Feasibility of a Community-Integrated Isometric Handgrip Exercise Program and Its Preliminary Effects on Blood Pressure and Cognitive Function in Older Adults

Feasibility of a Community-Integrated Isometric Handgrip Exercise Program and Its Preliminary Effects on Blood Pressure and Cognitive Function in Older Adults

The goal of this clinical trial is to evaluate whether a short, supervised isometric handgrip exercise program is feasible and acceptable for older adults with elevated blood pressure or hypertension. It will also explore whether this type of exercise may improve blood pressure and cognitive function.

The main questions it aims to answer are:

• Is this handgrip exercise program practical and acceptable for older adults to participate in within a community exercise setting?
• Does participation in the program lead to changes in blood pressure and cognitive function?

Researchers will compare two handgrip devices to determine whether the method of delivering the exercise influences feasibility and outcomes.

Participants will:

• Be randomly assigned to use one of two handgrip devices.
• Complete supervised exercise sessions twice per week for 4 weeks.
• Perform brief handgrip contractions at a set intensity during each session.
• Complete blood pressure and cognitive assessments before and after the program.

This study is a two-arm, parallel-group feasibility pilot trial designed to evaluate the feasibility, acceptability, and safety of a supervised isometric handgrip exercise program for older adults with elevated blood pressure or hypertension in a community setting. Participants will be recruited from the Physical Activity Centre of Excellence at McMaster University and randomized in a 1:1 ratio to one of two intervention arms, which differ only by the handgrip device used (Zona Plus or Squegg).

The intervention will be delivered over 4 weeks and integrated into participants' existing exercise routines at PACE. All participants will complete supervised sessions twice weekly, with each session consisting of four 2-minute isometric handgrip contractions at 30% of maximal voluntary contraction, with standardized rest periods between contractions. Sessions will be supervised by trained research staff to ensure adherence to the protocol and participant safety.

Feasibility outcomes will include recruitment rate, session attendance (adherence), retention, and protocol fidelity. Acceptability will be assessed using a standardized questionnaire and semi-structured exit interviews to capture participants' experiences, perceived burden, and integration into existing routines. Safety will be evaluated through the monitoring and documentation of adverse events.

Exploratory outcomes will include changes in resting blood pressure and cognitive function assessed before and after the intervention using standardized measures. Quantitative data will be analyzed descriptively to assess feasibility outcomes, with exploratory analyses conducted to examine pre-post changes. Qualitative data will be analyzed using inductive thematic analysis to identify key themes related to participant experience.

Inclusion Criteria:

• 65 years of age or older
• Currently attending the Physical Activity Centre of Excellence at McMaster University
• English speaking
• Diagnosed with hypertension or elevated blood pressure

Exclusion Criteria:

• Current or prior participation in chronic isometric exercise
• Unstable angina.
• Uncontrolled hypertension
• Uncontrolled heart failure and/or arrhythmias
• Recent myocardial infarction or electrocardiography changes
• Complete heart block
• Carpal tunnel syndrome
• Arthritis that may be aggravated by handgrip exercise
• Changes to the type and/or dose of blood pressure medications within 3 months of starting the study.