Daily Passive Muscle Stretching Improves Flow-Mediated Dilation of Popliteal Artery and 6-minute Walk Test in Elderly Patients with Stable Symptomatic Peripheral Artery Disease

Autor: William C. Dixon, John N. Katopodis, Brad J. Behnke, Rebecca Andrews, Judy M. Muller-Delp, James Graven, Aimee Pragle, Kazuki Hotta, Akash Ghai, Thomas Noel, Vishal Dahya, Jegghna Chheda, Wayne B. Batchelor, Lia Liberatore
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Time Factors
Vasodilation
Walk Test
030204 cardiovascular system & hematology
law.invention
03 medical and health sciences
Peripheral Arterial Disease
0302 clinical medicine
Randomized controlled trial
law
Predictive Value of Tests
Internal medicine
medicine.artery
Muscle Stretching Exercises
Medicine
Humans
Popliteal Artery
030212 general & internal medicine
Prospective Studies
Muscle
Skeletal
Aged
Soleus muscle
Aged
80 and over
Cross-Over Studies
Exercise Tolerance
business.industry
Skeletal muscle
General Medicine
Recovery of Function
Intermittent Claudication
Middle Aged
Crossover study
Popliteal artery
Peripheral
medicine.anatomical_structure
Treatment Outcome
Regional Blood Flow
Cardiology
Florida
Female
Endothelium
Vascular
Muscle stretching
Cardiology and Cardiovascular Medicine
business
Zdroj: Cardiovascular revascularization medicine : including molecular interventions. 20(8)
ISSN: 1878-0938
Popis: Background Patients with peripheral arterial disease (PAD) often have walking impairment due to insufficient oxygen supply to skeletal muscle . In aged rats, we have shown that daily stretching of calf muscles improves endothelium-dependent dilation of arterioles from the soleus muscle and increases capillarity and muscle blood flow during exercise. Therefore, we hypothesized that daily muscle stretching of calf muscles would improve endothelium-dependent vasodilation of the popliteal artery and walking function in PAD patients. Methods We performed a randomized, non-blinded, crossover study whereby 13 patients with stable symptomatic PAD were randomized to undergo either 4 weeks of passive calf muscle stretching (ankle dorsiflexion applied 30 min/d, 5 days/wk) followed by 4 weeks of no muscle stretching and vice versa. Endothelium-dependent flow-mediated dilation (FMD) and endothelium-independent nitroglycerin-induced dilation of the popliteal artery and 6 minute walk test (6MWT) were evaluated at baseline and after each 4 week interval. Results After 4 weeks of muscle stretching, FMD and 6MWT improved significantly in the muscle stretching group vs. the control (FMD: 5.1 ± 0.5% vs. 3.7 ± 0.3%, P = 0.005; 6MWT continuous walking distance: 304 ± 43 m vs. 182 ± 34 m; P = 0.0006). No difference in nitroglycerin-induced dilation was found between groups (10.9 ± 1.2 vs. 9.9 ± 0.4%, P = 0.48). Post-stretching, 6MWT total walking distance was positively correlated with normalized FMD (R = 0.645, P = 0.02). Conclusions Passive calf muscle stretching enhanced vascular endothelial function and improved walking function in elderly patients with stable symptomatic PAD. These findings merit further investigation in a prospective randomized trial.
Databáze: OpenAIRE
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