The review, led by Dr. Raju Vaishya, Senior Consultant Orthopaedic Surgeon at Indraprastha Apollo Hospitals, evaluates lower-body simple resistance activities (SRAs), soleus push-ups (SPUs), and stretching exercises as practical tools for improving metabolic outcomes. These exercises can be performed in seated or reclined positions and do not involve walking, jogging, or supporting full body weight, making them suitable for people with musculoskeletal disorders, cardiorespiratory disease, advanced age, chronic illness, or prolonged sedentary work routines.
“We often see older adults, patients recovering from injuries, and individuals with chronic diseases who are unable to perform high-intensity or weight-bearing exercise,” Dr. Vaishya said. “Our review shows that uncomplicated, low-impact leg movements—such as seated soleus push-ups—can keep muscles active and help preserve strength with minimal risk and virtually no equipment.”
The authors conducted a narrative review of randomized controlled trials, cohort studies, and pilot interventions sourced from major scientific databases.
The analysis revealed the following findings:
- Moderate lower-body muscle strength was associated with a 32–35% lower risk of type 2 diabetes.
- Interrupting prolonged sitting with three minutes of simple resistance activity every 30 minutes reduced insulin responses by 26%.
- Soleus push-ups lowered postprandial glucose levels by 39–52% and reduced insulin response by 60% during oral glucose tolerance tests.
- Passive stretching exercises acutely reduced blood glucose by 24–28 mg/dL.
- Regular stretching improved femoral blood flow by around 30% and enhanced flow-mediated dilation by approximately 25%, reflecting better vascular function.
Prof. Dr. Anoop Misra, Director of the Department of Endocrinology and Metabolism at Fortis C-Doc Hospital and corresponding author, highlighted the broader implications. He noted that lower-limb muscle strength is closely tied to glucose metabolism, balance, fall prevention, and overall functional independence. Simple resistance activities that do not require standing or heavy equipment could therefore become a valuable addition to public health recommendations, particularly for largely sedentary populations.
The physiological mechanisms behind these improvements likely involve activation of AMPK pathways, enhanced GLUT4-mediated glucose uptake, myokine release, and better endothelial function.
While the findings are encouraging, the authors call for larger and longer-term clinical trials to determine the sustained impact of these exercises on glycaemic control and cardiovascular risk reduction. However, the review offers a hopeful message: even for those unable to perform traditional aerobic exercise, maintaining metabolic health may be achievable through safe, simple, and accessible lower-limb movements integrated into daily life.
Reference:
Vaishya R, Vaish A, Gopinathan P, Misra A. Non-Weight-Bearing Lower Limb Simple Resistance Activities, Soleus Push-Ups, and Muscle Stretching: Impact on Glycemic Control and Metabolic–Circulatory Outcomes. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. February 2026; 20(2): 103375. DOI: https://doi.org/10.1016/j.dsx.2026.103375
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