The Therapeutic Effect of Nordic Walking on Freezing of Gait in Parkinson’s Disease: A Pilot Study

Abstract

Introduction. The effectiveness of the currently utilized therapies for FoG is limited. Several studies demonstrated a beneficial impact of Nordic walking (NW) on several gait parameters in Parkinson’s disease, but only one paper reported reduction of freezing. Research Question. In the present study, the question is whether NW is an effective therapeutic intervention in FoG. Methods. Twenty PD subjects trained NW for 12 weeks, with a frequency of twice per week. Each session lasted about 60 minutes. Twenty patients in the control group did not use any form of physiotherapy (no-intervention group). Freezing of Gait Questionnaire (FOGQ), the Timed Up and Go (TUG) test, and the Provocative Test for Freezing and Motor Blocks (PTFMB) were performed at baseline, immediately after the end of NW program, and three months later. Results. The results of FOGQ, TUG, and total PTFMB revealed significant improvement after completing the exercise program, and this effect persisted at follow-up. The results of the PTFMB subtests showed a different effect of NW on particular subtypes of FoG. Start hesitation, sudden transient blocks that interrupt gait, and blocks on turning improved considerably, while motor blocks, when walking through narrow space and on reaching the target, did not respond to NW training. Significance. The results show, for the first time, that FoG during turning and step initiation, two most common forms of this gait disorder, has been significantly reduced by NW training. Different responses of particular subtypes of FoG to NW probably reflect their different pathophysiologies. Conclusions. The present study showed that NW training had a beneficial effect on FOG in PD and that the achieved improvement is long-lasting. Future research should clarify whether the observed improvement limited to FoG triggered by only some circumstances reflects different pathomechanisms of FoG subtypes.

Enhancement of Executive Functions but Not Memory by Multidomain Group Cognitive Training in Patients with Parkinson’s Disease and Mild Cognitive Impairment: A Multicenter Randomized Controlled Trial

“…Due to the PD patients' symptom profile, further research on combined cognitive-motor trainings may have high potential for efficient treatment [43]. Even more broadly, a comparison of effects on various outcomes including cognition and motor functions of complementary interventions which challenge cognitive functions, such as theater therapy [44,45], Tai Chi [46], tango [47], Irish dance [48], or northern walking [49], e.g., in a network meta-analysis, could improve clinical decision-making. Unfortunately, in the field of primarily physical interventions, few studies so far included cognitive outcomes [50].…”

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.…”

A Novel Boot Camp Program to Help Guide Personalized Exercise in People with Parkinson Disease

“…The exercise sessions included practicing examples of amplitude-based interventions [ 5 , 6 , 7 , 8 ], Nordic walking [ 16 , 17 ], multitask cognitive and motor exercise challenges [ 2 , 28 , 29 , 30 ], hydrotherapy [ 21 , 22 , 31 ] and tai-chi [ 12 , 13 ], dance-based movements [ 9 , 10 , 11 ], as well as a boxing session [ 18 , 19 , 20 ].…”

“…Yet, there is a variety of rehabilitation, exercise, and physical activity programs that are now available for individuals with PD. Some of the more common approaches highlighted in recent literature include amplitude-based movements [ 5 , 6 , 7 , 8 ], dance [ 9 , 10 , 11 ], Tai Chi [ 12 , 13 ], Qigong [ 14 , 15 ], Nordic walking [ 16 , 17 ], boxing [ 18 , 19 , 20 ], and aquatic exercise [ 21 , 22 ].…”