expressing the number of minutes walked as a percentage of the number of minutes prescribed by the protocol Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote:"using computer‐generated random numbers on a 2:1 basis. " |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Blinding of participants and personnel not possible |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Quote:"Baseline anthropometric and functional capacity measurements were made by observers blinded to individual's group allocation." |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Dropout 16.1% (5 out of 31) 4 out of 21 (19%) in IG, 1 out of 10 (10%) in CG dropouts based on 26 completers analysis only 26 out of 31 randomised (baseline/outcome) PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Tully 2007a.
Study characteristics | ||
Methods |
Aim: to determine the effects of unsupervised home‐based walking at and below the current recommended level of exercise on cardiovascular risk factors and functional capacity in healthy sedentary adults, using pedometers for self‐monitoring. Design: parallel 3‐group RCT (2:2:1) Power/sample size calculation: Yes |
|
Participants |
No. randomised: 106 (44 in IG1_3D, 42 in IG2_5D, 20 in CG) No. completers: 93 Country: UK Study population: sedentary middle‐aged adults (civil servants) (aged 40 to 61) (email invitation to employees from Northern Ireland Civil Service <NICS> departments.) Ethnicity: NR Gender: male 39.6% (42/106) Age: mean 47.8 (SD 5.97) in IG1_3D, 46.37 (SD 4.76) in IG2_5D, 49.05 (SD 6.31) in CG Smokers: NR Hypertension: 0% Mean baseline BP: SBP = 134 (SD 15) in IG1_3D, 133 (SD 15) in IG2_5D, 128 (SD 15) in CG; DBP = 87 (SD 11) in IG1_3D, 87 (SD 11) in IG2_5D, 83 (SD 10) in CG HR = 69 (SD 12) in IG1_3D, 72 (SD 10) in IG2_5D, 75 (SD 11) in CG Inclusion criteria: aged 40 and order, quote:“sedentary (defined by self‐reported as not having undertaken more than one session of moderate intensity exercise each week over the past six months), blood pressure less than 140/90 mmHg; no history of musculoskeletal, pulmonary, or cardiac disease that would limit the ability to exercise; and taking no drugs with effects on lipid metabolism” Exclusion criteria: NR |
|
Interventions |
IG_3D: Walking (3‐day) group
IG_5D: walking (5‐day) group
CG: Control group: participants were asked to maintain their current lifestyle for 12 weeks, and a self‐reported diary recording any exercise taken above what they would normally do. |
|
Outcomes |
Review outcomes reported: SBP, DBP,HR Measurement method: arterial blood pressure and heart rate were measured in the seated position after three minutes of rest, using a validated automatic sphygmomanometer (Omron Devices M5I, USA) Primary/Main outcome of manuscript: BP, serum lipids, BMI, waist:hip ratio, and functional capacity Compliance/Adherence: adherence was similar within the three day (89%) and the five day (83%) groups Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Government(The researcher (MT) was supported by funding from the Department of Education and Learning NI.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote:"using computer generated random numbers" refer to Table 1 |
Allocation concealment (selection bias) | Low risk | Quote:"The allocation was determined at a remote location..." |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Blinding of participants and personnel is not possible. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Quote:"Baseline and 12 week samples were analysed at the same time, with blinding to the group allocation." |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 12.3% (13 out of 106) 5 out of 44 (11.4%) in IG3d, 6 out of 42 (14.3%) in IG5d, 2 out of 20 (10%) in CG dropouts refer to Figure 1 and Table 2 ITT analysis: quote:"Data were analysed using an intention to treat procedure, substituting baseline data for those at 12 weeks for the participants who withdrew during the study." |
Selective reporting (reporting bias) | Low risk | Reported measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Tully 2011.
Study characteristics | ||
Methods |
Aim: to determine the effects of taking 10,000 steps per day on fitness and cardiovascular risk factors in sedentary university students. Design: parallel 2‐group RCT (2:1) Power/sample size calculation: Yes |
|
Participants |
No. randomised: 12 (8 in IG, 4 in CG) No. completers: 12 Country:UK Study population: sedentary Queen’s University Belfast students Ethnicity: NR Gender: male 16.7% (2/12) Age: mean 21.16 (SD 6.17) Smokers: NR Hypertension: NR Mean baseline BP: SBP = 120 (SD 15.62) in IG, 131.67 (SD 11.85) in CG; DBP = 79.00 (SD 8.23) in IG, 86.33 (SD 8.50) in CG Inclusion criteria: sedentary students who were willing to participate in a walking program. Exclusion criteria: any known disease that would prevent from taking regular exercise. |
|
Interventions | All intervention and control group participants were asked to complete weekly diaries recording the number of steps they took per day, and returned to the researcher biweekly. The researcher would post new ones and phone or email participants to resolve any difficulties. IG: walking (10,000 step) group:
CG: Control group: wearing pedometer without modifying any aspect of lifestyle. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method:BP and HR were using a Digital Sphygmomanometer (Omron M5‐I, Japan). Primary/Main outcome of manuscript: BP, exercise capacity, body composition. Compliance/Adherence: measured as the number of days of data that was returned on the diaries as a percentage of the total number of days in the program Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Government (Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, Research and Development Office for the Northern Ireland Health and Social Services and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote:"using computer generated random numbers..." refer to Table 1 (small sample size) |
Allocation concealment (selection bias) | Unclear risk | Quote:"using computer generated random numbers by a researcher not involved in the day‐to‐day running of the trial." |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | No information |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Quote:"Measurements were made at baseline (pre‐intervention) and after 6 weeks (postintervention) in the university Physical Education Centre by the same researcher, who was blinded to the group allocation." |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Quote:"All participants completed the trial." "All participants in the 10,000 step group met their daily goal and significantly increased their daily step count over the course of the study (Table 2)." ITT analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 6 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Venturelli 2011.
Study characteristics | ||
Methods |
Aim: the feasibility of an institution‐based walking program carried out together with family member caregivers could reduce the functional, cognitive, and physical decline of nursing home residents in the later stages of Alzheimer disease. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: no |
|
Participants |
No. randomised: 24 (12 in IG, 12 in CG) No. completers: 21 Country: Italy Study population: late stage Alzheimer's disease patients (65+) in nursing home Ethnicity: NR Gender: male 0% (based on the inclusion criteria, 35 participants (5 men and 30 women) were selected; three caregivers declined and were excluded from the study; a multidisciplinary diagnostic evaluation team reviewed the clinical files of the 32 selected residents and excluded 7 (5 men and 2 women) because of severe heart disease, and another 1 due to reduced oxygen saturation during the walking test. Therefore all 24 participants are women.) Age: mean 83 (SD 6) in IG, 85 (SD 5) in CG. Smokers: NR Hypertension: 16.7% (4/24) Mean baseline BP: SBP = 132 (SD 10) in IG; 133 (SD 6) in CG; DBP = 84 (SD 5) in IG; 84 (SD 3) in CG. Inclusion criteria: quote:“65 years of age or older, dependent on assistance in 2 or more personal ADLs according to the Barthel index, Mini‐Mental State Examination (MMSE) maximum score of 15 and minimum of 5, and absence of mobility limitations, minimum score of 23, according to the Performance Oriented Mobility Assessment (POMA) index, and constant oxygen saturation during walking (SpO2 > 85%).” Exclusion criteria: severe heart disease and reduced oxygen saturation during the walking test. |
|
Interventions |
IG: Walking group: Single bout walking alone the hallway in the Alzheimer’s care unit (ACU). Cookie were offered after walking as positive psychological reinforcement. A walking log recording session times and number of laps was checked before and after each visit.
CG: Control group: routine care. Nursing home residents in the control group participated in the daily organized activities like bingo, patchwork sewing, and music therapy. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method:DBP and SBP were measured using a standard sphygmomanometer device (Heine G7, Germany) Primary/Main outcome of manuscript: cognitive function (MMSE), Barthel Index Adverse event: 0 Quote: "No adverse events related to the exercise program were observed during the experiment period nor did any event influence participation in the sessions. One woman in the walking group left the study after 6 weeks due to a serious medical condition (stroke); 2 people in the control group (reduced from 12 to 10 participants) also left the program because of serious health problems (heart failure and stroke)." |
|
Notes |
Trial registration: NR Funding sources: none |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "using StatPlus for Macintosh, version 2009 (AnalystSoft Inc, Alexandria, Virginia)" refer to Table 1 and 2 |
Allocation concealment (selection bias) | Low risk | Quote:"...The head nurse of the ACU (not involved in the residents' assessments) did the participants' randomization using StatPlus for Macintosh, version 2009 (AnalystSoft Inc, Alexandria, Virginia)." |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | Quote:"...the members of the research team did not know to which group each participant had been assigned." "No‐one on the research team was present during the walking exercise (afternoon); however, the head nurse of the ACU was always present. Before each intervention she checked the participants' health status and their ability to walk that day (exclusion criteria were fever, constipation treatment, low blood pressure, or other serious medical conditions)." |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Quote: "an evaluation was done before and after the experiment period in a blind way and the members of the research team did not know to which group each participant had been assigned.);" |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 12.5% (3 out of 24) 1 as 8.3% in TG and 2 as 16.7% in CG Quote: "The walking group had a 93.4% + 3.2% presence at the 96 scheduled training sessions (90 + 2 training days); individual numbers of visits during the 24 weeks of the program are shown in Figure 2, panel B."‐ " PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 24 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Wallis 2017.
Study characteristics | ||
Methods |
Aim: to evaluate the effect of a dosed walking program on knee pain for patients with severe knee osteoarthritis (OA). Design: parallel 2‐group RCT (1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised:46 (23 in IG, 23 in CG) No. completers: 39 Country: Australia Study population: severe OA patients rated as grade III or IV affecting at least one of the tibiofemoral compartments (50+) Ethnicity: NR Gender: male 56.5% (26/46) Age: mean 68 (SD 8) in IG; 67 (SD 7) in CG Smokers: 12 (26%) were current smokers Hypertension: 60.9% (28/46) Mean baseline BP: SBP = 142 (SD 10) in IG, 138 (SD 24) in CG; DBP = 82 (SD 10) in IG, 81 (SD 11.1) in CG Inclusion criteria: aged at least 50 years and living independently in the community; diagnosed with severe knee OA rated as grade III or IV affecting at least one of the tibiofemoral compartments determined radiographically; a cardiovascular risk profile with 2 total risk factors using stage 2 of the Adult Exercise Screening Tool; able to participate safely in the moderate‐intensity physical activity trial using stage 1 of the Adult Exercise Screening Tool; able to communicate in English. Exclusion criteria: lived in supported accommodation such as a nursing home; reported daily resting level of pain to be 9 or 10 on a 0 (no pain) to 10 (worst possible pain) Numerical Pain Rating Scale as this level of pain may be indicative of a more serious pathology; had high levels of psychological distress as measured by the Kessler 10 questionnaire with a K10 score >29; had a cognitive impairment measured by the Short Portable Mental Status Questionnaire with a score of 7 or less; had a systemic arthritic condition such as rheumatoid arthritis; had a neurological condition that affected walking; had knee surgery or intra‐articular corticosteroid injection within past six months; had used oral corticosteroids within 4 weeks. |
|
Interventions |
IG: walking group: No formal instructions on warming up or stretching were provided. Participants continued taking their usual medications and other non‐surgical treatments to manage their knee osteoarthritis and used normal assistive devices such as a cane.
CG: Control group: usual care. Participants and their health professionals were advised with written information not to include a prescription of physical activity in the 12‐week study period. |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: resting SBP and DBP (mmHg) was measured using an electronic blood pressure machine in sitting. Primary/Main outcome of manuscript: average knee pain Compliance/Adherence: participants completed at least 9 out of 12 of the weekly dose of 70 minutes. Adverse event: quote: "Three participants in the walking group had minor adverse events; two reported increased knee pain and were not able to continue the program after week 1, and one tripped during a supervised walking session and had to seek medical management due to knee pain. This participant continued the program following 2 days of rest. There were no serious adverse events." 3 knee pain were defined as minor adverse events as a short‐term exacerbation of a knee pain levels up to a week after the sessions, trips or falls without any serious sequelae or hospital admission. |
|
Notes |
Trial registration: yes (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367588) Funding sources: private sector (The research received $24,704 from La Trobe University's research focus area on Sport, Exercise and Rehabilitation.) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote:"using a permuted block design with a computer random number generator " refer to Table 1 |
Allocation concealment (selection bias) | Low risk | Quote:"Participants were randomly assigned using a permuted block design with a computer random number generator using sealed opaque envelopes prepared by an independent researcher with no role in recruitment or assessment." refer to Table 1 |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | Quote:"Intervention and control participants were non‐blinded to their group allocation" but possibly all participants were treated independently by their physicians who would not have knowledge of group allocation. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Quote:"The primary and secondary outcomes were collected at baseline and post‐intervention (week 13) by an assessor blinded to group allocation." |
Incomplete outcome data (attrition bias) All outcomes | Low risk | 1 out of 23 withdrew after randomisation Dropout 15.2% (7/46) 7 out of 23 in IG (30.4%) , 0 out of 23 in CG dropouts refer to Fig. 1 Both ITT and PP analysis done |
Selective reporting (reporting bias) | Low risk | Reported measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Wang (王正斌) 2014.
Study characteristics | ||
Methods |
Aim: to explore the effects of walking exercise on glycometabolism, dynamic blood pressure and the quality of life of patients with both hypertension and type 2 diabetes on the basis of conventional drug treatment. Design: Parallel 2‐group RCT (1:1) Power/sample size calculation: no |
|
Participants |
No. randomised: 62 (32 in IG, 30 in CG) No. completers: 62 Country: China Study population: cardiovascular clinic or hospitalised patients with both hypertension and type 2 diabetes (medicated) Ethnicity: Chinese Gender: male 62.9% ((20+19)/62) Age: mean 55.8 (SD 9.3) in IG; 57.4 (SD 8.9) in CG Smokers: No Hypertension: 100% Mean baseline BP: SBP = 143 (SD 11) in IG, 141 (SD 14) in CG; DBP = 81 (SD11) in IG, 88 (SD 9) in CG Inclusion criteria:
Exclusion criteria:
|
|
Interventions |
IG: walking exercise group: Participants had to walk more than 10,000 steps per day regardless of duration or intensity, but should avoid arduous exercise that could result in fatigue in the next day. Diabetes reminder with personal information and sugar products or chocolate should be carried at all time. When hypoglycaemic syndrome such as dizziness, palpitation, and hunger was occurred, participants should suspend walking and have some sugar. Another situation to suspend walking was when blood pressure was elevated, and participants should undergo medical treatment immediately. When chest tightness and asthma were happened during walking, participants should take rest and decrease walking intensity in accordance with their health situation.
CG: Control group: conventional drug treatment and community care |
|
Outcomes |
Review outcomes reported: dynamic blood pressure parameters Measurement method: blood pressure was taken by CB2300A (Wusih) ambulatory blood pressure monitor before and after 3‐month intervention. Blood pressure monitor cuff belt was tightened on right upper arm, measure interval was 20 minutes in the daytime (0600 to 2200) and 30 minutes at night (2201 to 0559). On measurement day, there was no activity restriction but participants should record any activity of that day and avoid smoke as well as alcohol beverage. Effective data of SBP 70 to 220 mmHg, DBP 40 to 130 mmHg, and pulse pressure 20 to 110mmHg were recorded, otherwise were taken as ineffective and abandoned. Primary/Main outcome of manuscript: fasting plasma glucose, glycated haemoglobin‐A1C, fasting insulin, the homeostasis model of assessment for insulin resistance index, the homeostasis model of assessment for insulin sensitivity, dynamic blood pressure parameters and quality of life. Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | "Quote:randomly divided" using "random number table" but no detail reported |
Allocation concealment (selection bias) | Unclear risk | NR |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 0% (0/62) 32 completers in exercise group, 30 completers in control group refer to table 1 to 3 ITT analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 3 months Only 1 analysis |
Other bias | Low risk | No other bias |
Wang (王聰) 2016.
Study characteristics | ||
Methods |
Aim: to discuss the influences of 8 weeks of walking and health education on blood pressure.. Design: parallel 4‐group RCT (1:1:1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised: 61 (31 in IG, 30 in CG) (31 in Health Education only and 32 in Walking+Health Education groups excluded) No. completers: 48 Country: China Study population: hypertensive patients (from Datong Coal Mine Group central factory) Ethnicity: Chinese Gender: male 64.6% ((21+10)/48) Age: Range 18 to 64; mean 49.61 (SD 4.91) in IG, 48.50 (SD 6.31) in CG. Smokers: yes (44.5% in IG; 46.6% in CG) Hypertension: 100% Mean baseline BP: SBP = 134.83 (SD 17.43) in IG, 143.97 (SD 20.91) in CG. DBP = 82.39 (SD 12.94) in IG, 87.63 (SD 10.48) in CG Inclusion criteria:
Exclusion criteria:
|
|
Interventions |
IG: walking group:
CG: Control group: no intervention control Note: a total of four groups and two groups excluded: 1.walking + health education on exercise and diet 2.health education on exercise and diet only |
|
Outcomes |
Review outcomes reported: BP Measurement method: participants were sitting and resting for at least 10 minutes, and Omron HEM‐1000 electronic sphygmograph was used to measure twice with interval of 1 to 2 minutes. The average of the two measurement was taken for analysis, but if the difference of the two measurement was more than 5mmHg, whether SBP or DBP, the third measurement was taken and averaged with the two for analysis. Primary/Main outcome of manuscript:BP Compliance/Adherence: adherence rate to 42 walking session: 76.9% (mean 32.28 (SD 7.97)) in walking IG and 87.6% (mean 36.78 (SD 5.79)) in walking plus health education IG. Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote:"randomly divided" but no detail reported |
Allocation concealment (selection bias) | Unclear risk | NR |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | High risk | Dropout 21.31%, 13/61: 13/31 in walking group (41.94%), 0 (30/30) in control group dropouts 18 out of 31 completers in walking group, 30 completer in control group refer to table 1, 2 PP analysis High risk due to high attrition rate in walking group |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 8 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Wang 2014.
Study characteristics | ||
Methods |
Aim: to explore the overall effects of a supervised endurance‐exercise training program on the risk components of MS, serum IL‐6 levels, and exercise capacity of postmenopausal women Design: parallel 2‐group RCT (1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised:53 (7 withdrawn, resulting23 in IG, 23 in CG) No. completers: 46 Country: Taiwan Study population: sedentary postmenopausal women from general population (aged 45 to 70) Ethnicity: Chinese Gender: male 0% Age: mean 56.9 (SD6.2) in IG, 55.1 (SD7.8) in CG, range 45 to 70 (46 completers only) Smokers: 0% Hypertension: 0% Mean baseline BP: SBP =124.6 (SD 9.2) in IG, 127 (SD 10.1) in CG; DBP = 76.8 (SD8.1) in IG, 79 (SD 9.4) in CG (46 completers only) Inclusion criteria:
Exclusion criteria:
|
|
Interventions |
IG: walking group: Treadmill walking 3 times/week for 12 weeks in a laboratory near the metabolic and cardiovascular outpatient department of the study hospital. Exercise training began with 10 min of warming up and ended with 10 minutes of cooling down.
CG: Control group: maintain customary lifestyle |
|
Outcomes |
Review outcomes reported: SBP, DBP Measurement method: BP was measured using a calibrated automated oscillometric blood‐pressure monitor (Datascope, Mahwah, NJ, USA). Primary/Main outcome of manuscript: exercise capacity, interleukin‐6 level Compliance/Adherence: dividing the number of attendances by the total of 36 training sessions Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: none |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | refer to Table 1, 46 completers only Quote: "No statistically significant differences were observed in basic characteristics or in the data on the study variables between the exercise and control groups at baseline (Table 1)." |
Allocation concealment (selection bias) | Unclear risk | No information refer to Table 1, 46 completers only |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Quote: "The individual‐based exercise training program was supervised by one of our research staff members." Not sure if the research staff had other role in the trial. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes Quote: "Study variables were measured by one of the members of our research staff, who was unaware of the group allocation of the participants." |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 7 out of 53 (13.2%). Quote: "Those who withdrew said they were too busy (n=3),had to care for family members (n=3), or had fallen ill (n=1)." "The adherence rate of exercise participants was calculated by dividing the number of attendances by the total of 36 training sessions; the mean adherence rate was measured to be 98% in the exercise group." PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Westhoff 2007.
Study characteristics | ||
Methods |
Aim: the impact of pulse pressure on the cardiovascular effects of a 12‐week aerobic physical exercise program in elderly hypertensives. Design: Parallel 2‐group RCT (1:1) Power/sample size calculation: yes |
|
Participants |
No. randomised: 54 (27 in IG, 27 in CG) No. completers: 51 Country: Germany Study population: sedentary Isolated Systolic Hypertension elderly patient (aged 60+) (hypertensive outpatient clinic) Ethnicity: NR Gender: male 48% (26/54) Age: mean 67.2 (SD 4.8) in IG, 68.9 (SD 5.2) in CG. Smokers: 7.4% (4/54) Hypertension: 100% Mean baseline BP: systolic ABP = 136.6 (SD 12.7) in IG, 134.8 (SD 11) in CG; diastolic ABP = 76.3 (SD 7.3) in IG, 72.8 (SD 7.2) in CG. Inclusion criteria: Quote: "current antihypertensive treatment, diastolic ambulatory blood pressure (ABP) ≤ 90 mmHg, age of ≥ 60 years." Exclusion criteria: Quote: "regular engagement in physical exercise training in the past 12 weeks prior to inclusion in the study, symptomatic peripheral arterial occlusive disease, aortic insufficiency or stenosis >stage I, hypertrophic obstructive cardiomyopathy, congestive heart failure (>NYHA II), uncontrolled cardiac arrhythmia with haemodynamic relevance, systolic office BP≥180 mmHg, signs of acute ischaemia in exercise ECG, change of antihypertensive medication in the past 6 weeks prior to inclusion in the study or during follow‐up period" |
|
Interventions |
IG: walking (exercise) group: treadmill walking. During the first week, training consisted of 5 workloads of 3 minutes; between workloads, patients walked with half‐speed for 3 minutes. Exercise duration was gradually increased and reached 30, 32, and 36 minutes in the sixth and further weeks and was carried out without interruption. As exercise heart rate decreased by more than 5/minute as a result of training adaptation, treadmill speed was increased by 0.5 km/hour or elevation was increased by 3% to maintain training intensity.
CG: Control group: sedentary activity and usual care of accurate drug intake. |
|
Outcomes |
Review outcomes reported: 24‐hour ABP, exercise BP Measurement method: 24‐Hour ABP monitoring was performed using Spacelabs 90207 monitors (Spacelabs, Redmond, Wash., USA). Primary/Main outcome of manuscript: 24‐hour ABP, pulse pressure, arterial compliance and endothelial function Adverse event: Quote:"One patient stopped within the first session due to knee pain, 1 patient discontinued the program after 4 weeks due to acute cholecystitis, and 1 patient had a change of medication within the observation period." Quote: "In the control group, 4 patients denied to redo the treadmill stress test. In these cases, the last observations of the treadmill test were carried forward." |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "According to these criteria, 54 patients (27 male, 27 female) were enrolled and randomized to exercise and control group by lot ( fig. 1 )." but no other details about randomisation. Characteristics of study groups are identical (Table 1) |
Allocation concealment (selection bias) | Unclear risk | No information |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Blinding of participants and personnel not possible Quote: "During training, patients were continuously supervised by a physician." Not sure if there was other co‐intervention provided in the training process. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Objective outcomes: ambulatory blood pressure monitoring Quote: "The American College of Sports Medicine criticizes that in most studies on endurance training, BP was not measured by a blinded observer or an automated device and emphasizes the need for studies using 24‐hour ABP monitoring [28]. We complied with this recommendation” Quote: "The computer‐assisted calculation of vessel diameters was conducted in a blinded fashion as published previously [21, 22]” |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 5.6% (3 out of 54) 3/27=11.1% in exercise group and 0/27 = 0% in control group PP analysis |
Selective reporting (reporting bias) | Low risk | Reported measurement at 12 weeks Only 1 analysis |
Other bias | Low risk | No other bias |
Xiao (肖卉) 2010.
Study characteristics | ||
Methods |
Aim: to investigate the effects of exercise on blood glucose and blood pressure in elderly diabetes patients. Design: parallel 2‐group RCT (1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 124 (62 in IG, 62 in CG) No. completers: 112 Country: China Study population: elderly diabetes residents Ethnicity: Chinese Gender: male 32.1% ((17+19)/112) Age: mean 65.84 (SD 6.32) in IG, 65.82 (SD 6.39) in CG. Smokers: NR Hypertension: NR Mean baseline BP: SBP = 141.82 (SD 16.23) in IG, 141.05 (SD 20.06) in CG. DBP = 82.91 (SD 9.94) in IG, 84.04 (SD 10.15) in CG. Inclusion criteria:
Exclusion criteria:
|
|
Interventions |
IG: walking group:
CG: Control group: usual care and lifestyle. |
|
Outcomes |
Review outcomes reported: BP Measurement method: before and after intervention. Primary/Main outcome of manuscript: total physical activity metabolic equivalent, fasting serum glucose, 2‐hour postprandial blood glucose, BP. Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomly divided" using "random table" but no detail reported |
Allocation concealment (selection bias) | Unclear risk | NR |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 9.7% (12 out of 124 dropouts) 55/62 completers in intervention group, 57/62 completers in control group refer to table 2 to 3 PP analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 6 months Only 1 analysis |
Other bias | Low risk | No other bias |
Yan (嚴華) 2010a.
Study characteristics | ||
Methods |
Aim: to evaluate the rehabilitation effects of walking training based on medicine therapy on heart function in patients with congestive heart failure (CHF). Design: parallel 3‐group RCT (1:1:1) Power/sample size calculation: NR |
|
Participants |
No. randomised: 418 (212 in IG, 206 in CG) (203 in unscheduled exercise group excluded) No. completers: 396 Country: China Study population: CHF (LVEF ≦45%) patients (clinic and hospitalised) Ethnicity: Chinese Gender: male 62.4% ((132+129)/418) Age: mean 61.2 (SD 11.8) in IG, 62.5 (SD 11.6) in CG Smokers: NR Hypertension: NR Mean baseline BP: SBP = 123.1 (SD 21.9) in IG, 125.6 (SD 20.2) in CG. DBP = 68.6 (SD 10.8) in IG, 68.5 (SD 10.6) in CG. HR= 74.2 (SD 15.7) in IG, 77.1 (SD 15.2) in CG Inclusion criteria:
Exclusion criteria:
|
|
Interventions |
IG: Exercise group: Participants walked slowly as warming‐up and cool‐down. In consideration of temperature, the walking time was day or night in summer and at noon in winter. Walking training was based on individual 6‐minute walking test. Starting from 10% to 20% 6‐minute walking distance, heart rate was kept at 5 to 10 bpm more than resting HR; BP, ECG and self‐perceived fatigue were also monitored. Participants felt energised normally after each session and the intensity and frequency were gradually increased.
CG: Control group: usual lifestyle Note: a total of 3 groups and only exercise (walking) and control groups included |
|
Outcomes |
Review outcomes reported: BP and HR Measurement method: participants were lying for at least 10 minutes and measured with right upper arm. Korotkoff maneuver was applied and the average of three measurements was taken for analysis. Heart rate was detected by stethoscope through chest auscultation. Primary/Main outcome of manuscript: resting HR, BP, 6‐minute walking test and echocardiography were measured before and after exercise training. Compliance/Adherence: NR Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: Guangxi Science and Technology Development Program (0592007‐2) |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "randomly divided" but no detail reported |
Allocation concealment (selection bias) | Unclear risk | NR |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Participants and investigators were unlikely to be blinded. |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Objective outcomes No information |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 5.26% (22 out of 418 dropouts) 203 out of 212 completers in group A (walking group), 193 out of 206 completers in group C (control group) refer to table 1, 2 PP analysis |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 6 months Only 1 analysis |
Other bias | Low risk | No other bias |
Yu (余冰清) 2018.
Study characteristics | ||
Methods |
Aim: to explore the effect of low‐ and moderate‐intensity exercise on the cardiovascular events and risk factors in phlegm dampness elderly patients with isolated systolic hypertension, and to determine the suitable exercise intensity for the elderly. Design: Parallel 3‐group RCT (1:1:1) Power/sample size calculation:yes |
|
Participants |
No. randomised: 231 (77 in IG1, 77 in IG2, 77 in CG) No. completers: 211 Country: China Study population: phlegm dampness elderly population with isolated systolic hypertension Ethnicity: Chinese Gender: male 65.9% ((44+52+43)/211) Age: mean 82.96 (SD 2.06) in IG1, 83.01 (SD 2.09) in IG2, 83.44 (SD 1.99) in CG Smokers: yes (43.1% in IG1, 43.5% in IG2, 41.4% in CG) Hypertension: 100% Mean baseline BP: SBP = 141.67 (SD 5.95) in IG1, 140.87 (SD 6.45) in IG2, 141.94 (SD 5.22) in CG; DBP = 63.20 (SD 3.59) in IG1, 62.36 (SD 2.84) in IG2, 63.43 (SD 3.11) in CG Inclusion criteria:
Exclusion criteria:
|
|
Interventions | Adaptive training was performed one week before formal training. Participants walked on a treadmill with EKG monitor, so that participants could experience the target intensity by heart rate and self‐perceived level of moderate intensity in Borg scale, and the EKG abnormality could be detected at the same time. The formal training was carried out in the rest room for retired military cadres. Participants were free to talk during walk; adequate sweating and fatigue after walk could be alleviated from rest. Overall participants should feel good and there should be no dizziness, headache, nausea or vomit. The walk should be suspended when the following situation occurred: ①signs for insufficient perfusion: paleness, cyanosis, and cold sweating; ②unchanged or even decreased heart rate during walk; ③angina pectoris; ④participants asked for stop; ⑤other occasional events. IG1: Lo‐ intensity group:
IG2: Moderate‐intensity group
CG: Control group: maintaining the original lifestyle |
|
Outcomes |
Review outcomes reported: blood pressure and blood pressure variability (24h SSD and 24h DSD) Measurement method: ①BP was detected by Microlife BP 3BTO and taken in the 900th Hospital of Joint Logistics Support Force before intervention by researchers; afterwards it was taken in the rest room for retired military cadres by the physicians or nurses one hour before each session, but only data measured in the sixth month were used for analysis. For each measurement, participants were sitting in a quiet room and resting for mood stabilisation for at least 5 minutes. Right upper arm was exposed and kept at the same level of heart with hand palm up when stretch into the BP monitoring device. There were three data in each measurement but only took average of the last two for analysis. ②24‐hour ambulatory BP measurement was detected by MQY‐ABPⅠ. The BP cuff belt was tightened at the right upper arm of the participants, and measured every 30 minutes in the daytime (0600 to 2200), every 60 minutes at night (2200 to 0600). Effective measurement was defined as >80% of effective data. The data were counted for SD of 24‐hour ambulatory mean SBP and SD of 24‐hour ambulatory mean DBP. Primary/Main outcome of manuscript: vascular function(ankle brachial index, pulse wave velocity), blood pressure, blood pressure variability (SD of 24‐hour ambulatory mean SBP and SD of 24‐hour ambulatory mean DBP), Homocysteine, blood glucose (fasting blood glucose,glycated haemoglobin), blood lipid (total cholesterol, triglycerides, LDL‐C, HDL‐C), BMI waist‐hip ratio and phlegm dampness constitution score. Compliance/Adherence: participants who attended less than 80% were ceased to be included in the trial. Adverse event: NR |
|
Notes |
Trial registration: NR Funding sources: NR |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Random sequence generation and randomisation procedure was clearly stated (p.3) |
Allocation concealment (selection bias) | Unclear risk | NR |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Quote: "...participants and investigators were not blinded..." |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Outcome assessors were blinded to participants' randomised allocation status. |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Dropout 8.7% (20 out of 231 dropouts) 141 out of 154 completers in intervention group, 70 out of 77 completers in control group refer to table 2.1 to 2.3 and figure 2.1 PP analysis (211 completers only) |
Selective reporting (reporting bias) | Low risk | Only 1 endpoint measurement at 6 months Only 1 analysis |
Other bias | Low risk | There is no other bias |
ABI: ankle‐brachial index; ABP: ambulatory blood pressure; AE(s): adverse event(s); BMI: body mass index;BP: blood pressure; BPM: beat per minute; BRS: baroreflex sensitivity; CAD: coronary artery disease; CG: control group;CHF: congestive heart failure; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; CRP: C‐reactive protein; CRV: heart rate variability; CVD: cardiovascular disease; DBP: diastolic blood pressure; HDL‐C: high‐density lipoprotein cholesterol; HR: heart rate;HRQoL: health‐related quality of life; HRT: hormone replacement therapy;IC: intermittent claudication; IG: intervention group;IGT: impaired glucose tolerance; IPAQ: International Physical Activity Questionnaire; ITT: intention‐to‐treat; LDL‐C: low‐density lipoprotein; LEVF: left ventricular ejection fraction; MET: metabolic equivalent of task; MMSE: Mini‐Mental State Examination; NGT: normal glucose tolerance; NI: no information;No.: number;NR: not reported;OA: osteoarthritis;OGTT: oral glucose tolerance test; PAD: peripheral arterial disease; PCI: percutaneous coronary intervention; PP: per protocol; RCT: randomised controlled trial;RPE: rating of perceived exertion; SBP: systolic blood pressure;SD: standard deviation; SE: standard error; SEM: standard error of the mean; SF‐12 IADL: Short Form 12 instrumental activities of daily living; TC: total cholesterol; TG: triglyceride; T2DM: type 2 diabetes mellitus; 6MWT: six‐minute walk test.
The following studies converted results from SE (reported) to SD [SD=SE*sqrt(n)]:
Hamdorf 1999; Karstoft 2013; Moreau 2001; Nemoto 2007; Stanton 1996.
Characteristics of excluded studies [ordered by study ID]
Study | Reason for exclusion |
---|---|
Ades 1995 | Not a randomised controlled trial |
Adragna 1985 | Not just walking intervention |
Albright 1992 | Not just walking intervention |
Aldred 1995 | Excluded after contacting author |
Andersen 2013 | Stair climbing |
Anderson 2015a | Outcome data were not available |
Anderson 2015b | Outcome data were not available |
Aoike 2012 | Not just walking intervention |
Arakawa 1993 | Not walking intervention |
Arija 2018a | Not just walking intervention |
Arija 2018b | Not just walking intervention |
Asbury 2008 | Not just walking intervention |
Asikainen 2002aStudyII | Active control |
Asikainen 2002bStudy I | Active control |
Asikainen 2003 | Active control |
Baraas 2011 | Not just walking |
Baraas 2013 | Blood pressure was not measured |
Baria 2012 | Excluded after contacting author |
Barone 2009 | Not just walking intervention |
Barroso 2008 | Non walking intervention |
Belli 2011 | Not just walking intervention |
Bergstrom 2009 | Not just walking intervention |
Bhammar 2012 | Intervention only on one exercise session (1 day) |
Bhammar 2017 | Intervention only on one exercise session (1 day) |
Blumenthal 1991 | Not just walking intervention |
Boer 2014 | Not just walking intervention |
Bonet 2003 | Active control |
Boyne 2011 | Non walking intervention |
Brawley 2000 | Excluded after contacting author |
Brekke 2013 | Non walking intervention |
Bronas2011 | Not just walking and active control |
Brun 2008 | Non‐walking intervention, walking is just a test |
Calfas 2001 | Active control |
Carrier 2008 | Not just walking intervention |
Carroll 1995a | Not just walking intervention |
Carroll 1995b | Outcome data not reported separately for the treadmill walking intervention group |
Casal 1984 | Abstract, insufficient information for outcome extraction |
Cashin 2008 | Not just walking intervention |
Castello 2011 | Not a usual blood pressure measurement |
Chan 2013 | No blood pressure data |
Chanruengvanich 2006 | Non‐walking intervention, walking is just a test |
Chen (陳佳萍) 2016 | Active control |
Chen ( 陳宣蘭) 2015 | No blood pressure data |
Chen (陳美娟) 2017 | No blood pressure data |
Chen 2007 | Not a randomised controlled trial |
Chen 2014 | Insufficient information for data extraction |
Chomiuk 2013 | Not a randomised controlled trial |
Clark 2017 | Not just walking intervention and active control |
Collins 2003 | Excluded after contacting author |
Collins 2005 | Excluded after contacting author |
Collins 2007 | Not just walking intervention |
Collins 2010a | Active control |
Collins 2010b | No blood pressure data |
Collins 2011a | Excluded after contacting author |
Collins 2011b | Excluded after contacting author |
Collins 2011c | Excluded after contacting author |
Cononie 1991 | Not just walking intervention but walking plus jogging |
Cooper 2001 | Active control |
Cotes 1963 | Active control |
Coulon 2013 | Not just walking intervention and not a a randomised controlled trial |
Crowther 2008 | Non walking intervention |
Cui 2010 | Non walking intervention |
Dahllof 1976 | Not just walking |
Dasgupta 2014 | Author contacted excluded because of insufficient information |
da Silva 2002 | Not just walking intervention |
Davey 2000 | Non walking intervention |
Dean 1989 | No blood pressure data |
Deligiannis 1999 | Non walking intervention |
De Vito 1999 | Not just walking intervention |
Devonish 2007 | No blood pressure data |
Digenio 1999 | Non walking intervention |
Di Loretoc 2005 | Non walking intervention |
Dimeo 2012 | Part of Pagonas 2014 |
Dowman 2013 | Non walking intervention |
Dressendorfer 1995 | Not just walking intervention but walking and cycling |
Duncan 1985 | Not just walking itnervention |
Dunn 1997 | Not just walking intervention |
Duyur 2006 | Iinsufficient information for data extraction |
Elley 2006 | Due to intervention period being too short, less than one week (4 days) |
Ettinger 1997 | Excluded after contacting author |
Fan 2018 | Not a randomised controlled trial |
Figueroa 2007 | Not a randomised controlled trial |
Filho 2013 | Not just walking intervention |
Finkelstein 2016 | Intervention of this study was incentive to exercise |
Flo 2011 | Blood pressure was not measured |
Fox 2011 | Not a randomised controlled trial |
Fukahori 1999 | Author contacted, excluded |
Gettman 1976 | Active control |
Giannuzzi 2003 | Not just walking intervention |
Gibellini 2000 | Not a randomised controlled trial |
Gill 1984 | Non walking intervention |
Goldstein 1977 | Non walking training |
Gram 2010 | Active control |
Grant 2004 | Non walking intervention |
Grosse 2001 | Not just walking intervention |
Guo 2011 | Active control |
Hagberg 1989a | Non walking intervention |
Hagberg 1989b | Not a randomised controlled trial |
Halbert 2000 | Non walking intervention and another intervention control |
Hambrecht 2000 | Not just walking intervention |
Hamdorf 1992 | No tandard deviation (SD) data for outcome data extraction |
Hamdorf 1993 | Insufficient information for outcome data extraction |
Hardman 1994 | Not a randomised controlled trial |
Hass 2001 | Not a randomised controlled trial |
Havlik 2005 | Active control |
Headley 2008 | Just tested acute aerobic effect |
Hiatt 1994 | Not just walking intervention |
Higashi 1999a | Duplicated with the other 1999 paper, used the other paper |
Hinkleman 1993 | From outcome extraction Excel file |
Hu 2016 | No pure control group |
Huang 2006 | Non walking intervention |
Huiskes 2009 | Not a randomised controlled trial |
Hurley 2019 | From outcome extraction Excel file |
Iida 2011 | Active control: control was slow walking |
Isaacs 2007 | Non walking intervention |
Jennings 1997 | Not a randomised controlled trial |
Jerome 2012 | Active control |
Jessup 1994 | Not just walking |
Jessup 1996 | Blood pressure was not measured |
Jette 1988 | Outcome data were not available |
Jiang 2004 | Active control |
Jiang 2007 | Non walking intervention |
Jiang 2013 | No controls |
Jo 1989 | Not a randomised controlled trial and not just walking intervention |
Johnson 2007 | Non walking intervention |
Kaltsatou 2011 | Non walking intervention |
Katz‐Leurer 2007 | Non walking intervention |
Kerse 2005 | Non walking intervention |
Kim 2010 | insufficient information for data extraction |
King 1991 | Not just walking intervention |
Kingwell 1993 | Not just walking intervention |
Kinoshita 1988 | Non walking tervention |
Klonizakis 2009a | Excluded after contacting author |
Klonizakis 2009b | Blood pressure was not measured |
Kobayashi 2001 | Not a randomised controlled trial |
Koh 2009 | Protocol |
Kolbe‐Alexander 2006 | Active control |
Kolt 2009 | Protocol |
Lamb 2002 | Control group got advice on physical activity |
Larsen 1969 | Not just walking intervention |
Lee 2001 | Not a randomised controlled trial |
Leehey 2009 | Not just walking intervention |
Leon 1996 | Not just walking intervention |
Ley 2013 | Unspecific exercise intervention |
Li (李合) 2018 | Not a randomised controlled trial |
Li 2005 | Active control |
Liang ( 梁曉琳) 2015 | N blood pressure data |
Liao 1987 | Non walking intervention |
Lima 2009 | Tested acute effect of walking |
Lin (林麗娟) 2010 | Not a randomised controlled trial |
Lin 2009 | Active control |
Liu (劉彥平) 2019 | Active control |
Llaberia 2013 | Llaberia 2013 is the abstract of Arija 2017 and therefore was excluded. |
Look Ahead Research Group 2010 | Non walking intervention |
Low 2007 | Active control |
Lunde 2012 | Walking is a test |
Mackey 2011 | Author contacted excluded previously |
Mackey 2011 | Author contacted excluded previously |
Marceau 1993 | Not just walking |
Martins 2010 | Resistence training |
Mason 1977 | Not a randomised controlled trial |
McAuley 2003 | Active control |
McDermott 2004 | No blood pressure outcome data |
McDermott 2013 | Blood pressure was not measured |
Mentz 2013 | Multiple exercise interventions |
Mereles 2006 | Non walking intervention, walking is a test |
Milecki 2013 | Non‐RCT nor walking intervention |
Miller 1993 | Not a randomised controlled trial |
Minus‐Grimes 2013 | Insufficient information for data extraction |
Miyashita 2008 | Not a resting or accumulated blood pressure but quotw: "Blood pressure was measured in a seated position immediately after each bout of walking" |
Mohammed 2016 | Not just walking, not a usual way to measure blood pressure. |
Molmen‐Hansen 2012 | Walking/running |
Monteiro 2010 | Active control |
Motlagh 2017a | Not just walking intervention |
Motlagh 2017b | Blood pressure was not an outcome |
Motoyama 1995 | No blood pressure data |
Motoyama 1998 | Non walking intervention |
Moul 1993 | Active control |
Mucha 2007 | Excluded after contacting author |
Muda 2006 | Not just walking intervention |
Myers 1999 | Not just walking intervention but walking and diet restriction |
Nam 2012 | Multiple exercise interventions:treadmill walking, stationary cycle, stair‐stepper |
Neto 2010 | Not a randomised controlled trial |
Newton 2002 | Active control |
Ngomane 2019 | Only a 30‐minute intervention |
Nieman 2013 | Not just walking intervention |
Nomura 1984 | Not a randomised controlled trial |
Norris 1990 | Not a randomised controlled trial |
Nussbaum 2013 | Not a randomised controlled trial, non walking intervention |
Oberman 1999 | Not a randomised controlled trial |
Obesity 2007 | Not a randomised controlled trial |
Oerkild 2012 | Unspecific exercise intervention |
Ogata 2012 | Walking is a test but not an intervention |
Ohta 2012 | Intervention is bench‐step exercise |
Okamoto 2013 | Walking is a test but not an intervention |
Oldroyd 2001 | Non walking intervention |
Osbak 2011 | Multiple exercise interventions: treadmill walking, stationary cycling |
Özdirenç 2004 | Non walking intervention |
Pal 2011 | Active control |
Paolillo 2013 | Not a randomised controlled trial |
Park 2005 | Not a randomised controlled trial |
Park 2006a | Active/treatment control |
Park 2006b | Active control |
Park 2014b | Not a randomised controlled trial |
Pascoalino 2015 | Walking and jogging |
Peel 1999 | Non walking intervention |
Pereira 2015 | Abstract, not enough information for risk of bias and outcome extraction |
Petersen 2013 | Abstract, not enough information for ridsk of bias and outcome extraction |
Petrella 1998 | Not a randomised controlled trial |
Piette 2011 | Active control |
Pinto 2006 | Not a randomised controlled trial |
Pitsavos 2011 | Non walking intervention |
Pollock 1971 | Not a randomised controlled trial |
Povoa 2010 | Active control |
Probart 1991 | Blood pressure was not measured |
Puggaard 2000 | Not just walking intervention |
Puig‐Ribera 2015 | Cluster randomisation (n = 6) |
Purzycka 2011 | Not a randomised controlled trial |
Qi 2011 | Excluded after contacting author |
Qiu (邱方) 2016 | Non‐human study |
Quinn 2006 | Active control |
Rauramaa 1986 | Walking + jogging |
Ready 1995 | No outcome data |
Reeder 2008 | Not just walking intervention |
Ren (任強) 2015 | No blood pressure data |
Ressl 1977 | Non walking intervention |
Richter 2010 | Not just walking |
Rogers 1996 | Not a randomised controlled trial and a non walking intervention |
Roghani 2012 | Control group data was not collected in the study |
Romain 2019 | The 30‐second sprint is probably like a running and therefore twas excluded |
Rosety‐Rodriguez 2011 | Not a randomised controlled trial |
Ross 2000 | Walking + jogging |
Roviaro 1984 | Not just a walking intervention |
Rudd 1967 | Not a randomised controlled trial and not a walking intervention |
Sandroff 2016 | Blood pressure was not measured |
Santana 2016 | Not a walking intervention |
Santiago 1995 | Excluded after contacting author |
Saremi 2010 | Not a randomised controlled trial |
Sari‐Sarraf 2015 | Intervention is not pure walking but walking plus running |
Saxena 2016 | Intervention only on one exercise session |
Seals 1991 | Active control |
Seals 1997 | Not a randomised controlled trial |
Seminario 1999 | Not just a walking intervention |
Seo 2010 | Multiple aerobic and resistence exercise |
Shabaaninia 2017 | Not just walking intervention but quote: " treadmill interval aerobic running" |
Shin 1999 | Not a randomised controlled trial |
Shvedko 2019 | Active control |
Sijie 2012 | Not just walking intervention |
Simons 2006 | Active control and not just walking intervention |
Sims 2012 | Not a randomised controlled trial |
Sivarajan 1981 | Not just walking intervention |
Sivarajan 1982 | Not just walking intervention |
Skvortsova 2010 | Not a randomised controlled trial |
Skvortsova 2011 | Not a randomised controlled trial |
Sohn 2007 | Walking plus sodium reduction |
Song 2017a | Tthe main focus of the study is steps but not blood pressure |
Song 2017b | Not just walking intervention |
Sousa 2013 | Not just walking intervention |
Staffileno 2001 | Multiple interventions |
Staffileno 2007 | Not just walking |
Staudter 2011 | Excluded after contacting author |
Stefanick 1998 | Not just walking intervention |
Stensel 1993 | Excluded after contacting author |
Stensel 1994 | Blood pressure was not measured |
Steptoe 1990 | Non walking intervention |
Subramanian 2011 | Not just walking intervention |
Svacinova 2003 | Blood pressure was not measured, active control. Not a randomised controlled trial |
Talakad 2011 | Non walking intervention |
Talbot 2011 | Active control |
Tanaka 1998a | No mention of randomisation |
Tang 2019 | Walking + medication |
Tao 2004 | Not just walking |
ter Bogt 2011 | Not just walking |
Thomas 2010 | Not just walking intervention |
Thompson 1988 | Non walking intervention |
Tian (田野) 2014 | No blood pressure data |
Tjonna 2008 | Non walking intervention study |
Toledano‐Zarhi 2011 | Not just walking intervention |
Torrente 2017 | This study excluded the control arm and keeping only the park‐walking group and relaxation exercise group, and using the days they were not exercising (before training, and 1 & 3 weeks after training) as their “own” control. The author did not analyse the data in the way that they randomised participants. |
Tsai 2002a | Not just walking but walking + jogging |
Tsai 2002b | Not just walking but walking + jogging |
Tsoukas 1995 | Not just walking intervention |
Tsuji 1990 | Not a randomised controlled trial |
Tully 2004 | Reference could not be found |
Tully 2007 | Not a randomised controlled trial |
Ubels 1999 | Not a randomised controlled trial |
Uemura 2012 | Not just walking |
Van Dyck 2013 | Excluded after contacting author |
van Sluijs 2005a | Non walking intervention |
van Sluijs 2005b | Non walking intervention |
Venojarvi 2013 | No biood pressure data |
Verity 1989 | Pseudo‐randomised controlled trial |
Vetrovsky 2018 | Active control |
Vicente‐Campos 2012 | Non walking intervention |
Waib 2011 | Non walking intervention |
Wanderley 2010 | Blood pressure was not measured |
Wanderley 2013 | Not just walking intervention |
Wang (王漫卓) 2017 | Not just walking |
Wang (王磊) 2016 | Not just walking intervention |
Wang (王純) 2007 | Not a randomised controlled trial |
Wang (王錦雲) 2005 | Not a randomised controlled trial |
Wang 2011 | Not a randomised controlled trial |
Wang 2012 | Not just walking intervention |
Weinstein 2013 | Blood pressure was not measured and active control |
Welsh 1985 | Not a randomised controlled trial |
Whitehurst 1991 | Not a randomised controlled trial |
Whitney 1991 | Non walking intervention |
Whitney 1993 | Non walking intervention |
Wijnen 1994 | Non walking intervention |
Wilmore 1970 | Non walking intervention |
Wilson 2010 | Excluded after contacting author |
Wing 1998 | Non walking intervention |
Wong 2018 | Stair‐climbing exercise |
Woolf‐May 1999 | Not a randomised controlled trial, and no blood pressure measurement |
Wu 2007 | Not a randomised controlled trial |
Xie 2015 | Insufficient information for outcome extraction |
Yates 2009 | Active control |
Yeater 1990 | Excluded after contacting author |
Yu (于進) 2003 | No blood pressure data |
Yuenyongchaiwat 2018 | Not a randomised controlled trial |
Zeng (曾玉萍) 2014 | No blood pressure data |
Zhang (張舒) 2012 | No blood pressure data |
Zhang 2015 | Insufficient information for outcome extraction, refer to Zhang 2016 full‐text paper |
Zhang 2016 | Active control and only provided percentage of change score but the parameters are unclear |
Zhou (周玉萍) 2015 | Active control |
Zoellner 2011 | Not a randomised controlled trial and active control |
Characteristics of ongoing studies [ordered by study ID]
Actrn 2015.
Study name | Prescribing the maximum tolerated dose of walking for people with severe knee osteoarthritis: a Phase II, randomised controlled trial |
Methods |
Aim: to test the effects of a prescribed walking program of 70 minutes per week for 12 weeks Design: a Phase II, randomised controlled trial |
Participants | People with severe knee osteoarthritis and at least moderate risk of cardiovascular disease 44 participants in total Both male and female Inclusion criteria
Exclusion criteria
|
Interventions |
Intervention group standard care+prescription "of a walking dose of 70 minutes per week, of at least moderate intensity using the rate of perceived exertion scale with a score of at least 3/10, in bouts of at least 10 minutes. The weekly dose will be completed for 12 weeks in the community. The walking doses will be completed in the community using normal assistive devices, such as a walking stick if required. Participants will continue taking their usual medications and other normal strategies to manage their knee osteoarthritis." "To increase the likelihood of adherence to the intervention and maximise the effectiveness of the intervention, we will use the following behavioural change techniques and strategies: Single planning session of up to 30 minutes with goal setting ‐ a physiotherapist will assist the participant to determine when and where to complete the dose of walking; Supervision ‐ physiotherapist supervision of one session of walking weekly; Monitoring ‐ each participant will wear a pedometer to self monitor the number of steps each week. They will also complete a logbook to record number of steps and time spent walking each week. A physiotherapist will monitor their progress with a weekly phone call or send weekly SMS reminders; Engaging social supports ‐ each participant will be encouraged to walk with a friend, or family member or other research participant." Control group standard care only for pain, cardiovascular risk, function and quality of life |
Outcomes |
Primary outcome: average knee pain over the previous week measured by a 0 to 10 Numerical Pain Rating Scale. [Baseline and post intervention (Week 12)] Secondary outcomes:
|
Starting date | 14 January 2015 |
Contact information | Mr Jason Wallis jason.wallis@easternhealth.org.au +61 3 9895 3715 Box Hill Hospital Building B, Level 3 8 Arnold Street Box Hill VIC 3128, Australia |
Notes | Trial registration: ACTRN12615000015549 |
Actrn 2017.
Study name | Activity for Wellbeing: promoting well‐being through physical activity in aged care workers |
Methods |
Aim: to study the efficacy of using a need‐supportive, person‐centred physical activity program for improving and maintaining physical activity participation and psychological well‐being in frontline aged care workers Design: cross‐over study with block randomisation |
Participants | Aged: 18 years or over Sex: males and females 25 participants in total Inclusion criteria • Current employee of ACH group • Able to speak fluent English • At least 18 years of age • Ability to engage in moderate physical activity (as defined by the American College of Sports Medicine (ACSM)) and complete all outcome measures (including the Six Minute Walk) • Not currently meeting ASCM recommendations for physical activity (greater than or equal to 30 minutes of moderate cardio‐respiratory exercise per day, 5 days per week) Exclusion criteria: no exclusion criteria, but volunteers who have previously diagnosed conditions or signs or symptoms of disease as indicated on the Adult Pre‐exercise Screening System will need to provide medical clearance prior to participation in the study. |
Interventions |
Intervention
Wait‐list control |
Outcomes |
Primary outcome: 2‐day activity recall Secondary outcomes: resting blood pressure at baseline, 12 weeks (post‐intervention) and 6‐month follow‐up (9 months post baseline); 6 minute Walk distance; BMI etc. |
Starting date | 21/09/2017 |
Contact information | Ms Merilyn Lock merilyn.lock@mymail.unisa.edu.au +61 8 8302 1752 Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences. Playford Bldg. City East Campus, University of South Australia, Adelaide, SA, 5001, Australia |
Notes | Trial registration: ACTRN12617001395325 |
Nct 2009.
Study name | Diabetic Kidney Disease: influence of Exercise therapy on Physical and Vascular Function. (DKD‐EXT) |
Methods |
Aim: to investigate the effect of a 12‐week walking exercise program on vascular endothelial function, arterial stiffness/compliance, and vascular health biomarkers in men and women with pre‐dialysis type 2 diabetic kidney disease (DKD) Design: parallel RCT 2 arms |
Participants | Men and women with pre‐dialysis type 2 diabetic kidney disease (DKD) 122 enrolled |
Interventions |
|
Outcomes |
Primary outcomes Eendothelial function measured by brachial artery flow mediated vasodilation [Time Frame: at week 0 and at week 12] Endothelium‐mediated change in vascular tone Secondary outcomes
|
Starting date | October 2009 |
Contact information | No information |
Notes |
Trial registration: ClinicalTrials.gov Identifier: NCT02112071; 0905M66282 K23DK082638-04 ( U.S. NIH Grant/Contract ) 22275 ( Other Identifier: University of Minnesota ) |
BMI: body mass index; RCT: randomised controlled trial.
Differences between protocol and review
Since considerable time passed from the publication of the protocol (Lee 2010b) and the completion of the review, a number of differences arose between protocol and review.
We refined our definition of walking to include flat walking only and to not include stair walking and uphill treadmill walking.
We updated the background section to include more recently published references.
We included data on adverse events where it was provided by included studies.
We undertook a post‐hoc analysis of the effect of walking intervention on blood pressure control by study sample size.
We undertook a post hoc analysis of the effect of walking intervention on blood pressure control by the baseline blood pressure.
Hui‐Hsin Lin and Yoko Kin Yoke Wong are authors on the review but were not authors on the protocol. They undertook screening of papers, data extraction and analysis.
Douglas Salzwedel was author on the protocol but is not author on the review. His contribution was acknowledged under Acknowledgements.
Contributions of authors
Ling‐Ling Lee (LLL) formulated the idea for the review and developed the basis for the protocol.
LLL, Caroline A Mulvaney (CM), Michael C Watson (MW) drafted the protocol.
Hui‐Hsin Lin (HHL), LLL, CM independently screened articles for inclusion or exclusion.
Yoko Kin Yoke Wong (YW), HHL, CM, LLL, MW extracted data and checked data entry.
CM, YW, Edwin SY Chan (EC), LLL, MW assessed the risk of bias of all included studies.
LLL, YW, CM conducted data analysis and interpretation of the study result.
LLL, CM, MW contributed to drafting and editing of the final draft of the review.
LLL, CM drafted and edited the final review.
All review authors reviewed and approved the final version.
Sources of support
Internal sources
-
Tzu Chi College of Technology, Taiwan
TCCT‐971B31
External sources
-
National Science Council of Taiwan, Taiwan
NSC 100‐2410‐H‐277‐005
Declarations of interest
Ling‐Ling Lee: none known
Caroline A Mulvaney: none known
Michael C Watson: none known
Edwin SY Chan: none known
Hui‐Hsin Lin: none known
Yoko Kin Yoke Wong: none known
Edited (no change to conclusions)
References
References to studies included in this review
Araiza 2006 {published data only}
- Araiza P, Hewes H, Gashetewa C, Vella CA, Burge MR. Efficacy of a pedometer-based physical activity program on parameters of diabetes control in type 2 diabetes mellitus. Metabolism: Clinical & Experimental 2006;55(10):1382-7. [DOI: 10.1016/j.metabol.2006.06.009] [PMID: ] [DOI] [PubMed] [Google Scholar]
Arija 2017 {published data only}
- Arija V, Villalobos F, Pedret R, Vinuesa A, Timón M, Basora T, et al and Pas-a-Pas research group. Effectiveness of a physical activity program on cardiovascular disease risk in adult primary health-care users: the “Pas-a-Pas”community intervention trial. BMC Public Health 2017;17(1):576. [DOI: 10.1186/s12889-017-4485-3] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Baker 2008 {published data only}
- Baker G, Gray SR, Wright A, Fitzsimons C, Nimmo M, Lowry R, et al. The effect of a pedometer-based community walking intervention "walking for wellbeing in the west" on physical activity levels and health outcomes: a 12-week randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity 2008;5:44. [DOI: 10.1186/1479-5868-5-44] [PMID: 18775062 ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Bang 2016 {published data only}
- Bang KS, Lee IS, Kim SJ, Song MK, Park SE. The effects of urban forest-walking program on health promotion behavior, physical health, depression, and quality of life: a randomized controlled trial of office-workers. Journal of Korean Academy of Nursing 2016;46:140-8. [DOI: 10.4040/jkan.2016.46.1.140] [PMID: ] [DOI] [PubMed] [Google Scholar]
Baross 2017 {published data only}
- Baross AW, Hodgson DA, Padfield SL, Swaine IL. Reductions in resting blood pressure in young adults when isometric exercise is performed whilst walking. Journal of Sports Medicine Hindawi Print 2017;2017:7123834. [DOI: 10.1155/2017/7123834] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Bayat 2018 {published data only}
- Bayat Z, Gaeini AA, Gholipoor AR. The effectiveness of regular walking on glycemic index and blood pressure in type 2 diabetic women. Payesh Health Monitor 2018;17(2):159-67. [Google Scholar]
Bell 2010 {published data only}
- Bell GJ, Harber V, Murray T, Courneya KS, Rodgers W. A comparison of fitness training to a pedometer-based walking program matched for total energy cost. Journal of Physical Activity and Health 2010;7(2):203-13. [DOI: 10.1123/jpah.7.2.203] [PMID: ] [DOI] [PubMed] [Google Scholar]
Braith 1994 {published data only}
- Braith RW, Pollock ML, Lowenthal DT, Graves JE, Limacher MC. Moderate- and high-intensity exercise lowers blood pressure in normotensive subjects 60 to 79 years of age. American Journal of Cardiology 1994;73(15):1124-8. [DOI: 10.1016/0002-9149(94)90294-1] [PMID: ] [DOI] [PubMed] [Google Scholar]
Brandon 2006 {published data only}
- Brandon LJ, Elliott-Lloyd MB. Walking, body composition, and blood pressure dose-response in African American and white women. Ethnicity & Disease 2006;16(3):675-81. [PMID: ] [PubMed] [Google Scholar]
Brenner 2020 {published data only}
- Brenner IK, Brown CA, Hains SJ, Tranmer J, Zelt DT, Brown PM. Low-intensity exercise training increases heart rate variability in patients with peripheral artery disease. Biological Research for Nursing 2020;22(1):24-33. [DOI: 10.1177/1099800419884642] [PMID: 31684758] [DOI] [PubMed] [Google Scholar]
Brown 2014 {published data only}
- Brown DK, Barton JL, Pretty J, Gladwell VF. Walks4work: assessing the role of the natural environment in a workplace physical activity intervention. Scandinavian Journal of Work, Environment & Health 2014;40(4):390-9. [DOI: 10.5271/sjweh.3421] [PMID: ] [DOI] [PubMed] [Google Scholar]
- Brown DK, Barton JL, Pretty J, Gladwell VF. Walks4work: rationale and study design to investigate walking at lunchtime in the workplace setting. BMC Public Health 2012;12:550. [DOI: 10.1186/1471-2458-12-550] [DOI] [PMC free article] [PubMed] [Google Scholar]
Chan 2018 {published data only}
- Chan AW, Chair SY, Lee DT, Leung DY, Sit JW, Cheng HY, et al. Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: a randomised controlled trial. International Journal of Nursing Studies 2018;88:44-52. [DOI: 10.1016/j.ijnurstu.2018.08.009] [PMID: ] [DOI] [PubMed] [Google Scholar]
- Chan AW, Sit JW, Chair SY, Leung DY, Lee DT, Wong EM, Fung LC. Evaluation of the effectiveness of tai chi versus brisk walking in reducing cardiovascular risk factors: protocol for a randomized controlled trial. International Journal of Environmental Research & Public Health [Electronic Resource] 2016;13(7):682. [DOI: 10.3390/ijerph13070682] [DOI] [PMC free article] [PubMed] [Google Scholar]
Chiang 2019 {published data only}
- Chiang TL, Chen C, Hsu CH, Lin YC, Wu HJ. Is the goal of 12,000 steps per day sufficient for improving body composition and metabolic syndrome? the necessity of combining exercise intensity: a randomized controlled trial. BMC Public Health 2019;19(1):1215. [DOI: 10.1186/s12889-019-7554-y] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Coghill 2008 {published data only}
- Coghill N, Cooper AR. The effect of a home-based walking program on risk factors for coronary heart disease in hypercholesterolaemic men - a randomized controlled trial. Preventive Medicine 2008;46(6):545-51. [DOI: 10.1016/j.ypmed.2008.01.002] [PMID: ] [DOI] [PubMed] [Google Scholar]
Cooper 2000 {published data only}
- Cooper AR, Moore LA, McKenna J, Riddoch CJ. What is the magnitude of blood pressure response to a programme of moderate intensity exercise? Randomised controlled trial among sedentary adults with unmedicated hypertension. British Journal of General Practice 2000;50(461):958-62. [PMID: ] [PMC free article] [PubMed] [Google Scholar]
Dong (董兆強) 2007 {published data only}
- Dong ZQ, Du YM, Cao WC, Jiang WD, Wang Q, Lu QH, et al. The effect of physical training on insulin resistance in patients with chronic heart failure [運動訓練對慢性心力衰竭患者胰島素抵抗的影響]. Chinese Journal of Physical Medicine and Rehabilitation 2007;10(29):667-9. [Google Scholar]
Dong (董雅娟) 2012 {published data only}
- Dong YJ, Wang J. Influence of aerobic exercise on blood pressure in patients with white coat hypertension [有氧運動對白大衣高血壓患者血壓的影響]. Chinese Journal of Cardiovascular Rehabilitation Medicine 2012;21(6):571-4. [DOI: 10.3969/j.issn.1008-0074.2012.06.02] [DOI] [Google Scholar]
Duncan 1991 {published data only}
- Duncan JJ, Gordon NF, Scott CB. Women walking for health and fitness. how much is enough? JAMA 1991;266(23):3295-9. [PMID: ] [PubMed] [Google Scholar]
Dureja 2014 {published data only}
- Dureja G, Bardhan S. Effect of treadmill training on blood pressure among young adult boys. Sports Medicine Journal / Medicina Sportivâ 2014;10(3):2394-400. [Google Scholar]
Foulds 2014 {published data only}
- Foulds HJ, Bredin SS, Charlesworth SA, Ivey AC, Warburton DE. Exercise volume and intensity: a dose-response relationship with health benefits. European Journal of Applied Physiology 2014;114:1563-71. [DOI: 10.1007/s00421-014-2887-9] [PMID: ] [DOI] [PubMed] [Google Scholar]
Fritz 2013 {published data only}
- Fritz T, Caidahl K, Krook A, Lundström P, Mashili F, Osler M, et al. Effects of Nordic walking on cardiovascular risk factors in overweight individuals with type 2 diabetes, impaired or normal glucose tolerance. Diabetes/Metabolism Research Reviews 2013;29:25-32. [DOI: 10.1002/dmrr.2321] [PMID: ] [DOI] [PubMed] [Google Scholar]
Geddes 2009 {published data only}
- Costello E, Raivel K, Wilson R. The effects of a twelve-week home walking program on cardiovascular parameters and fatigue perception of individuals with multiple sclerosis: a pilot study. Cardiopulmonary Physical Therapy Journal 2009;20(1):5-12. [PMID: ] [PMC free article] [PubMed] [Google Scholar]
- Geddes EL, Costello E, Raivel K, Wilson R. The effects of a twelve-week home walking program on cardiovascular parameters and fatigue perception of individuals with multiple sclerosis: a pilot study. Cardiopulmonary Physical Therapy Journal 2009;20(1):5-12. [PMID: ] [PMC free article] [PubMed] [Google Scholar]
Gilson 2007 {published data only}
- Gilson N, McKenna J, Cooke C, Brown W. Walking towards health in a university community: a feasibility study. Preventive Medicine 2007;44(2):167-9. [DOI: 10.1016/j.ypmed.2006.09.012] [PMID: ] [DOI] [PubMed] [Google Scholar]
Gradidge 2018 {published data only}
- Gradidge P J-L, Golele PN. Walking as a feasible means of effecting positive changes in BMI, waist, and blood pressure in black South African women. African Health Sciences 2018;118(4):917-21. [DOI: 10.4314/ahs.v18i4.10] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Hamdorf 1999 {published data only}
- Hamdorf PA, Penhall RK. Walking with its training effects on the fitness and activity patterns of 79-91 year old females. Australian & New Zealand Journal of Medicine 1999;29(1):22-8. [DOI: 10.1111/j.1445-5994.1999.tb01584.x] [PMID: ] [DOI] [PubMed] [Google Scholar]
Headley 2017 {published data only}
- Headley S, Germain M, Wood R, Joubert J, Milch C, Evans E, et al. Blood pressure response to acute and chronic exercise in chronic kidney disease. Nephrology 2017;22(1):72-8. [DOI: 10.1111/nep.12730] [PMID: ] [DOI] [PubMed] [Google Scholar]
Herzig 2014 {published data only}
- Herzig KH, Ahola R, Leppäluoto J, Jokelainen J, Jämsä T, Keinänen-Kiukaanniemi S. Light physical activity determined by a motion sensor decreases insulin resistance, improves lipid homeostasis and reduces visceral fat in high-risk subjects: PreDiabEx study randomized controlled trial. International Journal of Obesity 2014;38(8):1089-96. [DOI: 10.1038/ijo.2013.224] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Higashi 1999b {published data only}
- Higashi Y, Sasaki S, Sasaki N, Nakagawa K, Ueda T, Yoshimizu A, et al. Daily aerobic exercise improves reactive hyperemia in patients with essential hypertension. Hypertension 1999;33(1 Pt 2):591-7. [DOI: 10.1161/01.hyp.33.1.591] [PMID: ] [DOI] [PubMed] [Google Scholar]
Holloway 1997 {published data only}
- Holloway KL. Psychological and physiological responses to 12 weeks of aerobic exercise on various modes. Thesis 1997;0:1-117. [Thesis] [Google Scholar]
Hua 2006 {published data only}
- Hua LP. Effects of low-intensity exercise conditioning on blood pressure, heart rate, and cardiac autonomic function in men and women with mild hypertension. Thesis 2006;0:1-170. [Thesis] [DOI] [PubMed] [Google Scholar]
Karstoft 2013 {published data only}
- Karstoft K, Winding K, Knudsen SH, Nielsen JS, Thomsen C, Pedersen BK, et al. The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial. Diabetes Care 2013;36(2):228-36. [DOI: 10.2337/dc12-0658] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Khalid 2013 {published data only}
- Khalid T, Nesreen E, Ramadhan O. Effects of exercise training on postmenopausal hypertension: implications on nitric oxide levels. Medical Journal of Malaysia 2013;68(6):459-64. [PMID: ] [PubMed] [Google Scholar]
Koh 2010 {published data only}
- Koh KP, Fassett RG, Sharman JE, Coombes JS, Williams AD. Effect of intradialytic versus home-based aerobic exercise training on physical function and vascular parameters in hemodialysis patients: a randomized pilot study. American Journal of Kidney Diseases 2010;55(1):88-99. [DOI: 10.1053/j.ajkd.2009.09.025] [PMID: ] [DOI] [PubMed] [Google Scholar]
Kukkonen‐Harjula 1998 {published data only}
- Kukkonen-Harjula K, Laukkanen R, Vuori I, Oja P, Pasanen M, Nenonen A, et al. Effects of walking training on health-related fitness in healthy middle-aged adults--a randomized controlled study. Scandinavian Journal of Medicine & Science in Sports 1998;8(4):236-42. [DOI: 10.1111/j.1600-0838.1998.tb00198.x] [PMID: ] [DOI] [PubMed] [Google Scholar]
Kurban 2011 {published data only}
- Kurban S, Mehmetoglu I, Yerlikaya HF, Gönen S, Erdem S. Effect of chronic regular exercise on serum ischemia-modified albumin levels and oxidative stress in type 2 diabetes mellitus. Endocrine Research 2011;36(3):116-23. [DOI: 10.3109/07435800.2011.566236] [PMID: ] [DOI] [PubMed] [Google Scholar]
Lee 2007 {published data only}
- Lee LL, Arthur A, Avis M. Evaluating a community-based walking intervention for hypertensive older people in Taiwan: a randomized controlled trial. Preventive Medicine 2007;44(2):160-6. [DOI: 10.1016/j.ypmed.2006.09.001] [PMID: ] [DOI] [PubMed] [Google Scholar]
Li (李虎) 2018 {published data only}
- Li H, Wang BC, Tao K, Liu HG, Li DY, Kong LG. Effects of long-term walking exercise on health status of low labor—intensity people [長期步行鍛煉對低勞動強度人群健康狀況的影響]. Journal of Chinese Physician 2018;20(3):342-6. [DOI: 10.3760/cma.j.issn.1008-1372.2018.03.007] [DOI] [Google Scholar]
Li 2003 {published data only}
- Li F, Harmer P, Wilson NL, Fisher KJ. Health benefits of cobblestone-mat walking: preliminary findings. Journal of Aging and Physical Activity 2003;11(4):487-501. [Google Scholar]
Lin 2000 {published data only}
- Lin JH, Fang CL. Effects of 12 weeks different walking training in borderline hypertensive adolescents. Bulletin of Physical Education 2000;29:115-25. [Google Scholar]
Ming (明輝) 2018 {published data only}
- Ming H. Effects of long distance brisk walking on hemodynamics related indexes and cardiopulmonary function in elderly patients with coronary heart disease complicated with hypertension [長距離快走對老年冠心病合并高血壓患者介入術后血流動力學相關指標及心肺功能的影響]. Chinese Journal of Gerontology 2018;38(1):55-8. [DOI: 10.3969/j.issn.1005-9202.2018.01.021] [DOI] [Google Scholar]
Moreau 2001 {published data only}
- Moreau KL, Degarmo R, Langley J, McMahon C, Howley ET, Bassett Jr DR, et al. Increasing daily walking lowers blood pressure in postmenopausal women. Medicine & Science in Sports & Exercise 2001;33(11):1825-31. [DOI: 10.1097/00005768-200111000-00005 ] [DOI] [PubMed] [Google Scholar]
Murphy 1998 {published data only}
- Murphy MH, Hardman AE. Training effects of short and long bouts of brisk walking in sedentary women. Medicine & Science in Sports & Exercise 1998;30(1):152-7. [DOI: 10.1097/00005768-199801000-00021] [PMID: ] [DOI] [PubMed] [Google Scholar]
Murphy 2006 {published data only}
- Murphy MH, Murtagh EM, Boreham CA, Hare LG, Nevill AM. The effect of a worksite based walking programme on cardiovascular risk in previously sedentary civil servants. BMC Public Health 2006;22(6):136. [DOI: 10.1186/1471-2458-6-136] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Murtagh 2005 {published data only}
- Murtagh EM, Boreham CA, Nevill A, Hare LG, Murphy MH. The effects of 60 minutes of brisk walking per week, accumulated in two different patterns, on cardiovascular risk. Preventive Medicine 2005;41(1):92-7. [DOI: 10.1016/j.ypmed.2004.10.008] [PMID: ] [DOI] [PubMed] [Google Scholar]
Nemoto 2007 {published data only}
- Nemoto KI, Gen-No H, Masuki S, Okazaki K, Nose H. Effects of high-intensity interval walking training on physical fitness and blood pressure in middle-aged and older people. Mayo Clinic Proceedings 2007;82(7):803-11. [DOI: 10.4065/82.7.803] [PMID: ] [DOI] [PubMed] [Google Scholar]
Neumann 2006 {published data only}
- Neumann SA, Brown JR, Waldstein SR, Katzel LI. A walking program's attenuation of cardiovascular reactivity in older adults with silent myocardial ischemia. Journal of Aging & Physical Activity 2006;14(2):119-32. [DOI: 10.1123/japa.14.2.119] [PMID: ] [DOI] [PubMed] [Google Scholar]
Pagonas 2014 {published data only}
- Dimeo F, Pagonas N, Seibert F, Arndt R, Zidek W, Westhoff TH. The impact of aerobic exercise on blood pressure variability. Journal of Human Hypertension 2014;28(6):367-71. [DOI: 10.1038/jhh.2013.121] [PMID: ] [DOI] [PubMed] [Google Scholar]
- Pagonas N, Dimeo F, Bauer F, Seibert F, Kiziler F, Zidek W, et al. The impact of aerobic exercise on blood pressure variability. Journal of Human Hypertension 2014;28:367-71. [PMID: ] [DOI] [PubMed] [Google Scholar]
Palmer 1995b {published data only}
- Palmer LK. Effects of a walking program on attributional style, depression, and self-esteem in women. Perceptual and Motor Skills 1995;81(3 Pt 1):891-8. [DOI: 10.2466/pms.1995.81.3.891] [PMID: ] [DOI] [PubMed] [Google Scholar]
Pernar 2017 {published data only}
- Pernar CH, Fall K, Rider JR, Markt SC, Adami H-O, Andersson S-O, et al. A walking intervention among men with prostate cancer: a pilot study. Clinical Genitourinary Cancer 2017;15:31. [DOI: 10.1016/j.clgc.2017.05.022] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Pospieszna 2017 {published data only}
- Pospieszna B, Karolkiewicz J, Tarnas J, Lewandowski J, Laurentowska M, Pilaczynska-Szczesniak L. Influence of 12-week Nordic walking training on biomarkers of endothelial function in healthy postmenopausal women. Journal of Sports Medicine and Physical Fitness 2017;57(9):1178-85. [DOI: 10.23736/S0022-4707.16.06528-2] [PMID: ] [DOI] [PubMed] [Google Scholar]
Ready 1996 {published data only}
- Ready AE, Naimark B, Ducas J, Sawatzky JV, Boreskie SL, Drinkwater DT, et al. Influence of walking volume on health benefits in women post-menopause. Medicine & Science in Sports & Exercise 1996;28(9):1097-105. [DOI: 10.1097/00005768-199609000-00004] [PMID: ] [DOI] [PubMed] [Google Scholar]
Romero 2019 {published data only}
- Romero Z, Kimbrough S. The impact of moderate physical activity on weight and blood pressure in an elderly Mexican-American female population. Tahperd Journal 2019;87(3):8-12. [Google Scholar]
Sakuragi 2006 {published data only}
- Sakuragi S, Sugiyama Y. Effects of daily walking on subjective symptoms, mood and autonomic nervous function. Journal of Physiological Anthropology 2006;25(4):281-9. [DOI: 10.2114/jpa2.25.281] [PMID: ] [DOI] [PubMed] [Google Scholar]
Salesi 2014 {published data only}
- Salesi M, Rabiee SZ, Shikhani-Shahin H, Sadegipour HR. Effect of a walking program on metabolic syndrome indexes in non-athlete menopausal women during 8 weeks. Journal of Babol University of Medical Sciences 2014;16(10):68-74. [Google Scholar]
Saptharishi 2009 {published data only}
- Saptharishi L, Soudarssanane M, Thiruselvakumar D, Navasakthi D, Mathanraj S, Karthigeyan M, et al. Community-based randomized controlled trial of non-pharmacological interventions in prevention and control of hypertension among young adults. Indian Journal of Community Medicine 2009;34(4):329-34. [DOI: 10.4103/0970-0218.58393] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Serwe 2011 {published data only}
- Serwe KM, Swartz AM, Hart TL, Strath SJ. Effectiveness of long and short bout walking on increasing physical activity in women. Journal of Women's Health 2011;20(2):247-53. [DOI: 10.1089/jwh.2010.2019] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Shenoy 2010 {published data only}
- Shenoy S, Guglani R, Sandhu JS. Effectiveness of an aerobic walking program using heart rate monitor and pedometer on the parameters of diabetes control in Asian Indians with type 2 diabetes. Primary Care Diabetes 2010;4(1):41-5. [DOI: 10.1016/j.pcd.2009.10.004] [PMID: ] [DOI] [PubMed] [Google Scholar]
Stanton 1996 {published data only}
- Arroll B. Thesis. Auckland, New Zealand: University of Auckland, 1992. [Thesis] [Google Scholar]
- Stanton JM, Arroll B. The effect of moderate exercise on mood in mildly hypertensive volunteers: a randomized controlled trial. Journal of Psychosomatic Research 1996;40(6):637-42. [DOI: 10.1016/0022-3999(95)00643-5] [PMID: ] [DOI] [PubMed] [Google Scholar]
Stutzman 2010 {published data only}
- Stutzman SS, Brown CA, Hains SM, Godwin M, Smith GN, Parlow JL, et al. The effects of exercise conditioning in normal and overweight pregnant women on blood pressure and heart rate variability. Biological Research for Nursing 2010;12(2):137-48. [DOI: 10.1177/1099800410375979] [PMID: ] [DOI] [PubMed] [Google Scholar]
Tudor‐Locke 2004 {published data only}
- Tudor-Locke C, Bell RC, Myers AM, Harris SB, Ecclestone NA, Lauzon N, et al. Controlled outcome evaluation of the first step program: a daily physical activity intervention for individuals with type II diabetes. International Journal of Obesity & Related Metabolic Disorders: Journal of the International Association for the Study of Obesity 2004;28(1):113-9. [DOI: 10.1038/sj.ijo.0802485] [PMID: ] [DOI] [PubMed] [Google Scholar]
Tudor‐Locke 2020 {published data only}
- Tudor-Locke C, Schuna J M, Swift DL, Dragg AT, Davis AB, Martin CK, et al. Walkmore: a randomized controlled trial of pedometer-based interventions differing on intensity messages. BMC Public Health 2014;14(1):168. [DOI: 10.1186/1471-2458-14-168] [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tudor-Locke C, Schuna J M, Swift DL, Dragg AT, Davis AB, Martin CK et al. Evaluation of step-counting interventions differing on intensity messages. Journal of physical activity & health 2020;17:21-8. [DOI: 10.1123/jpah.2018-0439] [PMID: ] [DOI] [PubMed] [Google Scholar]
Tully 2005 {published data only}
- Tully MA, Cupples ME, Chan WS, McGlade K, Young IS. Brisk walking, fitness, and cardiovascular risk: a randomized controlled trial in primary care. Preventive Medicine 2005;41(2):622-8. [DOI: 10.1016/j.ypmed.2004.11.030] [PMID: ] [DOI] [PubMed] [Google Scholar]
Tully 2007a {published data only}
- Tully MA, Cupples ME, Hart ND, McEneny J, McGlade KJ, Chan WS, et al. Randomised controlled trial of home-based walking programmes at and below current recommended levels of exercise in sedentary adults. Journal of Epidemiology & Community Health 2007;61(9):778-83. [DOI: 10.1136/jech.2006.053058] [PMID: 17699531]] [DOI] [PMC free article] [PubMed] [Google Scholar]
Tully 2011 {published data only}
- Tully MA, Cupples ME. Unistep (university students exercise and physical activity) study: a pilot study of the effects of accumulating 10,000 steps on health and fitness among university students. Journal of Physical Activity and Health 2011;8:663-7. [DOI: 10.1123/jpah.8.5.663] [PMID: ] [DOI] [PubMed] [Google Scholar]
Venturelli 2011 {published data only}
- Venturelli M, Scarsini R, Schena F. Six-month walking program changes cognitive and ADL performance in patients with alzheimer. American Journal of Alzheimer's Disease & Other Dementias 2011;26(5):381-8. [DOI: 10.1177/1533317511418956] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Wallis 2017 {published data only}
- Wallis JA, Webster KE, Levinger P, Singh PJ, Fong C, Taylor NF. A walking program for people with severe knee osteoarthritis did not reduce pain but may have benefits for cardiovascular health: a phase II randomised controlled trial. Osteoarthritis and Cartilage 2017;25:1969-79. [DOI: 10.1016/j.joca.2016.12.017] [PMID: ] [DOI] [PubMed] [Google Scholar]
Wang (王正斌) 2014 {published data only}
- Wang ZB, Qiu CG, Huang ZW, Han ZY, Sun GJ, Sun H. The effects of walking exercise on glyeometabolism,dynamic blood pressure and the quality of life of patients with hypertension and type 2 diabetes [步行運動對高血壓合并糖尿病患者糖代謝、動態血壓及生活質量的影響]. Chinese Journal of Physical Medicine and Rehabilitation 2014;36(8):609-13. [DOI: 10.3760/cma.j.issn.0254-1424.2014.08.010] [DOI] [Google Scholar]
Wang (王聰) 2016 {published data only}
- Wang C, Huang JJ, Ren ZY, Sun CM, Wang T. The effect of walking and health education on blood pressure in hypertensive patients of datong coal mine group [健步走與健康教育相結合對同煤職工高血壓患者血壓的影響]. Chinese Journal of Disease Control & Prevention 2016;20(2):134-45. [DOI: 10.16462/j.cnki.zhjbkz.2016.02.007] [DOI] [Google Scholar]
Wang 2014 {published data only}
- Wang CH, Chung MH, Chan P, Tsai JC, Chen FC. Effects of endurance exercise training on risk components for metabolic syndrome, interleukin-6, and the exercise capacity of postmenopausal women. Geriatric Nursing 2014;35(3):212-8. [DOI: 10.1016/j.gerinurse.2014.02.001] [PMID: ] [DOI] [PubMed] [Google Scholar]
Westhoff 2007 {published data only}
- Westhoff TH, Franke N, Schmidt S, Vallbracht-Israng K, Meissner R, Yildirim H, et al. Too old to benefit from sports? The cardiovascular effects of exercise training in elderly subjects treated for isolated systolic hypertension. Kidney & Blood Pressure Research 2007;30(4):240-7. [DOI: 10.1159/000104093] [PMID: ] [DOI] [PubMed] [Google Scholar]
Xiao (肖卉) 2010 {published data only}
- Xiao H, Wang JH, Zhang YW, Tian Y. Effects of exercise on blood glucose and blood pressure in elderly diabetes patients [運動對中老年糖尿病患者血糖及血壓的影響]. Chinese Journal of Physical Medicine and Rehabilitation 2010;38(10):843-5. [Google Scholar]
Yan (嚴華) 2010a {published data only}
- Yan H, Fu CH, Zou EF, Fu YH, Chen LY, He DM, et al. Walk exercise training produces rehabilitation effects on heart function for patients with chronic heart failure [步行運動訓練對慢性充血性心力衰竭患者心臟的康復]. Chinese Journal of Cardiovascular Rehabilitation Medicine 2010;19(1):2-4 and 30. [DOI: 10.3969/j.issn.1008-0074.2010.01.01] [DOI] [Google Scholar]
- Yan H, Fu CH, Zou EF, Fu YH, Chen LY, He DM, et al. Walking training improves heart function in aged patients with chronic heart failure [步行訓練對老年慢性心力衰竭患者心臟功能康復的影響]. Chinese Journal of Cardiovascular Rehabilitation Medicine 2010b;19(5):456-9. [DOI: 10.3969/j.issn.1008-0074.2010.05.02] [DOI] [Google Scholar]
Yu (余冰清) 2018 {published data only}
- Yu BC. The effect of different exercise intensity on the cardioVascularevents and its risk factors in phlegm dampness elderly patients with isolated systolic hypertension [thesis] [不同運動強度對痰濕質老老年ISH患者心腦血管事件及危險因素的影響]. Fujian University of Traditional Chinese Medicine 2018:1-67.
References to studies excluded from this review
Ades 1995 {published data only}
- Ades PA, Waldmann ML, Gillespie C. A controlled trial of exercise training in older coronary patients. Journals of Gerontology Series A-Biological Sciences & Medical Sciences 1995;50A(1):M7-11. [DOI: 10.1093/gerona/50a.1.m7] [PMID: ] [DOI] [PubMed] [Google Scholar]
Adragna 1985 {published data only}
- Adragna NC, Chang JL, Morey MC, Williams RS. Effect of exercise on cation transport in human red cells. Hypertension 1985;7(1):132-9. [DOI: 10.1161/01.hyp.7.1.132] [PMID: ] [DOI] [PubMed] [Google Scholar]
Albright 1992 {published data only}
- Albright CL, King AC, Taylor CB, Haskell WL. Effect of a six-month aerobic exercise training program on cardiovascular responsivity in healthy middle-aged adults. Journal of Psychosomatic Research 1992;36(1):25-36. [DOI: 10.1016/0022-3999(92)90111-e] [PMID: ] [DOI] [PubMed] [Google Scholar]
Aldred 1995 {published data only}
- Aldred HE, Hardman AE, Taylor S. Influence of 12 weeks of training by brisk walking on postprandial lipemia and insulinemia in sedentary middle-aged women. Metabolism 1995;44(3):390-7. [DOI: 10.1016/0026-0495(95)90172-8] [PMID: ] [DOI] [PubMed] [Google Scholar]
Andersen 2013 {published data only}
- Andersen LL, Sundstrup E, Boysen M, Jakobsen MD, Mortensen OS, Persson R. Cardiovascular health effects of internet-based encouragements to do daily workplace stair-walks: randomized controlled trial. Journal of Medical Internet Research 2013;15(6):e127. [DOI: 10.2196/jmir.2340] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Anderson 2015a {published data only}
- Anderson DR. Thesis. US: ProQuest Information & Learning, 2015. [Google Scholar]
Anderson 2015b {published data only}
- Anderson DR, Harris KM, Landers J, Emery CF. Lower anxiety associated with greater physical activity in a pedometer-based intervention among cardiac patients. Psychosomatic Medicine 2015;77(3):A17-A18. [Google Scholar]
Aoike 2012 {published data only}
- Aoike DT, Baria F, Rocha ML, Kamimura MA. Home-based vs in center aerobic exercise: Impact on cardiorespiratory (CR) and functional capacities (FC) of nondialysis dependent overweight CKD patients. Kidney Research and Clinical Practice 2012;31(2):A27. [Google Scholar]
Arakawa 1993 {published data only}
- Arakawa K. Antihypertensive mechanism of exercise. Journal of Hypertension 1993;11(3):223-9. [DOI: 10.1097/00004872-199303000-00001] [PMID: ] [DOI] [PubMed] [Google Scholar]
Arija 2018a {published data only}
- Arija V, Villalobos F, Pedret R, Vinuesa A, Jovani D, Pascual G, et al. Physical activity, cardiovascular health, quality of life and blood pressure control in hypertensive subjects: randomized clinical trial. Health and Quality of Life Outcomes 2018;16(1):184. [DOI: 10.1186/s12955-018-1008-6] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Arija 2018b {published data only}
- Arija V, Martinez FV, Pedret Llaberia R, Vinuesa Fernandez A, Jovani D, Reche A, et al. Effectiveness of a physical activity program on cardiovascular disease risk in adult with overweight and obesity: the "Pas-a-Pas" community intervention trial. Obesity Facts 2018;11(Supplement 1):38. [Google Scholar]
Asbury 2008 {published data only}
- Asbury EA, Slattery C, Grant A, Evans L, Barbir M, Collins P. Cardiac rehabilitation for the treatment of women with chest pain and normal coronary arteries.. Menopause 2008;15(3):454-60. [DOI: 10.1097/gme.0b013e31815982eb] [PMID: ] [DOI] [PubMed] [Google Scholar]
Asikainen 2002aStudyII {published data only}
- Asikainen TM, Miilunpalo S, Oja P, Rinne M, Pasanen M, Uusi-Rasi K, et al. Randomised, controlled walking trials in postmenopausal women: the minimum dose to improve aerobic fitness? Sports Medicine 2002a;36:189-94. [DOI: 10.1136/bjsm.36.3.189] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Asikainen 2002bStudy I {published data only}
- Asikainen TM, Miilunpalo S, Kukkonen-Harjula K, Nenonen A, Pasanen M, Rinne M, et al. Walking trials in postmenopausal women: effect of one vs two daily bouts on aerobic fitness. British Journal of Sports Medicine 2002;12(2):99-105. [DOI: 10.1034/j.1600-0838.2002.120206.x] [PMID: ] [DOI] [PubMed] [Google Scholar]
Asikainen 2003 {published data only}
- Asikaine TM, Miilunpalo S, Kukkonen-Harjula K, Nenonen A Pasanen M, Rinne M et al. Walking trials in postmenopausal women: effect of low doses of exercise and exercise fractionization on coronary risk factors. Scandinavian Journal of Medicine & Science in Sports 2003;13(5):284-92. [DOI: 10.1034/j.1600-0838.2003.00331.x] [PMID: ] [DOI] [PubMed] [Google Scholar]
Baraas 2011 {published data only}
- Baraas F. The effect of short-term low intensity exercise training on oxygen free radicals and nitric-oxide production in male patients with acute myocardial infarction. Journal of the American College of Cardiology 2011;1:E1032. [DOI: 10.1055/s-0033-1348881] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Baraas 2013 {published data only}
- Baraas F, Rilantono L, Diniharini S, Kurniawan I, Christian R, Kusmana D. Effect of short-term low-intensity exercise training on association of oxygen free radicals and nitric oxide production in patients with acute myocardial infarction. International Journal of Angiology 2013;22:159-64. [DOI: 10.1055/s-0033-1348881] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Baria 2012 {published data only}
- Baria F, Kamimura MA, Aoike DT, Rocha ML, Ammirati A, Cuppari L. Impact of aerobic exercise on visceral fat of nondialysis dependent overweight CKD patients: a pilot study. Kidney Research and Clinical Practice 2012;31(2):A27. [Google Scholar]
Barone 2009 {published data only}
- Barone BB, Wang NY, Bacher AC, Stewart KJ. Decreased exercise blood pressure in older adults after exercise training: contributions of increased fitness and decreased fatness. British Journal of Sports Medicine 2009;43(1):52-6. [DOI: 10.1136/bjsm.2008.050906] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Barroso 2008 {published data only}
- Barroso WK, Jardim PC, Vitorino PV, Bittencourt A, Miquetichuc F. The influence of programmed physical activity on blood pressure of hypertensive elderly patients on non-pharmacological treatment. Revista Da Associacao Medica Brasileira 2008;54(4):328-33. [DOI: 10.1590/s0104-42302008000400018] [PMID: ] [DOI] [PubMed] [Google Scholar]
Belli 2011 {published data only}
- Belli T, Ribeiro LF, Ackermann MA, Baldissera V, Gobatto CA, da Silva RG. Effects of 12-week overground walking training at ventilatory threshold velocity in type 2 diabetic women. Diabetes Research and Clinical Practice 2011;93(3):337-43. [DOI: 10.1016/j.diabres.2011.05.007] [PMID: ] [DOI] [PubMed] [Google Scholar]
Bergstrom 2009 {published data only}
- Bergstrom I, Lombardo C, Brinck J. Physical training decreases waist circumference in postmenopausal borderline overweight women. Acta Obstetricia et Gynecologica Scandinavica 2009;88(3):308-13. [DOI: 10.1080/00016340802695942] [PMID: ] [DOI] [PubMed] [Google Scholar]
Bhammar 2012 {published data only}
- Bhammar DM, Angadi SS, Gaesser GA. Effects of fractionized and continuous exercise on 24-h ambulatory blood pressure. Medicine and Science in Sports and Exercise 2012;44(12):2270-6. [DOI: 10.1249/MSS.0b013e3182663117] [PMID: ] [DOI] [PubMed] [Google Scholar]
Bhammar 2017 {published data only}
- Bhammar DM, Sawyer BJ, Tucker WJ, Gaesser GA. Breaks in sitting time: effects on continuously monitored glucose and blood pressure. Medicine and Science in Sports and Exercise 2017;49(10):2119-30. [DOI: 10.1249/MSS.0000000000001315] [PMID: ] [DOI] [PubMed] [Google Scholar]
Blumenthal 1991 {published data only}
- Blumenthal JA, Siegel WC, Appelbaum M. Failure of exercise to reduce blood pressure in patients with mild hypertension. Joumal of the American Medical Association 1991;266(15):2098-104. [PMID: ] [PubMed] [Google Scholar]
Boer 2014 {published data only}
- Boer PH, Meeus M, Terblanche E, Rombaut L, Wandele I, Hermans L, et al. The influence of sprint interval training on body composition, physical and metabolic fitness in adolescents and young adults with intellectual disability: a randomized controlled trial. Clinical Rehabilitation 2014;28(3):221-31. [DOI: 10.1177/0269215513498609] [DOI] [PubMed] [Google Scholar]
Bonet 2003 {published data only}
- Bonet J, Coll R, Rocha E, Romero R. Supervised versus recommended physical exercise in hypertensive women. Is its recommendation enough? Blood Pressure 2003;12(3):139-44. [DOI: 10.1080/08037050310002533] [PMID: ] [DOI] [PubMed] [Google Scholar]
Boyne 2011 {published data only}
- Boyne J, Vrijhoef HJ, Nieman FH, De Wit R, Kragten J, De Weerd GJ, et al. Telemonitoring in patients with heart failure: Results from a multicenter randomized controlled trial (the TEHAF study). Journal of the American College of Cardiology 2011;1:E389. [Google Scholar]
Brawley 2000 {published data only}
- Brawley LR, Rejeski WJ, Lutes L. A group-mediated cognitive-behavioral intervention for increasing adherence to physical activity in older adults. Journal of Applied Biobehavioral Research 2000;5(1):47-65. [DOI: 10.1016/j.cct.2012.04.012] [PMID: 22575796] [DOI] [PMC free article] [PubMed] [Google Scholar]
Brekke 2013 {published data only}
- Brekke HK, Bertz F, Rasmussen KM, Bosaeus I, Ellegard L, Win Kvist A. Dietary behavior modification, with or without exercise, improves risk factors for CVD over one year in overweight and obese lactating women. The Federation of American Societies for Experimental Biology Journal 2013;27(S1):225.5. [Google Scholar]
Bronas2011 {published data only}
- Bronas UG, Treat-Jacobson D, Leon AS. Comparison of the effect of upper body-ergometry aerobic training vs treadmill training on central cardiorespiratory improvement and walking distance in patients with claudication. Journal of Vascular Surgery 2011;53(6):1557-64. [DOI: 10.1016/j.jvs.2011.01.077] [PMID: ] [DOI] [PubMed] [Google Scholar]
Brun 2008 {published data only}
- Brun JF, Bordenave S, Ghanassia E, Picot MC, Jaussent A, Mercier J, et al. One year endurance training at the level of the ventilatory threshold in type-2 diabetics reduces by 50% health costs: a randomized trial. [French]. Science and Sports 2008;23(3-4):193-7. [Google Scholar]
Calfas 2001 {published data only}
- Calfas KJ, Criqui MH, Sallis JF, Langer RD, Rupp JW, Kashani IA, et al. Six-month patient outcomes in a preventive cardiology center. Preventive Cardiology 2001;4(1):16-27. [PMID: ] [DOI] [PubMed] [Google Scholar]
Carrier 2008 {published data only}
- Carrier J. Aerobic plus resistance training was more effective than either alone for glycaemic control in type 2 diabetes. Evidence-Based Nursing 2008;11(2):48. [PMID: ] [DOI] [PubMed] [Google Scholar]
Carroll 1995a {published data only}
- Carroll JF, Convertino VA, Pollock ML, Graves JE, Lowenthal DT. Effect of 6 months of exercise training on cardiovascular responses to head-up tilt in the elderly. Clinical Physiology 1995a;15(1):13-25. [DOI: 10.1111/j.1475-097x.1995.tb00426.x] [PMID: ] [DOI] [PubMed] [Google Scholar]
Carroll 1995b {published data only}
- Carroll JF, Convertino VA, Wood CE, Graves JE, Lowenthal DT, Pollock ML. Effect of training on blood volume and plasma hormone concentrations in the elderly. Medicine and Science in Sports and Exercise 1995;27(1):79-84. [PMID: ] [PubMed] [Google Scholar]
Casal 1984 {published data only}
- Casal DC. Effects of 2000 kilocalories per week of treadmill walking and stair climbing on physical fitness and coronary risk factors of obese young men (exercise, disease, preventive medicine). Minnesota: University of Minnesota, 1984. [Google Scholar]
Cashin 2008 {published data only}
- Cashin A, Potter E, Stevens W, Davidson K, Muldoon D. Fit for prison: special population health and fitness programme evaluation. International Journal of Prison Health 2008;4(4):208-16. [DOI: 10.1080/17449200802473131] [PMID: ] [DOI] [PubMed] [Google Scholar]
Castello 2011 {published data only}
- Castello V, Simoes RP, Bassi D, Catai AM, Arena R, Borghi-Silva A. Impact of aerobic exercise training on heart rate variability and functional capacity in obese women after gastric bypass surgery. Obesity Surgery 2011;21:1739-49. [DOI: 10.1007/s11695-010-0319-4] [PMID: ] [DOI] [PubMed] [Google Scholar]
Chan 2013 {published data only}
- Chan L, Chin LM, Kennedy M, Woolstenhulme JG, Nathan SD, Weinstein AA. Benefits of intensive treadmill exercise training on cardiorespiratory function and quality of life in patients with pulmonary hypertension. Chest 2013;143:333-43. [DOI: 10.1378/chest.12-0993] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Chanruengvanich 2006 {published data only}
- Chanruengvanich W, Kasemkitwattana S, Charoenyooth C, Towanabut S, Pongurgsorn C. RCT: self-regulated exercise program in transient ischemic attack and minor stroke patients. Thai Journal of Nursing Research 2006;10(3):165-79. [Google Scholar]
Chen (陳佳萍) 2016 {published data only}
- Chen JP, Mao LH. Effect of health education combined with vigorous walking on blood pressure and quality of life of elderly hypertension patients [健康教育結合健步走對高校老年高血壓患者血壓及生活質量的影響]. Chinese Journal of Gerontology 2016;36(16):4024-6. [Google Scholar]
Chen ( 陳宣蘭) 2015 {published data only}
- Chen Xl, Jiang H, Zhong YM, Wang XP, Wei XJ, Qiu YQ. Clinical value of walking exercise in patients with coronary artery disease combining heart failure [步行運動訓練在冠心病心力衰竭患者中的臨床價值]. Chinese Circulation Journal 2015;30(12):1170-2. [DOI: 10.3969/j.issn.1000-3614.2015.12.009] [DOI] [Google Scholar]
Chen (陳美娟) 2017 {published data only}
- Chen MJ, Dong B, Li L, Zeng LZ, Shen DP. The effect of walking exercise on the IMT in elderly patients with hypertension and anxiety [步行運動對老年高血壓并焦慮患者頸動脈內膜中層厚度及焦慮狀態的作用]. Chinese Journal of Geriatric Care 2017;15(5):39-41. [DOI: 10.3969/j.issn.1672-4860.2017.05.012] [DOI] [Google Scholar]
Chen 2007 {published data only}
- Chen D, Yuan Y, Yang H. Effect of exercise on coagulation and fibrinolytic system in the elderly. [Chinese]. Journal of Clinical Rehabilitative Tissue Engineering Research 2007;11(42):8545-8. [Google Scholar]
Chen 2014 {published data only}
- Chen II, Lai CF, Chan WC, Hsu TF, Huang WL, Wang IG. The effects of regular exercise training on risk factors and mood states in subjects with metabolic syndrome. Diabetes Research and Clinical Practice 2014;106:S72-3. [Google Scholar]
Chomiuk 2013 {published data only}
- Chomiuk T, Folga A, Mamcarz A. The influence of systematic pulse-limited physical exercise on the parameters of the cardiovascular system in patients over 65 years of age. Archives of Medical Science 2013;9(2):201-9. [DOI: 10.5114/aoms.2013.34559] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Clark 2017 {published data only}
- Clark IN, Baker FA, Peiris CL, Shoebridge G, Taylor NF. Participant-selected music and physical activity in older adults following cardiac rehabilitation: a randomized controlled trial. Clinical Rehabilitation 2017;31(3):329-39. [DOI: 10.1177/0269215516640864] [PMID: ] [DOI] [PubMed] [Google Scholar]
Collins 2003 {published data only}
- Collins EG, Langbein WE, Orebaugh C, Bammert C, Hanson K, Reda D, et al. Polestriding exercise and vitamin for management of peripheral vascular disease. Medicine and Science in Sports and Exercise 2003;35(3):384-93. [DOI: 10.1249/01.MSS.0000053658.82687.FF] [PMID: ] [DOI] [PubMed] [Google Scholar]
Collins 2005 {published data only}
- Collins EG, Langbein WE, Orebaugh C, Bammert C, Hanson K, Reda D, et al. Cardiovascular training effect associated with polestriding exercise in patients with peripheral arterial disease. Journal of Cardiovascular Nursing 2005;20(3):177-85. [DOI: 10.1097/00005082-200505000-00009] [PMID: ] [DOI] [PubMed] [Google Scholar]
Collins 2007 {published data only}
- Collins TC, Johnson SL, Souchek J. Unsupervised walking therapy and atherosclerotic risk-factor management for patients with peripheral arterial disease: a pilot trial. Annals of Behavioral Medicine 2007;33(3):318-24. [DOI: 10.1007/bf02879914] [PMID: ] [DOI] [PubMed] [Google Scholar]
Collins 2010a {published data only}
- Collins T, Lunos S. Home-based walking therapy improves walking ability and quality of life in patients with diabetes mellitus and peripheral arterial disease. Journal of General Internal Medicine 2010a;25:S296-7. [Google Scholar]
Collins 2010b {published data only}
- Collins T, Lunos S. Home-based walking therapy improves walking ability and quality of life in persons with diabetes mellitus and peripheral arterial disease. Vascular Medicine 2010b;15(2):155. [DOI] [PubMed] [Google Scholar]
Collins 2011a {published data only}
- Collins T, Ghidei W, Ahluwalia J. Benefits of walking therapy in patients with diabetes mellitus and peripheral arterial disease who are limited by leg pain or fatigue. Journal of General Internal Medicine 2011a;26:S176-7. [Google Scholar]
Collins 2011b {published data only}
- Collins T, Lunos S, Hodges J. Effects of a walking intervention on systemic inflammation in persons with diabetes mellitus and peripheral arterial disease. Journal of General Internal Medicine 2011b;26:S174-5. [Google Scholar]
Collins 2011c {published data only}
- Collins TC, Lunos S, Carlson T, Henderson K, Lightbourne M, Nelson B, et al. Effects of a home-based walking intervention on mobility and quality of life in people with diabetes and peripheral arterial disease: a randomized controlled trial. Diabetes Care 2011c;34:2174-9. [DOI: 10.2337/dc10-2399] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Cononie 1991 {published data only}
- Cononie CC, Graves JE, Pollock ML, Phillips MI, Sumners C, Hagberg JM. Effect of exercise training on blood pressure in 70- to 79-yr-old men and women. Medicine and Science in Sports and Exercise 1991;23(4):505-11. [PMID: ] [PubMed] [Google Scholar]
Cooper 2001 {published data only}
- Cooper AR, Goff F. Does a single bout of brisk walking reduce ambulatory blood pressure in normotensives or hypertensives? Cardiovascular Reviews and Reports 2001;22(4):213-216+222. [Google Scholar]
Cotes 1963 {published data only}
- Cotes JE, Pisa Z, Thomas AJ. Effect of breathing oxygen upon cardiac output, heart rate, ventilation, systemic and pulmonary blood pressure in patients with chronic lung disease. Clinical Science 1963;25:305-21. [PMID: ] [PubMed] [Google Scholar]
Coulon 2013 {published data only}
- Coulon SM, Wilson DK, Egan BM. Associations among environmental supports, physical activity, and blood pressure in African-American adults in the path trial. Social Science & Medicine 2013;87:108-15. [DOI: 10.1016/j.socscimed.2013.03.018] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Crowther 2008 {published data only}
- Crowther RG, Spinks WL, Leicht AS, Sangla K, Quigley F, Golledge J. Effects of a long-term exercise program on lower limb mobility, physiological responses, walking performance, and physical activity levels in patients with peripheral arterial disease. Journal of Vascular Surgery 2008;47(2):303-9. [DOI: 10.1016/j.jvs.2007.10.038] [PMID: ] [DOI] [PubMed] [Google Scholar]
Cui 2010 {published data only}
- Cui F, Ren Y, Wang H, Mu X, Ma H. Effects of rehabilitation training on exercise tolerance of patients with coronary heart disease after percutaneous coronary intervention. In: Circulation. 2010:e319.
Dahllof 1976 {published data only}
- Dahllof AG, Holm J, Schersten T, Sivertsson R. Peripheral arterial insufficiency, effect of physical training on walking tolerance, calf blood flow, and blood flow resistance. Scandinavian Journal of Rehabilitation Medicine 1976;8(1):unknown. [PMID: ] [PubMed] [Google Scholar]
Dasgupta 2014 {published data only}
- Dasgupta K, Rosenberg E, Daskalopoulou SS for the SMARTER collaborators. Step monitoring to improve arterial health (smarter) through step count prescription in type 2 diabetes and hypertension: trial design and methods. Cardiovascular Diabetology 2014;13(1):7. [DOI: 10.1186/1475-2840-13-7] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
da Silva 2002 {published data only}
- da Silva MS, Bocchi EA, Guimaraes GV, Padovani CR, Silva MH, Pereira SF, et al. Benefits of exercise training in the treatment of heart failure: study with a control group. Arquivos Brasileiros de Cardiologia 2002;79(4):351-62. [DOI: 10.1590/s0066-782x2002001300003] [PMID: ] [DOI] [PubMed] [Google Scholar]
Davey 2000 {published data only}
- Davey GJ, Roberts JD, Patel S, Pierpoint T, Godsland IF, Davies B, et al. Effects of exercise on insulin resistance in South Asians and Europeans. Journal of Exercise Physiology Online 2000;3(2):6-11. [Google Scholar]
Dean 1989 {published data only}
- Dean E, Ross J, Bartz J, Purves S. Improving the validity of clinical exercise testing: the relationship between practice and performance. Archives of Physical Medicine and Rehabilitation 1989;70(8):599-604. [PMID: ] [PubMed] [Google Scholar]
Deligiannis 1999 {published data only}
- Deligiannis A, Kouidi E, Tassoulas E, Gigis P, Tourkantonis A, Coats A. Cardiac effects of exercise rehabilitation in hemodialysis patients. International Journal of Cardiology 1999;70(3):253-66. [DOI: 10.1016/s0167-5273(99)00090-x] [PMID: ] [DOI] [PubMed] [Google Scholar]
De Vito 1999 {published data only}
- De Vito G, Bernardi M, Forte R, Pulejo C, Figura F. Effects of a low-intensity conditioning programme on vo2max and maximal instantaneous peak power in elderly women. European journal of applied physiology and occupational physiology 1999;80(3):227-32. [PMID: 10.1007/s004210050586] [PMID: ] [DOI] [PubMed] [Google Scholar]
Devonish 2007 {published data only}
- Devonish JA, Culos-Reed SN, Keats MR, Stephenson LE. Physical activity for cancer survivors: fitness and QOL results from a 16-week intervention. Journal of Sport and Exercise Psychology 2007;29:S157-8. [Google Scholar]
Digenio 1999 {published data only}
- Digenio AG, Noakes TD, Joughin H, Daly L. Effect of myocardial ischaemia on left ventricular function and adaptability to exercise training. Medicine and Science in Sports and Exercise 1999;31(8):1094-101. [DOI: 10.1097/00005768-199908000-00003] [PMID: ] [DOI] [PubMed] [Google Scholar]
Di Loretoc 2005 {published data only}
- Di Loretoc C, Fanelli C, Lucidi P, Murdolo G, De Cicco A, Parlanti N, et al. Make your diabetic patients walk: long-term impact of different amounts of physical activity on type 2 diabetes. Diabetes Care 2005;28(6):1295-302. [DOI: 10.2337/diacare.28.6.1295] [PMID: ] [DOI] [PubMed] [Google Scholar]
Dimeo 2012 {published data only}
- Dimeo F, Pagonas N, Seibert F, Arndt R, Zidek W, Westhoff TH. Aerobic exercise reduces blood pressure in resistant hypertension. Hypertension 2012;60:653-8. [DOI: 10.1161/HYPERTENSIONAHA.112.197780] [PMID: ] [DOI] [PubMed] [Google Scholar]
- Pagonas N, Dimeo F, Bauer F, Seibert F, Kiziler F, Zidek W, et al. The impact of aerobic exercise on blood pressure variability. Journal of Human Hypertension 2014;28(6):367-71. [DOI] [PubMed] [Google Scholar]
Dowman 2013 {published data only}
- Dowman L, McDonald CF, Hill C, Lee A, Barker K, Boote C, et al. The benefits of exercise training in interstitial lung disease: protocol for a multicentre randomised controlled trial. BMC Pulmonary Medicine 2013;13:8. [DOI: 10.1186/1471-2466-13-8] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Dressendorfer 1995 {published data only}
- Dressendorfer RH, Franklin BA, Cameron JL, Trahan KJ, Gordon S, Timmis GC. Exercise training frequency in early post-infarction cardiac rehabilitation: Influence on aerobic conditioning. Journal of Cardiopulmonary Rehabilitation 1995;15(4):269-76. [DOI: 10.1097/00008483-199507000-00003] [PMID: ] [DOI] [PubMed] [Google Scholar]
Duncan 1985 {published data only}
- Duncan JJ, Farr JE, Upton SJ, Hagan RD, Oglesby ME, Blair SN. The effects of aerobic exercise on plasma catecholamines and blood pressure in patients with mild essential hypertension. JAMA 1985;254(18):2609-13. [PMID: ] [PubMed] [Google Scholar]
Dunn 1997 {published data only}
- Dunn AL, Marcus BH, Kampert JB, Garcia ME, Kohl HW, 3rd, Blair SN. Reduction in cardiovascular disease risk factors: 6-month results from project active. Preventive Medicine 1997;26(6):883-92. [DOI: 10.1006/pmed.1997.0218] [PMID: ] [DOI] [PubMed] [Google Scholar]
Duyur 2006 {published data only}
- Duyur CB, Sert E, Erdem HR, Nacir B, Genc H, Saracoglu M, et al. The effects of aerobic exercise on blood pressure in older patients [Turkish]. Romatoloji ve Tibbi Rehabilitasyon Dergisi [Journal of Rheumatology and Medical Rehabilitation] 2006;17(4):259-66. [Google Scholar]
Elley 2006 {published data only}
- Elley R, Bagrie E, Arroll B. Do snacks of exercise lower blood pressure? a randomised crossover trial. New Zealand Medical Journal 2006;119(1235):U1996. [PMID: ] [PubMed] [Google Scholar]
Ettinger 1997 {published data only}
- Ettinger WH Jr, Burns R, Messier SP, Applegate W, Rejeski WJ, Morgan T, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. the fitness arthritis and seniors trial (FAST). JAMA 1997;277(1):25-31. [PMID: ] [PubMed] [Google Scholar]
Fan 2018 {published data only}
- Fan, B. Effects of different steps of brisk walking on the fitness of middle-aged and old men. Zhongguo Ying Yong Sheng Li Xue Za Zhi [Chinese Journal of Applied Physiology] 2018;34(2):126-9. [DOI: 10.12047/j.cjap.5605.2018.000] [PMID: ] [DOI] [PubMed] [Google Scholar]
Figueroa 2007 {published data only}
- Figueroa A, Baynard T, Fernhall B, Carhart R, Kanaley JA. Endurance training improves post-exercise cardiac autonomic modulation in obese women with and without type 2 diabetes. European Journal of Applied Physiology 2007;100(4):437-44. [DOI: 10.1007/s00421-007-0446-3] [PMID: ] [DOI] [PubMed] [Google Scholar]
Filho 2013 {published data only}
- Filho ML, Matos DG, Rodrigues BM, Aidar FJ, Oliveira Venturini GR, da Silva Salgueiro R, et al. The effects of 16 weeks of exercise on metabolic parameters, blood pressure, body mass index and functional autonomy in elderly women. International SportS MedIicine Journal 2013;14(2):86-93. [Google Scholar]
Finkelstein 2016 {published data only}
- Finkelstein EA, Haaland BA, Bilger M, Sahasranaman A, Sloan RA, Nang EE et al. Effectiveness of activity trackers with and without incentives to increase physical activity (trippa): a randomised controlled trial. Lancet Diabetes & Endocrinology 2016;4(12):983-95. [DOI: 10.1016/S2213-8587(16)30284-4] [PMID: ] [DOI] [PubMed] [Google Scholar]
Flo 2011 {published data only}
- Flo GL, Dougherty CM, Burr RL, Kudenchuk PJ, Glenny R. Effects of aerobic exercise on biomarkers after an implantable defibrillator (ICD). Circulation 2011;1(suppl 21):A9542. [Google Scholar]
Fox 2011 {published data only}
- Fox BD, Kassirer M, Weiss I, Raviv Y, Peled N, Shitrit D, et al. Ambulatory rehabilitation improves exercise capacity in patients with pulmonary hypertension. Journal of Cardiac Failure 2011;17(3):196-200. [DOI: 10.1016/j.cardfail.2010.10.004] [PMID: ] [DOI] [PubMed] [Google Scholar]
Fukahori 1999 {published data only}
- Fukahori M, Aono H, Saito I, Ikebe T, Ozawa H. Program of exercise training as total health promotion plan and its evaluation. Journal of Occupational Health 1999;41(2):76-82. [Google Scholar]
Gettman 1976 {published data only}
- Gettman LR, Pollock ML, Durstine JL, Ward A, Ayres J, Linnerud AC. Physiological responses of men to 1, 3, and 5 day per week training programs. Research Quarterly 1976;47(4):638-46. [MEDLINE: ] [PubMed] [Google Scholar]
Giannuzzi 2003 {published data only}
- Giannuzzi P, Temporelli PL, Corrà U, Tavazzi L. Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure: results of the exercise in left ventricular dysfunction and chronic heart failure (ELVD-CHF) Trial. Circulation 2003;108(5):554-9. [DOI: 10.1161/01.CIR.0000081780.38477.FA] [PMID: ] [DOI] [PubMed] [Google Scholar]
Gibellini 2000 {published data only}
- Gibellini R, Fanello M, Bardile AF, Salerno M, Aloi T. Exercise training in intermittent claudication. International Angiology 2000;19(1):8-13. [PubMed] [Google Scholar]
Gill 1984 {published data only}
- Gill AA, Veigl VL, Shuster JJ, Notelovitz M. A well woman's health maintenance study comparing physical fitness and group support programs. Occupational Therapy Journal of Research 1984;4(4):286-308. [Google Scholar]
Goldstein 1977 {published data only}
- Goldstein DS, Ross RS, Brady JV. Biofeedback heart rate training during exercise. Biofeedback and Self-Regulation 1977;2(2):107-25. [DOI: 10.1007/bf00998662] [PMID: ] [DOI] [PubMed] [Google Scholar]
Gram 2010 {published data only}
- Gram B, Christensen R, Christiansen C, Gram J. Effects of Nordic walking and exercise in type 2 diabetes mellitus: a randomized controlled trial. Clinical Journal of Sport Medicine 2010;20(5):355-61. [DOI: 10.1227/NEU.0b013e3181e56e0a]] [PMID: ] [DOI] [PubMed] [Google Scholar]
Grant 2004 {published data only}
- Grant S, Todd K, Aitchison TC, Kelly P, Stoddart D. The effects of a 12-week group exercise programme on physiological and psychological variables and function in overweight women. Public Health 2004;118(1):31-42. [DOI: 10.1016/S0033-3506(03)00131-8] [PMID: ] [DOI] [PubMed] [Google Scholar]
Grosse 2001 {published data only}
- Grosse T, Kreulich K, Naegele H, Reer R, Petersen B, Braumann KM, et al. Peripheral muscular strength training in patients with severe heart failure [Peripheres muskelkrafttraining bei schwerer herzinsuffizienz.]. Deutsche Zeitschrift für Sportmedizin 2001;52(1):11-4. [Google Scholar]
Guo 2011 {published data only}
- Guo L. Effects of Tai Chi and Walking Exercise onSselected Parameters of Middle-aged Office Workers. Hong Kong: Hong Kong Baptist University, 2011. [Google Scholar]
Hagberg 1989a {published data only}
- Hagberg JM, Graves JE, Limacher M, Woods DR, Leggett SH, Cononie C, et al. Cardiovascular responses of 70- to 79-yr-old men and women to exercise training. Journal of Applied Physiology 1989a;66(6):2589-94. [DOI: 10.1152/jappl.1989.66.6.2589] [PMID: ] [DOI] [PubMed] [Google Scholar]
Hagberg 1989b {published data only}
- Hagberg JM, Montain SJ, Martin WH 3rd, Ehsani AA. Effect of exercise training in 60- to 69-year-old persons with essential hypertension. American Journal of Cardiology 1989;64(5):348-53. [DOI: 10.1016/0002-9149(89)90533-x] [PMID: ] [DOI] [PubMed] [Google Scholar]
Halbert 2000 {published data only}
- Halbert JA, Silagy CA, Finucane PM, Withers RT, Hamdorf PA. Physical activity and cardiovascular risk factors: effect of advice from an exercise specialist in Australian general practice. Medical Journal of Australia 2000;173(2):84-7. [PMID: ] [DOI] [PubMed] [Google Scholar]
Hambrecht 2000 {published data only}
- Hambrecht R, Gielen S, Linke A, Fiehn E, Yu J, Walther C, et al. Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure. JAMA 2000;283(23):3095-101. [DOI: 10.1001/jama.283.23.3095] [PMID: ] [DOI] [PubMed] [Google Scholar]
Hamdorf 1992 {published data only}
- Hamdorf PA, Withers RT, Penhall RK, Haslam MV. Physical training effects on the fitness and habitual activity patterns of elderly women. Archives of Physical Medicine and Rehabilitation 1992;73(7):603-8. [PMID: ] [PubMed] [Google Scholar]
Hamdorf 1993 {published data only}
- Hamdorf PA, Withers RT, Penhall RK, Plummer JL. A follow-up study on the effects of training on the fitness and habitual activity patterns of 60- to 70-year-old women. Archives of Physical Medicine and Rehabilitation 1993;74(5):473-7. [DOI: 10.1016/0003-9993(93)90108-m] [PMID: ] [DOI] [PubMed] [Google Scholar]
Hardman 1994 {published data only}
- Hardman AE, Hudson A. Brisk walking and serum lipid and lipoprotein variables in previously sedentary women--effect of 12 weeks of regular brisk walking followed by 12 weeks of detraining. British Journal of Sports Medicine 1994;28(4):261-6. [DOI: 10.1136/bjsm.28.4.261] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Hass 2001 {published data only}
- Hass CJ, Garzarella L, Hoyos DV, Connaughton DP, Pollock ML. Concurrent improvements in cardiorespiratory and muscle fitness in response to total body recumbent stepping in humans. European Journal of Applied Physiology 2001;85(1-2):157-63. [DOI: 10.1007/s004210100435] [PMID: ] [DOI] [PubMed] [Google Scholar]
Havlik 2005 {published data only}
- Havlik RJ, Phillips CL, Brock DB, Lohman K, Haskell W, Snell P, et al. Walking may be related to less vascular stiffness in the activity counseling trial (ACT). American Heart Journal 2005;150(2):270-5. [DOI: 10.1016/j.ahj.2004.09.006] [PMID: ] [DOI] [PubMed] [Google Scholar]
Headley 2008 {published data only}
- Headley SA, Germain MJ, Milch CM, Buchholz MP, Coughlin MA, Pescatello LS. Immediate blood pressure-lowering effects of aerobic exercise among patients with chronic kidney disease. Nephrology 2008;13(7):601-6. [DOI: 10.1111/j.1440-1797.2008.01030.x.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Hiatt 1994 {published data only}
- Hiatt WR, Wolfel EE, Meier RH, Regensteiner JG. Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease: implications for the mechanism of the training response. Circulation 1994;90(41):1866-74. [DOI: 10.1161/01.cir.90.4.1866.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Higashi 1999a {published data only}
- Higashi Y, Sasaki S, Kurisu S, Yoshimizu A, Sasaki N, Matsuura H, et al. Regular aerobic exercise augments endothelium-dependent vascular relaxation in normotensive as well as hypertensive subjects: role of endothelium-derived nitric oxide. Circulation 1999;100(11):1194-202. [DOI: 10.1161/01.cir.100.11.1194] [PMID: ] [DOI] [PubMed] [Google Scholar]
Hinkleman 1993 {published data only}
- Hinkleman LL, Nieman DC. The effects of a walking program on body composition and serum lipids and lipoproteins in overweight women. Journal of Sports Medicine and Physical Fitness 1993;33(1):49-58. [PMID: ] [PubMed] [Google Scholar]
Hu 2016 {published data only}
- Hu CH, Wu IT. Effects of walking program volume and frequency on blood pressure and functional fitness in elderly women. Adaptive Medicine 2016;8(1):32-9. [DOI: 10.4247/AM.2016.ABG130] [DOI] [Google Scholar]
Huang 2006 {published data only}
- Huang G, Thompson CJ, Osness WH. Influence of a 10-week controlled exercise program on resting blood pressure in sedentary older adults. Journal of Applied Research 2006;6(3):188-95. [DOI: 10.1097/HJH.0b013e328322cf60.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Huiskes 2009 {published data only}
- Huiskes BL. Advanced heart failure in older women with heart failure and preserved systolic function. University of California, San Francisco, 2009. [Google Scholar]
Hurley 2019 {published data only}
- Hurley DM, Williams ER, Cross JM, Riedinger BR, Meyer RA, Abela GS, et al. Aerobic exercise improves microvascular function in older adults. Medicine and Science in Sports and Exercise 2019;51(4):773-81. [DOI: 10.1249/MSS.0000000000001854] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Iida 2011 {published data only}
- Iida H, Yamasoba T, Nakajima T, Kurano M, Yasuda T, Sakamaki M, et al. Effects of walking with blood flow restriction on limb venous compliance in elderly subjects. Clinical Physiology and Functional Imaging 2011;31:472-6. [DOI: 10.1111/j.1475-097X.2011.01044.x. Epub 2011 Jul 28.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Isaacs 2007 {published data only}
- Isaacs AJ, Critchley JA, Tai SS, Buckingham K, Westley D, Harridge SDR, et al. Exercise evaluation randomised trial (exert): a randomised trial comparing GP referral for leisure centre-based exercise, community-based walking and advice only. Health Technology Assessment 2007;11(10):1-165, iii-iv. [EMBASE: 10.3310/hta11100.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Jennings 1997 {published data only}
- Jennings GL. Exercise and blood pressure: walk, run or swim? Journal of Hypertension 1997;15(6):567-9. [DOI: 10.1097/00004872-199715060-00001.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Jerome 2012 {published data only}
- Jerome GJ, Dalcin AT, Young DR, Stewart KJ, Crum RM, Latkin C, et al. Rationale, design and baseline data for the activating consumers to exercise through peer support (ace trial): a randomized controlled trial to increase fitness among adults with mental illness. Mental Health and Physical Activity 2012;5:166-74. [DOI: 10.1016/j.mhpa.2012.05.002] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Jessup 1994 {published data only}
- Jessup JV. The effects of endurance exercise training on renal function in older men and women. University of Florida, 1994. [Google Scholar]
Jessup 1996 {published data only}
- Jessup JV, Lowenthal DT, Pollock ML, Smyth KA, Williams L, Ruiz J, et al. Exercise training in older men and women: effects on cardiovascular and renal function. Geriatric Nephrology and Urology 1996;6(1):27-34. [Google Scholar]
Jette 1988 {published data only}
- Jette M, Sidney K, Campbell J. Effects of a twelve-week walking programme on maximal and submaximal work output indices in sedentary middle-aged men and women. Journal of Sports Medicine and Physical Fitness 1988;28(1):59-66. [PMID: ] [PubMed] [Google Scholar]
Jiang 2004 {published data only}
- Jiang X. The effect of a nurse-led cardiac rehabilitation programme on patients with coronary heart disease in Chengdu, China. Hong Kong Polytechnic University (People's Republic of China), 2004. [Google Scholar]
Jiang 2007 {published data only}
- Jiang X, Sit JW, Wong TK. A nurse-led cardiac rehabilitation programme improves health behaviours and cardiac physiological risk parameters: evidence from Chengdu, china. Journal of Clinical Nursing 2007;16(10):1886-97. [DOI: 10.1111/j.1365-2702.2007.01838.x.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Jiang 2013 {published data only}
- Jiang YY, Yang ZX, Ni R, Zhu YQ, Li ZY, Yang LC, et al. Effectiveness analysis on the physical activity and the health benefit of a community population based program. Biomedical and Environmental Sciences 2013;26:468-73. [DOI: 10.3967/0895-3988.2013.06.007.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Jo 1989 {published data only}
- Jo Y, Arita M, Baba A, Nakamura H, Ueda E, Hano T, et al. Blood pressure and sympathetic activity following responses to aerobic exercise in patients with essential hypertension. Clinical and Experimental Hypertension Part A 1989;11 Suppl 1:411-7. [DOI: 10.3109/10641968909045448.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Johnson 2007 {published data only}
- Johnson JL, Slentz CA, Houmard JA, Samsa GP, Duscha BD, Aiken LB, et al. Exercise training amount and intensity effects on metabolic syndrome (from studies of a targeted risk reduction Intervention through defined exercise). American Journal of Cardiology 2007;100(12):1759-66. [DOI: 10.1016/j.amjcard.2007.07.027.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Kaltsatou 2011 {published data only}
- Kaltsatou A, Mameletzi D, Douka S. Physical and psychological benefits of a 24-week traditional dance program in breast cancer survivors. Journal of Bodywork and Movement Therapies 2011;15(2):162-7. [DOI: 10.1016/j.jbmt.2010.03.002.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Katz‐Leurer 2007 {published data only}
- Katz-Leurer M, Shochina M. The influence of autonomic impairment on aerobic exercise outcome in stroke patients. Neurorehabilitation 2007;22(4):267-72. [PMID: ] [PubMed] [Google Scholar]
Kerse 2005 {published data only}
- Kerse N, Elley CR, Robinson E, Arroll B. Is physical activity counseling effective for older people?a cluster randomized, controlled trial in primary care. Journal of The American Geriatrics Society 2005;53(11):1951-6. [DOI: 10.1111/j.1532-5415.2005.00466.x.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Kim 2010 {published data only}
- Kim C, Choi HE, Lee DW. The effect of power walking in a phase 2 cardiac rehabilitation program. Physical Medicine and Rehabilitation 2010;1:S26-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
King 1991 {published data only}
- King AC, Haskell WL, Taylor CB, Kraemer HC, DeBusk RF. Group- vs home-based exercise training in healthy older men and women. a community-based clinical trial. JAMA 1991;266(11):1535-42. [PMID: ] [PubMed] [Google Scholar]
Kingwell 1993 {published data only}
- Kingwell BA, Jennings GL. Effects of walking and other exercise programs upon blood pressure in normal subjects. Medical Journal of Australia 1993;158(4):234-8. [PMID: ] [DOI] [PubMed] [Google Scholar]
Kinoshita 1988 {published data only}
- Kinoshita A, Urata H, Tanabe Y, Ikeda M, Tanaka H, Shindo M, et al. What types of hypertensives respond better to mild exercise therapy? Journal of Hypertension. Supplement 1988;6(4):S631-3. [DOI: 10.1097/00004872-198812040-00198] [PMID: ] [DOI] [PubMed] [Google Scholar]
Klonizakis 2009a {published data only}
- Klonizakis M, Tew G, Michaels J, Saxton J. Effects of exercise training on skin blood vessel function in post-surgical varicose vein patients.. Clinical Hemorheology and Microcirculation 2009a;42(3):203. [Google Scholar]
Klonizakis 2009b {published data only}
- Klonizakis M, Tew G, Michaels J, Saxton J. Exercise training improves cutaneous microvascular endothelial function in post-surgical varicose vein patient. Microvascular Research 2009b;78(1):67-70. [DOI: 10.1016/j.mvr.2009.03.002.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Kobayashi 2001 {published data only}
- Kobayashi Y, Hosoi T, Takeuchi T, Aoki S. Benefits of a convenient, self-regulated 6-month walking program in sedentary, middle-aged women. Japanese Journal of Physical Fitness and Sports Medicine 2001;50(3):313-24. [Google Scholar]
Koh 2009 {published data only}
- Koh KP, Fassett RG, Sharman JE, Coombes JS, Williams AD. Intradialytic versus home-based exercise training in hemodialysis patients: a randomised controlled trial. Bio Medical Center Nephrology 2009;10:2. [DOI: 10.1186/1471-2369-10-2.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Kolbe‐Alexander 2006 {published data only}
- Kolbe-Alexander TL, Lambert EV, Charlton KE. Effectiveness of a community based low intensity exercise program for older adults. Journal of Nutrition, Health and Aging 2006;10(1):21-9. [PMID: ] [PubMed] [Google Scholar]
Kolt 2009 {published data only}
- Kolt GS, Schofield GM, Kerse N, Garrett N, Schluter PJ, Ashton T, et al. The healthy steps study: a randomized controlled trial of a pedometer-based green prescription for older adults. Trial protocol. BMC Public Health 2009;9(404):1-6. [DOI: 10.1186/1471-2458-9-404.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Lamb 2002 {published data only}
- Lamb SE, Bartlett HP, Ashley A, Bird W. Can lay-led walking programmes increase physical activity in middle aged adults? a randomised controlled trial. Journal of Epidemiology and Community Health 2002;56:246-52. [DOI: 10.1136/jech.56.4.246.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Larsen 1969 {published data only}
- Larsen OA, Lassen NA. Medical treatment of occlusive arterial disease of the legs. walking exercise and medically induced hypertension. Angiologica 1969;6(5):288-301. [DOI: 10.1159/000157798.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Lee 2001 {published data only}
- Lee IM, Rexrode KM, Cook NR, Manson JE, Buring JE. Physical activity and coronary heart disease in women: Is "no pain, no gain" passe? JAMA 2001;285(11):1447-54. [DOI: 10.1001/jama.285.11.1447.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Leehey 2009 {published data only}
- Leehey DJ, Moinuddin I, Bast JP, Qureshi S, Jelinek CS, Cooper C, et al. Aerobic exercise in obese diabetic patients with chronic kidney disease: a randomized and controlled pilot study. Cardiovascular Diabetology 2009;8:62. [DOI: 10.1186/1475-2840-8-62.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Leon 1996 {published data only}
- Leon AS, Casal D, Jacobs D Jr. Effects of 2,000 kcal per week of walking and stair climbing on physical fitness and risk factors for coronary heart disease. Journal of Cardiopulmonary Rehabilitation 1996;16(3):183-92. [DOI: 10.1097/00008483-199605000-00006] [PMID: ] [DOI] [PubMed] [Google Scholar]
Ley 2013 {published data only}
- Ley S, Fink C, Risse F, Ehlken N, Fischer C, Ley-Zaporozhan J, et al. Magnetic resonance imaging to assess the effect of exercise training on pulmonary perfusion and blood flow in patients with pulmonary hypertension. European Radiology 2013;23(2):324-31. [DOI: 10.1007/s00330-012-2606-z..] [PMID: ] [DOI] [PubMed] [Google Scholar]
Li (李合) 2018 {published data only}
- Li H, Ran W, Hou XH, Liu X. Effects of 12 weeks brisk walking on serum ET-1, no and eNOS in postmenopausal women with essential hypertension. Journal of Beijing Sport University 2018;14(5):64-70. [Google Scholar]
Li 2005 {published data only}
- Li F, Fisher KJ, Harmer P. Improving physical function and blood pressure in older adults through cobblestone mat walking: a randomized trial. Journal of The American Geriatrics Society 2005;53(8):1305-12. [DOI: 10.1111/j.1532-5415.2005.53407.x.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Liang ( 梁曉琳) 2015 {published data only}
- Liang XL, Li WY. The effect of walking training on cardiac function rehabilitation of elderly patients with chronic heart failure [步行訓練對老年慢性心力衰竭患者心臟功能康復的影響]. Journal of Clinical Medical 2015;2(24):4997,5000. [Google Scholar]
Liao 1987 {published data only}
- Liao Y, Emidy LA, Gosch FC, Stamler R, Stamler J. Cardiovascular responses to exercise of participants in a trial on the primary prevention of hypertension. Journal of Hypertension 1987;5(3):317-21. [EMBASE: 10.1097/00004872-198706000-00009.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Lima 2009 {published data only}
- Lima LG, Jatte FG, Anunciato IF, Nobre F, Moriguti JC, Ferriolli E, et al. Short and prolonged effect of acute exercise on blood pressure in older individuals. Journal of Clinical Hypertension 2009;11(4 SUPPL):A155-6. [Google Scholar]
Lin (林麗娟) 2010 {published data only}
- Lin LJ, Wu ZI. Effect of brisk walking program on cardiovascular risk factors in middle-aged and older adults in the community [健走運動對社區中老年人心血管危險因子之影響]. Sports & Exercise Research 2010;12(4):90-8. [DOI: 10.5297/ser.1204.010] [DOI] [Google Scholar]
Lin 2009 {published data only}
- Lin X-Y, Wang L, Zhu D-B, Xu Y-H, Wang J-F. The effect of different intensity aerobic exercise training on blood pressure control in hypertensive patients. Chung-Hua Nei Ko Tsa Chih Chinese Journal of Internal Medicine 2009;48(12):1023-5. [PMID: ] [PubMed] [Google Scholar]
Liu (劉彥平) 2019 {published data only}
- Liu YP. The effect of 6-minute walking exercise on elderly patients with hypertension [6分鐘步行運動對老年高血壓病患者的保健作用]. Medical Information 2019;32:99-100. [Google Scholar]
Llaberia 2013 {published data only}
- Llaberia MR, Femdndez-Cacr JC, Aguas D, Vlnuesct A, Sliva AR, Dalmau S, et al. Pas a Pas program: a community randomized intervention study of physical activity. Annals of Nutrition and Metabolism 2013;62(Suppl 2):71. [Google Scholar]
Look Ahead Research Group 2010 {published data only}
- Look Ahead Research Group, Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look ahead trial. Archives of Internal Medicine 2010;170(17):1566-75. [DOI: 10.1001/archinternmed.2010.334.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Low 2007 {published data only}
- Low D, Gramlich M, Engram BW. Self-paced exercise program for office workers: impact on productivity and health outcomes. American Association of Occupational Health Nurses Journal 2007;55(3):99-105. [DOI: 10.1177/216507990705500302.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Lunde 2012 {published data only}
- Lunde MS, Hjellset VT, Hostmark AT. Slow post meal walking reduces the blood glucose response: an exploratory study in female Pakistani immigrants. Journal of Immigrant and Minority Health / Center for Minority Public Health 2012;14:816-22. [DOI: 10.1007/s10903-012-9574-x.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Mackey 2011 {published data only}
- Mackey M, Bohle P, Taylor P, Di Biase T, McLoughlin C, Purnell K. 'Walking to wellness' in an ageing sedentary university community-a randomised controlled feasibility study. In: Physiotherapy (United Kingdom). Vol. 97 (Supppl 1). 2011:eS733-4. [DOI: 10.1016/j.cct.2010.12.001.] [DOI]
Mackey 2011 {published data only}
- Mackey MG, Bohle P, Taylor P, Di Biase T, McLoughlin C, Purnell K. Walking to wellness in an ageing sedentary university community: design, method and protocol. Contemporary Clinical Trials 2011;32(2):273-9. [DOI: 10.1016/j.cct.2010.12.001.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Marceau 1993 {published data only}
- Marceau M, Kouame N, Lacourciere Y, Cleroux J. Effects of different training intensities on 24-hour blood pressure in hypertensive subjects. Circulation 1993;88(6):2803-11. [DOI: 10.1161/01.cir.88.6.2803.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Martins 2010 {published data only}
- Martins RA, Verissimo MT, Coelho ES, Cumming SP, Teixeira AM. Effects of aerobic and strength-based training on metabolic health indicators in older adults. Lipids in Health and Disease 2010;9:76. [DOI: 10.1186/1476-511X-9-76.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Mason 1977 {published data only}
- Mason DT, Zelis R, Longhurst J, Lee G. Cardiocirculatory responses to muscular exercise in congestive heart failure. Progress in Cardiovascular Diseases 1977;19(6):475-89. [DOI: 10.1016/0033-0620(77)90011-1.] [PMID: ] [DOI] [PubMed] [Google Scholar]
McAuley 2003 {published data only}
- McAuley E, Jerome GJ, Elavsky S, Marquez DX, Ramsey SN. Predicting long-term maintenance of physical activity in older adults. Preventive Medicine 2003;37(2):110-8. [EMBASE: 10.1016/s0091-7435(03)00089-6.] [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
McDermott 2004 {published data only}
- McDermott MM, Tiukinhoy S, Greenland P, Liu K, Pearce WH, Guralnik JM, et al. A pilot exercise intervention to improve lower extremity functioning in peripheral arterial disease unaccompanied by intermittent claudication. Journal of Cardiopulmonary Rehabilitation 2004;24(3):187-96. [DOI: 10.1097/00008483-200405000-00010.] [PMID: ] [DOI] [PubMed] [Google Scholar]
McDermott 2013 {published data only}
- McDermott MM, Liu K, Guralnik JM, Criqui MH, Spring B, Tian L, et al. Home-based walking exercise intervention in peripheral artery disease: a randomized clinical trial. JAMA 2013;310(1):57-65. [DOI: 10.1001/jama.2013.7231.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Mentz 2013 {published data only}
- Mentz RJ, Bittner V, Schulte PJ, Fleg JL, Pina IL, Keteyian SJ, et al. Race, exercise training, and outcomes in chronic heart failure: findings from heart failure - a controlled trial investigating outcomes in exercise training (HF-action). American Heart Journal 2013;166:488-95. [EMBASE: 10.1016/j.ahj.2013.06.002.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Mereles 2006 {published data only}
- Mereles D, Ehlken N, Kreuscher S, Ghofrani S, Hoeper MM, Halank M, et al. Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension. Circulation 2006;114(14):1482-9. [DOI: 10.1161/CIRCULATIONAHA.106.618397. ] [PMID: ] [DOI] [PubMed] [Google Scholar]
Milecki 2013 {published data only}
- Milecki P, Hojan K, Ozga-Majchrzak O, Molinska-Glura M. Exercise tolerance in breast cancer patients during radiotherapy after aerobic training. Wspolczesna Onkologia [Contemporary Oncology] 2013;17(2):205-9. [DOI: 10.5114/wo.2013.34453.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Miller 1993 {published data only}
- Miller WC, Wallace JP, Eggert KE. Predicting max HR and the HR-VO2 relationship for exercise prescription in obesity. Medicine & Science in Sports and Exercise 1993;25(9):1077-81. [PMID: ] [PubMed] [Google Scholar]
Minus‐Grimes 2013 {published data only}
- Minus-Grimes I, Frankson MA, Hanna-Mahase C. The impact of exercise on cognitive function in ambulatory elderly. Journal of the American Geriatrics Society 2013;61:S191. [Google Scholar]
Miyashita 2008 {published data only}
- Miyashita M, Burns SF, Stensel DJ. Accumulating short bouts of brisk walking reduces postprandial plasma triacylglycerol concentrations and resting blood pressure in healthy young men. American Journal of Clinical Nutrition 2008;88(5):1225-31. [DOI: 10.3945/ajcn.2008.26493.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Mohammed 2016 {published data only}
- Mohammed MA, Rahmy AF, Mohamed GS, Kaddah AF. Effect of exercise training on cardiovascular responses In diabetic autonomic neuropathy. International Journal of PharmTech Research 2016;9(5):110-8. [Google Scholar]
Molmen‐Hansen 2012 {published data only}
- Molmen-Hansen HE, Stolen T, Tjonna AE, Aamot IL, Ekeberg IS, Tyldum GA, et al. Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients. European Journal of Preventive Cardiology 2012;19:151-60. [DOI: 10.1177/1741826711400512.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Monteiro 2010 {published data only}
- Monteiro LZ, Vaz Fiani CR, Freitas MC, Zanetti ML, Foss MC. Decrease in blood pressure, body mass index and glycemia after aerobic training in elderly women with type 2 diabetes. Arquivos Brasileiros de Cardiologia 2010;95(5):563-70. [DOI: 10.1590/s0066-782x2010005000135. ] [PMID: ] [DOI] [PubMed] [Google Scholar]
Motlagh 2017a {published data only}
- Motlagh Z, Hidarnia A, Kaveh MH, Kojuri J. Effect of theory-based training intervention on physical activity and blood pressure in hypertensive patients: a randomized control trial. Iranian Red Crescent Medical Journal 2017;19(7):e55610. [Google Scholar]
Motlagh 2017b {published data only}
- Motlagh Z, Hidarnia A, Kaveh MH, Kojuri J. Influence of a trans-theoretical model based intervention on physical activity in hypertensive patients: a randomised clinical trial. Asian Journal of Sports Medicine 2017;8(2):1-9. [DOI: 10.5812/asjsm.42655] [DOI] [Google Scholar]
Motoyama 1995 {published data only}
- Motoyama M, Sunami Y, Kinoshita F, Irie T, Sasaki J, Arakawa K, et al. The effects of long-term low intensity aerobic training and detraining on serum lipid and lipoprotein concentrations in elderly men and women. European Journal of Applied Physiology and Occupational Physiology 1995;70(2):126-31. [DOI: 10.1007/bf00361539.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Motoyama 1998 {published data only}
- Motoyama M, Sunami Y, Kinoshita F, Kiyonaga A, Tanaka H, Shindo M, et al. Blood pressure lowering effect of low intensity aerobic training in elderly hypertensive patients. [Effet d'un entrainement aerobie de faible intensite sur la baisse de la pression arterielle chez des personnes agees souffrant d'hypertension]. Medicine and Science in Sports and Exercise 1998;30(6):818-23. [DOI: 10.1097/00005768-199806000-00007.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Moul 1993 {published data only}
- Moul JL. The Effects of 16-week Walking and 16-week Weight-training Programs on the Performance of Men and Women Ages 65-77 on the Ross Information Processing Assessment. Ann Arbor: The University of North Carolina at Greensboro, 1993. [Google Scholar]
Mucha 2007 {published data only}
- Mucha C. The influence of a moderate endurance training on fitness parameters and lipoprotein constellation in seniors [Der Einfluss eines moderaten Ausdauertrainings auf Fitnessparameter und Lipoproteinkonstellation bei Senioren. Ergebnisse einer Pilotstudie (German)]. Erfahrungsheilkunde 2007;56(10):581-2, 584-6. [Google Scholar]
Muda 2006 {published data only}
- Muda SH, Kadir AA. The effectiveness of physical activity counseling in primary care clinic university science Malaysia hospital. International Medical Journal 2006;13(4):249-53. [Google Scholar]
Myers 1999 {published data only}
- Myers J, Dziekan G, Goebbels U, Dubach P. Influence of high-intensity exercise training on the ventilatory response to exercise in patients with reduced ventricular function. Medicine and Science in Sports and Exercise 1999;31(7):929-37. [EMBASE: 10.1097/00005768-199907000-00003.] [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
Nam 2012 {published data only}
- Nam S, Dobrosielski DA, Stewart KJ. Predictors of exercise intervention dropout in sedentary individuals with type 2 diabetes. Journal of Cardiopulmonary Rehabilitation & Prevention 2012;32:370-8. [DOI: 10.1097/HCR.0b013e31826be485.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Neto 2010 {published data only}
- Neto ET, Aline ES, Monteiro MC, Camargo LM, Silva NP, Pinheiro MM, et al. Physical exercise improves endothelial function in patients with systemic lupus erythematosus. In: Arthritis and Rheumatism. Vol. 62 (Supplement). 2010:628.
Newton 2002 {published data only}
- Newton RL Jr. Exercise promotion in sedentary African American adults. US: ProQuest Information & Learning, 2002. [Google Scholar]
Ngomane 2019 {published data only}
- Ngomane AY, Fernandes B, Guimaraes GV, Ciolac EG. Hypotensive effect of heated water-based exercise in older individuals with hypertension. International Journal of Sports Medicine 2019;40(4):283-91. [DOI: 10.1055/a-0828-8017] [PMID: ] [DOI] [PubMed] [Google Scholar]
Nieman 2013 {published data only}
- Nieman D, Dew D, Krasen P. Gender difference in the acute influence of a 2-hour run on arterial stiffness in trained runners. Research in Sports Medicine 2013;21:66-77. [DOI: 10.1080/15438627.2012.738445.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Nomura 1984 {published data only}
- Nomura G, Kumagai E, Midorikawa K, Kitano T, Tashiro H, Toshima H. Physical training in essential hypertension: alone and in combination with dietary salt restriction. Journal of Cardiopulmonary Rehabilitation 1984;4:469-75. [Google Scholar]
Norris 1990 {published data only}
- Norris R, Carroll D, Cochrane R. The effects of aerobic and anaerobic training on fitness, blood pressure, and psychological stress and well-being. Journal of Psychosomatic Research 1990;34(4):367-75. [DOI: 10.1016/0022-3999(90)90060-h] [PMID: ] [DOI] [PubMed] [Google Scholar]
Nussbaum 2013 {published data only}
- Nussbaum J. Fall prevention, reduced morbidity, and improved functional outcome measures in frail patients with end stage kidney disease undergoing a skilled physical therapy program: The prohealth experience. Blood Purification 2013;35(1):157-8. [Google Scholar]
Oberman 1999 {published data only}
- Oberman AS, Harada RK, Gagnon MM, Kiely DK, Lipsitz LA. Effects of postprandial walking exercise on meal-related hypotension in frail elderly patients. American Journal of Cardiology 1999;84(9):1130-2. [DOI: 10.1016/s0002-9149(99)00520-2.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Obesity 2007 {published data only}
- No authors listed. Obesity: weight loss without drugs. a balanced diet avoiding high-calorie foods, plus exercise. Prescrire International 2007;16(90):162-7. [PMID: ] [PubMed] [Google Scholar]
Oerkild 2012 {published data only}
- Oerkild B, Frederiksen M, Hansen JF, Prescott ECSNLMPMC. Home-based cardiac rehabilitation is an attractive alternative to no cardiac rehabilitation for elderly patients with coronary heart disease: results from a randomised clinical trial. BMJ Open 2012;2(6):e001820. [DOI: 10.1136/bmjopen-2012-001820.] [PMID: 23253876] [DOI] [PMC free article] [PubMed] [Google Scholar]
Ogata 2012 {published data only}
- Ogata H, Fujimaru I, Yamada K, Kondo TC. Suppression of cardiocirculatory responses to orthostatic stress by passive walking-like leg movement in healthy young men. Journal of Physiological Anthropology 2012;31:24. [DOI: ] [EMBASE: 10.1186/1880-6805-31-24.] [DOI] [PMC free article] [PubMed] [Google Scholar]
Ohta 2012 {published data only}
- Ohta M, Hirao N, Mori Y, Takigami C, Eguchi M, Tanaka H, et al. Effects of bench step exercise on arterial stiffness in post-menopausal women:Contribution of IGF-1 bioactivity and nitric oxide production. Growth Hormone and IGF Research 2012;22:36-41. [DOI: 10.1016/j.ghir.2011.12.004.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Okamoto 2013 {published data only}
- Okamoto T, Sakamaki-Sunaga M, Min S, Miura T, Iwasaki T. Acute effect of brisk walking with graduated compression stockings on vascular endothelial function and oxidative stress. Clinical Physiology and Functional Imaging 2013;33:455-62. [DOI: 10.1016/j.ghir.2011.12.004.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Oldroyd 2001 {published data only}
- Oldroyd JC, Unwin NC, White M, Imrie K, Mathers JC, Alberti KG. Randomised controlled trial evaluating the effectiveness of behavioural interventions to modify cardiovascular risk factors in men and women with impaired glucose tolerance: outcomes at 6 months. Diabetes Research and Clinical Practice 2001;52(1):29-43. [DOI: 10.1016/s0168-8227(00)00244-8.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Osbak 2011 {published data only}
- Osbak PS, Mourier M, Kjaer A, Henriksen JH, Kofoed KF, Jensen GB. A randomized study of the effects of exercise training on patients with atrial fibrillation. American Heart Journal 2011;162:1080-7. [DOI: 10.1016/j.ahj.2011.09.013.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Özdirenç 2004 {published data only}
- Özdirenç M, Kocak G, Güntekin R. The acute effects of in-patient physiotherapy program on functional capacity in type II diabetes mellitus. Diabetes Research and Clinical Practice 2004;64(3):167-72. [DOI: 10.1016/j.diabres.2003.11.001.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Pal 2011 {published data only}
- Pal S, Cheng C, Ho S. The effect of two different health messages on physical activity levels and health in sedentary overweight, middle-aged women. BMC Public Health 2011;11:204. [DOI: 10.1186/1471-2458-11-204.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Paolillo 2013 {published data only}
- Paolillo FR, Corazza AV, Borghi-Silva A, Parizotto NA, Kurachi C, Bagnato VS. Infrared LED irradiation applied during high-intensity treadmill training improves maximal exercise tolerance in postmenopausal women: a 6-month longitudinal study. Lasers in Medical Science 2013;28:415-22. [DOI: 10.1007/s10103-012-1062-y.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Park 2005 {published data only}
- Park S, Jastremski CA, Wallace JP. Time of day for exercise on blood pressure reduction in dipping and nondipping hypertension. Journal of Human Hypertension 2005;19(8):597-605. [DOI: 10.1038/sj.jhh.1001901.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Park 2006a {published data only}
- Park S. Blood pressure reduction following the accumulation of short physical activity sessions versus a continuous physical activity session in prehypertension. Indiana: Indiana University, 2006. [DOI] [PubMed] [Google Scholar]
Park 2006b {published data only}
- Park S, Rink LD, Wallace JP. Accumulation of physical activity leads to a greater blood pressure reduction than a single continuous session, in prehypertension. Journal of Hypertension 2006;24(9):1761-70. [DOI: 10.1097/01.hjh.0000242400.37967.54.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Park 2014b {published data only}
- Park J-H, Miyashita M, Takahashi M, Kawanishi N, Hayashida H, Kim H-S, et al. Low-volume walking program improves cardiovascular-related health in older adults. Journal of Sports Science and Medicine 2014;13(3):624-31. [PMID: ] [PMC free article] [PubMed] [Google Scholar]
Pascoalino 2015 {published data only}
- Pascoalino LN, Ciolac EG, Tavares AC, Ertner Castro R, Ayub-Ferreira SM, Bacal F, et al. Exercise training improves ambulatory blood pressure but not arterial stiffness in heart transplant recipients. Journal of Heart and Lung Transplantation 2015;34(5):693-700. [DOI: 10.1016/j.healun.2014.11.013.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Peel 1999 {published data only}
- Peel C, Utsey C, MacGregor J. Exercise training for older adults with limitations in physical function. Journal of Aging and Physical Activity 1999;7(1):62-75. [Google Scholar]
Pereira 2015 {published data only}
- Pereira T, Costa C, Maldonado J. Vascular effects of a regular aerobic exercise programme in young healthy adults [abstract]. Journal of Hypertension 2015;33:e72. [Google Scholar]
Petersen 2013 {published data only}
- Petersen CB, Grønbæk M, Tolstrup JS. The effect of a pedometer-based physical activity intervention on health outcomes: a 3-month randomised controlled trial. European Journal of Epidemiology 2013;1:s220. [Google Scholar]
Petrella 1998 {published data only}
- Petrella, R J. How effective is exercise training for the treatment of hypertension? Clinical Journal of Sport Medicine 1998;8(3):224-31. [DOI: 10.1097/00042752-199807000-00011.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Piette 2011 {published data only}
- Piette JD, Richardson C, Himle J, Duffy S, Torres T, Vogel M, et al. A randomized trial of telephonic counseling plus walking for depressed diabetes patients. Medical Care 2011;49(7):641-8. [DOI: 10.1097/MLR.0b013e318215d0c9.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Pinto 2006 {published data only}
- Pinto A, Di Raimondo D, Tuttolomondo A, Fernandez P, Arnao V, Licata G. Twenty-four hour ambulatory blood pressure monitoring to evaluate effects on blood pressure of physical activity in hypertensive patients. Clinical Journal of Sport Medicine 2006;16(3):238-43. [DOI: 10.1097/00042752-200605000-00009.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Pitsavos 2011 {published data only}
- Pitsavos C, Chrysohoou C, Koutroumbi M, Aggeli C, Kourlaba G, Panagiotakos D, et al. The impact of moderate aerobic physical training on left ventricular mass, exercise capacity and blood pressure response during treadmill testing in borderline and mildly hypertensive males. Hellenic Journal of Cardiology 2011;52(1):6-14. [PMID: ] [PubMed] [Google Scholar]
Pollock 1971 {published data only}
- Pollock ML, Miller HS, Janeway R, Linnerud AC, Robertson B, Valentino R. Effects of walking on body composition and cardiovascular function of middle-aged ma. Journal of Applied Physiology 1971;30(1):126-30. [DOI: 10.1152/jappl.1971.30.1.126.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Povoa 2010 {published data only}
- Povoa T, Jardim P, Lima A, Salgado C, Souza C, Pacheco I, et al. Effects of aerobic and resistance training on quality of life and functional capacity in hypertensive women. Journal of Hypertension 2010;28:e374. [Google Scholar]
Probart 1991 {published data only}
- Probart CK, Notelovitz M, Martin D, Khan FY, Fields C. The effect of moderate aerobic exercise on physical fitness among women 70 years and older. Maturitas 1991;14(1):49-56. [DOI: 10.1016/0378-5122(91)90147-i.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Puggaard 2000 {published data only}
- Puggaard L, Larsen JB, Stovring H, Jeune B. Maximal oxygen uptake, muscle strength and walking speed in 85-year-old women: effects of increased physical activity. Aging (Milano) 2000;12(3):180-9. [DOI: 10.1007/bf03339835.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Puig‐Ribera 2015 {published data only}
- Puig-Ribera A, Bort-Roig J, Gonzalez-Suarez AM, Martinez-Lemos I, Gine-Garriga M, Fortuno J, et al. Patterns of impact resulting from a 'sit less, move more' web-based program in sedentary office employees. PLOS One [Electronic Resource] 2015;10(4):e0122474. [DOI: 10.1371/journal.pone.0122474.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Purzycka 2011 {published data only}
- Purzycka D, Prusik K, Bohdan M, Sroka T, Wlodarczyk P, Marczulin J, et al. Effect of 3-month Nordic walking training on arterial blood pressure in women aged 60 years and over [Polish] [Ocena wplywu 3-miesiecznego treningu Nordic walking na cisnienie tetnicze u kobiet po 60 roku zycia]. Nadcisnienie Tetnicze [Arterial Hypertension] 2011;15(6):335-40. [Google Scholar]
Qi 2011 {published data only}
- Qi L, Rui J, Qin J, Yili C, Guifu W, Jianxin D. Effects of exercise capacity between short-term high intensity interval exercise and moderate intensity continuous exercise training in young males. Heart 2011;97(3):A244-5. [Google Scholar]
Qiu (邱方) 2016 {published data only}
- Qiu F, Xiong KY, Shi LJ. Role of MT in exercise improving artery endothelial function in SHR by receptor [褪黑素经 MT 受体介导在运动改善SHR 动脉内皮功能中的作用]. Journal of Beijing Sport University 2016;39(10):51-7. [Google Scholar]
Quinn 2006 {published data only}
- Quinn TJ, Klooster JR, Kenefick RW. Two short, daily activity bouts vs. one long bout: are health and fitness improvements similar over twelve and twenty-four weeks? Journal of Strength and Conditioning Research 2006;20(1):130-5. [DOI: 10.1519/R-16394.1.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Rauramaa 1986 {published data only}
- Rauramaa R, Salonen J, Seppänen K, Salonen R, Venäläinen J, Ihanainen M, et al. Inhibition of platelet aggregability by moderate-intensity physical exercise: a randomized clinical trial in overweight men. Circulation 1986;74(5):939-44. [DOI: 10.1161/01.cir.74.5.939.] [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
Ready 1995 {published data only}
- Ready AE, Drinkwater DT, Ducas J, Fitzpatrick DW, Brereton DG, Oades SC. Walking program reduces elevated cholesterol in women postmenopause. Canadian Journal of Cardiology 1995;11(10):905-12. [PMID: ] [PubMed] [Google Scholar]
Reeder 2008 {published data only}
- Reeder BA, Chad KE, Harrison EL, Ashworth NL, Sheppard MS, Fisher KL, et al. Saskatoon in motion: class- versus home-based exercise intervention for older adults with chronic health conditions. Journal of Physical Activity and Health 2008;5(1):74-87. [DOI: 10.1123/jpah.5.1.74.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Ren (任強) 2015 {published data only}
- Ren Q, Dong N, Lin RM, Sun YH, Song AJ, Lin XM, et al. Effects of 10000-steps fast walking on exercise tolerance and quality of life in young patients with coronary heart disease after percutaneous coronary intervention [10000步快步走對年輕冠心病PCI術后患者運動耐力及生活質量的影響]. Academic Journal of Guangzhou Medical University 2015;43(1):44-7. [DOI: 10.3969/j.issn.2095-9664.2015.01.012] [DOI] [Google Scholar]
Ressl 1977 {published data only}
- Ressl J, Chrástek J, Jandová R. Haemodynamic effects of physical training in essential hypertension. Acta Cardiologica 1977;32(2):121-33. [MEDLINE: ] [PubMed] [Google Scholar]
Richter 2010 {published data only}
- Richter CM, Panigas TF, Bundchen DC, Dipp T, Belli KC, Viecili PR. Blood pressure reduction in hyper-reactive individuals after aerobic exercise. Arquivos Brasileiros De Cardiologia 2010;95(2):251-7. [DOI: 10.1590/s0066-782x2010005000085.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Rogers 1996 {published data only}
- Rogers MW, Probst MM, Gruber JJ, Berger R, Boone JB Jr. Differential effects of exercise training intensity on blood pressure and cardiovascular responses to stress in borderline hypertensive humans. Journal of Hypertension 1996;14(11):1369-75. [DOI: 10.1097/00004872-199611000-00017.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Roghani 2012 {published data only}
- Roghani T, Torkaman G, Movasseghe Sh, Hedayati M, Goosheh B, Bayat N. The effect of 6-week submaximal training with and without external loading on cardiovascular fitness, balance, cortisol, and lipid profiles in osteoporotic postmenopausal women. Iranian Journal of Endocrinology and Metabolism 2012;13(6):587-97. [Google Scholar]
Romain 2019 {published data only}
- Romain AJ, Fankam C, Karelis AD, Letendre E, Mikolajczak G, Stip E, et al. Effects of high intensity interval training among overweight individuals with psychotic disorders: a randomized controlled trial. Schizophrenia Research 2019;210:278-86. [DOI: 10.1016/j.schres.2018.12.021] [PMID: ] [DOI] [PubMed] [Google Scholar]
Rosety‐Rodriguez 2011 {published data only}
- Rosety-Rodriguez M, Ordonez FJ, Rosety I, Diaz-Ordonez A, Rosety MA, Camacho A, et al. Regular exercise increased plasma pre-beta 1-HDL concentration in adult women with metabolic syndrome. Atherosclerosis Supplements 2011;12(1):41. [Google Scholar]
Ross 2000 {published data only}
- Ross R, Dagnone D, Jones PJ, Smith H, Paddags A, Hudson R, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. a randomized, controlled trial. Annals of Internal Medicine 2000;133(2):92-103. [DOI: 10.7326/0003-4819-133-2-200007180-00008.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Roviaro 1984 {published data only}
- Roviaro S, Holmes DS, Holmsten RD. Influence of a cardiac rehabilitation program on the cardiovascular, psychological, and social functioning of cardiac patients. Journal of Behavioral Medicine 1984;7(1):61-81. [DOI: 10.1007/bf00845347.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Rudd 1967 {published data only}
- Rudd JL, Day WC. A physical fitness program for patients with hypertension. Journal of the American Geriatrics Society 1967;15(4):373-9. [DOI: 10.1111/j.1532-5415.1967.tb02809.x.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Sandroff 2016 {published data only}
- Sandroff BM, Wylie GR, Johnson CL, Sutton BP, Deluca J, Motl RW. Treadmill walking exercise training effects on processing speed and thalamic resting-state functional connectivity in multiple sclerosis: a pilot study. Multiple Sclerosis 2016;22:398. [Google Scholar]
Santana 2016 {published data only}
- Santana M, Pina J, Duarte G, Neto M, Machado A, Dominguez-Ferraz D. Nintendo Wii effects on cardiorespiratory fitness in older adults: A randomized clinical trial. A pilot trial [Efectos de la Nintendo wii sobre el estado cardiorrespiratorio de adultos mayores: ensayo clínico aleatorizado. Estudio piloto]. Fisioterapia 2016;38(2):71-7. [DOI: 10.1016/j.ft.2015.03.003] [DOI] [Google Scholar]
Santiago 1995 {published data only}
- Santiago MC, Leon AS, Serfass RC. Failure of 40 weeks of brisk walking to alter blood lipids in normolipemic women. Canadian Journal of Applied Physiology 1995;20(4):417-28. [DOI: 10.1139/h95-033.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Saremi 2010 {published data only}
- Saremi A, Asghari M, Ghorbani A. Effects of aerobic training on serum omentin-1 and cardiometabolic risk factors in overweight and obese men. Journal of Sports Sciences 2010;28(9):993-8. [DOI: 10.1080/02640414.2010.484070.] [MEDLINE: ] [DOI] [PubMed] [Google Scholar]
Sari‐Sarraf 2015 {published data only}
- Sari-Sarraf V, Aliasgarzadeh A, Naderali M-M, Esmaeili H, Naderali EK. A combined continuous and interval aerobic training improves metabolic syndrome risk factors in men. Inernational Journal of General Medicine 2015;8:203-10. [DOI: 10.2147/IJGM.S81938] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Saxena 2016 {published data only}
- Saxena Y, Gupta R, Moinuddin A, Narwal R. Blood pressure reduction following accumulated physical activity in prehypertensive. Journal of Family Medicine and Primary Care 2016;5(2):349-56. [DOI: 10.4103/2249-4863.192368.] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Seals 1991 {published data only}
- Seals DR, Reiling MJ. Effect of regular exercise on 24-hour arterial pressure in older hypertensive humans. Hypertension 1991;18(5):583-92. [DOI: 10.1161/01.hyp.18.5.583.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Seals 1997 {published data only}
- Seals DR, Silverman HG, Reiling MJ, Davy KP. Effect of regular aerobic exercise on elevated blood pressure in postmenopausal women. American Journal of Cardiology 1997;80(1):49-55. [DOI: 10.1016/s0002-9149(97)00282-8.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Seminario 1999 {published data only}
- Seminario NA, Sciacca RR, DiTullio MR, Homma S, Giardina EG. Effect of age on the exercise response in normal postmenopausal women during estrogen replacement therapy. Journal of Womens Health and Gender-Based Medicine 1999;8(10):1273-9. [DOI: 10.1089/jwh.1.1999.8.1273] [PMID: ] [DOI] [PubMed] [Google Scholar]
Seo 2010 {published data only}
- Seo D-I, Jun T-W, Park K-S, Chang H, So W-Y, Song W. 12 weeks of combined exercise is better than aerobic exercise for increasing growth hormone in middle-aged women. International Journal of Sport Nutrition & Exercise Metabolism 2010;20(1):21-6. [DOI: 10.1123/ijsnem.20.1.21.] [PMID: ] [DOI] [PubMed] [Google Scholar]
Shabaaninia 2017 {published data only}
- Shabaaninia M, Shahidi F, Rajabi H, Nazari I. Effect of 12-weeks interval aerobic training on blood pressure and flow-mediated dilation in middle-aged men with hypertension. [Persian]. Journal of Isfahan Medical School 2017;35:368-75. [Google Scholar]
Shin 1999 {published data only}
- Shin, Y. The effects of a walking exercise program on physical function and emotional state of elderly Korean women. Public Health Nursing 1999;16(2):146-54. [DOI: 10.1046/j.1525-1446.1999.00146.x] [PMID: ] [DOI] [PubMed] [Google Scholar]
Shvedko 2019 {published data only}
- Shvedko AV, Whittaker AC, Greig CA, Thompson JL. Physical activity intervention for loneliness (pail) in community-dwelling older adults: a randomised feasibility study. Psychosomatic Medicine 2019;81(4):A85. [DOI: 10.1097/PSY.0000000000000699] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Sijie 2012 {published data only}
- Sijie T, Hainai Y, Fengying Y, Jianxiong W. High intensity interval exercise training in overweight young women. Journal of Sports Medicine and Physical Fitness 2012;52(3):255-62. [PMID: ] [PubMed] [Google Scholar]
Simons 2006 {published data only}
- Simons R, Andel R. The effects of resistance training and walking on functional fitness in advanced old age. Journal of Aging and Health 2006;18(1):91-105. [DOI: 10.1177/0898264305281102] [PMID: ] [DOI] [PubMed] [Google Scholar]
Sims 2012 {published data only}
- Sims ST, Larson JC, Lamonte MJ, Michael YL, Martin LW, Johnson KC, et al. Physical activity and body mass: changes in younger versus older postmenopausal women. Medicine and Science in Sports and Exercise 2012;44(1):89-97. [DOI: 10.1249/MSS.0b013e318227f906] [PMID: ] [DOI] [PubMed] [Google Scholar]
Sivarajan 1981 {published data only}
- Sivarajan ES, Bruce RA, Almes MJ, Green B, Bélanger L, Lindskog BD, et al. In-hospital exercise after myocardial infarction does not improve treadmill performance. New England Journal of Medicine 1981;305(7):357-62. [DOI: 10.1056/NEJM198108133050701] [PMID: ] [DOI] [PubMed] [Google Scholar]
Sivarajan 1982 {published data only}
- Sivarajan ES, Bruce RA, Lindskog BD, Almes MJ, Bélanger L, Green B. Treadmill test responses to an early exercise program after myocardial infarction: a randomized study. Circulation 1982;65(7):1420-8. [DOI: 10.1161/01.cir.65.7.1420] [PMID: ] [DOI] [PubMed] [Google Scholar]
Skvortsova 2010 {published data only}
- Skvortsova VI, Ivanova GE, Rumiantseva NA, Staritsyn AN, Kovrazhkina EA, Suvorov AY. Modern approach to gait restoration in patients in the acute period of cerebral stroke. Zhurnal NevrologiiIPsikhiatrii Imeni S S Korsakova 2010;110(4):25-30. [PMID: ] [PubMed] [Google Scholar]
Skvortsova 2011 {published data only}
- Skvortsova VI, Ivanova GE, Rumyantseva NA, Staritsyn AN, Kovrazhkina EA, Suvorov AY. Current approaches to restoring walking in patients during the acute phase of cerebral stroke. Neuroscience and Behavioral Physiology 2011;41(5):536-41. [Google Scholar]
Sohn 2007 {published data only}
- Sohn AJ, Hasnain M, Sinacore JM. Impact of exercise (walking) on blood pressure levels in African American adults with newly diagnosed hypertension. Ethnicity and Disease 2007;17(3):503-7. [PMID: ] [PubMed] [Google Scholar]
Song 2017a {published data only}
- Song S, Araiza D, Reyes C, Willis P, Choi S, Kotick J, et al. "Worth the walk:" a randomized controlled trial of a walking intervention to decrease stroke risk among minority seniors. Neurology. Conference: 69th American Academy of Neurology Annual Meeting 2017;88(16):unknown. [Google Scholar]
Song 2017b {published data only}
- Song SY, Araiza D, Reyes C, Willis P, Choi S, Kottick J, et al. "Worth the walk:" a community-partnered intervention to decrease stroke risk for minority seniors. Annals of Neurology 2017;82(21):S78-9. [Google Scholar]
Sousa 2013 {published data only}
- Sousa N, Mendes R, Abrantes C, Sampaio J, Oliveira J. The long-term effects of aerobic training versus combined training on physical fitness and cardiovascular diseases risk factors in overweigh elderly men with high blood pressure. British Journal of Sports Medicine 2013;47:e3. [Google Scholar]
Staffileno 2001 {published data only}
- Staffileno BA, Braun LT, Rosenson RS. The accumulative effects of physical activity in hypertensive post-menopausal women. Journal of Cardiovascular Risk 2001;8(5):283-90. [DOI: 10.1177/174182670100800507] [PMID: ] [DOI] [PubMed] [Google Scholar]
Staffileno 2007 {published data only}
- Staffileno BA, Minnick A, Coke LA, Hollenberg SM. Blood pressure responses to lifestyle physical activity among young, hypertension-prone African-American women. Journal of Cardiovascular Nursing 2007;22(2):107-17. [DOI: 10.1097/00005082-200703000-00007] [PMID: 17318036] [DOI] [PubMed] [Google Scholar]
Staudter 2011 {published data only}
- Staudter M, Dramiga S, Webb L, Hernandez D, Cole R. Effectiveness of pedometer use in motivating active duty and other military healthcare beneficiaries to walk more. United States Army Medical Department Journal 2011;unknown:108-19. [PMID: ] [PubMed] [Google Scholar]
Stefanick 1998 {published data only}
- Stefanick ML, Mackey S, Sheehan M, Ellsworth N, Haskell WL, Wood PD. Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. New England Journal of Medicine 1998;339(1):12-20. [DOI: 10.1056/NEJM199807023390103] [PMID: ] [DOI] [PubMed] [Google Scholar]
Stensel 1993 {published data only}
- Stensel DJ, Hardman AE, Brooke-Wavell K, Vallance D, Jones PR, Norgan NG, et al. Brisk walking and serum lipoprotein variables in formerly sedentary men aged 42-59 years. Clinical Science 1993;85(6):701-8. [DOI: 10.1042/cs0850701] [PMID: ] [DOI] [PubMed] [Google Scholar]
Stensel 1994 {published data only}
- Stensel DJ, Brooke-Wavell K, Hardman AE, Jones PR, Norgan NG. The influence of a 1-year programme of brisk walking on endurance fitness and body composition in previously sedentary men aged 42-59 years. European Journal of Applied Physiology and Occupational Physiology 1994;68(6):531-7. [DOI: 10.1007/bf00599525] [PMID: 7957147] [DOI] [PubMed] [Google Scholar]
Steptoe 1990 {published data only}
- Steptoe A, Moses J, Mathews A, Edwards S. Aerobic fitness, physical activity, and psychophysiological reactions to mental tasks. Psychophysiology 1990;27(3):264-74. [DOI: 10.1111/j.1469-8986.1990.tb00381.x] [PMID: ] [DOI] [PubMed] [Google Scholar]
Subramanian 2011 {published data only}
- Subramanian H, Soudarssanane MB, Jayalakshmy R, Thiruselvakumar D, Navasakthi D, Sahai A, et al. Non-pharmacological Interventions in hypertension: a community-based cross-over randomized controlled trial. Indian Journal of Community Medicine 2011;36:191-6. [DOI: 10.4103/0970-0218.86519] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Svacinova 2003 {published data only}
- Svacinova H, Olsovsky J, Zackova V, Jancik J, Placheta Z, Siegelova J. Effect of walking exercise on the aerobic capacity and blood lipids in type 2 diabetics [Czech] [Vliv treninku chuzi na aerobni kapacitu a krevni lipidy u diabetiku 2. typu]. Vnitrni Lekarstvi 2003;49(3):205-9. [PMID: ] [PubMed] [Google Scholar]
Talakad 2011 {published data only}
- Talakad S, Ganesan M, Gupta A, Pal PK, Trichur R. Effect of partial weight supported treadmill gait training on cardiovascular dynamics in patients with Parkinson's disease. Movement Disorders 2011;26:S173. [Google Scholar]
Talbot 2011 {published data only}
- Talbot LA, Metter EJ, Morrell CH, Frick KD, Weinstein AA, Fleg JL. A pedometer-based intervention to improve physical activity, fitness, and coronary heart disease risk in national guard personnel. Journal of Military Medicine 2011;176(5):592-600. [DOI: 10.7205/milmed-d-10-00256] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Tanaka 1998a {published data only}
- Tanaka H, Reiling MJ, Seals DR. Regular walking increases peak limb vasodilatory capacity of older hypertensive humans: implications for arterial structure. Journal of Hypertension 1998;16(4):423-8. [DOI: 10.1097/00004872-199816040-00003] [PMID: ] [DOI] [PubMed] [Google Scholar]
Tang 2019 {published data only}
- Tang S, Gong FE. The adjuvant therapeutic effect of regularly taking slow walks over the long-term on inflammation in elderly hypertensive patients. International Journal of Clinical and Experimental Medicine 2019;12(8):10139-44. [Google Scholar]
Tao 2004 {published data only}
- Tao LL, Deng YB, Fan XB, Bao QD. Effect of exercise training in patients with impaired glucose tolerance. Chinese Journal of Clinical Rehabilitation 2004;8(15):2912-3. [Google Scholar]
ter Bogt 2011 {published data only}
- ter Bogt NC, Milder IE, Bemelmans WJ, Beltman FW, Broer J, Smit AJ, et al. Changes in lifestyle habits after counselling by nurse practitioners: 1-year results of the Groningen Overweight and Lifestyle study. Public Health Nutrition 2011;14(6):995-1000. [DOI: 10.1017/S1368980010003708] [PMID: ] [DOI] [PubMed] [Google Scholar]
Thomas 2010 {published data only}
- Thomas TR, Warner SO, Dellsperger KC, Hinton PS, Whaley-Connell AT, Rector RS, et al. Exercise and the metabolic syndrome with weight regain. Journal of Applied Physiology 2010;109(1):3-10. [DOI: 10.1152/japplphysiol.01361.2009] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Thompson 1988 {published data only}
- Thompson RF, Crist DM, Marsh M, Rosenthal M. Effects of physical exercise for elderly patients with physical impairments. Journal of the American Geriatrics Society 1988;36(2):130-5. [DOI: 10.1111/j.1532-5415.1988.tb01782.x] [PMID: ] [DOI] [PubMed] [Google Scholar]
Tian (田野) 2014 {published data only}
- Tian Y. Effect of Nordic walking exercise intervention on impaired glucose regulation[北歐式行走對糖調節受損人群的運動干預效果]. Shanghai: Shanghai University of Sport, 2014. [Google Scholar]
Tjonna 2008 {published data only}
- Tjonna AE, Lee SJ, Rognmo O, Stolen TO, Bye A, Haram PM, et al. Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Circulation 2008;118(4):346-54. [DOI: 10.1161/CIRCULATIONAHA.108.772822] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Toledano‐Zarhi 2011 {published data only}
- Toledano-Zarhi A, Tanne D, Carmeli E, Katz-Leurer M. Feasibility, safety and efficacy of an early aerobic rehabilitation program for patients after minor ischemic stroke: a pilot randomized controlled trial. NeuroRehabilitation 2011;28(2):85-90. [DOI: 10.3233/NRE-2011-0636] [PMID: ] [DOI] [PubMed] [Google Scholar]
Torrente 2017 {published data only}
- Sianoja M, Syrek CJ, Bloom J, Korpela K, Kinnunen U. Enhancing daily well-being at work through lunchtime park walks and relaxation exercises: Recovery experiences as mediators. Journal of Occupational Health Psychology 2017;23(3):422-8. [DOI: 10.1037/ocp0000083] [DOI] [PubMed] [Google Scholar]
- Torrente P, Kinnunen U, Sianoja M, Bloom J, Korpela K, Tuomisto MT, et al. The effects of relaxation exercises and park walks during workplace lunch breaks on physiological recovery. Scandinavian Journal of Work and Organizational Psychology 2017;2(1):1-15. [DOI: 10.16993/sjwop.19] [DOI] [Google Scholar]
Tsai 2002a {published data only}
- Tsai J-C, Chang W-Y, Kao C-C, Lu M-S, Chen Y-J, Chan P. Beneficial effect on blood pressure and lipid profile by programmed exercise training in Taiwanese patients with mild hypertension. Clinical and Experimental Hypertension 2002;24(4):315-24. [DOI: 10.1081/ceh-120004234] [PMID: ] [DOI] [PubMed] [Google Scholar]
Tsai 2002b {published data only}
- Tsai J-C, Liu J-C, Kao C-C, Tomlinson B, Kao P-F, Chen J-W, et al. Beneficial effects on blood pressure and lipid profile of programmed exercise training in subjects with white coat hypertension. American Journal of Hypertension 2002;15(6):571-6. [DOI: 10.1016/s0895-7061(02)02273-2] [PMID: ] [DOI] [PubMed] [Google Scholar]
Tsoukas 1995 {published data only}
- Tsoukas A, Andonakoudis H, Christakos S. Short-term exercise training effect after myocardial infarction on myocardial oxygen consumption indices and ischemic threshold. Archives of Physical Medicine and Rehabilitation 1995;76(3):262-5. [DOI: 10.1016/s0003-9993(95)80613-x] [PMID: ] [DOI] [PubMed] [Google Scholar]
Tsuji 1990 {published data only}
- Tsuji M, Saito S, Ando T, Moriuchi M, Tamura Y, Tanigawa N, et al. The clinical role of anaerobic threshold in physical training of patients with recent myocardial infarction. Journal of Cardiology 1990;20(2):275-82. [PMID: ] [PubMed] [Google Scholar]
Tully 2004 {published data only}
- Tully MA. The effects of home-based walking programmes on cardiovascular risk factors in healthy subjects. Belfast: Queen's University Belfast, 2004. [Google Scholar]
Tully 2007 {published data only}
- Tully MA, Cupples ME, Young IS. Evaluating a community-based walking intervention for hypertensive older people in Taiwan: a randomized controlled trial. Preventive Medicine 2007;44(5):466. [DOI: 10.1016/j.ypmed.2007.02.010] [DOI] [PubMed] [Google Scholar]
Ubels 1999 {published data only}
- Ubels FL, Links TP, Sluiter WJ, Reitsma WD, Smit AJ. Walking training for intermittent claudication in diabetes. Diabetes Care 1999;22(2):198-201. [DOI: 10.2337/diacare.22.2.198] [PMID: ] [DOI] [PubMed] [Google Scholar]
Uemura 2012 {published data only}
- Uemura K, Doi T, Shimada H, Makizako H, Yoshida D, Tsutsumimoto K, et al. Effects of exercise intervention on vascular risk factors in older adults with mild cognitive impairment: a randomized controlled trial. Dementia and Geriatric Cognitive Disorders Extra 2012;2:445-55. [DOI: 10.1159/000343486] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Van Dyck 2013 {published data only}
- Van Dyck D, De Greef K, Deforche B, Ruige J, Bouckaert J, Tudor-Locke CE, et al. The relationship between changes in steps/day and health outcomes after a pedometer-based physical activity intervention with telephone support in type 2 diabetes patients. Health Education Research 2013;28:539-45. [DOI: 10.1093/her/cyt038] [PMID: ] [DOI] [PubMed] [Google Scholar]
van Sluijs 2005a {published data only}
- Van Sluijs EM, Van Poppel MN, Twisk JW, Brug J, Van Mechelen W. The positive effect on determinants of physical activity of a tailored, general practice-based physical activity intervention. Health Education Research 2005;20(3):345-56. [DOI: 10.1093/her/cyg129] [PMID: ] [DOI] [PubMed] [Google Scholar]
van Sluijs 2005b {published data only}
- Sluijs EM, Poppel MN, Twisk JW, Chin A, Paw MJ, Calfas KJ, et al. Effect of a tailored physical activity intervention delivered in general practice settings: results of a randomized controlled trial. American Journal of Public Health 2005;95(10):1825-31. [DOI: 10.2105/AJPH.2004.044537] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Venojarvi 2013 {published data only}
- Venojarvi M, Wasenius N, Manderoos S, Heinonen OJ, Hernelahti M, Lindholm H, et al. Nordic walking decreased circulating chemerin and leptin concentrations in middle-aged men with impaired glucose regulation. Annals of Medicine 2013;45:162-70. [DOI: 10.3109/07853890.2012.727020] [PMID: ] [DOI] [PubMed] [Google Scholar]
Verity 1989 {published data only}
- Verity LS, Ismail AH. Effects of exercise on cardiovascular disease risk in women with NIDDM. Diabetes Research and Clinical Practice 1989;6(1):27-35. [DOI: 10.1016/0168-8227(89)90054-5] [PMID: ] [DOI] [PubMed] [Google Scholar]
Vetrovsky 2018 {published data only}
- Vetrovsky T, Cupka J, Dudek M, Kuthanova B, Vetrovska K, Capek V, et al. A pedometer-based walking intervention with and without email counseling in general practice: a pilot randomized controlled trial. BMC Public Health 2018;18(1):635. [DOI: 10.1186/s12889-018-5520-8] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Vicente‐Campos 2012 {published data only}
- Vicente-Campos D, Mora J, Castro-Pinero J, Gonzalez-Montesinos JL, Conde-Caveda J, Chicharro JL. Impact of a physical activity program on cerebral vasoreactivity in sedentary elderly people. Journal of Sports Medicine and Physical Fitness 2012;52:537-44. [PMID: ] [PubMed] [Google Scholar]
Waib 2011 {published data only}
- Waib P, Goncalves MI, Barrile SR. Improvement on insulin sensitivity and muscle blood flow in aerobic trained overweight-obese hypertensives is not associated with ambulatory blood pressure. Journal of Hypertension 2011;28:e398. [DOI: 10.1111/j.1751-7176.2010.00393.x] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Wanderley 2010 {published data only}
- Wanderley FA, Carvalho J, Oliveira J, Oliveira N. Cardiovascular function on older adults: effects of 4 and 8-month of aerobic training.. European Journal of Cardiovascular Prevention and Rehabilitation 2010;17:S26. [Google Scholar]
Wanderley 2013 {published data only}
- Wanderley FA, Moreira A, Sokhatska O, Palmares C, Moreira P, Sandercock G, et al. Differential responses of adiposity, inflammation and autonomic function to aerobic versus resistance training in older adults. Experimental Gerontology 2013;48:326-33. [DOI: 10.1016/j.exger.2013.01.002] [PMID: ] [DOI] [PubMed] [Google Scholar]
Wang (王漫卓) 2017 {published data only}
- Wang MD. The research on the effect of chronoexercise on weight loss in obese college students [擇時運動對肥胖大學生減肥效果的研究]. Shandong: Shandong University of Technology, 2017. [Google Scholar]
Wang (王磊) 2016 {published data only}
- Wang L, Zhao ZG, Gao ZZ, Zhou F. Equal-volume interval continuous physical exercise on dynamic blood pressure and hemorheology in mild and moderate hypertension [等量間斷和持續運動對輕中度高血壓患者動態血壓和血液流變性的影響]. Chinese Journal of Rehabilitation Medicine 2016;31(1):45-9,76. [DOI: 10.3969/j.issn.1001-1242.2016.01.010] [DOI] [Google Scholar]
Wang (王純) 2007 {published data only}
- Wang C, Lu W, Wu ZY. Effect of health education combined with vigorous walking on blood pressure and quality of life of elderly hypertension patients [太極拳與步行運動對高血壓的康復療效比較]. Chinese Journal of Gerontology 2016;36(16):4024-6. [Google Scholar]
Wang (王錦雲) 2005 {published data only}
- Wang CY, Chen PL, Kao CC, Yang S Y, Tsai JC. Effects of a home-based walking program on risk factors and mood status of middle age women with high risk for cardiovascular disease [居家行走運動計畫對心血管疾病危險群婦女危險因子及情緒狀態之影響]. Journal of Evidence-Based Nursing 2005;1(3):185-94. [DOI: 10.6225/JEBN.1.3.185] [DOI] [Google Scholar]
Wang 2011 {published data only}
- Wang RX, Hodge DO, Cha YM, Friedman PA, Rea RF, Munger TM, et al. Impact of pacing method on the risk of sudden cardiac death after atrioventricular node ablation and pacemaker implantation in patients with atrial fibrillation. Heart Rhythm 2011;1:S373-4. [DOI] [PubMed] [Google Scholar]
Wang 2012 {published data only}
- Wang X, Hsu FC, Isom S, Walkup MP, Kritchevsky SB, Goodpaster BH, et al. Effects of a 12-month physical activity intervention on prevalence of metabolic syndrome in elderly men and women. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 2012;67(4):417-24. [DOI: 10.1093/gerona/glr187] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Weinstein 2013 {published data only}
- Weinstein AA, Chin LM, Keyser RE, Kennedy M, Nathan SD, Woolstenhulme JG, et al. Effect of aerobic exercise training on fatigue and physical activity in patients with pulmonary arterial hypertension. Respiratory Medicine 2013;107(5):778-84. [DOI: 10.1016/j.rmed.2013.02.006] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Welsh 1985 {published data only}
- Welsh K, Ward A, Hanson P. Exercise blood pressure and baroreflex function in borderline hypertensive and normotensive young men. Clinical Science 1985;68(6):631-8. [DOI: 10.1042/cs0680631] [PMID: ] [DOI] [PubMed] [Google Scholar]
Whitehurst 1991 {published data only}
- Whitehurst M, Menendez E. Endurance training in older women: lipid and lipoprotein responses. Physician and Sportsmedicine 1991;19(6):95-102. [Google Scholar]
Whitney 1991 {published data only}
- Whitney JD. An experimental study of the effects of activity and inactivity on subcutaneous oxygen tension, subcutaneous perfusion and plasma volume. San Francisco: University of California, 1991. [Google Scholar]
Whitney 1993 {published data only}
- Whitney JD, Stotts NA, Goodson WH 3rd, Janson-Bjerklie S. The effects of activity and bed rest on tissue oxygen tension, perfusion, and plasma volume. Nursing Research 1993;42(6):349-55. [PMID: ] [PubMed] [Google Scholar]
Wijnen 1994 {published data only}
- Wijnen JA, Kool MJ, Baak MA, Kuipers H, Haan CH, Verstappen FT, et al. Effect of exercise training on ambulatory blood pressure. International Journal of Sports Medicine 1994;15(1):10-5. [DOI: 10.1055/s-2007-1021012] [PMID: ] [DOI] [PubMed] [Google Scholar]
Wilmore 1970 {published data only}
- Wilmore JH, Royce J, Girandola RN, Katch FI, Katch VL. Physiological alterations resulting from a 10-week program of jogging. Medicine and Science in Sports & Exercise 1970;2(1):7-14. [PMID: ] [PubMed] [Google Scholar]
Wilson 2010 {published data only}
- Wilson DK, Trumpeter NN, St George SM, Coulon SM, Griffin S, Lee Van Horn M, et al. An overview of the "positive action for today's health" (path) trial for increasing walking in low income, ethnic minority communities. Contemporary Clinical Trials 2010;31(6):624-33. [DOI: 10.1016/j.cct.2010.08.009] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Wing 1998 {published data only}
- Wing RR, Venditti E, Jakicic JM, Polley BA, Lang W. Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care 1998;21(3):350-9. [DOI: 10.2337/diacare.21.3.350] [PMID: ] [DOI] [PubMed] [Google Scholar]
Wong 2018 {published data only}
- Wong A, Figueroa A, Son WM, Chernykh O, Park SY. The effects of stair climbing on arterial stiffness, blood pressure, and leg strength in postmenopausal women with stage 2 hypertension. Menopause (New York, N.Y.) 2018;25(7):731-7. [DOI: 10.1097/GME.0000000000001072 EDT - 2018.05.15] [PMID: ] [DOI] [PubMed] [Google Scholar]
Woolf‐May 1999 {published data only}
- Woolf-May K, Kearney EM, Owen A, Jones DW, Davison RC, Bird SR. The efficacy of accumulated short bouts versus single daily bouts of brisk walking in improving aerobic fitness and blood lipid profiles. Health Education Research 1999;14(6):803-15. [DOI: 10.1093/her/14.6.803] [PMID: ] [DOI] [PubMed] [Google Scholar]
Wu 2007 {published data only}
- Wu TY, Yeh HI, Chan P, Chiou YF, Tsai JC. The effects of simple eight-week regular exercise on cardiovascular disease risk factors in middle-aged women at risk in Taiwan. Acta Cardiologica Sinica 2007;23(3):169-76. [Google Scholar]
Xie 2015 {published data only}
- Xie YJ, Hui SS, Kwok TCY, Woo J. A cluster randomized controlled trial to examine the effects of tai chi and walking exercises on weight loss, metabolic syndrome parameters, and bone mineral density. Circulation 2015;131:1-10. [DOI] [PMC free article] [PubMed] [Google Scholar]
Yates 2009 {published data only}
- Yates T, Davies M, Gorely T, Bull F, Khunti K. Effectiveness of a pragmatic education program designed to promote walking activity in individuals with impaired glucose tolerance: a randomized controlled trial. Diabetes Care 2009;32(8):1404-10. [DOI: 10.2337/dc09-0130] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Yeater 1990 {published data only}
- Yeater RA, Ullrich IH, Maxwell LP, Goetsch VL. Coronary risk factors in type II diabetes: response to low-intensity aerobic exercise. West Virgina Medical Journal 1990;86:287-90. [PMID: ] [PubMed] [Google Scholar]
Yu (于進) 2003 {published data only}
- Yu J. The effect of 6-minute walking training on dyspnea in COPD patients [6分鐘步行訓練對COPD患者呼吸困難的影響]. Chinese Journal of Rehabilitation Theory and Practice 2003;9(9):561-2. [Google Scholar]
Yuenyongchaiwat 2018 {published data only}
- Yuenyongchaiwat K, Pipatsitipong D, Sangprasert P. Increasing walking steps daily can reduce blood pressure and diabetes in overweight participants. Diabetology International 2018;9(1):75-9. [DOI: 10.1007/s13340-017-0333-z] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
Zeng (曾玉萍) 2014 {published data only}
- Zeng YP, Wu Y, Tao XB, Zhu JW, Mou XY, Liang D, et al. The effect of walking exercise on patients with type 2 diabetes and peripheral vascular disease [步行運動對2型糖尿病合并外周血管病變患者的改善作用]. Journal of Nursing(China) 2014;21(7):44-6. [Google Scholar]
Zhang (張舒) 2012 {published data only}
- Zhang S, Chen HY, Wang Q, Gong JG, Mu K. Clinical study of early rehabilitation in the treatment of heart failure patients [心力衰竭病人早期康復在治療的臨床研究]. Journal of Qiqihar University of Medicine 2012;33(11):1448-9. [Google Scholar]
Zhang 2015 {published data only}
- Zhang H, Ma Z, Pan LL, Chen Z, Huang Z, Han C, et al. A randomized trial of moderate and intensive exercise on fatty liver and cardiometabolic risk factors in obese adults [abstract 46]. Circulation 2015;131(1):A46. [Google Scholar]
Zhang 2016 {published data only}
- Zhang HJ, He J, Pan LL, Ma ZM, Han CK, Chen CS, et al. Effects of moderate and vigorous exercise on nonalcoholic fatty liver disease a randomized clinical trial. Journal American Medical Association Internal Medicine 2016;176(8):1074-82. [DOI: 10.1001/jamainternmed.2016.3202] [PMID: ] [DOI] [PubMed] [Google Scholar]
Zhou (周玉萍) 2015 {published data only}
- Zhou YP, Wang Y, Zhang ZQ. The effect of 6-minute walking test on improving endurance in breast cancer patients with chemotherapy [6 min步行試驗改善乳腺癌化療患者活動耐力的效果觀察]. International Journal of Nursing 2015;34(23):3299-302. [DOI: 10.3760/cma.j.issn.1673-4351.2015.23.053] [DOI] [Google Scholar]
Zoellner 2011 {published data only}
- Zoellner JM, Connell CC, Madson MB, Wang B, Reed VB, Molaison EF, et al. H.U.B city steps: methods and early findings from a community-based participatory research trial to reduce blood pressure among African Americans. International Journal of Behavioral Nutrition and Physical Activity 2011;8:59. [DOI: 10.1186/1479-5868-8-59] [PMID: ] [DOI] [PMC free article] [PubMed] [Google Scholar]
References to ongoing studies
Actrn 2015 {published data only}
Actrn 2017 {published data only}
- Actrn. Activity for wellbeing: promoting wellbeing through physical activity in aged care workers. http://www.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12617001395325 2017.
Nct 2009 {published data only}
- Nct. Diabetic kidney disease: influence of exercise therapy on physical and vascular function. http://ClinicalTrials.gov/show/NCT02112071 2009.
Additional references
ACSM 2018
- American College of Sports Medicine. ACSM's Guidelines for Exercise Testing and Prescription, 10th Edition. Indianapolis: American College of Sports Medicine, 2018. [Google Scholar]
Afonso 2001
- Afonso C, Graca P, Kearney JM, Gibney JM, Almeida MD. Physical activity in European seniors: attitudes, beliefs and levels. Journal of Nutrition, Health & Aging 2001;5(4):226-9. [PMID: ] [PubMed] [Google Scholar]
Altman 1997
- Altman DG (Ed). Practical Statistics for Medical Research. In: Chapman & Hall/CRC Texts in Statistical Science. London: Chapman & Hall/CRC, 1997. [Google Scholar]
Amici 2009
- Amici A, Cicconetti P, Sagrafoli C, Baratta A, Passador T, Pecci G, et al. Exaggerated morning blood pressure surge and cardiovascular events. A 5-year longitudinal study in normotensive and well-controlled hypertensive elderly. Archives of Gerontology and Geriatrics 2009;49(2):e105-9. [DOI: 10.1016/j.archger.2008.10.003] [DOI] [PubMed] [Google Scholar]
Asikainen 2004
- Asikainen TM, Kukkonen-Harjula K, Miilunpalo S. Exercise for health for early postmenopausal women: a systematic review of randomised controlled trials. Sports Medicine 2004;34(11):753-78. [DOI: 10.2165/00007256-200434110-00004] [DOI] [PubMed] [Google Scholar]
Australian Bureau of Statistics 2003
- Australian Bureau of Statistics. Participation in sport and physical activities. Australian Bureau of Statistics 2003:59.
Blood Pressure Lowering Treatment Trialists 2000
- Blood Pressure Lowering Treatment Trialists Collaboration. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Lancet 2000;356(9246):1955-64. [DOI: 10.1016/S0140-6736(00)03307-9] [DOI] [PubMed] [Google Scholar]
Blood Pressure Lowering Treatment Trialists 2008
- Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: meta-analysis of randomised trials. BMJ 2008;336:1121-3. [DOI: 10.1136/bmj.39548.738368.BE] [DOI] [PMC free article] [PubMed] [Google Scholar]
Bonilla Ocampo 2018
- Bonilla Ocampo DA, Paipilla AF, Marín E, Vargas-Molina S, Petro JL, Pérez-Idárraga A. Dietary nitrate from beetroot juice for hypertension: a systematic review. Biomolecules 2018;8(4):134. [DOI: 10.3390/biom8040134] [DOI] [PMC free article] [PubMed] [Google Scholar]
Borg 1982
- Borg GA. Psychophysical bases of perceived exertion. Medicine and Science in Sports and Exercise 1982;14:377-81. [PubMed] [Google Scholar]
Bravata 2007
- Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007;298(19):2296-304. [DOI: 10.1001/jama.298.19.2296] [DOI] [PubMed] [Google Scholar]
Brown 1995
- Brown MD, Hagberg JM. Does exercise training play a role in the treatment of essential hypertension? Journal of Cardiovascular Risk 1995;2(4):296-302. [DOI: 10.1177/174182679500200403] [DOI] [PubMed] [Google Scholar]
Bull 2020
- Bull FC, Sal-AnsarI S, SBiddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine 2020;54(24):1451-62. [DOI] [PMC free article] [PubMed] [Google Scholar]
Burt 1995
- Burt VL, Whelton P, Roccella EJ, Brown C, Cutler JA, Higgins M, et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension 1995;25(3):305-13. [DOI: 10.1161/01.hyp.25.3.305] [DOI] [PubMed] [Google Scholar]
Cai 2014
- Cai X, Qiu S, Ju C, Sun Z. Pedometer-based walking intervention and resting blood pressure in type 2 diabetes: A meta-analysis of randomised controlled studies. Diabetologia 2014;57:S434. [Google Scholar]
Carpio‐Rivera 2016
- Carpio-Rivera E, Moncada-Jimenez J, Salazar-Rojas W, Solera-Herrera A. Acute effects of exercise on blood pressure: a meta-analytic investigation. Arquivos Brasileiros de Cardiologia 2016;106(5):422-33. [DOI: 10.5935/abc.20160064] [DOI] [PMC free article] [PubMed] [Google Scholar]
Chiu 2015
- Chiu YY, Lin SS, Chang SC, Lee LL. Predictors of exercise maintenance behaviour in community-dwelling older people. Journal of Nursing and Healthcare Research 2015;11(1):43-52. [DOI: 10.1111/j.1525-1497.2001.00506.x] [DOI] [Google Scholar]
Christou 2005
- Christou DD, Jones PP, Jordan J, Diedrich A, Robertson D, Seals DR. Women have lower tonic autonomic support of arterial blood pressure and less effective baroreflex buffering than men. Circulation 2005;111(4):494-8. [DOI: 10.1161/01.CIR.0000153864.24034.A6] [DOI] [PubMed] [Google Scholar]
Cox 2001
- Cox KL, Burke V, Morton AR, Gillam HF, Beilin LJ, Puddey IB. Long-term effects of exercise on blood pressure and lipids in healthy women aged 40-65 years: the Sedentary Women Exercise Adherence Trial (SWEAT). Journal of Hypertension 2001;19(10):1733-43. [DOI: 10.1097/00004872-200110000-00006] [DOI] [PubMed] [Google Scholar]
Crespo 1996
- Crespo CJ, Keteyian SJ, Heath GW, Sempos CT. Leisure-time physical activity among US adults. Results from the Third National Health and Nutrition Examination Survey. Archives of Internal Medicine 1996;156(1):93-98. [PMID: ] [PubMed] [Google Scholar]
Duru 2010
- Duru OK, Sarkisian CA, Leng M, Mangione CM. Sisters in motion: a randomized controlled trial of a faith-based physical activity intervention. Journal of the American Geriatrics Society 2010;58:1863-9. [DOI: 10.1111/j.1532-5415.2010.03082.x] [DOI] [PMC free article] [PubMed] [Google Scholar]
Duval 2000
- Duval S, Tweedie R. A nonparametric "Trim and Fill" method of accounting for publication bias in meta-analysis. Journal of the American Statistical Association 2000;95(449):89-98. [DOI: 10.1080/01621459.2000.10473905] [DOI] [Google Scholar]
Elley 2003
- Elley CR, Kerse N, Arroll B, Robinson E. Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial. BMJ 2003;326(7393):793-8. [DOI: 10.1136/bmj.326.7393.793] [DOI] [PMC free article] [PubMed] [Google Scholar]
Ettehad 2016
- Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2016;387:957-67. [DOI: 10.1016/S0140-6736(15)01225-8] [DOI] [PubMed] [Google Scholar]
Follmann 1992
- Follmann D, Elliott P, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response. Journal of Clinical Epidemiology 1992;45(7):769-73. [DOI: 10.1016/0895-4356(92)90054-q] [DOI] [PubMed] [Google Scholar]
Guyatt 2011
- Guyatt G, Oxman AE, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction - GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology 2011;64(4):383-94. [DOI: 10.1016/j.jclinepi.2010.04.026] [DOI] [PubMed] [Google Scholar]
Hagberg 2000
- Hagberg JM, Park JJ, Brown MD. The role of exercise training in the treatment of hypertension: an update. Sports Medicine 2000;30(3):193-206. [DOI: 10.2165/00007256-200030030-00004] [DOI] [PubMed] [Google Scholar]
Haider 2003
- Haider AW, Larson MG, Franklin SS, Levy D. Systolic blood pressure, diastolic blood pressure, and pulse pressure as predictors of risk for congestive heart failure in the Framingham Heart Study. Annals of Internal Medicine 2003;138(1):10-6. [DOI: 10.7326/0003-4819-138-1-200301070-00006] [DOI] [PubMed] [Google Scholar]
Hamilton 2008
- Hamilton M, Healy GN, Dunstan DW, Zderic TW, Owen N. Too little exercise and too much sitting: inactivity physiology and the need for new recommendations on sedentary behavior. Current Cardiovascular Risk Reports 2008;2:292-8. [DOI: 10.1007/s12170-008-0054-8] [DOI] [PMC free article] [PubMed] [Google Scholar]
Han 2019
- Han M, Chen Q, Liu L, Li Q, Ren Y, Zhao Y, et al. Stage 1 hypertension by the 2017 American College of Cardiology/American Heart Association hypertension guidelines and risk of cardiovascular disease events: systematic review, meta-analysis, and estimation of population etiologic fraction of prospective cohort studies. Journal of Hypertension 2019;38(4):573-8. [DOI: 10.1097/HJH.0000000000002321] [DOI] [PubMed] [Google Scholar]
Hanson 2015
- Hanson S, Jones A. Is there evidence that walking groups have health benefits? A systematic review and meta-analysis. British Journal of Sports Medicine 2015;49(11):710-5. [DOI: 10.1136/bjsports-2014-094157] [DOI] [PMC free article] [PubMed] [Google Scholar]
Herrod 2018
- Herrod PJJ, Doleman B, Blackwell JE, O'Boyle F, Williams J P, Lund JN, et al. Exercise and other nonpharmacological strategies to reduce blood pressure in older adults: a systematic review and meta-analysis. Journal of the American Society of Hypertension 2018;12(4):248-67. [DOI: 10.1016/j.jash.2018.01.008] [DOI] [PubMed] [Google Scholar]
Higgins 2011
- Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). Cochrane 2011. Available from training.cochrane.org/handbook.
James 2014
- James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311(5):507-20. [DOI: 10.1001/jama.2013.284427] [DOI] [PubMed] [Google Scholar]
Kelley 2001
- Kelley GA, Kelley KS, Tran ZV. Walking and resting blood pressure in adults: a meta-analysis. Preventive Medicine 2001;33:120-7. [DOI: 10.1016/S0091-7435(01)80008-6] [DOI] [PubMed] [Google Scholar]
Kraus 2019
- Kraus WE, Janz KF, Powell KE, Campbell WW, Jakicic JM, Troiano RP, et al. Daily step counts for measuring physical activity exposure and its relation to health. Medicine & Science in Sports & Exercise 2019;51(6):1206-12. [DOI: 10.1249/MSS.0000000000001932] [DOI] [PMC free article] [PubMed] [Google Scholar]
Law 2009
- Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 2009;338:b1665. [DOI: 10.1136/bmj.b1665] [DOI] [PMC free article] [PubMed] [Google Scholar]
Lawes 2008
- Lawes CM, Vander Hoorn S, Rodgers A, International Society of Hypertension. Global burden of blood-pressure-related disease, 2001. Lancet 2008;371(9623):1513-8. [DOI: 10.1016/s0140-6736(08)60655-8] [DOI] [PubMed] [Google Scholar]
Lawton 2008
- Lawton BA, Rose SB, Elley CR, Dowell AC, Fenton A, Moyes SA. Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial. BMJ 2008;337:a2509. [DOI: 10.1136/bmj.a2509] [DOI] [PMC free article] [PubMed] [Google Scholar]
Lee 2006
- Lee LL, Arthur A, Avis M. Evaluating a community-based walking intervention for hypertensive older people in Taiwan: a randomized controlled trial. Preventive Medicine 2006;44:160-6. [DOI: 10.1016/j.ypmed.2006.09.001] [DOI] [PubMed] [Google Scholar]
Lefebrve 2019
- Lefebvre C, Glanville J, Briscoe S, Littlewood A, Marshall C, Metzendorf M-I, et al. Chapter 4: Searching for and selecting studies. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.0 (updated July 2019). Cochrane, 2019. Available from training.cochrane.org/handbook.
Lewington 2002
- Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360(9349):1903-13. [DOI: 10.1016/S0140-6736(02)11911-8] [DOI] [PubMed] [Google Scholar]
Li 2019
- Li Q, Li L, Wang F, Zhang W, Guo Y, Wang F, et al. Effect and safety of lcz696 in the treatment of hypertension: a meta-analysis of 9 RCT studies. Medicine 2019;98(28):e16093. [DOI: 10.1097/MD.0000000000016093] [DOI] [PMC free article] [PubMed] [Google Scholar]
Liira 2014
- Liira H, Engberg E, Leppävuori J, From S, Kautiainen H, Liira J, et al. Exercise intervention and health checks for middle-aged men with elevated cardiovascular risk: a randomized controlled trial. Scandinavian Journal of Primary Health Care 2014;32:152-62. [DOI: 10.3109/02813432.2014.984967] [DOI] [PMC free article] [PubMed] [Google Scholar]
Lim 2012
- Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380(9859):2224-60. [DOI: 10.1016/S0140-6736(12)61766-8] [DOI] [PMC free article] [PubMed] [Google Scholar]
Mabire 2017
- Mabire L, Mani R, Liu L, Mulligan, H, Baxter D. The Influence of age, sex and body mass index on the effectiveness of brisk walking for obesity management in adults: a systematic review and meta-analysis. Journal of Physical Activity and Health 2013;14(5):389-407. [PMID: ] [DOI] [PubMed] [Google Scholar]
Moker 2014
- Moker EA, Bateman LA, Kraus WE, Pescatello LS. The relationship between the blood pressure responses to exercise following training and detraining periods. PLOS One 2014;9(9):e105755. [DOI: 10.1371/journal.pone.0105755] [DOI] [PMC free article] [PubMed] [Google Scholar]
Morris 1997
- Morris JN, Hardman AE. Walking to health. Sports Medicine 1997;23(5):306-32. [DOI: 10.2165/00007256-199723050-00004] [DOI] [PubMed] [Google Scholar]
Murphy 2007
- Murphy MH, Nevill AM, Murtagh EM, Holder RL. The effect of walking on fitness, fatness and resting blood pressure: a meta-analysis of randomised, controlled trials. Preventive Medicine 2007;44(5):377-85. [DOI: 10.1016/j.ypmed.2006.12.008] [DOI] [PubMed] [Google Scholar]
Murtagh 2002
- Murtagh EM, Boreham CA, Murphy MH. Speed and exercise intensity of recreational walkers. Preventive Medicine 2002;35(4):397-400. [DOI: 10.1006/pmed.2002.1090] [DOI] [PubMed] [Google Scholar]
Musini 2019
- Musini VM, Tejani AM, Bassett K, Puil L, Wright JM. Pharmacotherapy for hypertension in adults 60 years or older. Cochrane Database of Systematic Reviews 2019, Issue 6. Art. No: CD000028. [ART. NO.: ] [DOI: 10.1002/14651858.CD000028.pub3] [DOI] [PMC free article] [PubMed] [Google Scholar]
Mutrie 2004
- Mutrie N, Hannah MK. Some work hard while others play hard: the achievement of current recommendations for physical activity levels at work, at home, and in leisure time in the West of Scotland. International Journal of Health Promotion and Education 2004;42:109-17. [DOI: 10.1080/14635240.2004.10708024] [DOI] [Google Scholar]
National Institutes of Health 1996
- National Institutes of Health. Physical activity and cardiovascular health. NIH Consensus Development Panel on Physical Activity and Cardiovascular Health. JAMA 1996;276(3):241-6. [PMID: ] [PubMed] [Google Scholar]
Office for National Statistics 2003
- Office for National Statistics, Ipsos-RSL. United Kingdom Time Use Survey, 2000. 3rd Edition. Office for National Statistics 2003. [DOI: 10.5255/UKDA-SN-4504-1] [DOI]
Oja 2018
- Oja P, Kelly P, Murtagh EM, Murphy MH, Foster C, Titze S. Effects of frequency, intensity, duration and volume of walking interventions on CVD risk factors: a systematic review and meta-regression analysis of randomised controlled trials among inactive healthy adults. British Journal of Sports Medicine 2018;52(12):769-75. [PMID: ] [DOI] [PubMed] [Google Scholar]
Pate 1995
- Pate RR. Recent statements and initiatives on physical activity and health. Quest 1995;47(3):304-10. [DOI: 10.1080/00336297.1995.10484159] [DOI] [Google Scholar]
Peters 2007
- Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Performance of the trim and fill method in the presence of publication bias and between-study heterogeneity. Statistics in Medicine 2007;26(25):4544-62. [DOI: 10.1002/sim.2889] [DOI] [PubMed] [Google Scholar]
Pini 2008
- Pini R, Cavalini MC, Palmieri V, Marchionni N, Bari MD, Devereux RB, et al. Central but not brachial blood pressure predicts cardiovascular events in an unselected geriatric population: the ICARe Dicomano study. Journal of the American College of Cardiology 2008;51(25):2432-9. [DOI: 10.1016/j.jacc.2008.03.031] [DOI] [PubMed] [Google Scholar]
Qamar 2018
- Qamar A, Braunwald E. Treatment of hypertension. Addressing a global health problem. JAMA 2018;320(17):1751-2. [DOI: 10.1001/jama.2018.16579] [DOI] [PubMed] [Google Scholar]
Qui 2014
- Qiu S, Cai X, Schumann U, Velders M, Sun Z, Steinacker JM. Impact of walking on glycemic control and other cardiovascular risk factors in type 2 diabetes: a meta-analysis. PLOS One 2014;9:e109767. [DOI: 10.1371/journal.pone.0109767] [DOI] [PMC free article] [PubMed] [Google Scholar]
Quinn 2000
- Quinn TJ. Twenty-four hour, ambulatory blood pressure responses following acute exercise: impact of exercise intensity. Journal of Human Hypertension 2000;14(9):547-53. [DOI: 10.1038/sj.jhh.1001106] [DOI] [PubMed] [Google Scholar]
Rahman 2019
- Rahman F, McEvoy J, Ohkuma T, Marre M, Hamet P, Harrap S, et al. Effects of blood pressure lowering on clinical outcomes according to baseline blood pressure and cardiovascular risk in patients with type 2 diabetes mellitus. Hypertension 2019;73(6):1291-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
RevMan 2014 [Computer program] [Computer program]
- The Nordic Cochrane Centre, The Cochrane Collaboration Review Manager Web 5 (RevMan W 5) [Computer program]. Version 5.4. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Rodriguez 2014
- Rodriguez CJ, Swett K, Agarwal SK, Folsom AR, Fox ER, Loehr LR, et al. Systolic blood pressure levels among adults with hypertension and incident cardiovascular events: the atherosclerosis risk in communities study. JAMA Internal Medicine 2014;174(8):1252-61. [DOI: 10.1001/jamainternmed.2014.2482] [DOI] [PMC free article] [PubMed] [Google Scholar]
Schünemann 2019a
- Schünemann HJ, Higgins JP, Vist GE, Glasziou P, Akl EA, Skoetz N, et al. Chapter 14 Completing 'Summary of findings' tables and grading the certainty of the evidence. In Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Available from www.training.cochrane.org/handbook.
Schünemann 2019b
- Schünemann HJ, Higgins JP, Vist GE, Glasziou P, Akl EA, Skoetz N, et al. Chapter 15: Interpreting results and drawing conclusions. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Available from www.training.cochrane.org/handbook.
Staessen 2001
- Staessen JA, Wang JG, Thijs L. Cardiovascular protection and blood pressure reduction: a meta-analysis. Lancet 2001;358(9290):1305-15. [DOI: 10.1016/S0140-6736(01)06411-X] [DOI] [PubMed] [Google Scholar]
Tanasescu 2002
- Tanasescu M, Leitzmann MF, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Exercise type and intensity in relation to coronary heart disease in men. JAMA 2002;288(16):1994-2000. [DOI: 10.1001/jama.288.16.1994] [DOI] [PubMed] [Google Scholar]
Tschentscher 2013
- Tschentscher M, Niederseer D, Niebauer J. Health benefits of Nordic walking: a systematic review. American Journal of Preventive Medicine 2013;44(1):76-84. [PMID: ] [DOI] [PubMed] [Google Scholar]
Unger 2020
- Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension 2020;75(6):1334-57. [DOI] [PubMed] [Google Scholar]
US Dept of Health & Human Sciences 2018
- US Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington: U.S. Department of Health and Human Services, 2018. [Google Scholar]
Vargas‐Urocoechea 2019
- Vargas-Uricoechea H, Cáceres-Acosta MF. Blood pressure control and impact on cardiovascular events in patients with type 2 diabetes mellitus: A critical analysis of the literature [Metas de control de la presión arterial e impacto sobre desenlaces cardiovasculares en pacientes con diabetes mellitus tipo 2: un análisis crítico de la literatura]. Clínica e Investigación en Arteriosclerosis 2019;31(1):31-47. [DOI: 10.1016/j.arteri.2018.07.001] [DOI] [PubMed] [Google Scholar]
Wang 2004
- Wang L. Physician-related barriers to hypertension management. Medical Principles & Practice 2004;13(5):282-5. [DOI: 10.1159/000079528] [DOI] [PubMed] [Google Scholar]
Whelton 2002
- Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, et al. Primary prevention of hypertension: clinical and public health advisory from the National High Blood Pressure Education Program. JAMA 2002;288(15):1882-8. [DOI: 10.1001/jama.288.15.1882] [DOI] [PubMed] [Google Scholar]
WHO 2002
- World Health Organization. The World Health Report 2002: reducing risks, promoting healthy life. Available here: https://www.who.int/whr/2002/en/whr02_en.pdf?ua=1 (Accessed 24th August 2020) edition. Geneva: World Health Organization, 2002. [Google Scholar]
WHO 2003
- Whitworth JA, World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. Journal of Hypertension 2003;21(11):1983-92. [DOI: 10.1097/00004872-200311000-00002] [DOI] [PubMed] [Google Scholar]
WHO 2013
- World Health Organization. Global action plan for the prevention and control of non-communicable diseases 2013–2020. Geneva: World Health Organization, 2013. [Google Scholar]
WHO 2019
- World Health Organization. Hypertension. Available at www.who.int/news-room/fact-sheets/detail/hypertension (accessed 27th July 2020).
Williams 2004
- Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JF, et al. Guidelines for management of hypertension: report of the fourth working party of the British Hpertension Society, 2004-BHS IV. Journal of Human Hypertension 2004;18(3):139-85. [DOI: 10.1038/sj.jhh.1001683] [DOI] [PubMed] [Google Scholar]
Williams 2018
- Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. European Heart Journal 2018;39(33):3021-104. [DOI] [PubMed] [Google Scholar]
Wright 2018
- Wright JM, Musini VM, Gill R. First-line drugs for hypertension. Cochrane Database of Systematic Reviews 2018, Issue 4. Art. No: CD001841. [DOI: 10.1002/14651858.CD001841.pub3] [DOI] [PMC free article] [PubMed] [Google Scholar]
References to other published versions of this review
Lee 2010a
- Lee LL, Watson MC, Mulvaney CA, Tsai CC, Lo SF. The effect of walking intervention on blood pressure control: a systematic review. International Journal of Nursing Studies 2010;47(12):1545-61. [DOI: 10.1001/jama.285.11.1447.] [DOI] [PubMed] [Google Scholar]
Lee 2010b
- Lee LL, Watson M, Mulvaney C, Salzwedel DM, Chan ES. Walking for hypertension. Cochrane Database of Systematic Reviews 2010, Issue 11. Art. No: CD008823. [DOI: 10.1002/14651858.CD008823] [DOI] [PMC free article] [PubMed] [Google Scholar]