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Abstract

Modern lifestyle, with its lack of everyday physical activity and exercise training, predisposes people to chronic diseases such as diabetes mellitus, obesity, hypertension, and coronary artery diseases. Brisk walking as a simple and safe form of exercise is undisputedly an effective measure to counteract sedentary lifestyle risks even in the most unfit and could lead to a reduction of the prevalence of chronic diseases in all populations. The purpose of this review is to systematically summarize, analyze, and interpret the health benefits of Nordic walking (walking with poles), and to compare it to brisk walking and jogging. A systematic and comprehensive literature search was performed between November 2010 and May 2012. Data were analyzed between April 2011 and May 2012. Sixteen RCTs with a total of 1062 patients and 11 observational studies with 831 patients were identified. The current analysis revealed that with regard to short- and long-term effects on heart rate, oxygen consumption, quality of life, and other measures, Nordic walking is superior to brisk walking without poles and in some endpoints to jogging. Nordic walking exerts beneficial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases and can thus be recommended to a wide range of people as primary and secondary prevention.

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... Physical inactivity is one of the five leading risks for mortality globally because it is responsible for increasing the risk of chronic disease and cancer [2]. So, it is important to identify forms of physical activity that are easily accessible and that can be performed by a large number of people to improve fitness and health status [3]. This aspect is important for people of all ages, especially for the middle-aged and elderly. ...
... By incorporating upper body muscle activity similar to that in cross-country skiing, NW incorporates a total body version of walking with a greater caloric expenditure due to the higher amount of muscle mass used and potentially enhanced physical fitness benefits [11,12]. According to previous systematic reviews, NW has a lot of important benefits for people [3,13], such as resting the heart rate, blood pressure, exercise capacity, maximal oxygen consumption and quality of life. For these reasons, NW is suitable for prevention, and nowadays, it is more and more frequently recommended for the elderly [14]. ...
... Regarding the previous literature about the positive effects of NW, several studies showed that NW influenced more the cardiorespiratory fitness than the normal walking, because of the use of poles that involved a higher amount of muscle mass [12]. NW has positive effects on chronic diseases such as diabetes or obesity [11], by benefits the resting heart rate, blood pressure, maximal oxygen consumption, exercise capacity and quality of life [3,13]. Most of the participants to the studies about this kind of physical activity were mid to older aged men and women from the clinical population (diabetes, cardiovascular disease, muscle-skeletal conditions, Parkinson's disease, etc.) [15][16][17][18][19][20][21][22][23]. ...
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Nordic walking (NW) is an easy physical exercise that is usually proposed for clinical populations and for the elderly. The aim of the present study was to examine the effects of a period of NW training in a non-clinical middle-aged population on anthropometric, body composition and functional parameters. A pre-test/post-test study design was conducted on 77 participants: 56 women (72.7%, age 55.53 ± 9.73 years) and 21 men (27.3%, age 60.51 ± 8.15 years). The measurements were carried out with physical tests at the baseline and at the follow up. Participants did two weekly NW training sessions of about 60 min each. A questionnaire was administered to evaluate their feelings after the training period. Paired Students’ test was carried out to evaluate the pre–post differences, and the analysis of variance was performed to evaluate the questionnaire. Participants had significantly less stress and anxiety after the NW training. Body fat parameters showed a significant decrease, especially for women. Phase angle and strength of lower body presented a significant increase in both sexes after the training period. In conclusion, NW shows many potential benefits also for the nonclinical population and could be an important exercise to remain active and to maintain a good health condition.
... Thus, RW involves moderate intensity that can provoke positive changes to health and minimise the risk of premature death [30]. With regard to NW, a systematic review reveals its enormous positive benefit on health [31]. NW has grown in popularity recently and is considered a good PE for older people due to its safety and low cost. ...
... Although the time to complete the activity was similar, the RW group presented a slightly shorter time. This is consonant with data found by Gomeñuka et al. [35] and contrary to what is found in other studies [31,33,46]. This could be explained by the fact that if the poles do not push the ground in the correct way for the propulsion of the movement, the dynamic stability is impaired; thus, the movement is not as efficient and fast, requiring more time to complete a given distance [47]. ...
... In contrast, in line with the findings of the present study, NW and RW showed similar results, which can be explained by the fact that both modalities share muscle synergies that mainly involve the activation of the muscles of the lower extremities and the trunk. Therefore, walking with the use of poles does not produce considerable changes in the muscular demands of the lower body [31]. ...
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1) Background: The main aim of this study was to examine the effect of an intervention of 12 weeks in three groups on anthropometric measurement and heart rate (HR) variables, fitness index, and maximal oxygen consumption (VO 2 max) in older women. (2) Methods: In total, 166 Ser-bian adult women, aged 50 to 69 years old, participated in this study, comprising a control group (60 participants, μage = 57.8 + 6.6), Nordic-walking (NW) group (53 participants, μage = 57.5 + 6.8), and recreational-walking (RW) group (53 participants, μage = 57.8 + 6.6) in a physical fitness programme for 12 weeks. (3) Results: Anthropometric measurement variables were measured using a stadiom-eter and an electronic scale. The data showed differences in walking heart rate (bt/min) (p < 0.001; ɳ 2 = 0.088) between control, NW, and RW groups in the pretest analysis. Moreover, there were significant differences in walking heart rate (bt/min) (ɳ 2 = 0.155), heart rate at the end of the test (bt/min) (ɳ 2 = 0.093), total time of fitness index test (min) (ɳ 2 = 0.097), fitness index (ɳ 2 = 0.130), and VO 2 max (ɳ 2 = 0.111) (all, p < 0.001) between control, NW, and RW groups in the posttest analysis. (4) Conclusions: NW group training resulted in slightly greater benefits than RW group training. The present study demonstrated that both groups could act as modalities to improve the functionality and quality of life of people during the ageing process, reflected mainly in HR variables; UKK test measurements , and VO 2 max. It also contributes to the extant research on older women during exercise and opens interesting avenues for future research.
... Once someone overcomes the poling technique, Nordic walking may be a safe and alternative exercise option to minimize the progression and negative consequences of age-related hyperkyphosis. Nordic walking can also provide health benefits for physical activity, such as improving maximum heart rate, peak oxygen consumption, and body composition [19,20]. Therefore, the primary aim of this pilot study was to investigate the influence of Nordic walking on spinal posture, physical function, and back pain in community-dwelling older adults. ...
... The results of this study support the literature that Nordic walking as a mean of physical activity provides health benefits for community-dwelling older adults [19,20,33]. In this study, 12 weeks of Nordic walking training led to an increase in upper and lower body strength by 7.1% and 5.4%, respectively. ...
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Nordic walking is an increasingly popular form of exercise among the elderly. Using poles is thought to facilitate a more upright posture; however, previous studies primarily investigated the effects of Nordic walking on respiratory function and physical fitness. The aims of this study were to investigate the influence of Nordic walking on spinal posture, physical functions, and back pain in community-dwelling older adults. Thirty-one community-dwelling older adults aged ≥ 60 years participated in a twice weekly Nordic walking training program for 12 weeks. The outcome measures, including spinal posture, physical functions, back pain, and the strength and endurance of back extensor muscles were assessed before and after a 12-week program. After training, spinal posture, back pain, and the strength and endurance of back extensor muscles did not show any statistically significant changes. Among the seven clinical tests of physical function, only the 30 s arm curl test, the 30 s chair stand test, and the single leg stance test showed significant improvements. Nordic walking has limited influence on age-related hyperkyphosis and back pain, but may be effective for physical function. The results of this study can provide useful information for people involved in the prevention and treatment of physical dysfunction in community-dwelling older adults.
... A lack of research on gait pattern among PAD patients undertaking NW with combined training (NW alternately with isokinetic training) does not allow for verification of the above results. However, based on an analysis of spatiotemporal parameters, NW lengthens the stride, shortens the stride time, improves gait regularity, and decreases the frequency of steps of healthy participants [49,50]. Additionally, research by Kocur et al. [48] confirmed beneficial effects on postural control, which may help to reduce the risk of falls. ...
... Parmenter et al. [46], comparing resistance training and treadmill training, also confirmed no statistical changes in this parameter. Authors suggest that Nordic Walking trains whole body not only isolated parts (lower limbs), so there is bigger influence on exercise capacity and maximal oxygen consumption [39,50]. It probably has an impact on lowering the pain threshold during walking [51]. ...
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Chronic ischemia of the lower extremities often presents as intermittent claudication characterized by lower limb pain which subsides after a short break. This study aimed to provide an assessment of the spatiotemporal parameters of gait and ground reaction forces in patients with PAD participating in three forms of supervised physical training. A total of 80 subjects completed a three-month supervised physical rehabilitation program with three sessions per week. The subjects were assigned to one of three programs: group 1—standard walking training on a treadmill (TT); group 2—Nordic walking (NW) training; group 3—strength and endurance training comprised of NW with isokinetic resistance training (NW + ISO). Gait biomechanics tests (kinematic and kinetic parameters of gait) and a six-minute walk test were carried out before and after three months of physical training. Nordic walking training led to the greatest improvements in the gait pattern of patients with PAD and a significant increase in the absolute claudication distance and total gait distance. Combined training (NW + ISO) by strengthening the muscles of the lower extremities increased the amplitude of the general center of gravity oscillation to the greatest extent. Treadmill training had little effect on the gait pattern. Nordic walking training should be included in the rehabilitation of patients with PAD as a form of gait training, which can be conducted under supervised or unsupervised conditions.
... In this sport, poles and a specific technique for walking are used, maintaining an upright posture and increasing the speed and intensity of effort (Mocera, Aquilino, & Somà, 2018). NW is increasingly recommended for older people because of its relative ease, accessibility and health effects (Tschentscher, Niederseer, & Niebauer, 2013). If NW practitioners monitor the pace of walking, depending on their specific abilities, they improve the effects of exercise (Takeshima et al., 2013). ...
... This is shown in the tablet graphics with a colour change (Humon, 2020). Other authors relate this inflection to the ventilatory threshold (Karatzano et al., 2010), although they indicate that there is a great individual variability due to fat percentage, age, and physical activity (Zwaard et al., 2016). ...
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Determining oxygen muscle saturation (SmO2) using near-infrared spectroscopy (NIRS) is an emerging technique that is increasingly used in sports science; therefore, it is necessary to know its results in different population groups. We analysed it in a group of recreational participants in Nordic Walking. The purpose of this research was to analyse the SmO2 values obtained at various times from testing in a group of athletes over 45. Thirty athletes (18 males) with a mean age of 51.3 years completed a maximal exercise testing in treadmill according to a modified Bruce protocol on a ramp. The electrocardiogram was continuously monitored. We measured VO2max (Metalyzer 3B). In addition, we placed a Humon Hex device on the right thigh to measure quadriceps oxygenation. Heart rate, VO2, and SmO2 ratios were obtained based on the exercise intensity. We obtained a SmO2 at startup of 63.3%, standard deviation (SD) 9.2%; SmO2 declined 61.8%, SD 11.4%; SmO2 in VO2max 57.4% SD 10.2% and SmO2 5 minutes after starting recovery 72.5% SD7.9%. There was a relationship between ventilatory thresholds and variations in SmO2. There were no significant differences between the sexes. We could conclude that the minimum values of SmO2 were related to the VO2 max. During the recovery phase, the values were higher than at rest. The information obtained could be used to control and plan the training.
... From both a muscular and biomechanical point of view, walking with poles engages the upper body musculature, especially targeting arm joint extensors, and despite there being no agreement on the effect of joint loading, it may also improve the dynamic balance of locomotion (113). Physical activity programs based on Nordic Walking were found to improve exercise capacity, functional status, quality of life cardiorespiratory outcomes and lipid profile, also reducing body weight and chronic pain (114,115). On the other hand, the effects on muscle strength are less clear (114,115). ...
... Physical activity programs based on Nordic Walking were found to improve exercise capacity, functional status, quality of life cardiorespiratory outcomes and lipid profile, also reducing body weight and chronic pain (114,115). On the other hand, the effects on muscle strength are less clear (114,115). ...
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Aims Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects. Data Synthesis Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior. Conclusions There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use.
... From both a muscular and biomechanical point of view, walking with poles engages the upper body musculature, especially targeting arm joint extensors, and despite there being no agreement on the effect of joint loading, it may also improve the dynamic balance of locomotion [112]. Physical activity programs based on Nordic Walking were found to improve exercise capacity, functional status, quality-of-life cardiorespiratory outcomes, and lipid profile, also reducing body weight and chronic pain [113,114]. On the other hand, the effects on muscle strength are less clear [113,114]. ...
... Physical activity programs based on Nordic Walking were found to improve exercise capacity, functional status, quality-of-life cardiorespiratory outcomes, and lipid profile, also reducing body weight and chronic pain [113,114]. On the other hand, the effects on muscle strength are less clear [113,114]. ...
Article
Full-text available
Aims Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects. Data synthesis Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight, and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior. Conclusions There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use.
... Among these walking methods, Nordic walking shows greater and faster benefits than general walking [25]. Meta-analysis has shown that Nordic walking provides a safe and effective way to improve the physical functions, such as blood pressure, exercise capacity, and maximal oxygen consumption in the elderly due to the use of a pole [26,27]. Furthermore, Nordic walking can be used to treat stress and depression by regulating the beta-endorphin hormone in the brain by naturally receiving sunlight outdoors and improving physical function using a stick [28]. ...
... Furthermore, Nordic walking can be used to treat stress and depression by regulating the beta-endorphin hormone in the brain by naturally receiving sunlight outdoors and improving physical function using a stick [28]. Most studies on Nordic walking have researched obesity, diabetes mellitus, or artery disease [26]. ...
... Nordic walking involves striding with the use of specially designed sticks and is a safe and relatively easy-to-learn form of fitness exercise. It is considered to be effective in patients with different chronic diseases [14], such as cardiovascular disease [15], aging [16], or women with breast cancer [17]. The movement sequences of Nordic walking make this physical activity suitable to support body posture and strengthen the muscles of the spine, shoulders, and hips [18]. ...
... Compared with walking without poles, it has different kinetic variables and involves stronger upper body movements [30]. Studies have shown that Nordic walking enhances muscular strength in healthy participants and in the elderly [14]. It is possible that muscle tension produces strains in the skeleton, which could induce bone formation [31]. ...
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This study investigated the impact of Nordic walking on bone properties in postmenopausal women with pre-diabetes and non-alcohol fatty liver disease (NAFLD). A total of 63 eligible women randomly participated in the Nordic walking training (AEx, n = 33), or maintained their daily lifestyle (Con, n = 30) during intervention. Bone mineral content (BMC) and density (BMD) of whole body (WB), total femur (TF), femoral neck (FN), and lumbar spine (L2-4) were assessed by dual-energy X-ray absorptiometry. Serum osteocalcin, pentosidine, receptor activator of nuclear factor kappa-B ligand (RANKL) levels were analyzed by ELISA assay. After an 8.6-month intervention, the AEx group maintained their BMCTF, BMDTF, BMCL2−4, and BMDL2−4, and increased their BMCFN (p = 0.016), while the Con group decreased their BMCTF (p = 0.008), BMDTF (p = 0.001), and BMDL2−4 (p = 0.002). However, no significant group × time interaction was observed, except for BMDL2−4 (p = 0.013). Decreased pentosidine was correlated with increased BMCWB(r = −0.352, p = 0.019). The intervention has no significant effect on osteocalcin and RANKL. Changing of bone mass was associated with changing of pentosidine, but not with osteocalcin and RANKL. Our results suggest that Nordic walking is effective in preventing bone loss among postmenopausal women with pre-diabetes and NAFLD.
... Nordic walking involves striding with the use of specially designed sticks and is a safe and relatively easy-to-learn form of tness exercise. It is considered to be effective in patients with different chronic diseases [14], such as cardiovascular disease [15], ageing [16], or women with breast cancer [17]. The movement sequences of Nordic walking make this physical activity suitable to support body posture and strengthen the muscles of the spine, shoulders, and hips [18]. ...
... Compared with walking without poles, it has different kinetic variables and involves stronger upper body movements [30]. Studies have shown that Nordic walking enhances muscular strength in healthy participants and in the elderly [14]. It is possible that muscle tension produces strains in the skeleton, which could induce bone formation [31]. ...
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Background: How bone properties would change after exercise intervention in patients with comorbidities are largely unknown. This study investigated the impact of Nordic walking on bone properties in postmenopausal women with pre-diabetes and non-alcohol fatty liver disease (NAFLD). Methods: The study is a part of a large randomized controlled trial. Of the eligible participants, 63 postmenopausal women (aged 50-65 years) with prediabetes and NAFLD participated in either a progressive supervised Nordic walking training (60-75% VO2max intensity), 2-3 times/week, 30-60 min/sessions for 8.6-month (AEx, n=33), or maintained their daily lifestyle during intervention (Con, n=30). Bone mineral content (BMC) and density (BMD) of the whole body (WB), total femur (TF), femoral neck (FN) and lumbar spine (L2-4) were assessed by a dual-energy X-ray absorptiometry. Venous blood samples were analyzed for serum osteocalcin, pentosidine and receptor activator of nuclear factor kappa-B ligand (RANKL) levels by ELISA assay. Results: After 8.6-month intervention, the AEx group maintained their BMCTF, BMDTF, BMCL2-4 and BMDL2-4, and increased their BMCFN (p<0.016), while the Con group decreased their BMCTF (p<0.008), BMDTF (p<0.001)) and BMDL2-4 (p<0.002). However, no significant group × time interaction was observed, except for BMDL2-4 (p=0.013). Decreased pentosidine was correlated with increased BMCWB (=-0.352, p=0.019). The intervention has no significant effect on osteocalcin and RANKL. Conclusions: Our results suggest that Nordic walking is effective in preventing bone loss among postmenopausal women with pre-diabetes and NAFLD. Changing of bone mass is associated with changing of pentosidine. However, this effect is not associated with osteocalcin and RANKL. Trial registration: ISRCTN registry, ISRCTN 42622771, registered 23 April 2013, https://www.isrctn.com/
... Nordic walking (NW) was first described in Scandinavia as a Nordic skiing training method during the summer of 1930. NW was further developed and was later introduced in Europe as a modern sport around 1990 (Tschentscher et al., 2013). NW is a walking fitness exercise that uses specially designed poles. ...
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Unlike the lumbar spine and femur, the radius does not bear a gravitational mechanical compression load during daily activities. The distal radius is a common fracture site, but few studies have addressed the effects of exercise on fracture risk. The aim of this study was to determine the effects of the pole push-off movement of Nordic walking (NW) on the bone mineral content (BMC) and areal bone mineral density (aBMD) of the distal radius and the muscle cross-sectional area (CSA) at the mid-humeral and mid-femoral levels. The participants were allocated to two groups: an NW group and a control group. The NW group walked at least 30 min with NW poles three times a week for six months. There were no significant changes in muscle CSA at the mid-humeral or mid-femoral levels between or within groups. There were also no significant changes in BMC or aBMD at 1/3 and 1/6 of the distance from the distal end of the radius in either group. However, the BMC and aBMD at 1/10 of the distance from the distal end of the radius were significantly increased by NW. The NW pole push-off movement provided effective loading to increase the osteogenic response in the ultra-distal radius. The ground reaction forces transmitted through the poles to the radius stimulated bone formation, particularly in the ultra-distal radius.
... Nordic walking (NW) is a type of walking with alternating movements of the arms and hands pushing off NW poles [1]. NW exerts beneficial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases including diabetes mellitus, obesity, chronic obstructive pulmonary disease, and Parkinson's disease [2]. A systematic review and meta-analysis reported that NW showed promising results in cardiovascular disorders compared to non-active control and suggested incorporation of NW for cardiovascular rehabilitation [3]. ...
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Background Nordic walking (NW) requires more energy compared with conventional walking (W). However, the metabolic equation for NW has not been reported. Therefore, this study aimed to characterize responses in oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography of the upper and lower limb muscles during NW and W and develop a metabolic equation for energy expenditure (E, mL·kg− 1·min− 1) of NW. Methods This study was performed in a randomized, controlled, crossover design to test the energy expenditure during NW and W. Fifteen healthy young men were enrolled (aged 23.7 ± 3.0 years). All participants performed two randomly ordered walking tests (NW and W) on a treadmill at a predetermined stepwise incremental walking speed (3–5 km·h− 1) and grade (0–7%). The oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography signals of the three upper limb muscles and three lower limb muscles in their right body were recorded and compared between NW and W using paired-t test. Multiple linear regression analysis was used to draw estimation of E during W and NW. Results Oxygen uptake (+ 15.8%), minute ventilation (+ 17.0%), heart rate (+ 8.4%), and systolic blood pressure (+ 7.7%) were higher in NW than in W (P < .05). NW resulted in increased muscle activity in all of the upper limb muscles (P < .05). In the lower limb, surface electromyography activities in two of the three lower limb muscles were increased in NW than in W only during level walking (P < .05). Energy expenditure during W and NW was estimated as follows: ENW = 6.1 + 0.09 × speed + 1.19 × speed × grade and EW = 4.4 + 0.09 × speed + 1.20 × speed × grade. Conclusion NW showed higher work intensity than W, with an oxygen consumption difference of 1.7 mL·kg− 1·min− 1. The coefficients were not different between the two walking methods. NW involved more muscles of the upper body than W.
... While it is not targeted at older adults, the program has been proven to be effective in improving heart rate, oxygen consumption, and quality of life. 24 Promoting this program further may be a valid strategy to increase physical activity among older adults. Alternatively, evidence-based older adult activity programs such as Enhance®Fitness may be introduced in the community. ...
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Introduction: Physical activity is proven to be a significant element of successful aging, but many seniors worldwide fail to achieve the recommended levels. This study aimed to assess the readiness of the community in Nur-Sultan, Kazakhstan, to act on the issue of physical inactivity among older adults. Methods: In order to achieve this purpose, we conducted qualitative interviews with key informants in the community and applied a validated community readiness tool. Results: The results suggest that the local community is at early stages of readiness to act on the issue of older adult physical inactivity. We identified a number of barriers that prevented seniors from leading active lifestyles, which included community misconceptions about older adult physical activity, family centeredness in older adulthood, scarcity of resources, passive support from the leadership, and lack of efforts in the community. Research findings also highlighted the importance of conducting in-depth analysis of key informant responses in addition to calculating readiness scores, when using the community readiness tool. Conclusion: Community-specific strategies for enhancing the level of physical activity among seniors are required to offset the disease burden associated with aging and to prolong life expectancy in Kazakhstan, and it is of paramount importance to tailor potential efforts as to address the current readiness of the community and its needs.
... NW exerts bene cial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases. Thus, it can be recommended to a wide range of people as primary and secondary preventions [2]. ...
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Background: Nordic walking (NW) requires more energy compared with conventional walking (W). However, the metabolic equation for NW has not been reported. Therefore, this study aimed to characterize responses in oxygen uptake (V̇O2), minute ventilation (V̇E), heart rate (HR), systolic blood pressure (SBP), and surface electromyography (sEMG) of the upper and lower limb muscles during NW and W and to develop a metabolic equation for energy expenditure (E) of NW. Methods: Fifty healthy young men constituted our sample (aged 23.7 ± 3.0 years). Two randomly assigned walking tests (NW and W) on a treadmill at a predetermined stepwise incremental walking speed (3–5 km·h⁻¹) and grade (0%–7%). The V̇O2, V̇E, HR, and SBP were measured. The sEMG signals of the three upper limb muscles and three lower limb muscles in their right body were recorded. Linear regression analysis was used to draw estimation of EE during W and NW. Results: V̇O2 (+15.8%), V̇E (+17.0%), RR (+18.2%), HR (+8.4%), and SBP (+7.7%) were higher in NW than in W. NW resulted in increased muscle activity in all of the upper limb muscles (P<.05). In the lower limb, sEMG activities in two of the three lower limb muscles were increased in NW than in W only during level walking (P<.05). EE during W and NW was estimated as follows: EW = 4.4 + 0.09 × speed + 1.20 × speed × grade; ENW = 6.1 + 0.09 × speed + 1.19 × speed × grade. Conclusion: NW showed higher work intensity than W, with an oxygen consumption difference of 1.7 mL·kg⁻¹·min⁻¹. The coefficients were not different between the two walking methods. NW involved more muscles of the upper body than W.
... Sedentary behavior and physical inactivity are well-known risk factors for developing chronic disease, threatening people's physical and mental health alike [1]. Among the different ways to be physically active, walking is the most popular and results in a range of health benefits (e.g., lower risk of type II diabetes and cardiovascular disease) [2,3]. In the Netherlands, the daily average distance walked by Dutch people is around 800 m [4], although it varies significantly across municipalities, which can to a certain extent be attributed to differences in the environment. ...
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Background Walking is a good and simple way to increase people’s energy expenditure, but there is limited evidence whether the neighborhood environment correlates differently with recreational and transportation walking. Aim To investigate how recreational walking and transportation walking are associated with the natural and built environmental characteristics of the living environment in the Netherlands, and examine the differences in their associations between weekdays and weekends. Method and data We extracted the total duration of daily walking (in minutes per person) for recreation and transport from the Dutch National Travel Survey 2015-2017 (N=66,880) and analyzed it as an outcome variable. Objective measures of the natural (i.e., Normalized Difference Vegetation Index (NDVI) and meteorological conditions) and built environment (i.e., crossing density, land-use mix, and residential building density) around respondents’ home addresses were determined for buffers with 300, 600, and 1,000 m radii using a geographic information system. To assess associations between recreational and transport walking and the environmental exposures separately, we fitted Tobit regression models to the walking data, adjusted for multiple confounders. Results On weekdays, people living in areas with less NDVI, higher land-use mix, higher residential building density, and higher crossing density were more likely to engage in transportation walking. While recreational walking was negatively associated with NDVI, crossing density, precipitation, and daily average temperature, it was positively associated with residential building density. At weekends, land-use mix supports both recreational and transportation walking. A negative association appeared for NDVI and transportation walking. Daily average rainfall and temperature were inversely correlated with recreational walking. Sensitivity tests indicated that some associations depend on the buffer size. Conclusions Our findings suggest that the built and natural environments have different impacts on people’s recreational and transportation walking. We also found differences in the walking–environment associations between weekdays and weekends. Place-based policies to design walking-friendly neighborhoods may have different implications for different types of walking.
... First, it is a low-cost, safe and relatively easy to learn and perform physical exercise modality. Second, compliance to the NW performance has been regarded as high in people with chronic conditions (Tschentscher et al., 2013). Finally, its practice can have beneficial effects on relevant hallmarks of PD, such as gait, balance and functional mobility (Dalton & Nantel, 2016;Virág et al., 2015), and can lead to an improved quality of life (Bullo et al., 2018). ...
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Nordic walking (NW) may be a beneficial treatment for people with Parkinson's disease (PD). Since high-quality research has been published on the effects of NW on people with PD by now, an actualised and comprehensive, in-depth review is recommended to guide practitioners in prescribing this exercise modality. The purpose of this study was to conduct a systematic review and meta-analysis on the effectiveness of NW as a rehabilitation strategy for PD. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was performed using Pubmed, SportDiscus and Scopus up to May 2021. Randomised controlled trials (RCTs) addressing the impact of a NW intervention on any outcomes in people with PD were included. The critical appraisal of the RCTs was retrieved from the Physiotherapy Evidence Database (PEDro) or evaluated using the PEDro scale. The Cochrane Collaboration's risk of bias tool was also employed. The review was not registered a priori on any database and a review protocol was not published. Twelve studies were included in the review. The investigations were mostly good-to-fair methodological quality, and risk of bias was acceptable. None of the reported statistically significant benefits of NW were clinically meaningful, except for walking ability. Although adherence to NW programs was good, some adverse effects derived from its practice were informed. The practice of Nordic Walking does not lead to clinically significant changes in global motor impairment, functional mobility, balance and physical fitness in patients with PD. This therapy seems to improve walking ability and quality of life, although further research in this latter outcome is needed.
... Different reviews examining the health benefits of NW have confirmed these results. NW exerts beneficial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases and can thus be recommended to a wide range of people as primary and secondary prevention (Tschentscher et al., 2013;Mathieson and Lin, 2014). ...
Article
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Electrical muscle stimulation (EMS) is an increasingly popular training method and has become the focus of research in recent years. New EMS devices offer a wide range of mobile applications for whole-body EMS (WB-EMS) training, e.g., the intensification of dynamic low-intensity endurance exercises through WB-EMS. The present study aimed to determine the differences in exercise intensity between WB-EMS-superimposed and conventional walking (EMS-CW), and CON and WB-EMS-superimposed Nordic walking (WB-EMS-NW) during a treadmill test. Eleven participants (52.0 ± years; 85.9 ± 7.4 kg, 182 ± 6 cm, BMI 25.9 ± 2.2 kg/m2) performed a 10 min treadmill test at a given velocity (6.5 km/h) in four different test situations, walking (W) and Nordic walking (NW) in both conventional and WB-EMS superimposed. Oxygen uptake in absolute (VO2) and relative to body weight (rel. VO2), lactate, and the rate of perceived exertion (RPE) were measured before and after the test. WB-EMS intensity was adjusted individually according to the feedback of the participant. The descriptive statistics were given in mean ± SD. For the statistical analyses, one-factorial ANOVA for repeated measures and two-factorial ANOVA [factors include EMS, W/NW, and factor combination (EMS*W/NW)] were performed (α = 0.05). Significant effects were found for EMS and W/NW factors for the outcome variables VO2 (EMS: p = 0.006, r = 0.736; W/NW: p < 0.001, r = 0.870), relative VO2 (EMS: p < 0.001, r = 0.850; W/NW: p < 0.001, r = 0.937), and lactate (EMS: p = 0.003, r = 0.771; w/NW: p = 0.003, r = 0.764) and both the factors produced higher results. However, the difference in VO2 and relative VO2 is within the range of biological variability of ± 12%. The factor combination EMS*W/NW is statistically non-significant for all three variables. WB-EMS resulted in the higher RPE values (p = 0.035, r = 0.613), RPE differences for W/NW and EMS*W/NW were not significant. The current study results indicate that WB-EMS influences the parameters of exercise intensity. The impact on exercise intensity and the clinical relevance of WB-EMS-superimposed walking (WB-EMS-W) exercise is questionable because of the marginal differences in the outcome variables.
... First, it is a physical exercise modality of low-cost, is safe and relatively easy to learn and perform. In people with chronic conditions, the compliance to NW has been regarded as high (Tschentscher et al., 2013). Second, its practice can lead to improvements in physical conditioning and QoL (Bullo et al., 2018). ...
Article
Background: Patients with multiple sclerosis (MS) show fatigue, impaired gait and decreased functional mobility, which lead to a low quality of life (QoL). Low-cost and easy to perform exercise modalities having a positive impact on the aforementioned symptoms are needed. The performance of Nordic Walking (NW) could be a useful rehabilitation strategy but, to our knowledge, no study has been published in this regard as yet. This case series study aims at providing information regarding the usefulness and impact of a three-month NW program on self-perceived fatigue, functional mobility, physical fitness and QoL on a group of people with mild relapsing-remitting MS. Methods: A case series study with multiple assessments was performed. Three data collection points at 1-week intervals for three weeks were done at baseline. The intervention consisted of a 12-weeks NW program with a total of four measurement occasions, one every three weeks. The Fatigue Severity Scale (FSS), the Timed up and Go test (TUG), the 6-Minute Walk test (6MWT) and the Multiple Sclerosis Impact Scale (MSIS-29), were used to assess the outcomes of the program on the participants' self-perceived fatigue, functional mobility, physical fitness and QoL, respectively. Results: Of the 14 participants who volunteered for the study, five completed at least 80% of the planned sessions and were included in the final analysis. The intervention did not have a clinical significant impact on the participants' fatigue while its impact on their QoL showed mixed results. Positive trends were found for all the participants in their functional mobility and physical fitness. Regarding functional mobility, clinically important changes were observed in three participants. None of the observed changes in physical fitness achieved clinical significance. Conclusion: A 12-week Nordic walking program did not appear to be particularly feasible and had little impact on the functional levels on a group of people with mild relapsing-remitting MS. Given that beneficial effects were seen in some participants, and taken into account the low adherence rate observed, future studies should explore the feasibility of NW programs performed under different environmental conditions (i.e. outdoors) and including motivational strategies aimed at increasing participation.
... Various exercise intervention programmes, such as muscle strengthening, flexibility and aerobic fitness training, have been found to be beneficial for reducing LBP 14) . Exercises of low to moderate intensity have been shown to improve aerobic capacity and systolic/diastolic blood pressure in sedentary workers 15) . Also, programmes that make workers more aware of potential risk factors by teaching them how to perform work tasks properly or how to deal with problems, including psychosocial ones, have shown to be effective 16,17) . ...
Article
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The aim of this study was to identify effective work place intervention strategies for the prevention of low back pain (LBP). The study focused on interventions to two major groups: personal interventions and technical interventions. Data basis were searched for with inclusion criteria: study design based on randomised controlled trial; outcome measures including non-specific LBP occurrence expressed by prevalence or intensity; intervention met the definition of the technical and/or personal (physical exercises, behavioural training, educational) intervention programme. Eighteen papers were selected for full analysis. The diversification of quantitative indicators of differences between control and intervention groups were carried out using Cohen's d index. The results of analysis showed strong differences in effects among intervention strategies, as well as among different cases within similar intervention strategies. LBP severity before intervention and the length of intervention were discussed as potentially influencing factors. The results of the analysis suggest that the most effective strategies for LBP prevention include technical modifications of the workstand and education based on practical training. Behavioural and physical training seems to be of lesser importance. LBP severity before intervention and the time when the measurements of outcome measures take place play an important role in the effectiveness of intervention.
... e majority, yet again, walked to their work places. Regular walking is a good form of exercise as supported by findings of various studies [26]. ese are all contributory factors for their good health. ...
Article
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Background: Globally, sodium intake has been found to be far above the normal level required by the body. Within countries, variations in salt intake exist between rural communities and urban communities. Experimental and epidemiological studies as well as studies involving clinical trials show the existence of adverse effect of salt consumption on the blood pressure of adults. The study evaluated salt intake among older normotensive adults in Atonsu, a suburb of Kumasi in the Ashanti region of Ghana. Methods: Participants were randomly selected from five churches which constituted cluster samples. A questionnaire was administered to participants for demographic information and dietary and lifestyle assessments. The study targeted 100 participants, twenty from each of the five churches. Eighty-two individuals gave their informed consent. Out of the 82 who gave their informed consent, 15 withdrew and 67 completed the course. The 67 participants comprised 36 (53.7%) men and 31 (46.3%) women. Systolic and diastolic blood pressure, BMI, urinary sodium, urinary potassium, serum creatinine, serum sodium, and serum potassium concentrations were also measured. Results: Participants' mean age was 52.3 ± 8.7 years. Participants had 24 hr urinary sodium excretion of 153.0 ± 26.9 mmol/day. All participants indicated that they consume foods high in salt even though none of them added salt to their diet at table. Mean 24 hr urinary potassium was 52.5 ± 12.9 mmol/day. Mean systolic blood pressure was 119.9 ± 10.8 mmHg and mean diastolic blood pressure was 72.5 ± 7.3 mmHg. Their mean BMI was 23.7 ± 3.5 kg/m2. Conclusion: The participants who can be described as quite old and normotensive were high salt consumers, indicated by their dietary assessment and urinary sodium excretion, even though they had normal blood pressure.
... Positive effects can be obtained only when following the proper NW gait technique. The proper NW gait ensures a form of training, which evenly engages the entire muscular system, while at the same time maintaining optimal intensity with a low, subjective feeling of fatigue [12], [13], [14]. The NW gait pattern is based, on the following main principles: a) arms and legs work alternately; b) pole should hit the ground at the level of the ancillary leg heel (approximately at an angle of 110°-120° from the horizon); c) the step should start from the heel and end with repulsing with the toe of the foreleg; d) the hand should tighten on the handle of the pole when it is inserted and gradually relax until the pole is released completely; e) the poles should not touch the ground while moving the hand forward [2], [3], [8], [12]. ...
Conference Paper
Gait with Nordic Walking poles (NW) is used in the rehabilitation process of patients with different diseases and disfunctions. In a typical rehabilitation process, the patient during gait is supervised by a trainer or physiotherapist who assesses the correctness of the patient's limb movements. In the work, the fundamentals of the design and operation of the mechatronic gait monitoring system with Nordic Walking poles were presented. The monitoring system provides the possibility for a trainer to analyse the gait of many patients online. The developed system consists of mechatronic NW poles equipped with a measuring system, which makes it possible to measure the kinematics and dynamics of poles. It is placed in a mobile device (smartphone or tablet) and connected wirelessly with a system for monitoring, analyzing and diagnosing patient movement. The monitoring system is also equipped with a selfdiagnosis module, which signals any patient with basic errors and irregularities in their NW gait. The paper describes pilot tests of the NW gait monitoring system and presents the obtained gait results in the terrain, which verify the correctness of the system operation.
... e traffic volume (i.e., hourly rate of cars), vehicular speed, and physical barriers between cars and pedestrians are likely to be the first public consideration to engage in outdoor activities [43]. Appropriate strategies not only enhance public safety but also encourage outdoor activities that help to improve both physical and mental health [44]. ...
Article
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Environmental influence is one of the attributing factors for health status. Chronic interaction with electronic display technology and lack of outdoor activities might lead to health issues. Given the concerns about the digital impact on lifestyle and health challenges, we aimed to investigate the daily activity inclination and health complaints among the Malaysian youth. A self-administered questionnaire covering lifestyle and health challenges was completed by 220 youths aged between 16 and 25. There were a total of 22 questions. Seven questions inspected the patterns of indoor and outdoor activities. Fifteen questions focused on the visual and musculoskeletal symptoms linked to both mental and physical health. The total time spent indoors (15.0 ± 5.4 hours/day) was significantly higher than that spent outdoors (2.5 ± 2.6 hours/day) (t = 39.01, p < 0.05). Total time engrossed in sedentary activities (13.0 ± 4.5 hours/day) was significantly higher than that in nonsedentary activities (4.5 ± 3.8 hours/day) comprised of indoor sports and any outdoor engagements (t = 27.10, p < 0.05). The total time spent on electronic related activities (9.5 ± 3.7 hours/day) was were higher than time spent on printed materials (3.4 ± 1.6 hours/day) (t = 26.01, p < 0.05). The association of sedentary activities was positive in relation to tired eyes (χ2 = 17.58, p < 0.05), sensitivity to bright light (χ2 = 12.10, p < 0.05), and neck pain (χ2 = 17.27, p < 0.05) but negative in relation to lower back pain (χ2 = 8.81, p < 0.05). Our youth spent more time in building and engaged in sedentary activities, predominantly electronic usage. The health-related symptoms, both visual and musculoskeletal symptoms, displayed a positive association with a sedentary lifestyle and a negative association with in-building time.
... Nordic walking (NW) is a type of walking with alternating movements of the arms and hands pushing off NW poles [1]. NW exerts bene cial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases including diabetes mellitus, obesity, chronic obstructive pulmonary disease, and Parkinson's disease [2]. A systematic review and metaanalysis reported that NW showed promising results in cardiovascular disorders compared to non-active control and suggested incorporation of NW for cardiovascular rehabilitation [3]. ...
Preprint
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Background: Nordic walking (NW) requires more energy compared with conventional walking (W). However, the metabolic equation for NW has not been reported. Therefore, this study aimed to characterize responses in oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography of the upper and lower limb muscles during NW and W and develop a metabolic equation for energy expenditure (E, mL·kg⁻¹·min⁻¹) of NW. Methods: This study was performed in a randomized, controlled, crossover design to test the energy expenditure during NW and W. Fifteen healthy young men were enrolled (aged 23.7 ± 3.0 years). All participants performed two randomly ordered walking tests (NW and W) on a treadmill at a predetermined stepwise incremental walking speed (3–5 km·h⁻¹) and grade (0%–7%). The oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography signals of the three upper limb muscles and three lower limb muscles in their right body were recorded and compared between NW and W using paired-t test. Multiple linear regression analysis was used to draw estimation of E during W and NW. Results: Oxygen uptake (+15.8%), minute ventilation (+17.0%), heart rate (+8.4%), and systolic blood pressure (+7.7%) were higher in NW than in W (P<.05). NW resulted in increased muscle activity in all of the upper limb muscles (P<.05). In the lower limb, surface electromyography activities in two of the three lower limb muscles were increased in NW than in W only during level walking (P<.05). Energy expenditure during W and NW was estimated as follows: ENW = 6.1 + 0.09 × speed + 1.19 × speed × grade and EW = 4.4 + 0.09 × speed + 1.20 × speed × grade. Conclusion: NW showed higher work intensity than W, with an oxygen consumption difference of 1.7 mL·kg⁻¹·min⁻¹. The coefficients were not different between the two walking methods. NW involved more muscles of the upper body than W.
... Nordic walking (NW) is a type of walking with alternating movements of the arms and hands pushing off NW poles [1]. NW exerts bene cial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases including diabetes mellitus, obesity, chronic obstructive pulmonary disease, and Parkinson's disease [2]. A systematic review and meta-analysis reported that NW showed promising results in cardiovascular disorders compared to non-active control and suggested incorporation of NW for cardiovascular rehabilitation [3]. ...
Preprint
Full-text available
Background: Nordic walking (NW) requires more energy compared with conventional walking (W). However, the metabolic equation for NW has not been reported. Therefore, this study aimed to characterize responses in oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography of the upper and lower limb muscles during NW and W and develop a metabolic equation for energy expenditure (E, mL·kg⁻¹·min⁻¹) of NW. Methods: This study was performed in a randomized, controlled, crossover design to test the energy expenditure during NW and W. Fifteen healthy young men were enrolled (aged 23.7 ± 3.0 years). All participants performed two randomly ordered walking tests (NW and W) on a treadmill at a predetermined stepwise incremental walking speed (3–5 km·h⁻¹) and grade (0%–7%). The oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography signals of the three upper limb muscles and three lower limb muscles in their right body were recorded and compared between NW and W using paired-t test. Multiple linear regression analysis was used to draw estimation of E during W and NW. Results: Oxygen uptake (+15.8%), minute ventilation (+17.0%), heart rate (+8.4%), and systolic blood pressure (+7.7%) were higher in NW than in W (P<.05). NW resulted in increased muscle activity in all of the upper limb muscles (P<.05). In the lower limb, surface electromyography activities in two of the three lower limb muscles were increased in NW than in W only during level walking (P<.05). Energy expenditure during W and NW was estimated as follows: ENW = 6.1 + 0.09 × speed + 1.19 × speed × grade and EW = 4.4 + 0.09 × speed + 1.20 × speed × grade. Conclusion: NW showed higher work intensity than W, with an oxygen consumption difference of 1.7 mL·kg⁻¹·min⁻¹. The coefficients were not different between the two walking methods. NW involved more muscles of the upper body than W.
... Sedentary behavior and physical inactivity are well-known risk factors for developing chronic disease, and both threaten people's physical and mental health (Thorp et al., 2011). Among the different ways to be physically active, walking is the most popular and results in a range of health benefits (e.g., lower risk of type II diabetes and cardiovascular disease) (Ferdman, 2019;Tschentscher et al., 2013). In the Netherlands, the daily average distance walked by people is around 800 m (Centraal Bureau voor de Statistiek, 2017), although it varies significantly across municipalities, which can to a certain extent be attributed to differences in the environment. ...
Article
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Background Walking is a good and simple way to increase people’s energy expenditure, but there is limited evidence whether the neighborhood environment correlates differently with recreational and transportation walking. AimTo investigate how recreational walking and transportation walking are associated with the natural and built environmental characteristics of the living environment in the Netherlands, and examine the differences in their associations between weekdays and weekends. Method and data We extracted the total duration of daily walking (in minutes per person) for recreation and transportation of adults aged 18 years and above from the Dutch National Travel Survey 2015-2017 (N=65,785) and analyzed it as an outcome variable. Objective measures of the natural (i.e., normalized difference vegetation index (NDVI), blue space and meteorological conditions) and built environment (i.e., crossing density, land-use mix, and residential building density) around respondents’ home addresses were determined for buffers with 300, 600, and 1,000 m radii using a geographic information system. To assess associations between recreational and transportation walking and the environmental exposures separately, we fitted Tobit regression models to the walking data, adjusted for multiple confounders. ResultsOn weekdays, people living in areas with less NDVI, higher land-use mix, and higher crossing density were more likely to engage in transportation walking. Recreational walking was negatively associated with NDVI, blue space, crossing density, precipitation and daily average temperature. At weekends, land-use mix supports both recreational and transportation walking. A negative association appeared for NDVI and transportation walking. Daily average rainfall and temperature were inversely correlated with recreational walking. Sensitivity tests indicated that some associations depend on the buffer size. Conclusions Our findings suggest that the built and natural environments are differently associated with people’s recreational and transportation walking. We also found differences in the walking-environment associations between weekdays and weekends. Place-based policies to design walking-friendly neighborhoods may have different implications for different types of walking.
... Luttenberger and colleagues even postulated that climbing in an outpatient setting has the same effect as cognitive behavioral therapy [31]. To further strengthen the importance of therapeutic climbing compared with other sports in the multimodal therapy approach, CT will be compared with another endurance sport in the following: Nordic walking (NW) is a recommended aerobic exercise for patients with mental disorders [42]. An improvement of the current mental state and mood-lifting effects through NW have been observed frequently in depressed persons [43][44][45]. ...
Article
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As climbing therapy is increasingly used for mental health disorders, the present study aimed to compare acute effects of a therapeutic climbing intervention (CT) on affective responses, anxiety, and self-efficacy with those of Nordic walking (NW) and a sedentary control condition (SC) in an inpatient setting with persons with depression, anxiety, or obsessive–compulsive disorders. A total of 21 inpatients (32 ± 12.2 years) participated in a clinical trial in all interventions using an experimental within-subject design. Anxiety and self-efficacy were assessed preintervention (t0) and postintervention (t2) using the State-Trait Anxiety Inventory and the General Self-Efficacy Scale, and affective responses were additionally evaluated during (t1) and 180 min after the intervention (t3) using the Feeling Scale, Felt Arousal Scale, and Positive and Negative Affect Schedule. Statistical evaluation was performed with a 3 × 2 or 3 × 4 repeated measures ANOVA. Significant interaction effects were found for affective responses regarding positive affect, affective valence, and perceived activation (p < 0.015) favoring CT over NW and SC. For anxiety, a significant interaction effect was found (F(2.40) = 6.603; p = 0.003; η2 = 0.248), and also perceived self-efficacy increased significantly (F(2.40) = 6.046; p = 0.005; η2 = 0.232). Single CT sessions may enhance affective responses and self-efficacy and reduce anxiety in inpatients with mental health disorders to a higher extent than NW. CT as part of an inpatient therapy program may help to improve key affective mechanisms and should be further studied in comparison with other exercise interventions with comparable intensity.
... Different reviews examining the health benefits of NW have confirmed these results. NW exerts beneficial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases and can thus be recommended to a wide range of people as primary and secondary prevention (Tschentscher et al., 2013;Mathieson and Lin, 2014). ...
Article
Full-text available
Electrical muscle stimulation (EMS) is an increasingly popular training method and has become the focus of research in recent years. New EMS devices offer a wide range of mobile applications for whole-body EMS (WB-EMS) training, e.g., the intensification of dynamic low-intensity endurance exercises through WB-EMS. The present study aimed to determine the differences in exercise intensity between WB-EMS-superimposed and conventional walking (EMS-CW), and CON and WB-EMS-superimposed Nordic walking (WB-EMS-NW) during a treadmill test. Eleven participants (52.0 ± years; 85.9 ± 7.4 kg, 182 ± 6 cm, BMI 25.9 ± 2.2 kg/m 2) performed a 10 min treadmill test at a given velocity (6.5 km/h) in four different test situations, walking (W) and Nordic walking (NW) in both conventional and WB-EMS superimposed. Oxygen uptake in absolute (VO 2) and relative to body weight (rel. VO 2), lactate, and the rate of perceived exertion (RPE) were measured before and after the test. WB-EMS intensity was adjusted individually according to the feedback of the participant. The descriptive statistics were given in mean ± SD. For the statistical analyses, one-factorial ANOVA for repeated measures and two-factorial ANOVA [factors include EMS, W/NW, and factor combination (EMS * W/NW)] were performed (α = 0.05). Significant effects were found for EMS and W/NW factors for the outcome variables VO 2 (EMS: p = 0.006, r = 0.736; W/NW: p < 0.001, r = 0.870), relative VO 2 (EMS: p < 0.001, r = 0.850; W/NW: p < 0.001, r = 0.937), and lactate (EMS: p = 0.003, r = 0.771; w/NW: p = 0.003, r = 0.764) and both the factors produced higher results. However, the difference in VO 2 and relative VO 2 is within the range of biological variability of ± 12%. The factor combination EMS * W/NW is statistically non-significant for all three variables. WB-EMS resulted in the higher RPE values (p = 0.035, r = 0.613), RPE differences for W/NW and EMS * W/NW were not significant. The current study results indicate that WB-EMS influences the parameters of exercise intensity. The impact on exercise intensity and the clinical relevance of WB-EMS-superimposed walking (WB-EMS-W) exercise is questionable because of the marginal differences in the outcome variables.
... Analysing the impact of using Nordic walking poles on temporal-spatial parameters of walking, i.e. walking speed, stride length, cadence and phases of double and single support, as well as posture-related characters of older people, it has been con rmed that this form of physical activity in uences the extension of stride, increases walking speed and forces the body to maintain more vertical positioning. Additionally, the use of poles while walking reduces fears related to falling [19][20][21][22][23][24][25][26][27]. ...
Preprint
Full-text available
Introduction. Demographic forecasts indicate the progressive aging process of societies in all countries worldwide. The extension of life span may be accompanied by deterioration of its quality resulting from a decrease in physical activity, mental or even social performance, and a deficit in certain chemical compounds responsible for proper functioning of the body. Aim. The aim of the study was to evaluate the influence of a 12-week Nordic walking (NW) training intervention on the level of vitamin D in the blood and quality of life among women aged 65-74 years. Materials and methods. The study comprised 37 women aged 65-74 (x=68.08, SD=4.2). The subjects were randomly assigned to 2 groups: experimental group (NW), which consisted of 20 women who underwent an intervention in the form of Nordic walking training for 12 weeks, and the control group (C), including 17 women who underwent observation. In the experimental group, training sessions were held 3 times a week for 1 hour. At that time, the C group was not subject to any intervention. The SF-36 questionnaire was used to measure quality of life. Vitamin D was assessed based on the results of biochemical blood tests. The analysed parameters were assessed twice - before and after the completed intervention or observation. Results. Comparison of the results regarding trials 1 and 2 allowed to note statistically significant improvement in quality of life for all health components and factors in the NW group. Analysis of vitamin D levels demonstrated a statistically significant increase in the NW group. In group C, no significant changes in the analysed parameters were observed. Conclusions. Regularly undertaking Nordic walking training significantly influences the improvement of self-evaluation regarding the components of physical and mental health, as well as the concentration of vitamin D in women aged 65-74 years.
... weekly). Moreover, it is important to highlight that, in terms of the community-based setting, we consider not only traditional indoor physical exercise training sessions, but also outdoor low-tech physical activities allowing exercising at high intensity, such as Nordic walking (48,49). As such, selfadministered community-based high intensity training, with the remote follow-up of a physical therapist, is a plausible option to enhance service delivery. ...
Article
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Prehabilitation has shown its potential for most intra-cavity surgery patients on enhancing preoperative functional capacity and postoperative outcomes. However, its large-scale implementation is limited by several constrictions, such as: i) unsolved practicalities of the service workflow, ii) challenges associated to change management in collaborative care; iii) insufficient access to prehabilitation; iv) relevant percentage of program drop-outs; v) need for program personalization; and, vi) economical sustainability. Transferability of prehabilitation programs from the hospital setting to the community would potentially provide a new scenario with greater accessibility, as well as offer an opportunity to effectively address the aforementioned issues and, thus, optimize healthcare value generation. A core aspect to take into account for an optimal management of prehabilitation programs is to use proper technological tools enabling: i) customizable and interoperable integrated care pathways facilitating personalization of the service and effective engagement among stakeholders; ii) remote monitoring (i.e. physical activity, physiological signs and patient-reported outcomes and experience measures) to support patient adherence to the program and empowerment for self-management; and, iii) use of health risk assessment supporting decision making for personalized service selection. The current manuscript details a proposal to bring digital innovation to community-based prehabilitation programs. Moreover, this approach has the potential to be adopted by programs supporting long-term management of cancer patients, chronic patients and prevention of multimorbidity in subjects at risk.
... Walking with poles is an attractive mode of physical activity for fitness (Tschentscher et al., 2013). The main reason for the increasing popularity is the increased energy expenditure using poles compared to walking despite reduced perceived exertion (Figard-Fabre et al., 2010). ...
Article
Although it has already been demonstrated that Nordic walking has some peculiar biomechanical features with respect to walking, the effects on balance and trunk coordination are still unknown. Our aim here was to compare margins of stability, hip stabilizer muscle activation and scapular-pelvis coordination (mean and variability of continuous relative phase) between walking and two different pole walking techniques (observational design). Eleven Nordic walking instructors were asked to walk at 5.5 km·h⁻¹ on a flat treadmill while 1) walking, 2) Nordic walking and 3) pole walking with just elbow flexion-extension motion allowed and constrained shoulder motion (elbow technique). The 3D movements of limbs and poles were measured by an optoelectronic motion capture system, and gluteus medius activation was measured through surface electromyography. Both techniques using poles show larger mediolateral margins of stability and similar anterior-posterior margins of stability in comparison with walking (p<0.001). The larger mediolateral margin of stability using poles (conditions 2 and 3) is accompanied by greater trunk coordination stability (greater continuous relative phase variability) than walking. Although the Nordic walking (condition 2) technique results in a similar range of scapular and pelvis transverse rotation, the general pattern of scapular-pelvis coordination was temporally delayed by approximately 20% of the gait cycle in relation to other conditions (1 and 3). In conclusion, Nordic walking provides enhanced mediolateral support and coordination stability of trunk compared with walking, suggesting that it could be proposed as a safer exercise modality than walking.
... Analysing the impact of using Nordic walking poles on temporal-spatial parameters of walking, i.e., walking speed, stride length, cadence and phases of double and single support, as well as posturerelated characters of older people, it has been confirmed that this form of physical activity influences the extension of stride, increases walking speed, and forces the body to maintain more vertical positioning. Additionally, the use of poles while walking reduces fears related to falling [26][27][28][29][30][31][32][33][34]. ...
Article
Full-text available
Introduction: Demographic forecasts indicate the progressive aging process of societies in all countries worldwide. The extension of life span may be accompanied by deterioration of its quality resulting from a decrease in physical activity, mental or even social performance, and a deficit in certain chemical compounds responsible for proper functioning of the body. Aim: The aim of the study was to evaluate the influence of a 12-week Nordic walking (NW) training intervention on the level of vitamin D in the blood and quality of life among women aged 65-74 years. Materials and methods: The study comprised 37 women aged 65-74 (x = 68.08, SD = 4.2). The subjects were randomly assigned to 2 groups: experimental group (NW), which consisted of 20 women who underwent an intervention in the form of Nordic walking training for 12 weeks, and the control group (C), including 17 women who underwent observation. In the experimental group, training sessions were held 3 times a week for 1 h. At that time, the C group was not subject to any intervention. The SF-36 questionnaire was used to measure quality of life. Vitamin D was assessed based on the results of biochemical blood tests. The analysed parameters were assessed twice-before and after the completed intervention or observation. Results: Comparison of the results regarding trials 1 and 2 allowed to note statistically significant improvement in quality of life for all health components and factors in the NW group. Analysis of vitamin D levels demonstrated a statistically significant increase in the NW group. In group C, no significant changes in the analysed parameters were observed. Conclusions: Regularly undertaking Nordic walking training significantly influences the improvement of self-evaluation regarding the components of physical and mental health, as well as the concentration of vitamin D in women aged 65-74 years.
... Unlike moderate and vigorous intensity physical activity in elderly could potentially increase the risk of mortality, walking as a low intensity physical activity with a lower risk of injury than running or sport participation is easily accessible without any requirements of special equipment or training (30). Numerous studies have reported that walking exerts beneficial effects on reduction of CV risk, blood pressure, exercise capacity, cardiac capacity, maximal oxygen consumption, and quality of life in hypertensive patients with concomitant diseases (31)(32)(33)(34)(35), which is recommended to a wide range of people as primary and secondary prevention. Nevertheless, in our present study, walking activity was only Bold values indicate significant results (P < 0.05). ...
Article
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Background: Walking, as the most common campaign in older people, is recommended to improve their cardiovascular health. However, the direct association between weekly walking activity and asymptomatic hypertensive mediated organ damage (HMOD) remains unclear. Methods: 2,830 community-dwelling elderly subjects (over 65 years) in northern Shanghai were recruited from 2014 to 2018. Weekly walking activity was assessed by International Physical Activity Questionnaires (IPAQ). Within the framework of comprehensive cardiovascular examinations, HMOD, including left ventricular mass index, peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity, creatinine clearance rate, urinary albumin–creatinine ratio, carotid-femoral pulse wave velocity (cf-PWV), carotid intima–media thickness (CIMT), arterial plaque, and ankle-brachial index (ABI), were all evaluated. Results: 1,862 (65.8%) participants with weekly walking activity showed lower CIMT, lower cf-PWV, fewer abnormal ABI, and lower prevalence of hypertension and coronary heart disease ( p < 0.05). Walking activity was negatively correlated with age and smokers (correlation coefficient: −0.066, −0.042; both p < 0.05). After adjusting for cardiovascular risk factors and concomitant diseases, walking activity was significantly associated with better indicator of most vascular HMOD in multivariate logistic regressions, including arterial stiffness [odds ratio (OR) = 0.75, p = 0.01], increased CIMT (OR = 0.70, p = 0.03), and peripheral artery disease (OR = 0.72, p = 0.005), but not cardiac or renal HMOD. Subgroup analysis further showed that walking duration ≥1 h/day was significantly associated with decreased risk of most vascular HMOD after adjustment for confounders and moderate-to-vigorous physical activity based on IPAQ (all p < 0.05). Conclusions: In the community-dwelling elderly Chinese, there was a significant negative association of weekly walking activity with vascular HMOD, but not cardiac or renal HMOD. Increased daily walking duration, but not walking frequency, was significantly associated with improved vascular HMOD. Hence, increasing daily walking duration seems to encourage a healthy lifestyle in terms of vascular protection. Clinical Trial Registration: ClinicalTrials.gov , identifier: NCT02368938.
... Physical exercise is an important factor in preventing fall and its associated injuries and improving balance and walking ability among elderly people (27). Studies show that regular physical activity is an effective strategy for reducing physiological weaknesses and preventing or reducing fall rate among elderly people (28)(29)(30)(31)(32)(33). ...
Article
Background and aims: Decreased physical functioning and increased risk of fall are among the most common age-related problems among elderly people. This study aimed at assessing the effects of tai chi exercise on gait speed (GS) and fall rate among a group of elderly women in Iran. Methods: This randomized controlled trial was conducted in 2018. Participants were sixty elderly women purposefully selected from comprehensive healthcare centers in Lahijan, Iran, and randomly assigned to an intervention and a control group. Study intervention was Yang-style tai chi exercise implemented in two group sessions per week for twelve consecutive weeks. GS was assessed before and after the intervention using the short physical performance battery and fall rate was assessed using a researcher-made self-report fall assessment checklist. The SPSS program for Windows (v. 18.0) was employed for data analysis at a significance level of less than 0.05. Results: Between-group differences respecting the pretest and the posttest GS were not statistically significant (P>0.05). Moreover, posttest fall rate in the intervention group was less than the control group. Conclusion: Tai chi exercise is effective in increasing GS and reducing fall rate among elderly women and is recommended for elderly people.
Article
Introduction: Nordic Walking (NW) as a form of physical activity has been shown to have benefits in various domains, but little is known about the effect of NW on more specific biomechanical parameters. The purpose is to determine the impact of NW on the following parameters: walking speed/distance, muscle activation, spatiotemporal parameters, kinematics and ground reaction force. Evidence acquisition: A literature search was carried out in different databases from October 2008 to October 2018. This review was conducted and reported in accordance with the PRISMA statement. Finally, 42 studies with a median PEDro score of 5.5/10 were included. Evidence synthesis: The included studies reported increased walking distance (+14.8%, p<0.05), walking speed (+25.5%, p<0.05), and stride length (+10.4%, p<0.05), but decreased cadence (-6.2%, p<0.05). NW generally increased: muscle activation and strength for upper limbs; upper and lower limb range of motion, and ground reaction force. Conclusions: NW has beneficial effects on many biomechanical parameters. It appears to be an effective way of doing physical activity and could be used in physical rehabilitation or in daily life.
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Overweight and physical inactivity adversely affect endothelial function and are risk factors for atherosclerosis and cardiovascular disease. Both Crataegus extract WS 1442 and physical exercise exert beneficial effects on endothelial function. We investigated whether WS 1442 and Nordic walking (NW) had comparable effects on endothelial function and lipid profile in overweight subjects. In this partially blinded pilot study, overweight, otherwise healthy volunteers aged 45-75 years were randomized into four groups as follows: WS 1442 2x450 mg/day (WS-standard), WS 1442 2x900 mg/day (WS-double), exercise 2x30 minutes/week (NW-low), and exercise 4x45 minutes/week (NW-high) for 12 weeks. Safety was assessed based on adverse events. Endothelial function testing (EndoPAT®), assessment of endothelial progenitor cells, lipid profiles, and treadmill testing were performed. Sixty subjects participated in the study. At baseline, subjects in WS-standard/-double groups had higher lipid levels and greater impairment of endothelial function. Subjects with impaired endothelial function showed improvement regardless of the type of intervention. Subjects in WS-standard and WS-double groups showed a trend towards modest decrease in triglycerides and modest increase in HDL-cholesterol; most changes were within the normal limits. In NW-low/-high groups, values also remained within the normal range. Exercise capacity improved in both NW groups. WS-double showed no additional benefits over WS-standard. All adverse events were unrelated or improbably related to treatment. In conclusion, WS 1442 and exercise training were safe and showed beneficial effects on endothelial function and lipid profile in overweight but otherwise healthy volunteers; exercise capacity improved only by Nordic walking.
Article
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.
Article
Мета: визначити вплив скандинавської ходьби на фізичний стан студентів в процесі навчально-оздоровчої діяльності. Матеріал і методи: аналіз науково-методичної літератури та положень про організацію фізичного виховання на кафедрі фізичного виховання в НТУ «ХПІ», методи математичної статистики, експрес оцінювання фізичного стану студентів за В.І. Бєловим [1], анкетування студентів. Обстежувана група складалася з 45 студенток НТУ «ХПІ» гуманітарних спеціальностей факультету соціально-гуманітарних технологій, які відносяться до основної медичної групи. Результати: у статті проаналізовано основні форми організації навчально-оздоровчої діяльності дисципліни «Фізичне виховання», визначено рівень фізичного стану студенток до занять скандинавською ходьбою та після. Аналізуючи результати первинних показників фізичного стану, студенткам було запропоновано заняття скандинавською ходьбою для підвищення показників фізичного стану. Заняття проходили впродовж 10 тижнів по 3 рази на тиждень, де кожний тиждень мав свою спрямованість. За результатами дослідження було надано рекомендації щодо введення скандинавської ходьби в навчальний процес дисципліни «Фізичне виховання» НТУ «ХПІ». Висновки: у ході дослідження було визначено позитивний вплив занять скандинавською ходьбою на фізичний стан студенток, про що свідчать показники повторного тестування рівня фізичного стану. Тому доцільно запропонувати вводити скандинавську ходьбу в навчальний процес дисципліни «Фізичне виховання». Ключові слова: студентки, скандинавська ходьба, фізичний стан, фізичне виховання, вплив.
Article
Background Nordic walking (NW) has shown promising outcomes for people with Parkinson's disease (PwP). Aims To explore the feasibility of the implementation of NW programmes for PwP in the NHS. Methods A literature review and feasibility study were conducted. PwP joined an 8-week NW programme. Attendance and measures of mobility (Timed Up and Go (TUG), 10-metre walk test (10MWT) and quality of life (QoL) (PD non-motor questionnaire) were recorded pre- and post-intervention. Barriers, facilitators and cost were recorded. Findings Eight studies indicated that NW is superior to walking and flexibility/relaxation exercise, with improvements in postural stability and gait. Nine of 10 participants completed the intervention with improvements in mobility (0.16 seconds faster (TUG), 1.27 seconds faster (10MWT) and QoL (better sleep, pain management, constipation, mood, exercising outside) after the intervention. Cost was recorded as £6.50 per participant per session, with no adverse events. Conclusions NW programmes can be safely delivered in the NHS, in partnership with British Nordic walking.
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Nordic walking (NW) is a practical form of healthy exercise. Up to now, few studies have been conducted on the non-clinical population and few has analysed muscular response after NW training. This study aimed to assess mechanical and neuromuscular changes of deltoideus and triceps brachii following short-term NW training. Twenty-four healthy and physically active females were randomly assigned to an NW group (NWG) (n =12) or control group (n =12). Training was carried out over a 6-week period (18 sessions) on a treadmill (4.5 km/h; 2% gradient). Mechanical and neuromuscular response was measured before and after training. Tensiomyography was used to assess maximum radial displacement, time contraction, time delay, sustain time, and half-relaxation time of deltoideus and triceps brachii. Heart rate (HR), and rating of perceived exertion (RPE) were used to control the training intensity. Mixed-design factorial analysis of variance (mixed ANOVA) was used to detect changes in the mechanical and neuromuscular characteristics after a NW training. During NW training, HR (115.83 bpm), 36.7% of HR reserve and RPE (10.25) corresponding to light intensity were reported. After the training period, only a moderate increase (6.25%, p =0.02; η2=0.06) in delay time for the triceps brachii were reported. A short-term and low to moderate intensity training conducted with a specific NW technique was not sufficient to modify the triceps brachii and deltoideus mechanical- neuromuscular response in healthy and young females.
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As a sustainable mode of travel, walking for transportation has multiple environmental, social, and health-related benefits. In existing studies, however, such walking has rarely been differentiated between commuting and non-commuting trips. Using multilevel zero-inflated negative binomial regression and multilevel Tobit regression models, this study empirically examines the frequency and duration of commuting and non-commuting walking and their correlates in Xiamen, China. It finds that (1) non-commuting walking, on average, has a higher frequency and longer duration than commuting walking; (2) most socio-demographic variables are significant predictors, and age, occupation, and family size have opposite-direction effects on commuting and non-commuting walking; and (3) different sets of built environment variables are correlated with commuting and non-commuting walking, and the built environment collectively influences the latter more significantly than the former. The findings provide useful references for customized interventions concerning promoting commuting and non-commuting walking.
Article
Introduction: Physical therapy interventions for patients with Parkinson's disease prioritize task-specific exercise to address gait and motor dysfunction. Nordic walking (NW) is a moderate intensity exercise promoting walking speed and rhythm. This case series describes the application of customized NW training in individuals with varied severity of Parkinson's gait dysfunction and the outcomes specific to gait, motor and non-motor symptoms; and NW engagement and retention in the follow-up phase. Case description: Three individuals with idiopathic PD (two males and one female; ages 59-69; Hoehn & Yahr stages II-III) participated. Supervised NW training phase included 15 one-hour sessions over 6-weeks, individually progressed for each participant. During the 3-month follow-up phase independent NW exercise was prescribed 3 times a week. Primary outcome measures examined gait function and impairment-based measures assessed Parkinson's motor and nonmotor symptoms. Outcomes: Participants improved in: 10-Meter walk-fast speed (0.13, 0.18, 0.15 m/s; respectively); 6-Minute Walk distance (137.5, 56.4, 129.4 m, respectively); Unified Parkinson's Disease Rating Scale-Motor Score (-6, -7, -14, respectively); and all Timed-Up-Go subtests. Participant 2 had 44.4% decline in freezing episodes and reduced fall rate. Participants' gains were retained at the 3-month follow-up. Discussion: This case series suggests that NW has therapeutic benefits for three individuals with varied Parkinson's gait dysfunction. Independent NW exercise was sustained post-training and motor and gait function gains were retained.
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Background: Increased physical activity has been recommended as an important lifestyle modification for the prevention and control of hypertension. Walking is a low-cost form of physical activity and one which most people can do. Studies testing the effect of walking on blood pressure have revealed inconsistent findings. Objectives: To determine the effect of walking as a physical activity intervention on blood pressure and heart rate. Search methods: We searched the following databases up to March 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 2), Ovid MEDLINE, Ovid Embase, CINAHL, PsycINFO, SPORTDiscus, PEDro, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched the following Chinese databases up to May 2020: Index to Taiwan Periodical Literature System; National Digital Library of Theses and Dissertation in Taiwan; China National Knowledge Infrastructure (CNKI) Journals, Theses & Dissertations; and Wanfang Medical Online. We contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions. Selection criteria: Randomised controlled trials of participants, aged 16 years and over, which evaluated the effects of a walking intervention compared to non-intervention control on blood pressure and heart rate were included. Data collection and analysis: We used standard methodological procedures expected by Cochrane. Where data were not available in the published reports, we contacted authors. Pooled results for blood pressure and heart rate were presented as mean differences (MDs) between groups with 95% confidence intervals (CIs). We undertook subgroup analyses for age and sex. We undertook sensitivity analyses to assess the effect of sample size on our findings. Main results: A total of 73 trials met our inclusion criteria. These 73 trials included 5763 participants and were undertaken in 22 countries. Participants were aged from 16 to 84 years and there were approximately 1.5 times as many females as males. The characteristics of walking interventions in the included studies were as follows: the majority of walking interventions was at home/community (n = 50) but supervised (n = 36 out of 47 reported the information of supervision); the average intervention length was 15 weeks, average walking time per week was 153 minutes and the majority of walking intensity was moderate. Many studies were at risk of selection bias and performance bias. Primary outcome We found moderate-certainty evidence suggesting that walking reduces systolic blood pressure (SBP) (MD -4.11 mmHg, 95% CI -5.22 to -3.01; 73 studies, n = 5060). We found moderate-certainty evidence suggesting that walking reduces SBP in participants aged 40 years and under (MD -4.41 mmHg, 95% CI -6.17 to -2.65; 14 studies, n = 491), and low-certainty evidence that walking reduces SBP in participants aged 41 to 60 years (MD -3.79 mmHg, 95% CI -5.64 to -1.94, P < 0.001; 35 studies, n = 1959), and those aged 60 years of over (MD -4.30 mmHg, 95% CI -6.17 to -2.44, 24 studies, n = 2610). We also found low certainty-evidence suggesting that walking reduces SBP in both females (MD -5.65 mmHg, 95% CI -7.89 to -3.41; 22 studies, n = 1149) and males (MD -4.64 mmHg, 95% CI -8.69 to -0.59; 6 studies, n = 203). Secondary outcomes We found low-certainty evidence suggesting that walking reduces diastolic blood pressure (DBP) (MD -1.79 mmHg, 95% CI -2.51 to -1.07; 69 studies, n = 4711) and heart rate (MD -2.76 beats per minute (bpm), 95% CI -4.57 to -0.95; 26 studies, n = 1747). We found moderate-certainty evidence suggesting that walking reduces DBP for participants aged 40 years and under (MD -3.01 mmHg, 95% CI -4.44 to -1.58; 14 studies, n = 491) and low-certainty evidence suggesting that walking reduces DBP for participants aged 41 to 60 years (MD -1.74 mmHg, 95% CI -2.95 to -0.52; 32 studies, n = 1730) and those aged 60 years and over (MD -1.33 mmHg, 95% CI -2.40 to -0.26; 23 studies, n = 2490). We found moderate-certainty evidence that suggests walking reduces DBP for males (MD -2.54 mmHg, 95% CI -4.84 to -0.24; 6 studies, n = 203) and low-certainty evidence that walking reduces DBP for females (MD -2.69 mmHg, 95% CI -4.16 to -1.23; 20 studies, n = 1000). Only 21 included studies reported adverse events. Of these 21 studies, 16 reported no adverse events, the remaining five studies reported eight adverse events, with knee injury being reported five times. Authors' conclusions: Moderate-certainty evidence suggests that walking probably reduces SBP. Moderate- or low-certainty evidence suggests that walking may reduce SBP for all ages and both sexes. Low-certainty evidence suggests that walking may reduce DBP and heart rate. Moderate- and low-certainty evidence suggests walking may reduce DBP and heart rate for all ages and both sexes.
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Seniorzy stanowią najszybciej rosnącą grupę populacji w rozwiniętych krajach. Jednak zwiększaniu się długości życia nie zawsze towarzyszy poprawa jakości życia. Dlatego istotną kwestią, również u osób starszych jest prowadzenie prozdrowotnego stylu życia, w którym ważne miejsce powinna zajmować aktywność fizyczna. Jest to element konieczny do zachowania sprawności fizycznej i funkcjonalnej, dobrego stanu zdrowia, także autonomii i niezależności. W niniejszej publikacji znajdują się treści dotyczące procesu starzenia, form jego przebiegu i obserwowane zmiany inwolucyjne w poszczególnych układach organizmu człowieka. Scharakteryzowano korzyści wynikające z regularnego podejmowania aktywności fizycznej, szczególnie w odniesieniu do osób starszych. Zaprezentowane zostały rekomendacje dotyczące odpowiedniej dla zdrowia „dawki” wysiłku fizycznego, opisano zasady ćwiczeń powalające bezpiecznie i zdrowo ćwiczyć oraz zaproponowano formy aktywności fizycznej dla osób dojrzałych i starszych. Książka pierwotnie dostępna w kolekcji Śląskiej Biblioteki Cyfrowej: https://sbc.org.pl/publication/579971#description
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Background: Nordic walking (NW) has been reported as a safe and effective exercise mode. However, the effects of NW on cognitive function are unknown. This study examined the effects of an unsupervised NW intervention on cognitive and physical function among older women engaging in volunteering. Methods: Forty-seven women aged ≥70 years were enrolled and assigned into three groups (NW (n = 16); walking (n = 19); control group (n = 12)) based on residential areas. Participants in NW and walking groups received a pedometer and recorded daily step counts. The NW group received poles and 2 hours of NW instruction. Participants were encouraged to perform the exercise individually more than once a week during the 3-month intervention. As baseline and follow-up assessments, cognitive function (Montreal Cognitive Assessment [MoCA-J] and Trail Making Test), physical function (handgrip strength, walking speed, balance ability, the Timed Up and Go test, and functional capacity), and objective physical activity were evaluated. Results: In the NW group, physical activity, maximal walking speed, and MoCA-J scores were improved during the intervention period. In the walking group, physical activity was increased after the intervention. Analysis of covariance showed that maximal walking speed among the NW group significantly improved compared with the walking group. Sub-group analysis of participants who exercised more than once a week showed that handgrip strength, gait speed, and MoCA-J scores were significantly improved in the NW compared with the walking group. Conclusion: NW intervention improved cognitive and physical function compared with simple walking among older women.
Article
Aim: To check the effectiveness of the program of physical therapy of patients with type 1 diabetes. Materials and Methods: The study involved 30 people (25-35-year-old women) with type 1 diabetes of moderate severity of the disease in the subcompensation stage, who were at the sanatorium stage of treatment. Patients, along with following a diet and insulin therapy, were engaged in physical exercises according to the author’s program based on the Nordic Walking. Assessment of the impact of physical rehabilitation was performed on blood sugar level, heart rate, blood pressure. Results: It is established that at the end of the experiment the blood sugar level of the EG patients significantly (p≤0.05) decreased by 0.8 mmol/l (7.54%), in contrast to CG, where the difference is 0.3 mmol/l (2.75%) and is unreliable (p≥0.05). This indicates the effectiveness of the developed program of physical therapy for diabetic patients based on Nordic Walking classes in combination with traditional methods of treatment. Conclusions: Nordic Walking classes for patients with type 1 diabetes help to increase insulin sensitivity, stabilize blood pressure, reduce the risk of developing coronary heart disease, increase immunity, expand the functional capabilities of the body, improve the well-being and psychoemotional state of patients.
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It is known that urinary incontinence remains one of the most common diseases in women, representing a serious medical and social problem. Practice shows that sling operations without subsequent rehabilitation measures, especially in the long term, do not solve the problem. In urogynecology, the use of physical exercises and physiotherapeutic methods is aimed at restoring impaired urinary functions. A relatively new approach to the rehabilitation of women after sling operations is the inclusion of Nordic walking (NW) into the rehabilitation program. Certain experience in this field has been accumulated in Sverdlovsk Regional Clinical Hospital № 1 (Yekaterinburg). Aim. To improve the efficiency of treatment of female stress urinary incontinence using the technique of NW in rehabilitation programs after sling operations. Material and methods. In Sverdlovsk Regional Clinical Hospital № 1 in Yekaterinburg, NW is included in rehabilitation programs for women with stress urinary incontinence after sling operations. Experience in planning and conducting a four-week course of NW under the physiotherapist guidance has been accumulated. Patients after sling operations (n= 85) were randomized into two groups. Rehabilitation program of patients of the first group (n = 37) included a 4-week course of NW on the background of basic therapy (antibacterial therapy, antispasmodics, anticoagulants), while in the second group (n = 48) only basic therapy was realized. The dynamics of clinical manifestations of stress urinary incontinence was studied, uroflowmetry parameters, PAD-test data, cough test were evaluated; the answers of the patients to the questions of the international questionnaires PFDI-20, PFIQ-7 were analyzed. Results and discussion. The variability of the currently used methods of rehabilitation of patients with stress urinary incontinence requires objectification of the results. The study showed that Nordic walking (NW) is a pathogenetically justified and clinically effective method for rehabilitation of women with stress urinary incontinence after sling operations. The analysis of the rehabilitation activities data based on the dynamics of leading clinical symptoms, PAD test, cough test, uroflowmetry parameters revealed significant differences (p
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Im Rahmen der vorliegenden Arbeit wurde ein Stressbewältigungstraining für Lehrkräfte mit dem Fokus auf Sport und Achtsamkeit und eine auf das Konzept abgestimmte Evaluation entwickelt. Zunächst wird das Phänomen Stress mit besonderem Fokus auf die Berufsgruppe der Lehrkräfte untersucht, die stressregulierenden Wirkungsweisen von Sport diskutiert. Anschließend werden bestehende Stressbewältigungstrainings auf die Relevanz körperlicher Aktivität untersucht. Da die körperliche Aktivität dort nur geringfügig Berücksichtigung findet, wird Mindful Walking als vielversprechende Methode diskutiert, um aus den gewonnenen Erkenntnissen ein Stressbewältigungstraining für Lehrkräfte mit dem Fokus auf Sport und Achtsamkeit zu entwickeln. Ziel des Stressbewältigungstrainings soll es sein, das Stressempfinden der Lehrkräfte zu verbessern, die Selbstwirksamkeit zu steigern, gesundheitsförderliche Verhaltensmuster aufzubauen und die körperliche Fitness der Teilnehmenden zu steigern. Unter Verwendung von sowohl subjektiven als auch objektiven Indikatoren wird ein Evaluationskonzept entwickelt, welches die Wirksamkeit des lehrkräfteorientierten Stressbewältigungstrainings (LOS!) auf einer wissenschaftlich validen Basis überprüfen soll. Diese Arbeit verdeutlicht die Notwendigkeit der Integration von Sport in die Prävention von Stress und gibt durch die Vorstellung des hier entwickelten LOS! ein Beispiel, wie dies gelingen kann. Das LOS! bietet sich aufgrund der wissenschaftlichen Fundierung zur weiteren Präzisierung und anschließenden Durchführung an. Die Wirksamkeit des LOS! sollte in einer zukünftigen Forschungsarbeit mit Hilfe des in dieser Arbeit entwickelten Evaluationskonzeptes überprüft werden, um zu erkennen, ob die Etablierung dieser Präventionsmaßnahme sinnvoll ist.
Article
To evaluate the effectiveness of brisk walking and stair climbing on cardiopulmonary endurance in university students. Methods: 28 (male=14, female=14) young healthy adults were recruited for this study. VO2max and BMI, baseline measures were taken before the follow up. Participants in stair climbing group were asked to climb 60 stairs (height= 15cm each step) comprises of three flights per bout and a total of 180 stairs per session; three days a week, for a total of 12 training sessions over 4 weeks. In group B participants were asked to walk briskly for least 20 min a day, 3 times a week, for a total of 12 sessions for four weeks. VO2max and BMI measures were taken after the follow up.Results: Out of a sample of 28 participants, In Group A (Stair Climbing) the age of participants was (21.86 ±1.45 years, BMI pre was 21.96±3.31 kg/m2, which decreased to BMI post was 21.93±3.29 kg/m2, VO2 max pre was 42.45±4.57 (mL.kg-1.min-1) and VO2 max post was increased to 46.07±4.51; mean ± SD). In Group B (Brisk Walking) the age of participants was (22.92±1.85 years, BMI pre was 22.03±2.75 kg/m2, BMI post was 21.53±1.93 kg/m2, VO2 max pre was 42.07±3.52 (mL.kg-1.min-1) and VO2 max post was increased to 43.84±3.36; mean ± SD). Conclusion: It is concluded from the study that stair climbing can improve cardiopulmonary endurance in young healthy university students as compared to the brisk walking.
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Background: Nordic pole Walking (NW) as trend sport is asso- ciated with beneficial effects on the cardiovascular system. Data regarding the injury and overload injury rates are pending. Methods: 137 athletes (74 % females, 53 ± 12 years, weight 73 ± 13 kg, height 169 ± 11 cm) were prospectively ask using a two-sided questionnaire. Mean NW experience was 212.8 weeks with 2.9 ± 1.8 hours/week. The overall exposure was 29 160 h. Results: NW injury rate was 0.926/1000 h. Falls were evident in 0.24/1000 h. The upper extremity was involved more frequently (0.549/1000 h) than the lower extremity (0.344/1000 h). The most severe injury was a concomitant shoulder dislocation and luxation of the proximal interphalangeal joint of the index finger after a fall. The most frequent injury in NW was a distorsion of the ulnar collateral ligament of the thumb (0.206/1000 h) after fall. Shoulder injuries account for 0.171/1000 h with 0.069/ 1000 h shoulder dislocations. Distal radius fractures were rare as ankle sprains and shinspints (0.034/1000 h). Muscle injuries were encountered only at the gastrocnemius muscle (0.137/ 1000 h). No knee ligament injuries were noted. In 5 %, NW inju- ries caused interruption of the performance, with all patients re- turning to sport within 4 weeks on the same level as before. Discussion: Nordic Walking is safe. Most frequently, a Nordic walking thumb is encountered during a fall with the athlete holding on to the NW pole until the very last moment before the hand hits the ground with the pole handle as hypomochlium that forces the thumb into abduction and extension. Modifica- tions of the grip construction as well as information of the ath- lete and behaviour changes may be preventive measures. Originalarbeit
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Symptoms of Parkinson's disease (PD) progress despite optimized medical treatment. The present study investigated the effects of a flexibility and relaxation programme, walking, and Nordic walking (NW) on walking speed, stride length, stride length variability, Parkinson-specific disability (UPDRS), and health-related quality of life (PDQ 39). 90 PD patients were randomly allocated to the 3 treatment groups. Patients participated in a 6-month study with 3 exercise sessions per week, each lasting 70 min. Assessment after completion of the training showed that pain was reduced in all groups, and balance and health-related quality of life were improved. Furthermore, walking, and Nordic walking improved stride length, gait variability, maximal walking speed, exercise capacity at submaximal level, and PD disease-specific disability on the UPDRS in addition. Nordic walking was superior to the flexibility and relaxation programme and walking in improving postural stability, stride length, gait pattern and gait variability. No significant injuries occurred during the training. All patients of the Nordic walking group continued Nordic walking after completing the study.
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The effects of a Nordic walking (NW) program compared to those of a walking (W) program on physiological and perceptual variables in obese middle-aged women were investigated. Subjects (n=12 NW group, n=11 W group) trained over 12 weeks 3 times.week (-1). Body mass, body mass index (BMI), body fat, heart rate (HR), resting blood pressure, peak oxygen consumption (V˙O (2peak)) were measured before and after the training period. Moreover, HR, rating of perceived exertion (RPE) and adherence were recorded during all training sessions. After the training period body mass, body fat and diastolic blood pressure decreased in both groups (P<0.05) whereas V˙O (2peak) increased in the NW group (+3.7 ml.min (-1).kg (-1); P=0.005). During the training sessions, mean HR (P=0.021), HR at preferred walking speed (P=0.020) and % of time at high intensity (P=0.031) were higher in NW than in the W group. Finally, RPE was not influenced by the modality of exercise and NW group showed a higher rate of adherence (91±19% vs. 81±29%; P=0.011). To conclude, NW activity in obese women allows an increase in exercise intensity and adherence to a training program without increasing the perception of effort leading to enhanced aerobic capacity.
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Although studies have shown that physically active breast cancer survivors have lower all-cause mortality, the association between change in physical activity from before to after diagnosis and mortality is not clear. We examined associations among pre- and postdiagnosis physical activity, change in pre- to postdiagnosis physical activity, and all-cause and breast cancer-specific mortality in postmenopausal women. A longitudinal study of 4,643 women diagnosed with invasive breast cancer after entry into the Women's Health Initiative study of postmenopausal women. Physical activity from recreation and walking was determined at baseline (prediagnosis) and after diagnosis (assessed at the 3 or 6 years post-baseline visit). Women participating in 9 MET-h/wk or more (∼ 3 h/wk of fast walking) of physical activity before diagnosis had a lower all-cause mortality (HR = 0.61; 95% CI, 0.44-0.87; P = 0.01) compared with inactive women in multivariable adjusted analyses. Women participating in ≥ 9 or more MET-h/wk of physical activity after diagnosis had lower breast cancer mortality (HR = 0.61; 95% CI, 0.35-0.99; P = 0.049) and lower all-cause mortality (HR = 0.54; 95% CI, 0.38-0.79; P < 0.01). Women who increased or maintained physical activity of 9 or more MET-h/wk after diagnosis had lower all-cause mortality (HR = 0.67; 95% CI, 0.46-0.96) even if they were inactive before diagnosis. High levels of physical activity may improve survival in postmenopausal women with breast cancer, even among those reporting low physical activity prior to diagnosis. Women diagnosed with breast cancer should be encouraged to initiate and maintain a program of physical activity.
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This study was aimed to investigate the effects of an exercise trial on self-esteem, self-concept and quality of life in patients with fibromyalgia and to evaluate whether improvements in psychological distress were related to changes in physical functioning. Twenty-eight women with a primary diagnosis of fibromyalgia were randomized to a usual care control group or to a 12-week supervised training programme consisting of 3 weekly sessions of aerobic, strengthening and flexibility exercises. Outcomes were physical functioning (Fibromyalgia Impact Questionnaire (FIQ), lower-body strength and flexibility) and psychological functioning (SF-36, Rosenberg self-esteem scale and Erdmann self-concept scale). Outcomes were measured at study entry and at the end of the intervention. Compared to the control group, statistically significant improvements in self-esteem, self-concept, FIQ, physical functioning, role physical, bodily pain, vitality, role emotional, social functioning, mental health, isometric strength, muscular endurance and flexibility were evident in the exercise group at the end of treatment. Self-esteem and self-concept scores were correlated positively with role emotional, mental health and the mental component summary of SF-36 and were negatively correlated to FIQ scores. No significant correlation existed between self-esteem or self-concept and isometric strength, muscular endurance or flexibility. Our results highlight the need for a broader array of physical and mental outcomes and the importance of examining patient's perceptions in future research therapies.
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Physical training is beneficial and should be included in the comprehensive management of all patients with COPD independently of disease severity. Different rehabilitative strategies and training modalities have been proposed to optimize exercise tolerance. Interval exercise training has been used as an effective alternative modality to continuous exercise in patients with moderate and severe COPD.Although in healthy elderly individuals and patients with chronic heart failure there is evidence that this training modality is superior to continuous exercise in terms of physiological training effects, in patients with COPD, there is not such evidence. Nevertheless, in patients with COPD application of interval training has been shown to be equally effective to continuous exercise as it induces equivalent physiological training effects but with less symptoms of dyspnea and leg discomfort during training.The main purpose of this review is to summarize previous studies of the effectiveness of interval training in COPD and also to provide arguments in support of the application of interval training to overcome the respiratory and peripheral muscle limiting factors of exercise capacity. To this end we make recommendations on how best to implement interval training in the COPD population in the rehabilitation setting so as to maximize training effects.
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The objective of this study was to investigate the effects of moderate-to-high intensity Nordic walking (NW) on functional capacity and pain in fibromyalgia (FM). A total of 67 women with FM were recruited to the study and randomized either to moderate-to-high intensity Nordic Walking (n = 34, age 48 ± 7.8 years) or to a control group engaging in supervised low-intensity walking (LIW, n = 33, age 50 ± 7.6 years). Primary outcomes were the six-minute walk test (6MWT) and the Fibromyalgia Impact Questionnaire Pain scale (FIQ Pain). Secondary outcomes were: exercise heart rate in a submaximal ergometer bicycle test, the FIQ Physical (activity limitations) and the FIQ total score. A total of 58 patients completed the post-test. Significantly greater improvement in the 6MWT was found in the NW group (P = 0.009), as compared with the LIW group. No between-group difference was found for the FIQ Pain (P = 0.626). A significantly larger decrease in exercise heart rate (P = 0.020) and significantly improved scores on the FIQ Physical (P = 0.027) were found in the NW group as compared with the LIW group. No between-group difference was found for the change in the FIQ total. The effect sizes were moderate for the above mentioned outcomes. Moderate-to-high intensity aerobic exercise by means of Nordic walking twice a week for 15 weeks was found to be a feasible mode of exercise, resulting in improved functional capacity and a decreased level of activity limitations. Pain severity did not change over time during the exercise period. Clinicaltrials.gov identifier NCT00643006.
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In patients with COPD progressive dyspnoea leads to a sedentary lifestyle. To date, no studies exist investigating the effects of Nordic Walking in patients with COPD. Therefore, the aim was to determine the feasibility of Nordic Walking in COPD patients at different disease stages. Furthermore we aimed to determine the short- and long-term effects of Nordic Walking on COPD patients' daily physical activity pattern as well as on patients exercise capacity. Sixty COPD patients were randomised to either Nordic Walking or to a control group. Patients of the Nordic Walking group (n = 30; age: 62 +/- 9 years; FEV1: 48 +/- 19% predicted) underwent a three-month outdoor Nordic Walking exercise program consisting of one hour walking at 75% of their initial maximum heart rate three times per week, whereas controls had no exercise intervention. Primary endpoint: daily physical activities (measured by a validated tri-axial accelerometer); secondary endpoint: functional exercise capacity (measured by the six-minute walking distance; 6MWD). Assessment time points in both groups: baseline, after three, six and nine months. After three month training period, in the Nordic Walking group time spent walking and standing as well as intensity of walking increased (Delta walking time: +14.9 +/- 1.9 min/day; Delta standing time: +129 +/- 26 min/day; Delta movement intensity: +0.40 +/- 0.14 m/s2) while time spent sitting decreased (Delta sitting time: -128 +/- 15 min/day) compared to baseline (all: p < 0.01) as well as compared to controls (all: p < 0.01). Furthermore, 6MWD significantly increased compared to baseline (Delta 6MWD: +79 +/- 28 meters) as well as compared to controls (both: p < 0.01). These significant improvements were sustained six and nine months after baseline. In contrast, controls showed unchanged daily physical activities and 6MWD compared to baseline for all time points. Nordic Walking is a feasible, simple and effective physical training modality in COPD. In addition, Nordic Walking has proven to positively impact the daily physical activity pattern of COPD patients under short- and long-term observation.
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Active approaches including both specific and unspecific exercise are probably the most widely recommended treatment for patients with chronic low back pain but it is not known exactly which types of exercise provide the most benefit. Nordic Walking - power walking using ski poles - is a popular and fast growing type of exercise in Northern Europe that has been shown to improve cardiovascular metabolism. Until now, no studies have been performed to investigate whether Nordic Walking has beneficial effects in relation to back pain. A total of 151 patients with low back and/or leg pain of greater than eight weeks duration were recruited from a hospital based outpatient back pain clinic. Patients continuing to have pain greater than three on the 11-point numeric rating scale after a multidisciplinary intervention were included. Fifteen patients were unable to complete the baseline evaluation and 136 patients were randomized to receive A) Nordic walking supervised by a specially trained instructor twice a week for eight weeks B) One-hour instruction in Nordic walking by a specially trained instructor followed by advice to perform Nordic walking at home as much as they liked for eight weeks or C) Individual oral information consisting of advice to remain active and about maintaining the daily function level that they had achieved during their stay at the backcenter. Primary outcome measures were pain and disability using the Low Back Pain Rating Scale, and functional limitation further assessed using the Patient Specific Function Scale. Furthermore, information on time off work, use of medication, and concurrent treatment for their low back pain was collected. Objective measurements of physical activity levels for the supervised and unsupervised Nordic walking groups were performed using accelerometers. Data were analyzed on an intention-to-treat basis. No mean differences were found between the three groups in relation to any of the outcomes at baseline. For pain, disability, and patient specific function the supervised Nordic walking group generally faired best however no statistically significant differences were found. Regarding the secondary outcome measures, patients in the supervised group tended to use less pain medication, to seek less concurrent care for their back pain, at the eight-week follow-up. There was no difference between physical activity levels for the supervised and unsupervised Nordic walking groups. No negative side effects were reported. We did not find statistically significant differences between eight weeks of supervised or unsupervised Nordic walking and advice to remain active in a group of chronic low back pain patients. Nevertheless, the greatest average improvement tended to favor the supervised Nordic walking group and - taking into account other health related benefits of Nordic walking - this form of exercise may potentially be of benefit to selected groups of chronic back pain patients. http://www.ClinicalTrials.gov # NCT00209820.
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This study aimed to compare physiological and perceptual responses to Nordic walking (NW) in obese women to those of walking (W), and to assess if these responses were modified by a learning period of NW technique. Eleven middle-aged obese women completed exercise trials (5 min each) at 4 km/h, inclinations of -5, 0 and +5%, with and without poles. Ventilation (V(E)) oxygen consumption V(O)(2) energy cost (EC), heart rate (HR), rating of perceived exertion (RPE) and cycle length were measured before and after a 4-week learning period (12 sessions). V(E), V(O)(2), EC, HR and cycle length were significantly higher (P < 0.001) during NW trials than W trials. RPE was significantly diminished (pole x inclination interaction, P = 0.031) when using NW poles compared to W uphill. Significant pole x inclination interactions were observed for V(O)(2) (P = 0.022) and EC (P = 0.022), whereas significant pole x time interaction was found for EC (P = 0.043) and RPE (P = 0.039). Our results confirmed that use of NW poles increased physiological responses at a given speed but decreased RPE in comparison with W during inclined level. Moreover, this is the first study showing that a learning period of NW technique permitted to enhance the difference between EC with NW poles versus the W condition and to decrease the RPE when using NW poles. Thus, although it requires a specific learning of the technique, the NW might be considered like an attractive physical activity with an important public health application.
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To investigate the effects of Nordic Walking training supplemental to a standard, early rehabilitation programme on exercise capacity and physical fitness in men after an acute coronary syndrome. A controlled trial. Cardiac rehabilitation service of a provincial hospital. Eighty men 2-3 weeks after an acute coronary syndrome, with good exercise tolerance. Three-week, inpatient cardiac rehabilitation programme (control group) supplemented with Nordic Walking (Nordic Walking group), or with traditional walking training (walking training group). Exercise capacity was assessed as peak energy cost (in metabolic equivalents) in symptom-limited treadmill exercise test, and physical fitness with the Fullerton Functional Fitness Test. Exercise capacity after the rehabilitation programme was higher in the Nordic Walking group than in the control group (10.8 +/- 1.8 versus 9.2 +/- 2.2 metabolic equivalents, P =0.025). The improvement in exercise capacity in the Nordic Walking group was higher than in the control group (1.8 +/- 1.5 versus 0.7 +/- 1.4 metabolic equivalents, P =0.002). In contrast to the control group, the results of all components of the Fullerton test improved in the Nordic Walking and walking training groups. After the programme, lower body endurance, and dynamic balance were significantly better in the Nordic Walking group in comparison with the walking training and control groups, and upper body endurance was significantly better in the Nordic Walking and walking training groups than in the control group. Nordic Walking may improve exercise capacity, lower body endurance and coordination of movements in patients with good exercise tolerance participating in early, short-term rehabilitation after an acute coronary syndrome.
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The aim of this study was to analyze the influence of moderate endurance training on a set of physiological parameters accompanying menopausal transition. One hundred sixty-eight women participated in the study. The cohort was divided into three subgroups: premenopausal, perimenopausal, and postmenopausal. A 12-week moderate intensity Nordic Walking program was administered to the cohort. The changes in body mass index (BMI), total fat mass (TF), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TGs), and waist circumference (WC) were assessed by means of appropriate statistical methods. Significant differences are observed in VO2max and cholesterol levels as a function of age, both ovarian and chronological. BMI, TF, LDL, HDL, TGs, and WC also fluctuate, however insignificantly, as a function of age. Administration of a 12-week Nordic Walking program results in significant changes in the parameters studied. The only exception is HDL level in postmenopausal women. Significant decreases in BMI, TF, LDL, TGs, and WC and increase in HDL in premenopausal and perimenopausal women indicate the outstanding role the appropriately chosen moderate endurance training may play in the quality of daily life in perimenopausal women.
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The objectives of this study were to find out how motivated depressed patients are to exercise regularly, to measure the physical activity of depressed patients and to find out how regular Nordic Walking affects the mood and physical fitness of depressed patients. A cross-sectional study was carried out. Three years after the Prediction of Primary Episodes of Depression in Primary Medical Care study, telephone calls were made to 178 patients who had had depression during that study. We enquired whether and why they would be interested in starting regular Nordic Walking three times a week, at least 30 min at a time, for 24 weeks. Furthermore, there were questions about the patients' earlier physical activity. The Composite International Diagnostic Interview was used to assess depression. To measure physical fitness, we used an outdoor 2 km walking test. Altogether, 106 patients were interviewed, 48 (45%) of them were depressed and 58 (55%) were nondepressed. Of the depressed patients, 16, and of the nondepressed patients, five, started the training programme. During the past 2 years, 12 of the patients had not had any regular physical activity. One-fourth of the depressed patients completed the study. Mean fitness index was 21.99+/-20.38 at week 0 and 38.72+/-26.12 at week 24. The feedback of the patients and their families to the programme was positive. Depressed patients in family practice were physically inactive. About one-third of the depressed patients were motivated to start regular physical activity. Nordic Walking increased the patients' physical activity and improved their mood.
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To investigate the immediate effects of Nordic pole walking (NPW) on walking distance and cardiopulmonary workload in patients with intermittent claudication. Using a standardised treadmill test (3.2 km h(-1) at 4% gradient), walking distance, cardiopulmonary responses, leg pain and perceived exertion during NPW were compared to responses evoked by normal walking in 20 patients with intermittent claudication. The distance to onset of claudication pain (claudication distance: CD) and to maximum walking distance (MWD), heart rate (HR), expired gas parameters, leg pain (Borg's CR-10 Scale) and perceived exertion (Borg's Rating of Perceived Exertion: RPE Scale) were compared. CD increased significantly from a median (range) distance of 77 m (28-503) to 130 m (41-1080) and MWD increased significantly from 206 m (81-1078) to 285 m (107-1080) when patients used the Nordic poles (P=0.000). The level of leg pain at MWD was also significantly reduced during NPW (P=0.002). Perceived exertion at MWD did not increase despite an increase in cardiopulmonary work, as indicated by an increase in oxygen consumption (16.5%; P=0.000). These results show that NPW immediately enables patients with intermittent claudication to walk further with less pain, despite a higher workload. NPW might also be a useful exercise strategy for improving the cardiovascular fitness of patients with intermittent claudication.
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We provide an updated version of the Compendium of Physical Activities, a coding scheme that classifies specific physical activity (PA) by rate of energy expenditure. It was developed to enhance the comparability of results across studies using self-reports of PA. The Compendium coding scheme links a five-digit code that describes physical activities by major headings (e.g., occupation, transportation, etc.) and specific activities within each major heading with its intensity, defined as the ratio of work metabolic rate to a standard resting metabolic rate (MET). Energy expenditure in MET-minutes, MET-hours, kcal, or kcal per kilogram body weight can be estimated for specific activities by type or MET intensity. Additions to the Compendium were obtained from studies describing daily PA patterns of adults and studies measuring the energy cost of specific physical activities in field settings. The updated version includes two new major headings of volunteer and religious activities, extends the number of specific activities from 477 to 605, and provides updated MET intensity levels for selected activities.
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Breast cancer treatment often results in impaired shoulder function, in particular, decrements in muscular endurance and range of motion, which may lead to decreased quality of life. The purpose of this investigation was to determine the effects of walking pole use on shoulder function in female breast cancer survivors. Participants had previously been treated with 1 or a combination of the following: mastectomy, breast conservation therapy, axillary lymph node dissection, chemotherapy, or radiation. Participants were randomly placed in experimental (n = 6) and control (n = 6) groups and met with a cancer exercise specialist 2 times each week for 8 weeks. The experimental group used walking poles during the 20-minute aerobic portion of their workout, whereas the control group did not use walking poles but performed 20 minutes of aerobic exercise per workout session. Both groups participated in similar resistance training programs. Testing was done pre- and postexercise intervention to determine upper body muscular endurance and active range of motion at the glenohumeral joint. Repeated-measures analysis of variance (ANOVA) revealed significant improvements in muscular endurance as measured by the bench press (P = .046) and lat pull down (P = .013) in the walking pole group. No within-group improvements were found in the group that did not use walking poles. The data suggest that using a walking pole exercise routine for 8 weeks significantly improved muscular endurance of the upper body, which would clearly be beneficial in helping breast cancer survivors perform activities of daily living and regain an independent lifestyle.
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The goal of this study was to evaluate the physiological responses during incremental field tests (FT) in nordic walking (NW), walking (W) and jogging (J). Fifteen healthy middle-aged women participated in three FT. Heart rate (HR) and oxygen uptake \({\left( {\ifmmode\expandafter\dot\else\expandafter\.\fi{V}{\text{O}}_{2} } \right)} \) were monitored continuously by portable analyzers. Capillary blood lactate (La) was analyzed at rest and after every stage of the FT. The disciplines showed differences during stage 1.8 and 2.1 m s−1 for \( \ifmmode\expandafter\dot\else\expandafter\.\fi{V}{\text{O}}_{2} \) between NW and W (P < 0.05). The maximum value was measured at 1.8 m s−1 (8%). In accordance with La, \( \ifmmode\expandafter\dot\else\expandafter\.\fi{V}{\text{CO}}_{2} \) was higher in NW compared with W during all stages (P < 0.05) and even higher in NW compared with J during 2.1 and 2.4 m s−1. While there were higher HR for NW and W at 2.4 m s−1 than in J (P < 0.01), there were increases for HR at fixed values of 2 (La2) and 4 (La4) mmol l−1 lactate for J compared with NW and W (P < 0.01). Although the speed of NW was slower than that of W at La2 and La4 (P < 0.05), there were no differences for the HR and the \( \ifmmode\expandafter\dot\else\expandafter\.\fi{V}{\text{O}}_{2} . \) Our results demonstrate that metabolic responses are a helpful instrument to assess the intensity during bipedal exercise. As NW speed at submaximal lactate levels is lower than in W and J, W and J test measures of HR and \( \ifmmode\expandafter\dot\else\expandafter\.\fi{V}{\text{O}}_{2} \) are not suitable for NW training recommendations. Additionally, the \( \ifmmode\expandafter\dot\else\expandafter\.\fi{V}{\text{O}}_{2} \) formed by performing NW is not as high as previously reported.
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Nordic pole Walking (NW) as trend sport is associated with beneficial effects on the cardiovascular system. Data regarding the injury and overload injury rates are pending. 137 athletes (74 % females, 53 +/- 12 years, weight 73 +/- 13 kg, height 169 +/- 11 cm) were prospectively ask using a two-sided questionnaire. Mean NW experience was 212.8 weeks with 2.9 +/- 1.8 hours/week. The overall exposure was 29 160 h. NW injury rate was 0.926/1000 h. Falls were evident in 0.24/1000 h. The upper extremity was involved more frequently (0.549/1000 h) than the lower extremity (0.344/1000 h). The most severe injury was a concomitant shoulder dislocation and luxation of the proximal interphalangeal joint of the index finger after a fall. The most frequent injury in NW was a distorsion of the ulnar collateral ligament of the thumb (0.206/1000 h) after fall. Shoulder injuries account for 0.171/1000 h with 0.069/1000 h shoulder dislocations. Distal radius fractures were rare as ankle sprains and shinspints (0.034/1000 h). Muscle injuries were encountered only at the gastrocnemius muscle (0.137/1000 h). No knee ligament injuries were noted. In 5%, NW injuries caused interruption of the performance, with all patients returning to sport within 4 weeks on the same level as before. Nordic Walking is safe. Most frequently, a Nordic walking thumb is encountered during a fall with the athlete holding on to the NW pole until the very last moment before the hand hits the ground with the pole handle as hypomochlium that forces the thumb into abduction and extension. Modifications of the grip construction as well as information of the athlete and behaviour changes may be preventive measures.
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Walking with poles (Nordic walking, NW) has become popular. We compared training responses of brisk walking (W) or NW on cardiorespiratory and neuromuscular fitness. We randomized 121 non-obese sedentary women (aged 50-60) to an NW or W group (NWG, WG), to train 40 min four times weekly for 13 weeks. Intensity was based on subjective perception of exertion. Cardiorespiratory performance was assessed in four levels corresponding to 50%, 65%, 80% and 100% of peak VO(2). Fifty-four NWG and 53 WG subjects completed the study. The mean intensity was about 50% of heart rate (HR) reserve. The baseline peak VO(2) was 25.8 (SD 3.9) mL/min/kg. Both groups improved peak VO(2) similarly (NWG 2.5 mL/min/kg, 95% confidence interval (CI) 1.9-3.3; WG 2.6, CI 1.9-3.3). In the submaximal stages while walking with or without poles, HR and lactate decreased after training in both groups, but the changes were not statistically significantly different between the groups. Of the neuromuscular tests after training, the only significant difference between the groups was in the leg strength in the one-leg squat, favoring WG. In conclusion, both training modes improved similarly health-enhancing physical fitness, and they were feasible and safe.
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To evaluate the short-term effects of exercise in patients with major depression. Prospective, randomised, controlled study. A university hospital. A consecutive series of 38 inpatients with a major depression episode undergoing standard clinical antidepressant drug treatment. Patients were randomly assigned to an exercise (walking, n = 20) or placebo (low-intensity stretching and relaxation exercises, n = 18) group. Training was carried out for 10 days. Main outcome measurements: Severity of depression assessed with the Bech-Rafaelsen Melancholy Scale (BRMS) and the Center for Epidemiologic Studies Depression scale (CES-D). After 10 days, reduction of depression scores in the exercise group was significantly larger than in the placebo group (BRMS: 36% v 18%; CES-D: 41% v 21%; p for both = 0.01); the proportion of patients with a clinical response (reduction in the BRMS scores by more than six points) was also larger for the exercise group (65% v 22%, p<0.01). Endurance exercise may help to achieve substantial improvement in the mood of selected patients with major depression in a short time.
Article
Background The number of people with chronic neck pain is growing continuously even though exact epidemiologic numbers and cost analyses for Germany do not yet exist. It has been extensively confirmed that chronic neck pain is caused by fear, agitation, anxiety and depression. The aim of this secondary preventive study was to clarify if three standardized 12-week health programs, back school, Nordic walking and Masai barefoot technology (MBT) shoes, show positive effects on functional health for people in the chronication phase of neck pain. Methods A clinical, randomized, prospective, interventional trial with baseline design was established. A total of 85 participants (mean 50.7 ± 11.1) were randomized into 3 intervention groups: 27 (52. 6± 11.6) were included in the back school, 28 (52.5 ± 11.3) participated in Nordic walking and 30 (47.4 ± 9.9) were assigned to MBT. Analyses were carried out from the assessments SF-36, EQ-5D, FFbH-R and NDI. Results Neck pain (NDI) and functional spine impairment (FFbH-R) were significantly alleviated in all groups. The results of health quality (SF-36) indicated that back school and Nordic walking performed better than MBT. Nordic walking had worse results in state of health (EQ-5D). Discussion The study confirmed that continuous training in groups shows significant improvements in all three programs. The small numbers of participants allow no generalizations. Further studies must be carried out to clarify the situation, because many other programs are on market where the effectiveness is unexplained.
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Sturm J, Plöderl M, Fartacek C, Kralovec K, Neunhäuserer D, Niederseer D, Hitzl W, Niebauer J, Schiepek G, Fartacek R. Physical exercise through mountain hiking in high-risk suicide patients. A randomized crossover trial. Objective: The following crossover pilot study attempts to prove the effects of endurance training through mountain hiking in high-risk suicide patients. Method: Participants (n = 20) having attempted suicide at least once and clinically diagnosed with hopelessness were randomly distributed among two groups. Group 1 (n = 10) began with a 9-week hiking phase followed by a 9-week control phase. Group 2 (n = 10) worked vice versa. Assessments included the Beck Hopelessness Scale (BHS), Beck Depression Inventory (BDI), Beck Scale of Suicide Ideation (BSI), and maximum physical endurance. Results: Ten participants of Group 1 and seven participants of Group 2 completed the study. A comparison between conditions showed that, in the hiking phase, there was a significant decrease in hopelessness (P < 0.0001, d = −1.4) and depression (P < 0.0001, d = −1.38), and a significant increase in physical endurance (P < 0.0001, d = 1.0), but no significant effect for suicide ideation (P = 0.25, d = −0.29). However, within the hiking phase, there was a significant decrease in suicide ideation (P = 0.005, d = −0.79). Conclusion: The results suggest that a group experience of regular monitored mountain hiking, organized as an add-on therapy to usual care, is associated with an improvement of hopelessness, depression, and suicide ideation in patients suffering from high-level suicide risk.