Written by Joyce Smith, BS. Passive stretching (PS) is an effective non-pharmaceutical approach for improving vascular function particularly for those with limited mobility.
Vascular function and arterial stiffness are important markers of cardiovascular health and cardiovascular co-morbidity. A biomarker of vascular function involves the ability of an artery to dilate and constrict 1, thus maintaining healthy vascular function is vital for the prevention of cardiovascular disease 2. Many studies have shown that short bouts of passive static stretching (PS) is a well-established practice frequently used in rehabilitation and sport medicine to increase joint range of motion (ROM) 3,4. While it may have a positive effect on vascular function, arterial stiffness and arterial structure, very little is known regarding the long-term effects of PS on vascular health and function in older adults 5.
The Bisconti research team 6 hypothesized that PS training might induce mechanical remodulation of the walls of arteries directly involved in PS training. Perhaps the drag force on the artery’s endothelial lining incites production of nitric oxide 7 which might lead to endothelial remodeling (changing vascular stiffness and structure) 8 and may have practical implications for cardiovascular health in people who have limited mobility and those who are bedridden.
Thirty-nine participants were randomly assigned to bilateral PS (n = 14), monolateral (one-side only) PS (n = 13) or a control group of no PS training (n = 12). Vascular function (measured via flow mediated dilatation [FMD]), arterial stiffness of femoral and carotid arteries (measured using pulse-wave velocity [PWV]), and systolic and diastolic blood pressures were all evaluated before and at 6 and 12 weeks of training and re-evaluated 6 weeks after completion of the 12-week training. The specific arteries measured were the femoral and popliteal arteries that were treated with stretching, and the untreated arteries (i.e. contralateral femoral and popliteal arteries and brachial arteries) of both right and left sides.
After PS training, vascular function and blood pressure, and arterial stiffness decreased in all the arteries of the body parts directly and not directly involved in PS training of the lower limbs, suggesting that PS training induced both local and systemic cardiovascular adjustments. The following significant changes were observed in the PS training groups following 12 weeks of training: increase in femoral artery blood flow, increases in flow-mediated dilatation of both popliteal and brachial arteries, decreases in central and peripheral arterial stiffness, and decreases in systolic and diastolic blood pressures.
The control group, randomized to no stretching, had no evident changes. The passive stretching-induced improvements that related to arteries not involved in PS training (i.e. contralateral femoral and popliteal arteries and brachial artery), appeared to have a short duration. They returned to pre-training baseline levels within 6 weeks following training cessation, whereas improvements in the arteries directly related to the PS training persisted during the follow-up.
This study was not without limitations. Had researchers directly assessed sympathetic nerve activity or the bioavailability of nitric oxide, they could have perhaps more definitively established the respective roles of both in the remodulation of sympathetic vessel tone and improved endothelial function. Female participants were always tested during the same days of their menstrual cycles due to the cycles’ strong fluctuations in vascular responsiveness which could have varied the testing week by 5 days. Also, possible gender differences may have been detected in the responses of male and female participants to PS training had researchers used a larger study population.
Source: Bisconti, A. V., E. Cè, S. Longo, M. Venturelli, G. Coratella, E. Limonta, C. Doria, S. Rampichini, and F. Esposito. “Evidence for improved systemic and local vascular function after long‐term passive static stretching training of the musculoskeletal system.” The Journal of Physiology (2020).
©2020 The Authors. The Journal of Physiology C 2020 The Physiological Society
Posted July 20, 2020.
Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.
References:
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- Esposito F, Limonta E, Cè E. Time course of stretching-induced changes in mechanomyogram and force characteristics. Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology. 2011;21(5):795-802.
- Behm DG, Blazevich AJ, Kay AD, McHugh M. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2016;41(1):1-11.
- Cortez-Cooper MY, Anton MM, Devan AE, Neidre DB, Cook JN, Tanaka H. The effects of strength training on central arterial compliance in middle-aged and older adults. European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology. 2008;15(2):149-155.
- Bisconti AV, Cè E, Longo S, et al. Evidence for improved systemic and local vascular function after long-term passive static stretching training of the musculoskeletal system. J Physiol. 2020.
- Niebauer J, Cooke JP. Cardiovascular effects of exercise: role of endothelial shear stress. J Am Coll Cardiol. 1996;28(7):1652-1660.
- Bisconti AV, Cè E, Longo S, et al. Evidence of Improved Vascular Function in the Arteries of Trained but Not Untrained Limbs After Isolated Knee-Extension Training. Frontiers in physiology. 2019;10:727.
