Effects of Nordic walking training on functional parameters in Parkinson's disease: a randomized controlled clinical trial

Abstract

We compare the effects of Nordic walking training (NW) and Free walk (FW) on functional parameters (motor symptoms, balance) and functional mobility (Timed Up and Go at Self-selected Speed - TUGSS, and at forced speed, TUGFS; Self-selected Walking Speed, SSW; locomotor rehabilitation index, LRI) of Parkinson's disease (PD) patients. The study included 33 patients with clinical diagnosis of idiopathic PD, and staging between 1 and 4 in the Hoehn and Yahr scale (H&Y) randomized into two groups: NW (N = 16) and FW (N = 17) for 6 weeks. Baseline characteristics were compared trough a one-way ANOVA. Outcomes were analyzed using the Generalized Estimation Equations (GEE) with a Bonferroni post-hoc. Data were analyzed using SPSS v.20.0. Improvements in UPDRS III (P < 0.001), balance scores (P < 0.035), TUGSS distance (P < 0.001), TUGFS distance (P < 0.001), SSW (P < 0.001), and LRI (P < 0.001) were found for both groups. However, the NW group showed significant differences (P < 0.001) when compared to the FW group for the functional mobility. We conclude the NW improves functional parameters and walking mobility demonstrating that NW is as effective as the FW, including benefits for FW on the functional mobility of people with PD.

Increased energy expenditure during posture maintenance and exercise in early Parkinson disease

“…This study demonstrated that increased energy expenditure in PD patients occurs only during posture maintenance and physical activity, not during rest. Recent research showed that training with Nordic walking poles improved motor function and locomotion in PD patients . Nordic walking poles increase stability of gait during walking and may off‐load posture‐maintaining accessory muscles that, as we shown, are overworked in these patients.…”

“…Recent research showed that training with Nordic walking poles improved motor function and locomotion in PD patients. 16 Nordic walking poles increase stability of gait during walking and may off-load posture-maintaining accessory muscles that, as we shown, are overworked in these patients. Based on our results, we predict improvement in exercise energetics for PD patients in conjunction with muscular function improvement following this type of training.…”

Resistance training reduces depressive symptoms in elderly people with Parkinson disease: A controlled randomized study

“…A meta‐analysis suggests that aerobic training improves the UPDRS scores . In addition, endurance training (nordic walking training and free walk) improves performance on the TUG test and walking speed . Our findings show that isolated resistance training can also improve UPDRS scores, TUG test performance, and walking speed.…”

Nordic walking training in elderly, a randomized clinical trial. Part II: Biomechanical and metabolic adaptations

“…Individuals with Parkinson's disease seem to be most sensitive to the usage of poles concerning functional mobility than elderly without neurodegenerative illness. Monteiro et al [10] have shown that the dopaminergic nigrostriatal pathways are liberated using the technique of NW affecting the functional mobility positively in comparison to FW. Therefore, the NW training may be a useful alternative in aging groups with frailty and movement/cognitive disorders due to dual-task condition with increased cognitive demands.…”

“…Furthermore, movement patterns that lead to mechanical energy fluctuations of the body center of mass (BCoM) are essential for detecting gait alterations of the elderly. These adaptations from walking interventions should test if an improvement in the metabolic economy of walking [6,8] is accompanied by enhanced pendular mechanism [9] or due to an increase in self-selected walking speed of the elderly [10][11][12]. Recently, studies with Nordic walking (NW) training have been carried out in older adults [6,8,[13][14][15][16][17][18].…”