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European Journal of Physical and Rehabilitation Medicine 2020 Jun 23

DOI: 10.23736/S1973-9087.20.06120-1


language: English

Effects of Nordic walking on cardiovascular performance and quality of life in coronary artery disease

Iveta NAGYOVA 1 , Marian JENDRICHOVSKY 1, 2, Rastislav KUCINSKY 3, Marketa LACHYTOVA 1, Viliam RUS 2, 4

1 Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University, Kosice, Slovak Republic; 2 Cardiovascular Rehabilitation Centre, Vysne Ruzbachy, Slovak Republic; 3 Klamath Heart Clinic, Klamath Falls, OR, USA; 4 Cardiology Outpatient Department, Agency of Social Services - ASS n.o., Dubnica and Vahom, Slovak Republic


BACKGROUND: Cardiometabolic effects of physical exercise depend on its intensity, duration, and type. Conventional cardiovascular rehabilitation (CCVR) programmes have significant advantages, but non-conventional activities such as Nordic walking (NW) may offer additional health benefits.
AIM: The aim of this study was to determine the feasibility and effectiveness of NW on cardiovascular performance and quality of life in patients with coronary artery disease (CAD) compared to a CCVR programme.
DESIGN: This was a pseudo-randomised, prospective, single-blinded, parallel-group trial.
SETTING: The study was conducted at a resort/spa type facility located in a mountainous natural environment, 650 metres above sea level.
POPULATION: 83 CAD patients were allocated to either a Nordic walking or a control group.
METHODS: The NW group (n=53; age 59.1±7.0 years) underwent a three-week outdoor exercise programme consisting of 40 minutes of walking four-times per week, whereas the controls performed traditional walking instead of NW. A patient’s prescribed exercise intensity was according to exertion tolerance within 50-70% of peak oxygen consumption - VO2 max; rating of perceived exertion ‘mild/moderate’ (12 to 14 points) on the 0-20 Borg scale. Primary endpoint: cardiovascular and functional performance (EE-exercise ergometry; METs-metabolic equivalent of tasks; EF-ejection fraction; 6MWT-six-minute walking test). Secondary endpoint: quality of life (SF-36-Short Form Health Survey). Statistical analysis - Generalized Estimating Equations with Cohen’s d Effect Size (ES).
RESULTS: NW led to higher cardiovascular performance compared to CCVR (Δ EE: +11.0% vs +3.2% - ES small; Δ METs: +9.8% vs +1.5% - ES medium) and better functional performance (Δ 6MWT: +8.3% vs +5.1% - ES small). No significant differences were detected in EF (p=0.240) and SF-36 (PCS, p=0.425; MCS, p=0.400).
CONCLUSIONS: A three-week NW training programme had clinically important effects, above and beyond CCVR, on cardiovascular and functional performance in CAD patients.
CLINICAL REHABILITATION IMPACT: Nordic walking is an accessible, safe, and effective low-threshold cardiac rehabilitation exercise training modality that seems to be particularly well-suited for people with limited functional and motivational capacities.

KEY WORDS: Polestriding; Walking with poles; Cardiac rehabilitation; Cardiovascular disease; Non-pharmacological intervention; Pseudo-randomised controlled trial

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