The Effect of Stretching Exercises on Vascular Function, Blood Flow, and Walking Function in Middle and Older Adults

Study Overview
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Brief Summary
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This study examines the relationship between circulation and walking speed after performing 8-week stretching exercises.

Detailed Description
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This study examines the relationship between circulations and walking speeds. Most studies in the field of stretching exercises have only focused on improvements of endothelial functions in younger population; however, I aim to emphasize its effects on different populations, such as people with frailty, low physical activity level, weakness and postoperative status. Previous research has established that stretching exercises can improve walking function by modulations of musculoskeletal or neuromuscular system. The importance and originality of this study are that it explores the relationship between circulation and walking speed. Due to the inability to extrapolate outcomes; short-term effect of improved blood vessel function; the unclear mechanism of stretching exercises; and considering the different physical fitness groups, I design a home-based, low-dose, and anatomic chain-based stretching exercises to verify the possible mechanism and effects.

Official Title
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The Effect of Stretching Exercises on Vascular Function, Blood Flow, and Walking Function in Middle and Older Adults

Conditions
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Stretch

Intervention / Treatment
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* Other: stretching exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age between 20-85 years old Follow instructions Walk with/without assistive technology Exclusion Criteria: Unstable acute or chronic health conditions Peripheral vascular diseases Non-musculoskeletal problems that would limit stretching exercises Participate in other exercise programs

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Stretching exercises<br>Interventions are home-based stretching exercises. The experimental group will receive 6 stretching exercises which stretch 20-30 seconds, relax for 10 seconds, and repeat 5 times for each side. It will take 25-30 minutes every day for continuous 8 weeks. | Other: stretching exercises<br>* Our interventions are home-based stretching exercises. The experimental group will receive 6 stretching exercises which stretch 20-30 seconds, relax for 10 seconds, and repeat 5 times for each side. It will take 25-30 minutes every day for continuous 8 weeks. Those include stretching of the deep front line, spiral line, superficial front line, lateral line, superficial back line, and plantar flexors. Designed concepts are the following three: 1) based on ''Anatomy- Train'' theory, 2) emphasize on movements of trunk and pelvis, and 3) stress on the stretching of lower extremities.<br>|
| No Intervention: Control group<br>Maintain their daily activity level in the 8 weeks. We use the study desigh-''waiting list control'' in this group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| vascular functions-Stiffness index(1) | (Stiffness index, SI，unit：m/s) | pre-intervention(1st week) | 
| vascular functions-Stiffness index(2) | (Stiffness index, SI，unit：m/s) | during intervention(4th week) | 
| vascular functions-Stiffness index(3) | (Stiffness index, SI，unit：m/s) | post-intervention(8th week) | 
| vascular functions-Reflective index(1) | (Reflective index, RI，unit：％) | pre-intervention(1st week) | 
| vascular functions-Reflective index(2) | (Reflective index, RI，unit：％) | during intervention(4th week) | 
| vascular functions-Reflective index(3) | (Reflective index, RI，unit：％) | post-intervention(8th week) | 
| vascular functions-Vascular age | (Vascular age, VA，unit：year-old) | pre-intervention(1st week) | 
| Ultrasound parameters-peak-systolic velocity(1) | （peak-systolic velocity, PSV) | pre-intervention(1st week) | 
| Ultrasound parameters-peak-systolic velocity(2) | （peak-systolic velocity, PSV） | during intervention(4th week) | 
| Ultrasound parameters-peak-systolic velocity(3) | （peak-systolic velocity, PSV） | post-intervention(8th week) | 
| Ultrasound parameters-end-diastolic velocity(1) | （end-diastolic velocity, EDV） | pre-intervention(1st week) | 
| Ultrasound parameters-end-diastolic velocity(2) | （end-diastolic velocity, EDV） | during intervention(4th week) | 
| Ultrasound parameters-end-diastolic velocity(3) | （end-diastolic velocity, EDV） | post-intervention(8th week) | 
| Ultrasound parameters-mean velocity(1) | （mean velocity, mV） | pre-intervention(1st week) | 
| Ultrasound parameters-mean velocity(2) | （mean velocity, mV） | during intervention(4th week) | 
| Ultrasound parameters-mean velocity(3) | （mean velocity, mV） | post-intervention(8th week) | 
| Ultrasound parameters-mean volume flow(1) | (mean volume flow, vFl) | pre-intervention(1st week) | 
| Ultrasound parameters-mean volume flow(2) | (mean volume flow, vFl) | during intervention(4th week) | 
| Ultrasound parameters-mean volume flow(3) | (mean volume flow, vFl) | post-intervention(8th week) | 
| Ultrasound parameters-resistance index(1) | (resistance index, RI) | pre-intervention(1st week) | 
| Ultrasound parameters-resistance index(2) | (resistance index, RI) | during intervention(4th week) | 
| Ultrasound parameters-resistance index(3) | (resistance index, RI) | post-intervention(8th week) | 
| Ultrasound parameters-pulsatility index(1) | (pulsatility index, PI) | pre-intervention(1st week) | 
| Ultrasound parameters-pulsatility index(2) | (pulsatility index, PI) | during intervention(4th week) | 
| Ultrasound parameters-pulsatility index(3) | (pulsatility index, PI) | post-intervention(8th week) | 
| Ultrasound parameters-diameter(1) | （diameter, D） | pre-intervention(1st week) | 
| Ultrasound parameters-diameter(2) | （diameter, D） | during intervention(4th week) | 
| Ultrasound parameters-diameter(3) | （diameter, D） | post-intervention(8th week) | 
| Ultrasound parameters-area(1) | （area, A） | pre-intervention(1st week) | 
| Ultrasound parameters-area(2) | （area, A） | during intervention(4th week) | 
| Ultrasound parameters-area(3) | （area, A） | post-intervention(8th week) | 
| walking speed-preferred(1) | Timed 10-Meter Walk Test (preferred) | pre-intervention(1st week) | 
| walking speed-preferred(2) | Timed 10-Meter Walk Test (preferred) | during intervention(4th week) | 
| walking speed-preferred(3) | Timed 10-Meter Walk Test (preferred) | post-intervention(8th week) | 
| walking speed-fast(1) | Timed 10-Meter Walk Test (fast) | pre-intervention(1st week) | 
| walking speed-fast(2) | Timed 10-Meter Walk Test (fast) | during intervention(4th week) | 
| walking speed-fast(3) | Timed 10-Meter Walk Test (fast) | post-intervention(8th week) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| body composition-height | height(cm) | pre-intervention(1st week) | 
| body composition-weight | weight(kg) | pre-intervention(1st week) | 
| body composition-waist circumference | waist circumference(cm) | pre-intervention(1st week) | 
| vital sign-blood pressure(1) | blood pressure(mmHg) | pre-intervention(1st week) | 
| vital sign-blood pressure(2) | blood pressure(mmHg) | during intervention(4th week) | 
| vital sign-blood pressure(3) | blood pressure(mmHg) | post-intervention(8th week) | 
| vital sign-heart rate(1) | heart rate(bpm) | pre-intervention(1st week) | 
| vital sign-heart rate(2) | heart rate(bpm) | during intervention(4th week) | 
| vital sign-heart rate(3) | heart rate(bpm) | post-intervention(8th week) | 
| flexibility-chair sit and reach test (1) | chair sit and reach test (cm) | pre-intervention(1st week) | 
| flexibility-chair sit and reach test (2) | chair sit and reach test (cm) | during intervention(4th week) | 
| flexibility-chair sit and reach test (3) | chair sit and reach test (cm) | post-intervention(8th week) | 
| grip strength | hand dynamometer | pre-intervention(1st week) | 
| cognitive function | Montreal Cognitive Assessment.Minimum value is 0 and maximum value is 30, and higher scores mean a better outcome | pre-intervention(1st week) | 
| frailty | SOF (Study of Osteoporotic Fractures). Minimum value is 0 and maximum value is 3, and higher scores mean a worse outcome | pre-intervention(1st week) | 
| basic data | gender, age, education, living status, smoking, and exercise habits | pre-intervention(1st week) | 
| ACSM-PAR-Q+ | The Physical Activity Readiness Questionnaire for Everyone AND follow-up questions about their medical conditions (PAR-Q+) is used to identify whether subjects are at risk in engaging in exercises. Thus, researchers can prescribe individual exercise prescriptions. | pre-intervention(1st week) | 
| IPAQ | International Physical Activity Questionnaire to investigate their physical activity levels. Higher the amount of physical activity (min-METs/week) means a more active life-style(physical activity level). | pre-intervention(1st week) | 
| fitness | (Duke activity status index, DASI) Minimum value is 0 and maximum value is 58.2, and higher scores mean a better physical activity level. | pre-intervention(1st week) | 
| adherence of exercise | usage records from the Line app | post-intervention(8th week) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stretching exercise, vascular function, blood flow, walking function, fitness