1. INFLUENCE OF UPPER AND LOWER LIMB EXERCISES IN REVIVING BLOOD PRESSURE IN HYPERTENSIVE PATIENTS
ANUM HAIDER
(BSPT, MSPT, ADPT)

2. BACKGROUND
Hypertension is the leading cardiovascular problem worldwide. It persist in the patient for a long time without any symptoms which results in weakening of coronary vessels. High blood pressure is a major risk for stroke, neuropathy, coronary artery disease. Increase blood pressure and lack of exercise is strongly related to each other.

3. AIM AND OBJECTIVE
The purpose of this study was to explore the effectiveness of lower limb cycling and upper limb arm stretch exercise in recovering blood pressure in hypertensive patients.

4. INTRODUCTION
High blood pressure and high cholesterol level plays a major role in progression of heart disease.
Long sustained high blood pressure can weaken the heart muscles.
Headache, nausea and vertigo are some linked symptoms associated with hypertension.
Physical activity not only reduces blood pressure but also helps to manage your fitness and makes your general health better and heart stronger
It is veracious that exercise reduces blood pressure level to a good extent. It is a drug free approach to reduce hypertension

5. METHODOLOGY A randomized comparative study was performed
The research was based on total 10 sessions
90 hypertensive patients with the age between years were elected for our study. Those patients were equally divided into two groups ( that is 48 in each group)
Group A hypertensive patients were treated via upper limb exercise for that purpose arm stretch trainer was used

7. Group B patients were treated via only lower limb exercise
Group B patients were treated via only lower limb exercise. Cycling was used for lower limb exercise
On first visit time period starts from 5mins and ends the session on 20mins.
Pre n post exercise blood pressure was taken in order to note any identifiable changes in the blood pressure. Apart from that Questionnaire was designed to know the patients past medical history, daily physical activities, addictions, stress level etc. Furthermore pulse rate and BMI was also monitored.

9. ASSESSMENT FORM Pateint’s details; age marital status occupation BMI
Primary and secondary hypertension
Life style
Blood pressure before and after session
Heart rate

10. RESULTS
The results revealed that both type of exercises reduce hypertension however lower limb exercises significantly reduced 27±4 mmHg blood pressure. While the upper limb exercises reduced 9±3 mmHg blood pressure.

15. 30% showing result of upper limb VIA ARM STRETCH TRAINER
70% showing result of lower limb VIA CYCLING

16. DISCUSSION
High blood pressure response to heart rate increases during exercise and it is associated with increase risk for developing hypertension.
Physical exercise leads to increase cardiac output because there is a rise in systolic blood pressure whereas diastolic blood pressure remains unchanged or shows a slight increment
But in haemodynamic pattern of sympathetic nerves and increased vascular response not only raises Systolic blood pressure but also cause marked elevation in diastolic blood pressure.
Therefore, both diastolic and systolic are important criteria to find out relation between physical stress and exercise

17. Studies have proven that endurance-trained persons represents with significantly higher systolic blood pressure than untrained persons during maximal exercise.
Increased BP response to exercise should be determined based on systolic and diastolic blood pressure both obtained during relatively low submaximal exercise workload.

18. CONCLUSION
Aerobic exercise improves endothelial vasomotor function in the coronary circulation of patients with coronary artery disease.
Patients who were using cycling to reduce blood pressure shows marked depression in blood pressure .Whereas patients with arm stretch trainer show a slight change in blood pressure. So we conclude that cycling effects more in reducing blood pressure.

19. REFERENCES
Wallace, J.P Exercise in hypertension: A clinical review. Sports medicine 2003
Park et al.Journal of hypertension September 2006
National heart lung and blood institute. September 2008
Chintanadilok et al. Exercise in training hypertension Active living. 2002
Exercise recommendations to people with hypertension (Adopted from department of Health Central Education Unit Exercise prescription 2011 edition)