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For PAD, Walking Tolerance Boosted With Simple Calf Stretching

— Better vascular endothelial function tied to more walking ability

Last Updated May 8, 2017
MedpageToday

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Just one month of simple calf stretching helped peripheral artery disease (PAD) patients to walk more despite their lower extremity claudication, researchers found in a small trial.

Investigators randomized 13 patients to 4 weeks of muscle stretching (30 minutes a day, 5 days a week) or a sedentary lifestyle sans stretching. At follow-up, flow-mediated dilation was better in the stretching group (5.2% versus 3.7% for no stretching, P=0.003), as was this cohort's 6-minute walking distance (355 versus 311 meters, P=0.007). What's more, relative gains in walking distance correlated with flow-mediated dilation (P=0.03).

There was no difference in nitroglycerin-induced dilation between groups, however (10.9% versus 9.9%, P=0.54), reported study authors led by Kazuki Hotta, PhD, of Tokyo's University of Electro-Communications.

"These results indicate that static calf muscle stretching enhances vascular endothelial function of the popliteal artery, contributing to improvement of walking tolerance in PAD patients," according to Hotta's poster presentation at the American Heart Association's meeting.

In this study, stretching required the use of ankle dorsiflexion splints at home.

"A physical therapist can instruct you how to adjust and wear the splints correctly so you can do the stretches at home. There is no doubt about the benefit of exercise training on blood vessel health in PAD patients. If you have limited walking ability, I recommend that you at least perform muscle stretches so you can gain enough comfort and confidence in walking to participate in a walking exercise program," Hotta said in a statement.

Earlier studies had demonstrated that exercise is beneficial for PAD patients and that a home-based program was effective for getting them to walk more.

In the current study, the 13 participants were 71 years old on average and 53.8% men. Most were on statins and antiplatelet drugs at the time of enrollment.

"This is a very safe, easy intervention that can be done at home and has the potential to really improve your tolerance for walking and get you into a walking program," said senior author Judy M. Muller-Delp, PhD, of Florida State University College of Medicine in Tallahassee, in a statement.

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    Nicole Lou is a reporter for 51˶, where she covers cardiology news and other developments in medicine.

Disclosures

The study was funded by the National Institute on Aging and Florida State University.

Hotta disclosed no conflicts of interest.

Primary Source

American Heart Association

Hotta K, et al "Effects of muscle stretching on flow-mediated dilation of popliteal artery in patients with peripheral artery disease" ATVB-PVD 2017; Presentation 319.