Effects of Active Stretching on Cardiovascular Response and Arterial Stiffness in Older Adults With Low Flexibility

NCT06944886 | Completed

• 1 other identifier: UPhayaoChonticha-220
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

A study of the effects of active static stretching exercise in elderly people with poor lower extremity muscle flexibility on autonomic and cardiovascular responses and balance ability.

Conditions

Arterial Stiffness; Autonomic Nervous System; Musculoskeletal Diseases; Range of Motion

Keywords

Active static stretching; Arterial stiffness; Autonomic nervous system response; Lower-limb flexibility; Balance control in older adults

Outcome Measures

Primary Outcomes (9)

• Heart Rate Variability (HRV) Assessment

  HRV was evaluated to measure the variability between heartbeats, providing insight into autonomic nervous system (ANS) function, stress resistance, and arterial elasticity (Nunan et al., 2009). Measurements were conducted using the SA-3000P device in a temperature-controlled room (25-27 °C) during a consistent morning time frame (8:00-10:00 AM). Participant data (e.g., sex, date of birth) were entered into the system, and the individual was instructed to sit comfortably, refrain from speaking or moving, and breathe normally for 3 minutes while a finger probe was attached. Results were automatically displayed and stored for analysis.

  pre-test, 4weeks and 8 weeks

• Timed Up and Go (TUG) Test

  The TUG test was used to assess dynamic balance and fall risk. Participants were instructed to rise from a chair, walk 3 meters at a safe and fastest possible pace, turn around a cone, and return to the chair. Timing stopped once they sat back down. Each participant performed three trials, and the average time was recorded.

  pre-test, 4weeks and 8 weeks

• Hand Grip Strength Test

  Upper extremity strength was assessed using a hand grip dynamometer. Participants stood upright with arms at their sides. The test was conducted on the dominant arm with the elbow extended and the arm in a neutral pronated position. The dynamometer handle was adjusted to the second phalanx. Participants were asked to abduct the arm approximately 15 degrees and, upon the signal "start," squeeze the device with maximum force.

  pre-test, 4weeks and 8 weeks

• Five Times Sit to Stand Test (FTSST)

  Lower limb strength was assessed using the FTSST. Participants sat in a standard-height chair (without armrests), feet flat on the floor, heels 10 cm behind the knees, and hips flexed at approximately 90 degrees. Upon the command "start," they were instructed to stand up and sit down five times as quickly and safely as possible. Timing began at the command and ended when they sat down on the fifth repetition. Three trials were conducted, and the average time was used.

  pre-test, 4weeks and 8 weeks

• Single-Leg Stance Test (SLST)

  Static balance was measured using the SLST (Franchignoni et al., 2010). Participants crossed their arms over their chest and stood on their preferred leg with the opposite leg lifted at 90-degree knee flexion. Timing started upon command and stopped when any of the following occurred: (1) lifted leg touched the ground, (2) lifted leg touched the standing leg, (3) the standing leg shifted position, or (4) arms moved from the chest. The test was repeated three times, and the average time (in seconds) was recorded. Participants were allowed to rest for one minute between trials.

  pre-test, 4weeks and 8 weeks

• Isometric Strength Assessment

  Isometric back, leg, and chest strength was evaluated using a calibrated dynamometer (Takei 5402 Back Muscle Digital Dynamometer). Participants stood on the device base with knees extended. The handle height was adjusted to the knee joint. During testing, participants flexed hips and knees slightly, maintaining a natural lordotic curve. They were instructed to pull vertically using maximal isometric contraction over 3 seconds, holding for 2 seconds. After one demonstration and one trial, three formal trials were performed, with 30-second rests in between. The maximum value from the trials (in kilograms) was recorded for analysis.

  pre-test, 4weeks and 8 weeks

• Sit and Reach Test (SRT)

  Flexibility of the lower back and hamstrings was measured using the SRT. Participants sat on the floor with knees fully extended and reached forward along a standardized box. They were instructed to reach as far as possible and hold for two seconds. Two trials were conducted with 2-minute rests, and the best average score was used

  pre-test, 4weeks and 8 weeks

• Back Scratch Test

  Upper body flexibility was assessed using the Back Scratch Test (ICC: 0.98, 95% CI: 0.97-0.98). Participants stood upright and reached one hand over the shoulder and the other behind the back to touch or overlap fingertips. The distance (in cm) between fingertips was measured: overlapping = positive score; unable to touch = negative score; fingertips touching = 0. Two trials were performed for each arm, and the average was recorded. The minimal detectable change reported in previous studies was 1.41 cm.

  pre-test, 4weeks and 8 weeks

• Body Composition Analysis

  Body composition was assessed using the InBody analyzer, which measures muscle mass, fat, water, minerals, and bone mass via bioelectrical impedance analysis. Participants grasped the hand electrodes and stood still on the platform for approximately 5 minutes. The device automatically analyzed and printed the results.

  pre-test, 4weeks and 8 weeks

Study Arms (2)

Active Static Stretching Exercise Combined with Breathing Exercise (Experimental Group)

EXPERIMENTAL

Participants received a pre-intervention orientation at the SHPH, including instruction by a licensed physical therapist on active static stretching and breathing techniques. Each participant was given an illustrated manual and logbook. The 8-week program combined home-based stretching with weekly supervised sessions at the SHPH. Exercises targeted neck, trunk, upper and lower limb muscles (e.g., flexors, extensors, pectorals, triceps, quadriceps, hamstrings, adductors). Movements were performed in seated, lying, and standing positions, synchronized with breathing. Each session included a 5-min warm-up, 30 min of stretching, and 5-min cool-down. Exercises were done 5 times/week (4 at home, 1 supervised). Community health volunteers followed up weekly.

Other: Active Static Stretching Exercise Combined with Breathing Exercise (Experimental Group)

Control group

NO INTERVENTION

regular activity

Interventions

Active Static Stretching Exercise Combined with Breathing Exercise (Experimental Group) OTHER

Participants in the intervention group performed active static stretching exercises using a pictorial exercise booklet. The booklet contained a series of self-directed stretching postures targeting major muscle groups. Each stretch was held in a static position without external assistance, encouraging the participant to engage and maintain the stretch voluntarily." Each stretch was held for 30 seconds and repeated 3 times per muscle group. The targeted areas included the hamstrings, quadriceps, calves, hip flexors, and shoulders."

Also known as: Active Static Stretching

Active Static Stretching Exercise Combined with Breathing Exercise (Experimental Group)

Eligibility Criteria

• Age: 60 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \- Elderly males and females
• Have a normal body mass index (between 18.5-24.5 kg/m2)
• Be able to follow instructions and willing to participate in the study
• Be able to communicate with the researcher and provide information by themselves (the researcher will read the questions to the volunteers and let the volunteers choose the answers by themselves)
• Be able to walk continuously for at least 10 meters with or without walking aids
• Have low flexibility with a forward lean distance not exceeding the 40th percentile from the sit and reach test according to the American College of Sports Medicine criteria

You may not qualify if:

• \- Abnormalities such as pain or inflammation of the legs more than 5 points, assessed by (visual analog scale (VAS) \> 5 points)
• Significantly different leg lengths (more than 1.4 centimeters) or abnormalities of joints, including abnormal sensations that affect movement and walking
• Uncontrolled chronic diseases or obstacles to study, such as high blood pressure, diabetes, asthma, neurological diseases such as Parkinson's disease, Alzheimer's disease, skeletal and muscular diseases such as chronic back pain, acute osteoarthritis, sprained ankle
• Vision problems that cannot be corrected by wearing glasses
• Uncorrected hearing Inner ear disturbances that affect balance, such as otitis media

Sponsors & Collaborators

• University of Phayao: lead

Study Sites (1)

Chonticha Kaewjoho

Phayao, 56000, Thailand

Location

MeSH Terms

Conditions

Musculoskeletal Diseases

Interventions

Breathing Exercises; Muscle Stretching Exercises

Intervention Hierarchy (Ancestors)

Mind-Body Therapies; Complementary Therapies; Therapeutics; Exercise Movement Techniques; Physical Therapy Modalities; Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Chonticha Kaewjoho, PT, PhD Kaewjoho

  University of Phayao

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer, Department of Physical Therapy

Model Details: Older adult participants attended an orientation at the SHPH, where a licensed physical therapist provided instruction on active static stretching and breathing techniques. Each participant received an illustrated manual and logbook. The 8-week hybrid program included home-based stretching with one supervised session weekly. Exercises targeted neck, trunk, upper and lower limb muscles (e.g., flexors, extensors, pectorals, triceps, hamstrings, adductors). Movements were done in seated, lying, and standing positions, synchronized with breathing. Each session included a 5-min warm-up, 30 min of stretching, and 5-min cool-down. Participants trained 5 days/week (4 home, 1 group). Community health volunteers provided weekly follow-up.

Study Record Dates

• First Submitted: April 10, 2025
• First Posted: April 25, 2025
• Study Start: December 1, 2024
• Primary Completion: April 5, 2025
• Study Completion: April 9, 2025
• Last Updated: April 25, 2025

Record last verified: 2025-04

Locations

TH (1)