Nordic Walking and Free Walking Improve the Quality of Life, Cognitive Function, and Depressive Symptoms in Individuals with Parkinson’s Disease: A Randomized Clinical Trial

Abstract

Nordic walking’s (NW) degree of effectiveness regarding health-related parameters in people with Parkinson’s Disease (PD) is a subject of debate. While NW seems to improve functionality, a clear non-motor benefit has not been demonstrated. The aim of this randomized controlled trial was to compare the effects of 9-week NW and free walking (FW) training programs on quality of life, cognitive function, and depressive symptoms in individuals with PD. Thirty-three people with PD, (Hoehn and Yahr 1–4) were randomized into two groups: NW (n = 16) and FW (n = 17). We analyzed quality of life, cognitive function, depressive symptoms, and motor symptoms. Significant improvements were found in the overall, physical, psychological, social participation, and intimacy domains of quality of life, as well as in cognitive function and depressive symptoms for both groups. Only the NW group showed improvement in the autonomy domain. Individuals with PD had a similar enhancement of non-motor symptoms after walking training, with or without poles. However, the NW group showed a more significant improvement in the autonomy domain, strengthening the applied and clinical potential of NW in people with PD. Future studies are needed to determine the efficacy of walking training without poles in subjects with PD.

Effects of Nordic walking in people with Parkinson's disease: A systematic review and meta‐analysis

“…Disease duration was informed in 11 studies. In six investigations, participants had been living with the disease between 5.1 and 7.8 years (Cugusi et al, 2015; Ebersbach et al, 2010, 2014; Granziera et al, 2021; Monteiro et al, 2017; Passos‐Monteiro et al, 2020; Wróblewska et al, 2019). Szefler‐Derela et al (2020), reported the information as a median (NW group: 6 years; Control Group: 5 years), minimum and maximum (NW group: 3–18 years; Control Group: 2–14 years).…”

“…Methodological quality is shown in Table 1, being good in eight RCTs (Antunes Marques et al, 2019; Bang & Shin, 2017; Ebersbach et al, 2010, 2014; Franzoni et al, 2018; Granziera et al, 2021; Passos‐Monteiro et al, 2020; Reuter et al, 2011) and fair in four studies (Cugusi et al, 2015; Monteiro et al, 2017; Wróblewska et al, 2019) All the trials accomplished items 1 (random allocation), 9 (between‐group comparison) and 10 (point estimates and variability). Items 3 (baseline comparability), 7 (adequate follow‐up) and 6 (blinding assessors) were met by 92%, 83% and 75% of the included studies respectively.…”

“…Table 3 shows the intervention characteristics of the included publications. In a total of 10 studies, NW was compared against other interventions (walking, LSVT®BIG, domestic training, flexibility and relaxation training, standard rehabilitation) (Antunes Marques et al, 2019; Bang & Shin, 2017; Ebersbach et al, 2010, 2014; Franzoni et al, 2018; Granziera et al, 2021; Monteiro et al, 2017; Passos‐Monteiro et al, 2020; Reuter et al, 2011; Szefler‐Derela et al, 2020).…”

“…Three studies indicated that training protocol progressed over time until reaching 50 minutes (Antunes Marques et al, 2019; Franzoni et al, 2018; Monteiro et al, 2017). The training protocol progressed to 60 minutes in another study (Passos‐Monteiro et al, 2020).…”

Samba, deep water, and poles: a framework for exercise prescription in Parkinson's disease

“…The most studied outcomes are quality of life, motor and disease staging, physical mobility, and depressive symptoms [5,12,14,30]. Few studies have studied biomechanical and balance outcomes, especially on anticipatory postural adjustments and the relationship with falls.…”