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Physiological Impact and Clinical Relevance of Passive Exercise/Movement

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Abstract

Passive exercise/movement has a long history in both medicine and physiology. Early clinical applications of passive exercise/movement utilized pneumatic and direct limb compression to stimulate the vasculature and evoke changes in blood flow to avoid complications brought about by stasis and vascular disease. Over the last 50 years, passive exercise/movement has continued to progress and has provided physiologists with a reductionist approach to mechanistically examine the cardiorespiratory, hyperemic, and afferent responses to movement without the confounding influence of metabolism that accompanies active exercise. This review, in addition to providing an historical perspective, focuses on the recent advancements utilizing passive leg movement, and how the hyperemic response at the onset of this passive movement has evolved from a method to evaluate the central and peripheral regulation of blood flow during exercise to an innovative and promising tool to assess vascular function. As an assessment of vascular function, passive leg movement is relatively simple to perform and provides a nitric oxide-dependent evaluation of endothelial function across the lifespan that is sensitive to changes in activity/fitness and disease state (heart failure, peripheral artery disease, sepsis). The continual refinement and characterization of passive leg movement are aimed at improving our understanding of blood flow regulation and the development of a clinically ready approach to predict and monitor the progression of cardiovascular disease.

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Fig. 1

Modified from Nobrega et al. [29]

Fig. 2

Modified from Radegran and Saltin [46]

Fig. 3

Modified from McDaniel et al. [33]

Fig. 4

Modified from Groot et al. [52]

Fig. 5

Modified from Trinity et al. [40]

Fig. 6

Modified from Rossman et al. [54]

Fig. 7

Modified from Groot et al. [52] and Casey et al. [69]

Fig. 8
Fig. 9

Similar content being viewed by others

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Authors and Affiliations

  1. George E Wahlen Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center, Bldg 2, RM 1D29A, 500 Foothill Dr., Salt Lake City, UT, 84148, USA

    Joel D. Trinity & Russell S. Richardson

  2. Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA

    Joel D. Trinity & Russell S. Richardson

  3. Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA

    Joel D. Trinity & Russell S. Richardson

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  1. Joel D. Trinity
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Correspondence to Joel D. Trinity.

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Funding

This work was supported by Veterans Affairs Rehabilitation Research and Development Career Development (IK2RX001215), Merit (E6910-R and E1697-R), Spire (E1433-P), Senior Research Career Scientist (E9275-L) awards, American Heart Association (14SDG18850039), and a National Heart, Lung, and Blood Institute grant (HL-091830).

Conflict of interest

Joel D. Trinity and Russell S. Richardson have no conflicts of interest that are directly relevant to the content of this article.

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Trinity, J.D., Richardson, R.S. Physiological Impact and Clinical Relevance of Passive Exercise/Movement. Sports Med 49, 1365–1381 (2019). https://doi.org/10.1007/s40279-019-01146-1

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