Physical therapists like Nordic walking

A physical therapist's view that has some interesting bits of information worth looking at.

Here are some observations:

• Beneficial for any age group. Finnish army recruits use it as alternative physical training as they recover from injury.
• Potential rehabilitation approach a number of health conditions.
• A common sight in Europe. Coming to Canada as well.

How physical therapists are using Nordic walking into practice:

• Help patients improve general health and fitness.
• Help patients with chronic conditions.
• Help patients who are post-surgery or dealing with chronic pain.
• Help patients transition to active post-rehabilitation lives.

A couple of other observations about Nordic walking benefits:

• Helps maintain erect posture.
• Low rate of perceived exertion things people can work hard without feeling like they're working overly hard.

The article also summarized several research studies:

• More effective than regular walking in improving walking speed.
• Significant improvement in walking speed of people with Parkinson's disease.
• Better improvement in cardiac rehabilitation patients over regular care.
• Improvement for patients with fibromyalgia.
• Increase in caloric expenditure and oxygen consumption over regular walking but with no change in perceived exertion.

Most of the material I looked at focus on the benefits of Nordic walking for people in poor health work with injuries. I would suggest that people like strength athletes in their prime would benefit as well. For example, one writer suggests a form of interval training so strength athletes can get cardio benefits.

• Nordic walking is phenomenal for interval training like that because simply walking fast uphill or even jogging that involves the upper body raises the exertion level significantly.
• The writer also suggests that extended running actually hampered strength gains because of the damage from impact with the ground, but that biking helped with gains. Nordic walking certainly fills the bill with low impact, customizable intensity.

Overall, I can't say enough good things about Nordic walking and its benefits as regular activity for people.

Nordic walking and Parkinson's

A study compared the benefits of flexibility and relaxation training, regular walking, and Nordic walking for people with Parkinson's disease. Overall, all three approaches helped reduce pain and improve balance and quality of life. Walking and Nordic walking led to improvements in overall walking ability and fitness. However, Nordic walking provided the most benefits of the three approaches for improving posture and walking ability.

The researchers' recommendations included this: "Physiotherapists should be encouraged to teach PD [Parkinson's disease] patients NW [Nordic walking] and to provide practise sessions with high intensity."

Read on for details.

How they conducted the study:

• The study involved 90 patients with Parkinson's, 45 men and 45 women.
• The patients were randomly assigned to one of the three groups: flexibility and relaxation training, regular walking, or Nordic walking.

How it turned out:

• Nordic walking required a little more training so that patients could master the skill.
• The patients experienced a decrease in pain during the training.

Some detailed results:

	Flexibility and relaxation	Regular walking	Nordic walking
Pain	Decreased	Decreased	Decreased
Unified Parkinson's disease rating scale (UPDRS)	Some improvement	Significant improvement	Most improvement
Quality of life	Improvement	Improvement	Improvement
Balance	Improvement	Improvement	Improvement
Walking speed	Some improvement	Significant improvement	Significant improvement
Stride length	Some improvement	Significant improvement	Most improvement
Stride variability (consistent stride length to reduce risk of falling) NOTE: As patients walked faster, only Nordic walkers maintained consistent stride lengths; the others got worse at higher walking speeds)	Some improvement	Significant improvement	Most improvement
Stride time (duration between a foot leaving the ground and hitting the ground again that is related to walking speed)	Some improvement	Significant improvement	Most improvement
Double stance (time between each foot hitting the ground)	Some improvement	Significant improvement	Significant improvement
Exercise test (top walking speed patients could achieve)	Some improvement	Significant improvement	Most improvement
Blood pressure	Some improvement	Significant improvement	Significant improvement
Heart rate	Some improvement	Significant improvement	Most improvement
Sustainment of training	50% continued	60% continued walking, 10% stopped, 30% switched to Nordic walking	All had continued training after the study and had formed training groups

What did the researchers in this particular study conclude about Nordic walking?

• "The Nordic walking training resulted in a mean improvement of  points of the UPDRS motor scale, while the walking group failed to reach a 5-point improvement."
• "Neurological signs such as rigidity and tremor were not improved by exercise treatment, but it is to note that walking and Nordic walking had positive effects on some key symptoms of PD such as posture, alternating movements, freezing, and postural stability."
• "Posture and postural instability were most improved by NW [Nordic walking]."
• "The cross country training has possibly improved balance so far that subjects of the NW group are also more stable without poles."
• "…Walking and Nordic walking improved walking speed and gait parameters most."

Some of their conclusions help us keep from thinking of Nordic walking as the panacea that will fix everything:

• "It was expected that Nordic walking is most effective in increasing cardiorespiratory capacity. However, there was no superiority of the NW group."
• "…the physiological effects of NW depend largely on the technical skills of the individuals. Without being competent in using the correct NW technique patients cannot exercise with high intensity."

However, Nordic walking was positively received, as shown by all the patients continuing training and most being joined by their spouses.

NW was most attractive for the patients, and all patients continued the training, which might be a prerequisite to maintain an active life style.

Supportive was that 70% of the spouses took up NW and accompanied the patients after completion of the study. Since social aspects were very important for the PD patients, the participation of the spouses in NW might support further physical activity.

Nordic walking as a full body exercise

Research comparing upper body involvement in Nordic walking versus regular walking showed "…when Nordic poles are used, many muscles in the arms, shoulders, chest, and back are used and energy consumption is increased."

Here are some details:

• Purpose of the study: "…assess the effect of Nordic pole walking on the electromyographic [monitoring electrical signals generated when muscles are used] activities of upper extremity and lower extremity muscles."
• Nordic walkers and regular walkers performed their walking activity on a treadmill for 30 minutes at a time.

Here's what they found out:

• "…the activities of the biceps brachii, triceps, deltoid medius, and latissimus dorsi [upper arm, shoulder, and upper back] increased remarkably when Nordic poles were used compared with when Nordic poles were not used."
• "…muscle activities of the rectus femoris, lateral hamstring, tibialis anterior, and gastrocnemius [front of thigh, back of thigh, front of lower leg, back of lower leg] did not show big differences between when Nordic poles were used and when Nordic poles were not used."

Thoughts about the results:

• This study supported the idea that Nordic walking is a full body exercise because it involves the upper body as well as the lower body.
• However, the researchers did not find a difference in the use of the leg muscles between Nordic walkers and regular walkers even though previous studies by other researchers suggested that was the case.

What can Nordic walkers take away from this?

• The involvement of the upper body will improve upper body conditioning and will also improve cardiovascular conditioning.
• However, it still remains to be seen whether use of the poles actually helps people walk faster. The authors of this study said the previous research showed that use of the polls helped engage lower body muscles but that this particular study didn't reveal that. In other words, Nordic walkers' legs got the same exercise benefit as the legs of regular walkers.

At this point, the overall assessment of Nordic walking is that it provides a greater exercise benefits over regular walking.