Nordic Walking Research

June 15, 2015 Written by JP       [Font too small?]

Question: Here in Europe I’ve noticed many people Nordic Walking, especially in the countryside. Even some of my friends have joined clubs that do this exercise together as a group. I don’t know if it’s popular in the United States. Can you tell me if this practice is markedly superior to ordinary walking or other forms of aerobic activity? I prefer taking hikes or walks in nature. Though I would consider investing in Nordic poles and possibly joining a club if the benefits make it worthwhile.

Answer: For those unfamiliar with Nordic Walking (NW), it essentially combines elements of cross-country skiing and walking. Nordic walkers affix poles to their wrists and use them to push off against the ground as they otherwise walk normally. This action involves more of an upper body workout than taking a typical stroll. This provides a more comprehensive workout. The question that hasn’t been fully resolved yet is whether or not NW is worth the added effort and expense as compared to other types of exercise. Thus far, here’s what has been reported in the medical literature:

Nordic Walking vs. Pilates: A first of its kind study, appearing in the March 2015 issue of Menopause examined the relative effects of NW and Pilates in a group of overweight, postmenopausal women. After ten weeks, the women in the NW group lost significantly more weight (6.4% vs 1.7%) and demonstrated greater reductions in blood sugar, LDL (“bad”) cholesterol and triglycerides. Additionally, the NW volunteers exhibited a statistically greater increase in HDL (“good”) cholesterol in comparison to the Pilates participants (9.6% vs. 3.1%).

Nordic Walking vs Home Exercise and Water Aerobics: The reason I’m combining these two forms of exercises is because they’ve been compared to NW in relation to the promotion of blood flow. The water aerobic intervention determined that only NW “improved venous blood flow in the lower extremities and normalized body composition in the direction of reducing chronic venous disorder risk factors”. The home exercise experiment discovered that NW alone improved maximum walking distance in patients with intermittent claudication, a condition characterized by compromised blood flow to the legs that is often accompanied by burning, cramping and pain.

Nordic Walking vs. Resistance Training: Two studies from 2013 came to similar conclusions when comparing Nordic Walking to resistance training (RT). In both interventions, NW outperformed RT in relation to risk factors associated with metabolic syndrome. Some of the key findings indicate that NW preferentially reduced body fat, fatty liver index, LDL and total cholesterol in this population who is at greater risk for cardiovascular disease and diabetes.

Nordic Walking vs Conventional Walking: In my opinion, this is the most direct and interesting comparison. In most controlled trials, NW has been shown to be a “cut above” the variety of walking we do in daily life and even on a treadmill. A current examination of the research reveals that NW offers certain distinct advantages by: a) enhancing oxygen uptake (VO2) without increasing the rate of perceived exertion in those with compromised respiratory function such as COPD and overweight patients; b) improving cardiovascular endurance, flexibility, upper-body strength, total cholesterol and walking speed in seniors.

My interpretation of the above studies is that Nordic Walking does confer some benefits over the sort of walking that most people do. Having said that, I’m not certain that it would contrast much from my usual style of walking. Most of my structured walking is done a treadmill. I warm up for five minutes, then spend the next 50 minutes or so using a modified interval pattern that fluctuates elevation and speed. I close with a five minute cool down. But, the main thing that distinguishes my walking style is that I pump my arms back and forth during the entire session. Sometimes I even throw shadow punches and stretch my upper body during the warm up and cool down periods. Doing so turns a predominately lower body workout into a full body session. I can’t say that it’s more effective than Nordic Walking, but it doesn’t require poles and I’m confident that I get a much more efficient, well rounded workout than if my arms took the hour off.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Effects of Nordic Walking & Pilates Exercise Programs on Blood Glucose (link)

Study 2 - Effect of Nordic Walking & Water Aerobics Training on Body Composition (link)

Study 3 – Randomized Clinical Trial Comparing Nordic Pole Walking and (link)

Study 4 - Nordic Walking Decreased Circulating Chemerin & Leptin Concentrations (link)

Study 5 - 12 Weeks’ Aerobic and Resistance Training Without Dietary Intervention (link)

Study 6 - Nordic Walking Enhances Oxygen Uptake Without Increasing the Rate of (link)

Study 7 - Efficacy of Nordic Walking in Obesity Management (link)

Study 8 - Effects of Nordic Walking Compared to Conventional Walking and Band- (link)

Study 9 - Nordic Walking for Geriatric Rehabilitation: A Randomized Pilot Trial (link)

Study 10 - Effects of Nordic Walking on Body Composition, Muscle Strength (link)

Nordic Walking Improves Exercise Capacity in COPD Patients

Source: Respir Res. 2010 Aug 22;11:112. (link)

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12 Comments & Updates to “Nordic Walking Research”

  1. JP Says:

    Update 06/15/15:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4434013/

    J Phys Ther Sci. 2015 Apr;27(4):1215-7.

    Effects of trunk rotation induced treadmill gait training on gait of stroke patients: a randomized controlled trial.

    [Purpose] This study was conducted to find out the effect of arm swing during treadmill training on the gait of stroke patients. [Subjects and Methods] This study subjects were 20 stroke subjects patients who were randomly assigned to either the experimental group (EG) or the control group (CG), 10 subjects in each group. Therapists induced arm swing of affected side of EG subjects using Nordic poles, while subjects in CG had the affected arm restricted to prevent arm swing. Training was performed for 30 minutes, 3 times a week for 4 weeks. The timed up and go test (TUG), the dynamic gait index (DGI) and the 6-minute walk test (6MWT) were assessed before and after the training. [Results] After the training, there were no significant differences in the TUG times of EG and CG. There were significant differences in the DGI and the 6-minute walking distance of EG, but not of CG. There were also significant differences in the improvements of the DGI and the 6-minute walking distance between the groups. [Conclusion] Arm swing training had a positive effect on patients’ gait ability. Further studies are required to generalize the results of this study.

    Be well!

    JP

  2. JP Says:

    Update 06/15/15:

    http://www.tandfonline.com/doi/abs/10.1080/07347332.2015.1020465?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed

    J Psychosoc Oncol. 2015 May-Jun;33(3):278-96.

    Stick together: a nordic walking group intervention for breast cancer survivors.

    Axillary lymph node dissection and axillary radiation as part of breast cancer treatment often result in arm and shoulder morbidity and limitations in daily functioning. Over and above the general benefits for cardiorespiratory fitness, Nordic Walking particularly targets at the muscles of the upper extremities and shoulder. This may increase shoulder range of motion and lead to a reduction in functional limitations. The aim of this study was to offer a Nordic Walking intervention to women after treatment for breast cancer and to investigate changes in subjective well-being and shoulder function. Three supervised Nordic Walking courses were organized (2009-2011). The intervention consisted of ten weekly 1-hour sessions focusing on upper body strength and condition. In total, 28 women participated in one of the cohorts. Results showed that after 10 weeks, patients’ vitality had improved, whereas perceived shoulder symptom severity and limitations in daily activities had decreased. Goniometric data indicated that range of motion (forward flexion, abduction, and external rotation) of the affected shoulder improved significantly within 10 weeks of training. Group interviews at 6 months follow-up confirmed that patients had appreciated the physical and psychosocial benefits of the intervention. These benefits outweighed the practical disadvantages. Patient selection, assessment and training should take place under (para-)medical supervision and group instructors should have the knowledge and skills to work with a group of recent cancer survivors. Results from this explorative study suggest that Nordic Walking is a feasible and potentially valuable tool in the rehabilitation of patients with breast cancer.

    Be well!

    JP

  3. JP Says:

    Update 06/15/15:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4332179/

    J Hum Kinet. 2014 Nov 12;43:185-90.

    Physiological Responses Associated with Nordic-walking training in Systolic Hypertensive Postmenopausal Women.

    Loss of physical strength and hypertension are among the most pronounced detrimental factors accompanying aging. The aim of this study was to evaluate the influence of a supervised 8-week Nordic-walking training program on systolic blood pressure in systolic-hypertensive postmenopausal women. This study was a randomized control trial on a sample of 24 subjects who did not take any hypertension medications. There was a statistically significant decrease in systolic blood pressure and an increase in lower and upper-body strength in the group following Nordic-walking training. There was a decrease in serum levels of total cholesterol, triglycerides, and low-density cholesterol. The obtained results indicate that an 8-week Nordic-walking program may be efficiently employed for counteracting systolic hypertension through a direct abatement of systolic blood pressure and an increase of maximal aerobic capacity.

    Be well!

    JP

  4. JP Says:

    Update 05/20/15:

    http://www.prd-journal.com/article/S1353-8020%2815%2900051-6/abstract

    Parkinsonism Relat Disord. 2015 Apr;21(4):413-6.

    Gait velocity and step length at baseline predict outcome of Nordic walking training in patients with Parkinson’s disease.

    BACKGROUND: The impact of Nordic walking (NW) in Parkinson’s disease (PD) has been investigated in several studies but results are inconsistent. This may be due to different cohorts studied and the heterogeneity of their PD symptoms which impact the outcome of NW. This study aimed at determining predictive factors for a positive effect of NW on PD.

    METHODOLOGY AND PRINCIPAL FINDINGS: Primary outcome was to define the baseline disease-associated and demographic parameters that distinguish patients who demonstrate improvement in the Unified PD rating scale (UPDRS) motor part following NW training (“U+”) from those patients with no improvement after the same intervention (“U-”). The potentially predictive parameters were: age, age at onset, disease duration, gait velocity, step length, daily step number, UPDRS-motor part, Berg-Balance-Scale, Parkinson-Neuropsychometric-Dementia-Assessment, verbal-fluency-test and Becks-Depression-Inventory-II. Twenty-two PD patients (H&Y stage 2-2.5) performed twelve weeks of NW training. Eighteen patients were included in the final analysis. Overall, the UPDRS motor part did not improve significantly; however, eight patients had an improvement in the UPDRS motor part from baseline to end of study (U+). When comparing the potentially predictive factors of the U+ cohort with those ten patients who did not improve (U-), there was a notable difference in gait velocity and step length, and showed a significant correlation with an improvement in the UDPRS motor part scores.

    CONCLUSION: Gait velocity and step length can predict the outcome of NW training as determined by the UPDRS motor part, indicating that PD patients with only slightly impaired gait performance benefit most.

    Be well!

    JP

  5. JP Says:

    Update 07/19/15:

    http://dvr.sagepub.com/content/early/2015/05/27/1479164115588548.long

    Diab Vasc Dis Res. 2015 Jun 19. pii: 1479164115588548.

    Influence of physical activity and gender on arterial function in type 2 diabetes, normal and impaired glucose tolerance.

    To determine whether Nordic walking improves cardiovascular function in middle-aged women and men, we included 121 with normal glucose tolerance, 33 with impaired glucose tolerance and 47 with Type 2 diabetes mellitus in a randomized controlled study. The intervention group added Nordic walking 5 h/week for 4 months to their ordinary activities. Aortic pulse wave velocity, aortic augmentation index, stiffness index, reflection index, intima-media thickness in the radial and carotid arteries, echogenicity of the carotid intima-media and systemic vascular resistance were measured. While baseline blood pressure did not differ by gender or diagnosis, aortic augmentation index was found to be higher in women in all groups. Vascular function was unchanged with intervention, without differences by gender or diagnosis. In conclusion, 4 months of Nordic walking is an insufficient stimulus to improve vascular function. Future studies should consider hard endpoints in addition to measures of vascular health, as well as larger population groups, long-term follow-up and documented compliance to exercise training.

    Be well!

    JP

  6. JP Says:

    Updated 11/06/15:

    http://www.tandfonline.com/doi/abs/10.3109/13697137.2015.1058354

    Climacteric. 2015 Sep 25:1-6.

    The effect of a 10-week Nordic walking training program on the level of GH and LH in elderly women.

    Objective: The aim of this study was to determine the effect of a 10-week Nordic walking training program on resting growth hormone (GH) and luteinizing hormone (LH) blood concentrations and their relationships to the values of inflammatory, metabolic, and muscle injury parameters in postmenopausal women with overweight and obesity.

    Methods: Thirty-two postmenopausal women with overweight or obesity (body mass index 30.5 ± 4.1 kg/m2), aged 59.6 ± 5.9 years were included in the investigation. Concentrations of GH, LH, C-reactive protein, total cholesterol, low density (LDL) and high density lipoprotein (HDL) cholesterol, triglycerides and albumin, as well as the plasma activity of muscle enzymes such as creatine kinase and lactate dehydrogenase, were examined before and after the participants finished a 10-week Nordic walking rehabilitation program.

    Results: After a 10-week rehabilitation period in accordance with a Nordic walking program, significant increases in blood concentrations of GH (median 47.5%) and HDL cholesterol (on average by 0.1%) as well as a decrease in LH values (on average by 19%), total cholesterol, LDL cholesterol and triglycerides (all on a similar average by between 0.1 and 0.2%), creatine kinase (on average by 14%), lactate dehydrogenase (on average by 4%), C-reactive protein (on average by 24%), and body mass index (on average by 5.7%) were found.

    Conclusions: Nordic walking for postmenopausal women with overweight and obesity led to favorable hormonal responses, as well as improvement in muscle integrity and nutritional and inflammatory states, suggesting chronic, regular exercise as an effective tool in protecting against menopause-related catabolic processes.

    Be well!

    JP

  7. John Gibbs Says:

    A regular walking habit slashes the risk of type 2 diabetes by around 60 percent.You’ll burn around 75 calories simply by walking at 2mph for 30 minutes.

  8. JP Says:

    Hi John,

    I’m a big walking fan. Here’s my latest blog about the health benefits walking more:

    http://www.healthyfellow.com/1976/prescription-2015-walk-this-way/

    Be well!

    JP

  9. JP Says:

    Updated 1/31/16:

    http://www.strokejournal.org/article/S1052-3057%2815%2900662-X/abstract

    J Stroke Cerebrovasc Dis. 2016 Jan 18.

    Six-Week Nordic Treadmill Training Compared with Treadmill Training on Balance, Gait, and Activities of Daily Living for Stroke Patients: A Randomized Controlled Trial.

    BACKGROUND: Recently, stroke rehabilitation training programs have contained elements of sporting activities. Arm swing is a particularly important factor in gait; accordingly, the use of the Nordic walking exercise has been advocated in the literature.

    OBJECTIVE: Our objective is to compare the effects of Nordic treadmill training (NTT) and treadmill training (TT) on balance, gait, and activities of daily living (ADL) in stroke patients.

    METHODS: Thirty stroke patients were randomly allocated to NTT and TT groups. NTT and TT were performed for 30 minutes each day, 5 times per week for 6 weeks. The Berg Balance Scale, the timed up and go test, and the tetra-ataxiometric posturography tests were used to assess balance; the 10-meter walk test, 6-minute walk test, and modified Barthel Index were used to measure balance, gait, and ADL.

    RESULTS: After 6 weeks of training, balance, gait, and ADL improved significantly in both groups, but NTT was associated with greater improvements compared to TT for all 3 measures.

    CONCLUSION: This study is the first to assess the effects of NTT on balance, gait, and ADL in stroke patients. The data indicate that NTT represents an effective adjunctive treatment to TT in this population.

    Be well!

    JP

  10. JP Says:

    Updated 08/22/16:

    http://www.jpsmjournal.com/article/S0885-3924(16)30143-9/abstract

    J Pain Symptom Manage. 2016 Jun 3.

    Nordic Walking as an Exercise Intervention to Reduce Pain in Women With Aromatase Inhibitor-Associated Arthralgia: A Feasibility Study.

    CONTEXT: Women taking aromatase inhibitors as treatment for breast cancer commonly experience joint pain and stiffness (aromatase inhibitor-associated arthralgia [AIAA]), which can cause problems with adherence. There is evidence that exercise might be helpful, and Nordic walking could reduce joint pain compared to normal walking.

    OBJECTIVES: To determine the feasibility of a trial of Nordic walking as an exercise intervention for women with AIAA.

    METHODS: A feasibility study was carried out in a sample of women with AIAA using a randomized control design. Women were randomized to exercise (six-week supervised group Nordic walking training once per week with an increasing independent element, followed by six weeks 4 × 30 minutes/week independent Nordic walking); or enhanced usual care. Data were collected on recruitment, retention, exercise adherence, safety, and acceptability. The Brief Pain Inventory, GP Physical Activity Questionnaire, and biopsychosocial measures were completed at baseline, six and 12 weeks.

    RESULTS: Forty of 159 eligible women were recruited and attrition was 10%. There was no increased lymphedema and no long-term or serious injury. Adherence was >90% for weekly supervised group Nordic walking, and during independent Nordic walking, >80% women managed one to two Nordic walking sessions per week. From baseline to study end point, overall activity levels increased and pain reduced in both the intervention and control groups.

    CONCLUSION: Our findings indicate that women with AIAA are prepared to take up Nordic walking, complete a six-week supervised course and maintain increased activity levels over a 12-week period with no adverse effects.

    Be well!

    JP

  11. JP Says:

    Updated 12/14/16:

    https://www.ncbi.nlm.nih.gov/pubmed/27942207

    Clin Interv Aging. 2016 Nov 30;11:1763-1771.

    Effects of short-term Nordic walking training on sarcopenia-related parameters in women with low bone mass: a preliminary study.

    BACKGROUND: Several studies have demonstrated the positive effects of physical activity on skeletal muscle mass and muscle strength in women with osteoporosis. However, the impact of Nordic walking training on sarcopenia-related parameters in women with low bone mass remains unknown. Therefore, the purpose of this study was to evaluate the impact of 12 weeks of Nordic walking training on skeletal muscle index, muscle strength, functional mobility, and functional performance in women with low bone mass.

    MATERIALS AND METHODS: The participants were 45 women, aged 63-79 years, with osteopenia or osteoporosis. The subjects were randomly assigned either to an experimental group (12 weeks of Nordic walking training, three times a week) or to a control group. Skeletal muscle mass and other body composition factors were measured with octapolar bioimpedance InBody 720 analyser. Knee extensor and flexor isometric muscle strength were measured using Biodex System 4 Pro™ dynamometers. This study also used a SAEHAN Digital Hand Dynamometer to measure handgrip muscle strength. The timed up-and-go test was used to measure functional mobility, and the 6-minute walk test was used to measure functional performance.

    RESULTS: Short-term Nordic walking training induced a significant increase in skeletal muscle mass (P=0.007), skeletal muscle index (P=0.007), strength index of the knee extensor (P=0.016), flexor (P<0.001), functional mobility (P<0.001), and functional performance (P<0.001) and a significant decrease in body mass (P=0<006), body mass index (P<0.001), and percent body fat (P<0.001) in participants. Regarding handgrip muscle strength, no improvement was registered (P=0.315). No significant changes in any of the analyzed parameters were observed in the control group.

    CONCLUSION: Overall, short-term Nordic walking training induces positive changes in knee muscle strength and functional performance in women with low bone mass. This finding could be applied in clinical practice for intervention programs in women with osteopenia and osteoporosis.

    Be well!

    JP

  12. JP Says:

    Updated 09/19/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28920458

    Climacteric. 2017 Sep 17:1-7.

    Nordic walking increases circulating VEGF more than traditional walking training in postmenopause.

    OBJECTIVES: Nordic walking (NW) is widely practiced by postmenopausal women. Its effects are peculiar owing to the involvement of more muscle groups than in traditional walking training (WT). Since mechanical load promotes secretion of vascular endothelial growth factor (VEGF) from both skeletal muscle and muscle endothelium, the aim of the study was to compare the effect of NW and WT on VEGF levels.

    METHOD: Thirty postmenopausal women were randomly assigned to NW or WT. Both groups trained 40-50 min/day, three times per week, at a mean intensity of 12 on a 15-category scale of the ratings of perceived exertion. Since VEGF is also released from adipocytes, anthropometric parameters were assessed.

    RESULTS: NW increased circulating VEGF more than WT (p = 0.041). Furthermore, both study groups exhibited an average decrease in weight (p = 0.023), body mass index (p = 0.024), hip circumference (p = 0.001), and arm fat index, although WT participants had higher values for this index at baseline (p < 0.001) and thus exhibited a greater net decrease compared with the NW participants (p < 0.011).

    CONCLUSIONS: These data imply that NW increases the level of circulating VEGF more than does traditional walking when the intensity of training is equivalent.

    Be well!

    JP

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