Passive Stretching Linked to Improved Vascular Function Interview with:
Prof. Emiliano Cè

Department of Biomedical Sciences for Health
University of Milan
Via Giuseppe Colombo, 71(2nd Building)
Milan, Italy What is the background for this study?

Response: We investigated the effects of long-term passive stretch training of the lower limb on vascular function and stiffness of the arteries involved (femoral and popliteal) and uninvolved (brachial) in the stretching protocol. Thirty-nine healthy participants of both sexes were randomly assigned to bilateral, unilateral or control (i.e., no passive stretch training). Passive stretch training was performed on knee extensor, plantar flexor muscles, and posterior muscle chain, 5 times a week for 12 weeks. Before and after the training period, vascular function was measured by Doppler ultrasounds during single passive limb movement (i.e., passive knee flexion-extension) and flow-mediated dilation (i.e., brachial and popliteal arteries). Measures of central (carotid-femoral artery) and peripheral (carotid-radial artery) arterial stiffness were performed by applanation tonometry technique. The same technique was used to assess the pulse wave velocity at the carotid artery level. What are the main findings? 

Response: As novel results, this study demonstrates that the repetitive administration of passive mechanical stimuli (such as passive stretch training) can alter peripheral blood flow patterns and can be effective in increasing vascular function, maximal arterial dilation capacity (a biomarker to determine in-vivo changes in human vascular structure), and decreasing arterial stiffness, by improving central and local blood flow control mechanisms. What should readers take away from your report? 

Response: The present results are important because the repetitive application of passive mechanical stimuli to a muscle group may be used as a novel, non-pharmacological treatment for improving and/or preserving vascular health, thus reducing the overall cardiovascular risk, especially in individuals with limited mobility. Moreover, this passive maneuver may also be used during hospitalization or after surgical interventions, in order to preserve the cardiovascular health in a low-mobility scenario. Noteworthy, these positive outcomes were obtained with long-term training that can be performed also at home by self-administration. This is relevant in the current period of home confinement, where the possibility to perform beneficial training for cardiovascular health is strongly limited. What recommendations do you have for future research as a result of this work?

Response: As follow-up study, it would be very interesting to assess the efficacy of passive stretch training in populations with impaired cardiovascular function, and or limited mobility capacity, either due to age (e.g., older adults) or pathological conditions (e.g., neuromuscular disorders). Is there anything else you would like to add? 

Response: A direct assessment of muscle sympathetic nerve activity and of nitric oxide bioavailability would have evidenced possible stretch-induced remodulation of sympathetic vessel tone and endothelial function, respectively. The lack of a direct assessment of these measurements did not permit to establish a clear balance between central and local mechanisms underlying the positive changes in vascular function. Lastly, a larger sample size may have helped to detect possible differences in the passive stretch training-induced response between female and male participants. 


V. Bisconti, E. Cè, S. Longo, M. Venturelli, G. Coratella, E. Limonta, C. Doria, S. Rampichini, 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; DOI: 10.1113/JP279866


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Last Modified: Jul 8, 2020 @ 11:47 pm 

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