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

European journal of physical and rehabilitation medicine
October 1, 2020
Iveta Nagyova et al. (5 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine the feasibility and effectiveness of Nordic walking (NW) on cardiovascular performance and quality of life in patients with coronary artery disease (CAD) compared to a conventional cardiovascular rehabilitation (CCVR) program.

Results Summary

NW led to higher cardiovascular and functional performance compared to CCVR, with improvements in exercise ergometry, metabolic equivalent of tasks, and the Six-Minute Walking Test, but no significant differences in ejection fraction or quality of life measures.

Population

83 CAD patients (59.1±7.0 years)

Effective Dosage

40 minutes of walking four times per week

Duration

Three weeks

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Nordic walking
increase
cardiovascular performance
CAD patients
ΔEE: +11.0% vs. +3.2%, small ES; ΔMETs: +9.8% vs. +1.5%, medium ES
led to higher cardiovascular performance compared to CCVR
#1
Nordic walking
increase
functional performance
CAD patients
Δ6MWT: +8.3% vs. +5.1%, small ES
better functional performance
#2
Nordic walking
no change
EF
CAD patients
P=0.240
No significant differences were detected
#3
Nordic walking
no change
SF-36 (PCS)
CAD patients
P=0.425
No significant differences were detected
#4
Nordic walking
no change
SF-36 (MCS)
CAD patients
P=0.400
No significant differences were detected
#5
three-week NW training program
increase
cardiovascular and functional performance
CAD patients
-
had clinically important effects, above and beyond CCVR
#6
Abstract

BACKGROUND: Cardiometabolic effects of physical exercise depend on its intensity, duration, and type. Conventional cardiovascular rehabilitation (CCVR) programs 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 program. DESIGN: This was a pseudo-randomized, prospective, single-blinded, parallel-group trial. SETTING: The study was conducted at a resort/spa type facility located in a mountainous natural environment, 650 meters above sea level. POPULATION: Eighty-three 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 program 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 (VO<inf>2max</inf>); rating of perceived exertion 'mild/moderate' (12 to 14 points) on the 0-20 Borg Scale. Primary endpoint: cardiovascular and functional performance (exercise ergometry [EE], metabolic equivalent of tasks [METs], ejection fraction [EF], Six-Minute Walking Test [6MWT]). Secondary endpoint was quality of life (Short-Form 36 Health Survey). Statistical analysis was performed by generalized estimating equations with Cohen's d effect size (ES). RESULTS: NW led to higher cardiovascular performance compared to CCVR (ΔEE: +11.0% vs. +3.2%, small ES; ΔMETs: +9.8% vs. +1.5%, medium ES) and better functional performance (Δ6MWT: +8.3% vs. +5.1%, small ES). 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 program 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.

Medical Subject Headings (MeSH)
AgedCardiac RehabilitationCoronary Artery DiseaseFemaleHumansMaleMiddle AgedProspective StudiesQuality of LifeSingle-Blind MethodSurveys and QuestionnairesWalk TestWalking
Study Links
Quality Scores
Safety85
Efficacy80/10
Quality75/10
Citation Metrics
Total Citations11
Citations/Year2.2
Relative Citation Ratio1.05
NIH Percentile52%
Research Impact Scores
APT Score0.75
Weight Score2.24
Normalized Score0.81
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