Nordic Walking improves quality of life, depression and functional capacity

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Nordic walking, also known as pole walking, requires more effort on the poles with each step than conventional walking. The muscles of the upper body are stimulated more during Nordic walking than during normal walking, which can cause a significant increase in heart rate at a certain speed. Compared to walking without poles, Nordic walking has been reported to increase energy expenditure by more than 40%.

A recent study published in the Canadian Journal of Cardiology shows that Nordic walking is superior to other types of exercise in cardiovascular rehabilitation for improving long-term functional capacity

Compared to standard high-intensity interval training and moderate-to-vigorous intensity continuous training, researchers found that Nordic walking in patients with coronary artery disease resulted in greater improvement in functional capacity, or ability to perform activities of daily living. The findings of their randomized clinical trial were recently published in the Canadian Journal of Cardiology.

After major cardiovascular events, cardiovascular rehabilitation and exercise programs have been linked to significant improvements in functional ability, cardiorespiratory fitness, and mental health. However, some people find boring exercises such as stationary cycling and walking boring and may stop exercising after their cardiovascular rehabilitation program is over. To find out whether they could encourage more people to continue exercising and what benefits that could bring, researchers looked at more appealing exercise choices that would appeal to a wider audience.

A growing body of research indicates that non-standard training interventions, such as Nordic walking and high-intensity interval training, are superior to conventional training methods for increasing functional capacity, as evaluated by the six-minute walk test, an important indicator of cardiovascular events in people with coronary artery disease. Nordic walking is a more advanced form of walking exercise that uses poles with specialized designs to better engage the muscles in both the upper and lower body.

“Patients with coronary artery disease often show decreased functional capacity, low quality of life, and an increased risk of subsequent cardiovascular events and mortality,” explains lead researcher Jennifer L. Reed, Ph.D., Exercise Physiology and Cardiovascular Health Lab, Division. of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute; Faculty of Medicine; and School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.

Researchers compared the long-lasting effects of 12-week rehabilitation with 1) high-intensity interval training; 2) continuous training at moderate to vigorous intensity; and 3) Nordic walking, on functional capacity, quality of life and depression symptoms in patients with coronary artery disease. One hundred and thirty patients were randomized to 12-week training in one of these three groups, followed by a 14-week observation phase.

Although all exercise programs improved depression symptoms and quality of life, the improvement in functional capacity was greatest after Nordic walking (+19%) compared with high-intensity interval training (+13%) and moderate-to-vigorous continuous training ( +12%

“This is an important finding because lower functional capacity predicts a higher risk of future cardiovascular events in people with coronary artery disease,” noted Dr. Drove up. “Nordic walking activates the core, upper and lower body muscles while reducing stress on the knee, potentially leading to greater improvements in functional capacity.”

“No previous study has directly compared the long-term effects of high-intensity interval training, moderate-to-vigorous intensity continuous exercise, and Nordic walking,” said Tasuku Terada, Ph.D., Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada.

“This study is novel because it simultaneously compared the sustained effects (ie 14 weeks after completion of cardiovascular rehabilitation) of different exercise programs that can be easily incorporated into daily exercise. Patient preferences should be taken into account when prescribing exercise for patients with coronary artery disease. Our findings may impact patient care by providing alternative exercise options based on their interests and needs,” he concluded.

In an accompanying editorial, Carl J. Lavie, MD, Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, USA, and colleagues noted that the addition from Nordic walking to a cardiovascular rehabilitation program could be an ideal transition from standard moderate-intensity continuous exercise or traditional walking, especially for deconditioned patients who cannot tolerate the high-intensity exercise, or for patients in whom high-intensity interval training may be contraindicated.

“Adding Nordic poles to moderate-to-vigorous intensity walking is a simple, accessible option to improve gait improvements, increase energy expenditure, activate upper body muscles, and other functional parameters such as posture, gait and balance to improve,” the comment said. dr. lavie.

“Offering a variety of exercise options improves patient enjoyment and progression, which is important for adherence and maintenance. Exercise modalities should be prescribed taking into account the patient’s goals, preferences, and capabilities,” he advised.

The study was funded by the Academic Health Sciences Centers of the Ministry of Ontario, the Heart and Stroke Foundation of Canada and the Canadian Institutes of Health Research.

Reference: “Sustained Effects of Different Exercise Modalities on Physical and Mental Health in Patients with Coronary Artery Disease: A Randomized Clinical Trial” by Tasuku Terada, Ph.D., Lisa M. Cotie, Ph.D., Heather Tulloch, Ph. D., Matheus Mistura, MSc, Sol Vidal-Almela, MSc, Carley D. O’Neill, Ph.D., Robert D. Reid, Ph.D., Andrew Pipe, MD, and Jennifer L. Reed, Ph.D . ., June 14, 2022, Canadian Journal of Cardiology.
DOI: 10.116/j.cjca.2022.03.017

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