The Efficacy of Soleus Push-Up in Individuals with Prediabetes: A Pilot Study

Abstract

Background/objectives: Hamilton and colleagues invented the soleus push-up exercise and showed that this exercise method was successful in reducing postprandial blood glucose levels in sedentary individuals. The objective of the current pilot study was to assess the efficacy of the soleus push-up in individuals with prediabetes and to evaluate the feasibility of incorporating this exercise method into their daily routine.

Methods: Ten participants (mean age: 53.3 ± 2.7 years; four females, six males) with prediabetes were included in the study. Initially, participants underwent an oral glucose tolerance test (OGTT) while being sedentary to establish baseline postprandial blood glucose measurements. During a subsequent OGTT, participants concurrently performed the soleus push-up (SPU) exercise either with or without electromyographic (EMG) feedback. Blood glucose levels were measured at 15 min intervals over the two-hour duration of both OGTTs.

Results: We observed that performing the SPU in a sitting position during the oral glucose tolerance test resulted in approximately a 32% reduction in postprandial glucose excursion compared to the sedentary baseline results. This effect was also present in the absence of EMG feedback.

Conclusions: Our findings suggest that this repetitive, prolonged contractile muscle activity can improve metabolic regulation in prediabetic individuals without the need for a laboratory setting. SPU may be a viable and effective exercise to support metabolic health in home or work environments. However, further validation is needed with a larger sample size.

Keywords: SPU; blood glucose levels; metabolism; prediabetic condition; soleus push-up.

Figure 1

Study design.

Figure 2

(a) Participants walked on a treadmill at a comfortable pace while receiving realtime EMG feedback on laptop monitor. (b) After a few minutes of walking, participants transitioned to a seated position with the knee bent in order to (c) perform the soleus push-up.

Figure 3

Performing soleus-dominant exercise is an effective way of immediately achieving improved glucose tolerance. Comparing the effect of SPUs on the group blood glucose level during the 120 min glucose tolerance test. (A) Performing soleus push-ups while continuously receiving EMG feedback about the soleus muscle activity (EMG_SPU) versus control measurement (Control) (n = 5). (B) Performing soleus push-ups while not receiving EMG feedback (SPU) versus control measurement (Control) (n = 5). Mean ± SEM. * p < 0.05, ** p < 0.005, *** p < 0.001 versus control measurement. Mixed effect model followed by Tukey’s multiple comparison test was used to evaluate the effect of SPUs. See Table 1 for detailed comparison at each time point.

Figure 4

Repetitive soleus activity decreases the blood glucose incremental area under the curve by ~32%. Data represented as incremental area under the curve (iAUC), calculated by using the trapezoid method. Colored areas show the blood glucose iAUC change (A) in the group using continuous EMG feedback (EMG_SPU) versus control (n = 5) and (B) in the group without EMG feedback (SPU) versus control (n = 4). Mixed effect model, followed by Tukey’s multiple comparison test, was used to evaluate the difference of the iAUC between the interventional and the control. * denotes significance.

Figure 5

Prolonged soleus muscle activity improves glucose tolerance with and without electromyographic feedback. Colored triangles represent each individual glucose iAUC when performing soleus push-ups relative to the control measurement. Bar charts summarize the mean change in the group iAUC relative to the control results in the group that used EMG feedback (EMG_SPU) and in the group that did not use external biofeedback while performing the SPUs (SPU). Mixed effect model, followed by Tukey’s multiple comparison test, was used to evaluate the difference of the iAUC between the interventional and the control measurement. *** p < 0.001 versus control. ns = p > 0.05.