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Szpala A, Winiarski S, Kołodziej M, Jasiński R, Lejczak A, Kałka D, Lorek K, Bałchanowski J, Wudarczyk S, Woźniewski M, Pietraszewski B. Effects of nordic walking training on gait and exercise tolerance in male ischemic heart disease patients. Sci Rep 2024; 14:11249. [PMID: 38755348 PMCID: PMC11099289 DOI: 10.1038/s41598-024-62109-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 05/14/2024] [Indexed: 05/18/2024] Open
Abstract
This technique-focused observational study explores the impact of a 6-week Nordic Walking (NW) program on physiological and biomechanical aspects in ischemic heart disease (IHD) patients. Twelve male IHD patients (66.2 ± 5.2 years, 12.2 ± 7.5 years of disease duration) were evaluated pre- and post-training for (i) gait parameters, (ii) exercise tolerance using electrocardiographic (ECG) stress test, (iii) a 6-min walk test (6MWT). The NW training, adhering to IHD patient guidelines, involved a 100-m walk at a self-selected, preferred speed without sticks, with classic NW sticks and mechatronic sticks. A mechatronic measuring system, specifically engineered for measuring, diagnosing and monitoring the patient's gait, was integrated into mechatronic sticks. Post-training, significant enhancements were observed in ECG stress test duration, metabolic equivalency, and 6MWT distance, irrespective of the stick type. However, no significant changes were noted in spatiotemporal parameters concerning the measured side, stick utilisation, or type. The results suggest that NW training boosts exercise capacity and refines gait mechanics in male IHD patients. However, the improvement in exercise capacity was not linked to changes in gait mechanics from NW training but rather to the movement during NW gait. Hence, the key to enhancing exercise capacity in IHD patients is the movement during NW gait, not the quality of gait mechanics.
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Affiliation(s)
- Agnieszka Szpala
- Department of Biomechanics, Wroclaw University of Health and Sport Sciences, Mickiewicza 58 Street, 51-684, Wrocław, Poland
| | - Sławomir Winiarski
- Department of Biomechanics, Wroclaw University of Health and Sport Sciences, Mickiewicza 58 Street, 51-684, Wrocław, Poland.
| | - Małgorzata Kołodziej
- Department of Biomechanics, Wroclaw University of Health and Sport Sciences, Mickiewicza 58 Street, 51-684, Wrocław, Poland
| | - Ryszard Jasiński
- Department of Human Biology, Wroclaw University of Health and Sport Sciences, Paderewskiego 35 Avenue, 51-612, Wrocław, Poland
| | - Andrzej Lejczak
- Department of Physiotherapy in Surgical Medicine and Oncology, Wroclaw University of Health and Sport Sciences, Paderewskiego 35 Avenue, 51-612, Wrocław, Poland
| | - Dariusz Kałka
- Department of Physiotherapy in Internal Diseases, Wroclaw University of Health and Sport Sciences, Paderewskiego 35 Avenue, 51-612, Wrocław, Poland
| | - Karolina Lorek
- Department of Kinesiology, Wroclaw University of Health and Sport Sciences, Paderewskiego 35 Avenue, 51-612, Wrocław, Poland
| | - Jacek Bałchanowski
- Department of Fundamentals of Machine Design and Mechatronics Systems, Wroclaw University of Science and Technology, Łukasiewicza 7/9 Street, 50-371, Wrocław, Poland
| | - Sławomir Wudarczyk
- Department of Fundamentals of Machine Design and Mechatronics Systems, Wroclaw University of Science and Technology, Łukasiewicza 7/9 Street, 50-371, Wrocław, Poland
| | - Marek Woźniewski
- Department of Physiotherapy in Surgical Medicine and Oncology, Wroclaw University of Health and Sport Sciences, Paderewskiego 35 Avenue, 51-612, Wrocław, Poland
| | - Bogdan Pietraszewski
- Department of Biomechanics, Wroclaw University of Health and Sport Sciences, Mickiewicza 58 Street, 51-684, Wrocław, Poland
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Giovanelli N, Pellegrini B, Bortolan L, Mari L, Schena F, Lazzer S. Do poles really "save the legs" during uphill pole walking at different intensities? Eur J Appl Physiol 2023; 123:2803-2812. [PMID: 37392255 DOI: 10.1007/s00421-023-05254-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/10/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE In sky- and trail-running competitions, many athletes use poles. The aims of this study were to investigate whether the use of poles affects the force exerted on the ground at the feet (Ffoot), cardiorespiratory variables and maximal performance during uphill walking. METHODS Fifteen male trail runners completed four testing sessions on different days. On the first two days, they performed two incremental uphill treadmill walking tests to exhaustion with (PWincr) and without poles (Wincr). On the following days, they performed submaximal and maximal tests with (PW80 and PWmax) and without (W80 and Wmax) poles on an outdoor trail course. We measured cardiorespiratory parameters, the rating of perceived exertion, the axial poling force and Ffoot. RESULTS When walking on the treadmill, we found that poles reduced maximum Ffoot (- 2.8 ± 6.4%, p = 0.03) and average Ffoot (- 2.4 ± 3.3%, p = 0.0089). However, when outdoors, we found pole effect only for average Ffoot (p = 0.0051), which was lower when walking with poles (- 2.6 ± 3.9%, p = 0.0306 during submaximal trial and - 5.21 ± 5.51%, p = 0.0096 during maximal trial). We found no effects of poles on cardiorespiratory parameters across all tested conditions. Performance was faster in PWmax than in Wmax (+ 2.5 ± 3.4%, p = 0.025). CONCLUSION The use of poles reduces the foot force both on the treadmill and outdoors at submaximal and maximal intensities. It is, therefore, reasonable to conclude that the use of poles "saves the legs" during uphill without affecting the metabolic cost.
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Affiliation(s)
- Nicola Giovanelli
- Department of Medicine, University of Udine, P.Le Kolbe 4, 33100, Udine, Italy.
- School of Sport Science, Udine, Italy.
| | - Barbara Pellegrini
- CeRiSM Research Centre "Sport, Mountain, and Health", Rovereto, TN, Italy
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Lorenzo Bortolan
- CeRiSM Research Centre "Sport, Mountain, and Health", Rovereto, TN, Italy
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Lara Mari
- Department of Medicine, University of Udine, P.Le Kolbe 4, 33100, Udine, Italy
- School of Sport Science, Udine, Italy
| | - Federico Schena
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Stefano Lazzer
- Department of Medicine, University of Udine, P.Le Kolbe 4, 33100, Udine, Italy
- School of Sport Science, Udine, Italy
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Kettinen J, Tikkanen H, Hiltunen M, Murray A, Horn N, Taylor WR, Venojärvi M. Cognitive and biomarker responses in healthy older adults to a 18-hole golf round and different walking types: a randomised cross-over study. BMJ Open Sport Exerc Med 2023; 9:e001629. [PMID: 37860153 PMCID: PMC10582962 DOI: 10.1136/bmjsem-2023-001629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction The global burden of age-related cognitive decline is increasing, with the number of people aged 60 and over expected to double by 2050. This study compares the acute effects of age-appropriate cognitively demanding aerobic exercises involving walking, on cognitive functions and exerkine responses such as brain-derived neurotrophic factor (BDNF) and cathepsin B (CTSB) in older, healthy adults. Methods/design Healthy older golfers (n=25, 16 male and 9 female, 69±4 years) were enrolled in a 5-day randomised cross-over study and completed three different exercise trials (18-hole golf round, 6 km Nordic walking, 6 km walking) in a real-life environment, in random order and at a self-selected pace. Differences in cognition (the Trail-Making Test (TMT) AB) and exerkines (BDNF and CTSB) were analysed within groups using the Wilcoxon signed-rank test and between groups using the Kruskal-Wallis test. Results All exercise types resulted in a significant decrease in the TMT A-test (p<0.05; golf: -4.43±1.5 s, Nordic walking: -4.63±1.6 s, walking: -6.75±2.26 s), where Nordic walking and walking demonstrated a decrease in the TMT B-test (p<0.05; Nordic walking: -9.62±7.2 s, walking: -7.55±3.2 s). In addition, all exercise types produced significant decreases in the TMT AB test scores (p<0.05), and Nordic walking (p=0.035) showed decreases in the TMTB-TMTA-test. There were no immediate postexercise changes in the levels of BDNF or CTSB. Conclusion Acute bouts of golf, Nordic walking and walking improved cognitive functions irrespective of exerkines in healthy older adults. In addition, Nordic walking and walking in general enhanced executive functions. No significant effects were seen on the levels of BDNF and CTSB. Trial registration number ISRCTN10007294.
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Affiliation(s)
- Julia Kettinen
- Institute of Biomedicine, Sports and Exercise Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Heikki Tikkanen
- Institute of Biomedicine, Sports and Exercise Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Mikko Hiltunen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Andrew Murray
- Edinburgh Sports Medicine Research Network & UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), University of Edinburgh, Edinburgh, UK
- Medical and Scientific Department, The R&A, St Andrews, UK
| | - Nils Horn
- Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
- Schulthess Clinic, Zürich, Switzerland
| | | | - Mika Venojärvi
- Institute of Biomedicine, Sports and Exercise Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
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Saller M, Nagengast N, Frisch M, Fuss FK. A Review of Biomechanical and Physiological Effects of Using Poles in Sports. Bioengineering (Basel) 2023; 10:bioengineering10040497. [PMID: 37106684 PMCID: PMC10135831 DOI: 10.3390/bioengineering10040497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
The use of poles in sports, to support propulsion, is an integral and inherent component of some sports disciplines such as skiing (cross-country and roller), Nordic walking, and trail running. The aim of this review is to summarize the current state-of-the-art of literature on multiple influencing factors of poles in terms of biomechanical and physiological effects. We evaluated publications in the subfields of biomechanics, physiology, coordination, and pole properties. Plantar pressure and ground reaction forces decreased with the use of poles in all included studies. The upper body and trunk muscles were more active. The lower body muscles were either less active or no different from walking without poles. The use of poles led to a higher oxygen consumption (VO2) without increasing the level of perceived exertion (RPE). Furthermore, the heart rate (HR) tended to be higher. Longer poles reduced the VO2 and provided a longer thrust phase and greater propulsive impulse. The mass of the poles showed no major influence on VO2, RPE, or HR. Solely the activity of the biceps brachii increased with the pole mass.
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Affiliation(s)
- Maximilian Saller
- Chair of Biomechanics, Faculty of Engineering Science, University of Bayreuth, 95447 Bayreuth, Germany
| | - Niko Nagengast
- Chair of Biomechanics, Faculty of Engineering Science, University of Bayreuth, 95447 Bayreuth, Germany
| | - Michael Frisch
- Chair of Biomechanics, Faculty of Engineering Science, University of Bayreuth, 95447 Bayreuth, Germany
| | - Franz Konstantin Fuss
- Chair of Biomechanics, Faculty of Engineering Science, University of Bayreuth, 95447 Bayreuth, Germany
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Kettinen J, Tikkanen H, Venojärvi M. Comparative effectiveness of playing golf to Nordic walking and walking on acute physiological effects on cardiometabolic markers in healthy older adults: a randomised cross-over study. BMJ Open Sport Exerc Med 2023; 9:e001474. [PMID: 36816424 PMCID: PMC9930551 DOI: 10.1136/bmjsem-2022-001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 02/08/2023] Open
Abstract
Objectives The acute effects of aerobic exercise on cardiometabolic markers are well documented in younger healthy individuals, but the same effects in older adults have not been elucidated. As such, this study compares the acute effects of three different types of age-appropriate aerobic exercises on cardiometabolic markers. Methods Healthy older golfers (n=25, 16 male and 9 female, 68±4 years) were enrolled in a randomised cross-over experiment. We compared the effects of three different acute aerobic exercises (18-hole golf, 6 km Nordic walk, 6 km walk) on blood pressure, blood glucose and blood lipid profile in a real-life environment. Results In the between-group comparison, playing golf resulted in a difference in blood glucose (golf: 0.01±1.0 mmol/L, walk: 1.3±0.9 mmol/L, p<0.001) compared with walking and triglycerides (golf: 0.13±0.2 mmol/L, Nordic walk: 0.31±0.2 mmol/L, walk: 0.23±0.2 mmol, p=0.012) and high-density lipoprotein cholesterol (golf: 0.04±0.06 mmol/L, Nordic walk: -0.02±0.06 mmol/L, walk: -0.02±0.07 mmol/L, p=0.002) compared with Nordic walking and walking. In addition, all groups had significant decreases (p<0.001) in systolic blood pressure, and Nordic walking and walking also demonstrated a decrease in diastolic blood pressure (p<0.05). Conclusion Acute bouts of aerobic exercise improved cardiovascular profile in healthy older adults. Despite the lower exercise intensity of golf, the longer duration and higher energy expenditure appeared to have a more positive effect on lipid profile and glucose metabolism compared with Nordic walking and walking. Trial registration number ISRCTN10007294.
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Affiliation(s)
- Julia Kettinen
- Institute of Biomedicine, Sports and Exercise Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Heikki Tikkanen
- Institute of Biomedicine, Sports and Exercise Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Mika Venojärvi
- Institute of Biomedicine, Sports and Exercise Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
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Nordic walking with an integrated resistance shock absorber affects the femur strength and muscles torques in postmenopausal women. Sci Rep 2022; 12:20089. [PMID: 36418455 PMCID: PMC9684118 DOI: 10.1038/s41598-022-24131-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022] Open
Abstract
Deterioration of the structure and function of the musculoskeletal system represents a significant problem during aging and intervention with a suitable load of physical activity may improve the quality of life. Nordic walking (NW) has become a popular and easily accessible form of activity, especially for older adults people around the world. Thus, the purpose of the study was to evaluate the influence of an Nordic walking training program with classic poles (NW) and with integrated resistance shock absorber (RSA) on bone mineral density and the peak torques of upper limb muscles and to compare the effects of both intervention programs. 25 women were randomly assigned to two training groups: 10 subjects using RSA (68 ± 4.19 years) and 15 subjects using NW poles (65 ± 3.40 years), which completed 8 weeks of training program. The hip, spine and forearm areal bone mineral density, torques of the flexors and extensors at the elbow and shoulder joints were measured before starting the training programs and after their completion. The most significant effect was found in differences between the two groups of women with respect to the femur strength index (p = 0.047) and the ratio of the flexors to extensors in the elbow (p = 0.049) and shoulder (p = 0.001) joints and peak torque of flexors in the shoulder joint (p = 0.001) for the left arm. A significant difference was also found in the index of torque asymmetry of flexors in the shoulder joint (p = 0.002). The study shows that Nordic walking with RSA poles for postmenopausal women led to beneficial changes in the femur strength index. However, we found no significant influence on bone mineral density values measured on the whole body, the femoral neck, forearm or lumbar spine regions. The occurrence of asymmetry in biomechanical muscle parameters, which was observed using RSA poles, may suggest the necessity of systematic controlling the gait technique to avoid the adverse consequences of asymmetrical rotation of the lumbar spine.
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Harro CC, Shoemaker MJ, Coatney CM, Lentine VE, Lieffers LR, Quigley JJ, Rollins SG, Stewart JD, Hall J, Khoo SK. Effects of nordic walking exercise on gait, motor/non-motor symptoms, and serum brain-derived neurotrophic factor in individuals with Parkinson's disease. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1010097. [PMID: 36311206 PMCID: PMC9614339 DOI: 10.3389/fresc.2022.1010097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/28/2022] [Indexed: 11/11/2022]
Abstract
Objective The primary purpose of this study was to investigate the immediate and long-term effects of Nordic Walking (NW) exercise on walking function, motor/non-motor Parkinson's Disease (PD) symptoms, and serum brain-derived neurotrophic factor (BDNF) in persons with idiopathic PD. Methods Twelve community-dwelling participants with mild to moderate idiopathic PD and varied degrees of gait dysfunction were recruited for this prospective, repeated measures design that examined clinical measures and BDNF levels at baseline (T0), post-intervention (T1) and 3-month follow-up (T2). Participants engaged in 6 weeks of supervised NW exercise training with individualized instruction, followed by 14 weeks of independent NW exercise with remote coaching. Outcome measurements included daily step counts, 6-Minute Walk Test (6-MinWT), 10-Meter Walk Test (10MWT), spatiotemporalparameters, Timed Up and Go Test (TUG), dual-task TUG, Revised-Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Revised-Freezing of Gait Questionnaire, MDS-Nonmotor Symptom scale (NMS), Parkinson's Fatigue Scale, and serum BDNF levels. The Friedman test with post hoc Wilcoxon sign-ranked pairwise comparisons were used to compare baseline to T1, baseline to T2, and T1 to T2 timepoints with a Benjamini-Hockberg correction applied. Results Statistically significant improvements found post-training and retained at 3-month follow-up included 6-MinWT, daily step count, 10mWT, MDS-UPDRS, and TUG with effect sizes of 0.57 to 1.03. Serum BDNF at T2 was significantly greater than T0 and T1. Although no statistically significant improvements were observed in the MDS-NMS, 9 of 12 participants had improved non-motor symptoms. There was good adherence, sustained independent exercise engagement, and no adverse events over the 5-month study duration. Conclusions This study demonstrated that NW exercise was a safe, feasible, and sustainable mode of aerobic exercise for this sample of participants with varied Parkinson's disease duration and severity. Following an individualized and progressive NW training intervention, significant improvements in walking function, daily activity level, and motor function were observed. Following the supervised NW training phase, independent three-month engagement in NW exercise was sustained with long-term retention of these clinical improvements and an increase in serum BDNF levels over this five-month NW exercise trial. Impact Nordic walking exercise may be a safe, feasible and sustainable mode of independent exercise for improving daily ambulatory activity, gait and motor function, and serum BDNF in individuals with mild to moderate PD with varied gait abilities. Clinical Trials Registry ID 20-101-H.
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Affiliation(s)
- Cathy C. Harro
- Department of Physical Therapy and Athletic Training, Grand Valley State University, Grand Rapids, MI, United States,Correspondence: Cathy Harro
| | - Michael J Shoemaker
- Department of Physical Therapy and Athletic Training, Grand Valley State University, Grand Rapids, MI, United States
| | - Cassandra M. Coatney
- Department of Physical Therapy and Athletic Training, Grand Valley State University, Grand Rapids, MI, United States
| | - Valerie E. Lentine
- Department of Physical Therapy and Athletic Training, Grand Valley State University, Grand Rapids, MI, United States
| | - Lillian R. Lieffers
- Department of Physical Therapy and Athletic Training, Grand Valley State University, Grand Rapids, MI, United States
| | - Jessica J. Quigley
- Department of Physical Therapy and Athletic Training, Grand Valley State University, Grand Rapids, MI, United States
| | - Shannon G. Rollins
- Department of Physical Therapy and Athletic Training, Grand Valley State University, Grand Rapids, MI, United States
| | - Jonathan D. Stewart
- Department of Physical Therapy and Athletic Training, Grand Valley State University, Grand Rapids, MI, United States
| | - Julie Hall
- Department of Medical Laboratory Science, Grand Valley State University, Grand Rapids, MI, United States
| | - Sok Kean Khoo
- Department of Cell and Molecular Biology, Grand Valley State University, Grand Rapids, MI, United States
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Intersubjectivity and the meaning of Nordic Walking practice in the view of people with Parkinson’s disease. SCIENTIA MEDICA 2022. [DOI: 10.15448/1980-6108.2022.1.39969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aims: whilst Nordic Walking (NW) practice is spreading worldwide, few studies have addressed the issue of intersubjectivity and the perception of PD individuals practicing NW and its possible impact on their daily life across different countries and cultures. This pilot study sought to explore the possible relationship between the habit of practicing NW and the perception of functionality and quality of life in the participants’ cultural context. Methods: the focus group (FG) technique was used, with 10 individuals participating in a NW program. Results: content analysis revealed five main discourse categories: a) “NW benefits for people with PD”; b) “incorporation of the NW poles in daily life”; c) “Belonging to a NW group as a treatment aid”; d) “how PD people feel about their condition”; and, finally, e) “the present and the future: expectations and issues”. Conclusion: in general, NW was found to generates positive content regarding coping with PD, beyond the biomechanical and quantitative functional effects previously studied. We suggest NW might be an important adjuvant resource for improving perceived functionality among people with PD.
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Di Bacco VE, Kiriella JB, Gage WH. The Influence of the Relative Timing between Pole and Heel Strike on Lower Limb Loading among Young and Older Naïve Pole Walkers. TRANSLATIONAL SPORTS MEDICINE 2022; 2022:3938075. [PMID: 38655163 PMCID: PMC11022778 DOI: 10.1155/2022/3938075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/20/2022] [Accepted: 05/18/2022] [Indexed: 04/26/2024]
Abstract
Current research is unclear with respect to whether pole walking (PW) reduces lower limb loading when compared to regular walking (RW). Contradictory findings in the literature may be related to the relative timing between pole and foot contact events, which were examined in the current study among naïve pole walkers. Fourteen young (4 F; 25.3 ± 5.4 years) and 8 older adults (4 F; 68.5 ± 3.2 years) performed PW and RW trials along a force plate embedded walkway at two different visits. The time difference between pole and foot contact during both the onset of ground contact and the peak force application was calculated. Several kinetic measures were calculated for the lower limbs and poles. A significant decrease during PW, compared to RW, was found for foot impulse (2.1%; p < 0.01), peak vertical ground reaction force (vGRF) (3.4%; p < 0.01), rate of loading (5.2%; p=0.02), and peak push-off vGRF (2.1%; p=0.01). No difference in pole loading was found between age groups and visits. No significant correlations were found between the relative timing and foot loading measures. Significant low-to-moderate negative correlations were found between peak foot and pole vGRFs (p=0.04), peak foot vGRF and pole strike impulse (p=0.01), peak foot vGRF and pole impulse (p=0.02), and peak foot push-off vGRF and pole impulse (p=0.01), suggesting that as pole loading increased, foot loading decreased. Findings suggest timing between pole and heel contact may not be related to unloading the lower limbs but may be related to other aspects of pole use since PW reduced lower limb loading.
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Affiliation(s)
| | - Jeevaka B. Kiriella
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - William H. Gage
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
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Cokorilo N, Ruiz-Montero PJ, González-Fernández FT, Martín-Moya R. An Intervention of 12 Weeks of Nordic Walking and Recreational Walking to Improve Cardiorespiratory Capacity and Fitness in Older Adult Women. J Clin Med 2022; 11:jcm11102900. [PMID: 35629025 PMCID: PMC9142967 DOI: 10.3390/jcm11102900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/10/2022] [Accepted: 05/19/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: The main aim of this study was to examine the effect of an intervention of 12 weeks in three groups on anthropometric measurement and heart rate (HR) variables, fitness index, and maximal oxygen consumption (VO2max) in older women. (2) Methods: In total, 166 Serbian adult women, aged 50 to 69 years old, participated in this study, comprising a control group (60 participants, μage = 57.8 + 6.6), Nordic-walking (NW) group (53 participants, μage = 57.5 + 6.8), and recreational-walking (RW) group (53 participants, μage = 57.8 + 6.6) in a physical fitness programme for 12 weeks. (3) Results: Anthropometric measurement variables were measured using a stadiometer and an electronic scale. The data showed differences in walking heart rate (bt/min) (p < 0.001; η2 = 0.088) between control, NW, and RW groups in the pretest analysis. Moreover, there were significant differences in walking heart rate (bt/min) (η2 = 0.155), heart rate at the end of the test (bt/min) (η2 = 0.093), total time of fitness index test (min) (η2 = 0.097), fitness index (η2 = 0.130), and VO2max (η2 = 0.111) (all, p < 0.001) between control, NW, and RW groups in the posttest analysis. (4) Conclusions: NW group training resulted in slightly greater benefits than RW group training. The present study demonstrated that both groups could act as modalities to improve the functionality and quality of life of people during the ageing process, reflected mainly in HR variables; UKK test measurements, and VO2max. It also contributes to the extant research on older women during exercise and opens interesting avenues for future research.
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Affiliation(s)
- Nebojsa Cokorilo
- Faculty of Sport, University UNION Nikola Tesla, 11158 Belgrade, Serbia;
| | - Pedro Jesús Ruiz-Montero
- Physical Education and Sport Department, Faculty of Education and Sport Sciences, Campus of Melilla, University of Granada, 52005 Melilla, Spain; (F.T.G.-F.); (R.M.-M.)
- Correspondence:
| | - Francisco Tomás González-Fernández
- Physical Education and Sport Department, Faculty of Education and Sport Sciences, Campus of Melilla, University of Granada, 52005 Melilla, Spain; (F.T.G.-F.); (R.M.-M.)
| | - Ricardo Martín-Moya
- Physical Education and Sport Department, Faculty of Education and Sport Sciences, Campus of Melilla, University of Granada, 52005 Melilla, Spain; (F.T.G.-F.); (R.M.-M.)
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Peyré-Tartaruga LA, Boccia G, Feijó Martins V, Zoppirolli C, Bortolan L, Pellegrini B. Margins of stability and trunk coordination during Nordic walking. J Biomech 2022; 134:111001. [DOI: 10.1016/j.jbiomech.2022.111001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 10/19/2022]
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Leal-Nascimento AH, da Silva ES, Zanardi APJ, Ivaniski-Mello A, Passos-Monteiro E, Martinez FG, Rodrigo de Carvalho A, Baptista RR, Peyré-Tartaruga LA. Biomechanical responses of Nordic walking in people with Parkinson's disease. Scand J Med Sci Sports 2021; 32:290-297. [PMID: 34780079 DOI: 10.1111/sms.14095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/28/2021] [Accepted: 11/08/2021] [Indexed: 11/27/2022]
Abstract
In healthy adults, Nordic walking (NW) is known to increase the external mechanical energy fluctuations, though the external work is unaltered due to an improved pendulum-like recovery in comparison with free walking (FW). We aimed to compare mechanical, pendulum-like, and spatiotemporal parameters of gait at different speeds with and without NW poles in people with Parkinson's disease and healthy controls. The study included 11 people (aged 65.6 ± 7.0 years) with idiopathic Parkinson's disease, scoring between 1 and 1.5 on the Hoehn and Yahr scale (H&Y), and nine healthy controls (aged 70.0 ± 5.6 years). All the people were experienced Nordic walkers. Walking tests were performed at 1.8 km h-1 and 4.7 km h-1 , on eight 3D force platforms on a walkway. We found greater pendulum-like energy recovery (p < 0.05) in the Parkinson group during NW than in FW, while external mechanical work remained similar (p > 0.05). People with Parkinson's disease showed a major increase in vertical and forward energy fluctuations using poles than in healthy controls. In addition, the Parkinson group showed increased stride frequency and reduced stride length compared to controls in the NW and FW conditions. Our findings partly justify the lower walking economy in Parkinson's disease due to reduced pendulum-like mechanism at commonly used speeds. NW alters gait mechanics similarly in Parkinson group and healthy control, increasing the total mechanical work. Therefore, NW can be a compelling strategy for rehabilitation because of its potential for improving functional mobility, increasing pendulum-like mechanism in Parkinson's disease.
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Affiliation(s)
- Antonio Henrique Leal-Nascimento
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Federal Institute of Education, Science and Technology of Pará, Abaetetuba, Brazil
| | - Edson Soares da Silva
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - André Ivaniski-Mello
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Elren Passos-Monteiro
- Postgraduate in Human Movement Sciences, Faculty of Physical Education, Universidade Federal do Pará, Castanhal, Brazil
| | - Flávia Gomes Martinez
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Rafael Reimann Baptista
- Physical Activity Research Laboratory, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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Mazumder O, Poduval M, Ghose A, Sinha A. Walking Pole Gait to Reduce Joint Loading post Total Knee Athroplasty: Musculoskeletal modeling Approach. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:4605-4610. [PMID: 34892240 DOI: 10.1109/embc46164.2021.9630849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Excessive knee contact loading is precursor to osteoarthritis and related knee ailment leading to knee athroplasty. Reducing contact loading through gait modifications using assisted pole walking offers noninvasive process of medial load offloading at knee joint. In this paper, we evaluate the efficacy of different configuration of pole walking for reducing contact force at the knee joint through musculoskeletal (MSK) modeling. We have developed a musculoskeletal model for a subject with knee athroplasty utilizing in-vivo implant data and computed tibio-femoral contact force for different pole walking conditions to evaluate the best possible configuration for guiding rehabilitation, correlated with different gait phases. Effect of gait speed variation on knee contact force, hip joint dynamics and muscle forces are simulated using the developed MSK model. Results indicate some interesting trend of load reduction, dependent on loading phases pertaining to different pole configuration. Insights gained from the simulation can aid in designing personalized rehabilitation therapy for subjects suffering from Osteoarthritis.
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Kantorowicz M, Szymura J, Szygula Z, Kusmierczyk J, Maciejczyk M, Wiecek M. Nordic Walking at Maximal Fat Oxidation Intensity Decreases Circulating Asprosin and Visceral Obesity in Women With Metabolic Disorders. Front Physiol 2021; 12:726783. [PMID: 34539448 PMCID: PMC8446531 DOI: 10.3389/fphys.2021.726783] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/13/2021] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Excess visceral adipose tissue is associated with insulin resistance and other metabolic disorders, including deregulation of adipokine secretion, which may be corrected by aerobic exercise training. Asprosin is a novel adipokine responsible for the regulation of appetite and the release of glucose from the liver, and its levels are pathologically elevated in obesity. The aim of the study was to evaluate the effects of 8-week Nordic walking (NW) training at maximal fat oxidation intensity (FAT max ) on changes in body mass, as well as those in insulin resistance and asprosin levels among young women with visceral obesity and metabolic disorders. MATERIALS AND METHODS The study was completed by 14 women (30.14 ± 3.63 years) representing low levels of physical activity, visceral obesity (waist circumference 105.50 ± 14.87 cm, BMI 33.85 ± 5.48 kg/m2) and with metabolic disorders, who for 8 weeks (three times a week, 60 min), participated in NW training at the FAT max intensity (61.92 ± 6.71% HR max , 42.33 ± 8.69% VO2max) controlled on the basis of heart rate (114.21 ± 14.10 bpm). RESULTS After 4 and 8 weeks of NW training, a significant decrease in the concentration of asprosin, waist and hip circumference (HC), waist-to-height ratio and body adiposity index (BAI) (p < 0.05, large effect size) were found. CONCLUSION The 8-week NW training at an FAT max intensity decreases the concentration of asprosin in the blood as well as visceral obesity in young women with metabolic disorders.
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Affiliation(s)
- Malgorzata Kantorowicz
- Ph.D. Studies, Faculty of Physical Education and Sport, University School of Physical Education in Kraków, Kraków, Poland
| | - Jadwiga Szymura
- Department of Clinical Rehabilitation, Faculty of Motor Rehabilitation, University School of Physical Education in Kraków, Kraków, Poland
| | - Zbigniew Szygula
- Department of Sports Medicine and Human Nutrition, Faculty of Physical Education and Sport, Institute of Biomedical Sciences, University School of Physical Education in Kraków, Kraków, Poland
| | - Justyna Kusmierczyk
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, University School of Physical Education in Kraków, Kraków, Poland
| | - Marcin Maciejczyk
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, University School of Physical Education in Kraków, Kraków, Poland
| | - Magdalena Wiecek
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, University School of Physical Education in Kraków, Kraków, Poland
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Podsiadło S, Skiba A, Kałuża A, Ptaszek B, Stożek J, Skiba A, Marchewka A. Influence of Nordic Walking Training on Vitamin D Level in the Blood and Quality of Life among Women Aged 65-74. Healthcare (Basel) 2021; 9:healthcare9091146. [PMID: 34574920 PMCID: PMC8471811 DOI: 10.3390/healthcare9091146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction. Demographic forecasts indicate the progressive aging process of societies in all countries worldwide. The extension of life span may be accompanied by deterioration of its quality resulting from a decrease in physical activity, mental or even social performance, and a deficit in certain chemical compounds responsible for proper functioning of the body. Aim. The aim of the study was to evaluate the influence of a 12-week Nordic walking (NW) training intervention on the level of vitamin D in the blood and quality of life among women aged 65–74 years. Materials and methods. The study comprised 37 women aged 65–74 (x = 68.08, SD = 4.2). The subjects were randomly assigned to 2 groups: experimental group (NW), which consisted of 20 women who underwent an intervention in the form of Nordic walking training for 12 weeks, and the control group (C), including 17 women who underwent observation. In the experimental group, training sessions were held 3 times a week for 1 h. At that time, the C group was not subject to any intervention. The SF−36 questionnaire was used to measure quality of life. Vitamin D was assessed based on the results of biochemical blood tests. The analysed parameters were assessed twice-before and after the completed intervention or observation. Results. Comparison of the results regarding trials 1 and 2 allowed to note statistically significant improvement in quality of life for all health components and factors in the NW group. Analysis of vitamin D levels demonstrated a statistically significant increase in the NW group. In group C, no significant changes in the analysed parameters were observed. Conclusions. Regularly undertaking Nordic walking training significantly influences the improvement of self-evaluation regarding the components of physical and mental health, as well as the concentration of vitamin D in women aged 65–74 years.
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Affiliation(s)
- Szymon Podsiadło
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
- Correspondence:
| | - Agnieszka Skiba
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Anna Kałuża
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Bartłomiej Ptaszek
- Institute of Applied Sciences, University of Physical Education in Krakow, 31-571 Kraków, Poland;
| | - Joanna Stożek
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Amadeusz Skiba
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
| | - Anna Marchewka
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Kraków, Poland; (A.S.); (A.K.); (J.S.); (A.S.); (A.M.)
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The Effects of Nordic Walking Compared to Conventional Walking on Aerobic Capacity and Lipid Profile in Women Over 55 Years of Age. J Phys Act Health 2021; 18:669-676. [PMID: 33883288 DOI: 10.1123/jpah.2020-0182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the effects of Nordic Walking compared to conventional walking on aerobic capacity, the lipid profile, left ventricular ejection fraction, body mass, and body mass index in women over 55 years old. METHODS The study was comprised of 74 women over 55 years of age. Participants were randomized to the Nordic Walking (n = 38) or conventional walking (n = 36) training groups. The echocardiogram, treadmill exercise stress test, lipid profile, and body mass were assessed at baseline (pretest) and after 12 weeks (posttest). RESULTS The authors found a significant main effect over time in duration (effect size [ES] = 0.59, P < .0001), distance covered (ES = 0.56, P < .0001), peak oxygen consumption (ES = 0.43, P < .0001), metabolic equivalent (ES = 0.29, P < .0001), peak heart rate (ES = 0.2, P < .0001), peak diastolic blood pressure (ES = 0.11, P = .0045), total cholesterol (ES = 0.26, P < .0001), and low-density lipoprotein cholesterol (ES = 0.16, P = .0005). The authors did not observe a time versus group interaction or the effect between groups. Post hoc tests revealed significant pretraining to posttraining differences in low-density lipoprotein cholesterol after the Nordic Walking training program and in peak diastolic blood pressure after the conventional walking training program. The heart rate, systolic blood pressure, and diastolic blood pressure at rest, peak diastolic blood pressure, somatic parameters (body mass and body mass index), and left ventricular ejection fraction did not change in either group. CONCLUSIONS Both training programs resulted in increases in aerobic capacity and decreases in total cholesterol.
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Muollo V, Rossi AP, Milanese C, Zamboni M, Rosa R, Schena F, Pellegrini B. Prolonged unsupervised Nordic walking and walking exercise following six months of supervision in adults with overweight and obesity: A randomised clinical trial. Nutr Metab Cardiovasc Dis 2021; 31:1247-1256. [PMID: 33549445 DOI: 10.1016/j.numecd.2020.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS This study is a randomized trial that examined the effects of 6 months of unsupervised Nordic walking (NW) and walking (W) exercise following 6 months of supervised training in overweight/obese adults. METHODS AND RESULTS After a 6-month program of diet and supervised training participants (n = 27) of NW (66 ± 7 yrs, body mass index (BMI) 34 ± 5) and W (66 ± 8 yrs, BMI 32 ± 5) group continue the training without supervision for other 6 months. Steps count and mean heart rate (HRmean) were performed in each session; anthropometric and body composition, aerobic capacity and strength of the upper and lower limbs were evaluated at baseline, after 6 months of supervised and 6 months of unsupervised training. In the unsupervised training, monthly sessions and steps count decreased over time in both groups (p < 0.05), with no significant changes in HRmean. Compared to the supervised phase, adherence decreased significantly only in the W group in the last 3 months of unsupervised training. Compared to baseline in both groups BMI did not change, but W group lost total fat; only the NW group maintained (p < 0.05) the gains in arm curl (33%) and chair stand (31%); both groups improved in six-minute walking test (p < 0.05). CONCLUSION Despite unsupervised training was not effective for a further increase in performance, participants, especially in NW, maintained some of the improvements achieved during the supervision. However, the presence of instructor that guides training, may enhance adherence and health benefits of NW and W exercise. CLINICAL TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT03212391 (July 11, 2017).
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Affiliation(s)
- Valentina Muollo
- Department of Medicine, Clinical and Experimental Biomedical Sciences, University of Verona, Verona, Italy.
| | - Andrea P Rossi
- Department of Medicine, Geriatrics Division, University of Verona, Verona, Italy
| | - Chiara Milanese
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Mauro Zamboni
- Department of Medicine, Geriatrics Division, University of Verona, Verona, Italy
| | - Raffaela Rosa
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy; CeRiSM, Sport, Mountain and Health Research Center, University of Verona, Rovereto, Italy
| | - Barbara Pellegrini
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy; CeRiSM, Sport, Mountain and Health Research Center, University of Verona, Rovereto, Italy
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18
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Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F, Moghetti P, Balducci S, Guidetti L, Schena F, Mazzuca P, Rossi E. Walking for subjects with type 2 diabetes: a systematic review and joint AMD/SID/SISMES evidence-based practical guideline. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-020-00690-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
Aims
Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects.
Data synthesis
Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight, and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior.
Conclusions
There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use.
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19
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Baek S, Ha Y. Estimation of energy expenditure of Nordic walking: a crossover trial. BMC Sports Sci Med Rehabil 2021; 13:14. [PMID: 33608046 PMCID: PMC7893942 DOI: 10.1186/s13102-021-00240-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 02/03/2021] [Indexed: 11/17/2022]
Abstract
Background Nordic walking (NW) requires more energy compared with conventional walking (W). However, the metabolic equation for NW has not been reported. Therefore, this study aimed to characterize responses in oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography of the upper and lower limb muscles during NW and W and develop a metabolic equation for energy expenditure (E, mL·kg− 1·min− 1) of NW. Methods This study was performed in a randomized, controlled, crossover design to test the energy expenditure during NW and W. Fifteen healthy young men were enrolled (aged 23.7 ± 3.0 years). All participants performed two randomly ordered walking tests (NW and W) on a treadmill at a predetermined stepwise incremental walking speed (3–5 km·h− 1) and grade (0–7%). The oxygen uptake, minute ventilation, heart rate, systolic blood pressure, and surface electromyography signals of the three upper limb muscles and three lower limb muscles in their right body were recorded and compared between NW and W using paired-t test. Multiple linear regression analysis was used to draw estimation of E during W and NW. Results Oxygen uptake (+ 15.8%), minute ventilation (+ 17.0%), heart rate (+ 8.4%), and systolic blood pressure (+ 7.7%) were higher in NW than in W (P < .05). NW resulted in increased muscle activity in all of the upper limb muscles (P < .05). In the lower limb, surface electromyography activities in two of the three lower limb muscles were increased in NW than in W only during level walking (P < .05). Energy expenditure during W and NW was estimated as follows: ENW = 6.1 + 0.09 × speed + 1.19 × speed × grade and EW = 4.4 + 0.09 × speed + 1.20 × speed × grade. Conclusion NW showed higher work intensity than W, with an oxygen consumption difference of 1.7 mL·kg− 1·min− 1. The coefficients were not different between the two walking methods. NW involved more muscles of the upper body than W.
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Affiliation(s)
- Sora Baek
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Baengnyeong-ro 156, Chuncheon-si, Gangwon-do, 24289, Republic of Korea. .,Department of Rehabilitation Medicine, Kangwon National University School of Medicine, Kangwondaehak-gil 1, Chuncheon-si, Gangwon-do, 24341, Republic of Korea.
| | - Yuncheol Ha
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Baengnyeong-ro 156, Chuncheon-si, Gangwon-do, 24289, Republic of Korea
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20
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Moghetti P, Balducci S, Guidetti L, Mazzuca P, Rossi E, Schena F. Walking for subjects with type 2 diabetes: A systematic review and joint AMD/SID/SISMES evidence-based practical guideline. Nutr Metab Cardiovasc Dis 2020; 30:1882-1898. [PMID: 32998820 DOI: 10.1016/j.numecd.2020.08.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/19/2022]
Abstract
AIMS Regular exercise is considered a cornerstone in the management of type 2 diabetes mellitus (T2DM). It improves glucose control and cardiovascular risk factors, contributes to weight loss, and also improves general well-being, likely playing a role in the prevention of chronic complications of diabetes. However, compliance to exercise recommendations is generally inadequate in subjects with T2DM. Walking is the most ancestral form of physical activity in humans, easily applicable in daily life. It may represent, in many patients, a first simple step towards lifestyle changes. Nevertheless, while most diabetic patients do not engage in any weekly walking, exercise guidelines do not generally detail how to improve its use. The aims of this document are to conduct a systematic review of available literature on walking as a therapeutic tool for people with T2DM, and to provide practical, evidence-based clinical recommendations regarding its utilization in these subjects. DATA SYNTHESIS Analysis of available RCTs proved that regular walking training, especially when supervised, improves glucose control in subjects with T2DM, with favorable effects also on cardiorespiratory fitness, body weight and blood pressure. Moreover, some recent studies have shown that even short bouts of walking, used for breaking prolonged sitting, can ameliorate glucose profiles in diabetic patients with sedentary behavior. CONCLUSIONS There is sufficient evidence to recognize that walking is a useful therapeutic tool for people with T2DM. This document discusses theoretical and practical issues for improving its use. This article is co-published in the journals Sport Sciences for Health and Nutrition, Metabolism and Cardiovascular Diseases.
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Affiliation(s)
- P Moghetti
- Unit of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy; Hospital Trust of Verona, Verona, Italy.
| | - S Balducci
- Department of Clinical and Molecular Medicine, La Sapienza University, Rome, Italy; Diabetes Unit, Sant'Andrea University Hospital, Rome, Italy; Metabolic Fitness Association, Monterotondo, Rome, Italy
| | - L Guidetti
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - P Mazzuca
- Unit of Internal Medicine, Diabetes and Metabolic Disease Center, Romagna Health District, Rimini, Italy; Department for Life Quality Studies, University of Bologna, Rimini, Italy
| | - E Rossi
- Diabetes Unit, ASL of Benevento, Benevento, Italy
| | - F Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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21
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Kato T, Tomioka T, Yamashita T, Yamamoto H, Sugajima Y, Ohnishi N. Nordic Walking Increases Distal Radius Bone Mineral Content in Young Women. J Sports Sci Med 2020; 19:237-244. [PMID: 32390716 PMCID: PMC7196759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/15/2020] [Indexed: 06/11/2023]
Abstract
Unlike the lumbar spine and femur, the radius does not bear a gravitational mechanical compression load during daily activities. The distal radius is a common fracture site, but few studies have addressed the effects of exercise on fracture risk. The aim of this study was to determine the effects of the pole push-off movement of Nordic walking (NW) on the bone mineral content (BMC) and areal bone mineral density (aBMD) of the distal radius and the muscle cross-sectional area (CSA) at the mid-humeral and mid-femoral levels. The participants were allocated to two groups: an NW group and a control group. The NW group walked at least 30 min with NW poles three times a week for six months. There were no significant changes in muscle CSA at the mid-humeral or mid-femoral levels between or within groups. There were also no significant changes in BMC or aBMD at 1/3 and 1/6 of the distance from the distal end of the radius in either group. However, the BMC and aBMD at 1/10 of the distance from the distal end of the radius were significantly increased by NW. The NW pole push-off movement provided effective loading to increase the osteogenic response in the ultra-distal radius. The ground reaction forces transmitted through the poles to the radius stimulated bone formation, particularly in the ultra-distal radius.
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Affiliation(s)
- Takeru Kato
- Asahi University, Department of Health Science and Sports Sciences, School of Health Sciences, Mizuho, Gifu, Japan
- Suzuka University of Medical Science, Faculty of Health Sciences, Department of Clinical Nutrition, Suzuka, Mie, Japan
| | - Toru Tomioka
- Meijo University, Faculty of Foreign Studies, Nagoya, Aichi, Japan
| | - Takenori Yamashita
- Suzuka University of Medical Science, Faculty of Health Sciences, Department of Clinical Radiation, Suzuka, Mie, Japan
| | - Hidehiro Yamamoto
- Asahi University, Department of Health Science and Sports Sciences, School of Health Sciences, Mizuho, Gifu, Japan
| | - Yasuhiro Sugajima
- Asahi University, Department of Health Science and Sports Sciences, School of Health Sciences, Mizuho, Gifu, Japan
| | - Norikazu Ohnishi
- Mie Prefectural College of Nursing, Faculty of Nursing, Tsu, Mie, Japan
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22
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Gomeñuka NA, Oliveira HB, da Silva ES, Passos-Monteiro E, da Rosa RG, Carvalho AR, Costa RR, Rodríguez Paz MC, Pellegrini B, Peyré-Tartaruga LA. Nordic walking training in elderly, a randomized clinical trial. Part II: Biomechanical and metabolic adaptations. SPORTS MEDICINE-OPEN 2020; 6:3. [PMID: 31932999 PMCID: PMC6957599 DOI: 10.1186/s40798-019-0228-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/20/2019] [Indexed: 12/04/2022]
Abstract
Background Nordic walking is an attractive method of endurance training. Nevertheless, the biomechanic response due to the additional contribution of using poles in relation to free walking training has been less explored in the elderly. Purpose: This randomized parallel controlled trial aimed to assess the effects of 8 weeks of Nordic walking and free walking training on the walking economy, mechanical work, metabolically optimal speed, and electromyographic activation in elderly. Methods Thirty-three sedentary elderly were randomized into Nordic walking (n = 16) and free walking group (n = 17) with equalized loads. Submaximal walking tests were performed from 1 to 5 km h−1 on the treadmill. Results Walking economy was improved in both free and Nordic walking groups (x2 4.91, p = 0.014) and the metabolically optimal speed was increased by approximately 0.5 km h−1 changing the speed-cost profile. The electromyographic activation in lower and upper limbs, pendular recovery, and total, external, and internal mechanical work remained unchanged (p > 0.05). Interestingly, the internal mechanical work associated with arm movement was higher in the Nordic walking group than in the free walking group after training, while the co-contraction from upper limb muscles was reduced similarly to both groups. Conclusions Eight weeks of Nordic walking training effectively improved the walking economy and functionality as well as maintained the gait mechanics, similar to free walking training in elderly people. This enhancement in the metabolic economy may have been mediated by a reduction in the co-contraction from upper limb muscles. Trial registration ClinicalTrails.gov NCT03096964
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Affiliation(s)
- Natalia Andrea Gomeñuka
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil.,Departamento de Investigación de la Facultad de Ciencias de la Salud, (UCAMI) Universidad Católica de las Misiones, Posadas, Argentina
| | - Henrique Bianchi Oliveira
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil
| | - Edson Soares da Silva
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil
| | - Elren Passos-Monteiro
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil.,Post-Graduate Program in Health Sciences, Federal University of Health Sciences, Porto Alegre, Brazil
| | - Rodrigo Gomes da Rosa
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil
| | - Alberito Rodrigo Carvalho
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil.,Physical Therapy College, Universidade Estadual do Oeste do Paraná, Cascavel, Brazil
| | - Rochelle Rocha Costa
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, 750 Felizardo Street, Porto Alegre, 90690-200, Brazil
| | | | - Barbara Pellegrini
- CeRiSM (Research Centre of Mountain Sport and Health), University of Verona, Rovereto, Italy
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23
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Muollo V, Rossi AP, Milanese C, Masciocchi E, Taylor M, Zamboni M, Rosa R, Schena F, Pellegrini B. The effects of exercise and diet program in overweight people - Nordic walking versus walking. Clin Interv Aging 2019; 14:1555-1565. [PMID: 31695344 PMCID: PMC6717875 DOI: 10.2147/cia.s217570] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/31/2019] [Indexed: 01/06/2023] Open
Abstract
Purpose Nordic walking (NW) has been recommended as a form of exercise for clinical populations. Despite intervention programs designed to face a clinical status may last several months, no longitudinal studies have compared the effect of NW to another usual form of exercise, like walking (W). We evaluated the effects of diet combined with a long-supervised NW versus W training on body composition, aerobic capacity and strength in overweight adults. Patients and methods Thirty-eight participants, randomized into a NW (n=19, 66±7 years, body mass index (BMI) 33±5)) and a W (n=19, 66±8 years, BMI 32±5) group, followed a diet and a supervised training routine 3 times/week for 6 months. The variables assessed at baseline, after 3 and 6 months were: anthropometric indexes (ie, BMI and waist circumference (WC)), body composition, aerobic capacity (oxygen consumption (VO2peak), peak power output (PPO), 6-min walking test (6MWT)) and strength (maximal voluntary contraction of biceps brachialis (MVCBB) and quadriceps femoris (MVCQF), chair stand and arm curl (AC)). Results After 6 months both NW and W group decreased significantly BMI (6% and 4%, respectively) and WC (8% and 4%, respectively), but only the NW group reduced (P<0.05) total body fat (8%), android fat (14%) and leg fat (9%). After 6 months, PPO increased (P<0.05) in both groups, but VO2peak improved (P<0.05) only in the NW group (8%). After 6 months, 6MWT increased (P<0.001) in both groups and only the NW group improved (P<0.05) in MVCBB (14%), MVCQF (17%) and AC (35%). Conclusion Our results suggest that NW can give in some relevant health parameters, greater and faster benefits than W. Thus, NW can be a primary tool to counteract the obesity and overweight state in middle-aged adults.
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Affiliation(s)
- Valentina Muollo
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.,CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
| | - Andrea P Rossi
- Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Italy
| | - Chiara Milanese
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Elena Masciocchi
- Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Italy
| | - Miriam Taylor
- Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Italy
| | - Mauro Zamboni
- Department of Medicine, Section of Geriatrics, University of Verona Healthy Aging Center, Verona, Italy
| | - Raffaela Rosa
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.,CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
| | - Barbara Pellegrini
- Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy.,CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
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24
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Giovanelli N, Sulli M, Kram R, Lazzer S. Do poles save energy during steep uphill walking? Eur J Appl Physiol 2019; 119:1557-1563. [PMID: 31020400 DOI: 10.1007/s00421-019-04145-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/17/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE In trail running and in uphill races many athletes use poles. However, there are few data about pole walking on steep uphill. The aim of this study was to compare the energy expenditure during uphill walking with (PW) and without (W) poles at different slopes. METHODS Fourteen mountain running athletes walked on a treadmill in two conditions (PW and W) for 5 min at seven different angles (10.1°, 15.5°, 19.8°, 25.4°, 29.8°, 35.5° and 38.9°). We measured cardiorespiratory parameters, blood lactate concentration (BLa) and rating of perceived exertion (RPE). Then, we calculated the vertical cost of transport (CoTvert). Using video analysis, we measured stride frequency (SF) and stride length (SL). RESULTS Compared to W, CoTvert during PW was lower at 25.4°, 29.8° and 35.5° PW ([Formula: see text] 2.55 ± 3.97%; [Formula: see text] 2.79 ± 3.88% and [Formula: see text] 2.00 ± 3.41%, p < 0.05). RPE was significantly lower during PW at 15.5°, 19.8°, 29.8°, 35.5° and 38.9° ([Formula: see text] 14.4 ± 18.3%; [Formula: see text] 16.2 ± 15.2%; [Formula: see text] 16.6 ± 16.9%; [Formula: see text] 17.9 ± 18.7% and [Formula: see text] 18.5 ± 17.8%, p < 0.01). There was no effect of pole use on BLa. However, BLa was numerically lower with poles at every incline except for 10.1°. On average, SF for PW was lower than for W ([Formula: see text] 6.7 ± 5.8%, p = 0.006) and SL was longer in PW than in W (+ 8.6 ± 4.5%, p = 0.008). CONCLUSIONS PW on steep inclines was only slightly more economical than W, but the substantially lower RPE during PW suggests that poles may delay fatigue effects during a prolonged effort. We advocate for the use of poles during steep uphill walking, although the energetic savings are small.
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Affiliation(s)
- Nicola Giovanelli
- Department of Medicine, University of Udine, P.le M. Kolbe 4, Udine, Italy.
- School of Sport Science, Udine, Italy.
| | - Michele Sulli
- Department of Medicine, University of Udine, P.le M. Kolbe 4, Udine, Italy
- School of Sport Science, Udine, Italy
| | - Rodger Kram
- Locomotion Laboratory, Integrative Physiology Department, University of Colorado, Boulder, CO, USA
| | - Stefano Lazzer
- Department of Medicine, University of Udine, P.le M. Kolbe 4, Udine, Italy
- School of Sport Science, Udine, Italy
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25
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Fujita E, Yakushi K, Takeda M, Islam MM, Nakagaichi M, Taaffe DR, Takeshima N. Proficiency in pole handling during Nordic walking influences exercise effectiveness in middle-aged and older adults. PLoS One 2018; 13:e0208070. [PMID: 30481199 PMCID: PMC6258543 DOI: 10.1371/journal.pone.0208070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/12/2018] [Indexed: 11/18/2022] Open
Abstract
Nordic walking (NW) is a total body version of walking increasingly used as a health-promoting activity by middle-aged and older adults. The present study examined the relationship between force exerted through the pole and physiological response during NW. In this non-randomized exercise trial, 17 participants comprising 8 middle-aged and older recreationally trained Nordic walkers (NWrec: 63.7 ± 8.1 years) and 9 experienced NW instructors (NWinstr: 57.5 ± 7.8 years) underwent outdoor ordinary walking (OW) and NW bouts as fast as possible for 12 minutes. Walking distance, speed, heart rate (HR), energy expenditure (METs and J/kg/m) and upper and lower limb muscle activities using surface electromyogram (EMG) were assessed. A pole with a built-in load cell measured force applied to the pole with peak pole force, pole contact time, % of pole contact time with respect to the gait cycle, and pole impulse derived. We conducted two-way analysis of covariance adjusted for age and BMI. There was a significant group and walking type interaction for walking distance and speed (P = 0.04), METs (P < 0.01), and HR (P = 0.04) with higher values in the NWinstr group during NW than OW. As expected, upper limb EMG activities increased (P < 0.01) with NW in both groups. All pole force measures were significantly higher in NWinstr than NWrec (P ≤ 0.01). Change in walking distance and speed were correlated with pole peak force (r = 0.67, P < 0.01) and pole impulse (r = 0.63, P = 0.01). Similarly, change in METs was associated with peak pole force (r = 0.66, P < 0.01) and pole impulse (r = 0.56, P = 0.02). These results indicate that planting the pole on the ground more forcefully and for longer periods to derive a driving force in NW enhances the effectiveness of the exercise and potentially the health-derived benefits.
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Affiliation(s)
- Eiji Fujita
- Department of Sports and Life Science, National Institute of Fitness and Sports in Kanoya, 1 Shiromizucho, Kanoya, Kagoshima, Japan
| | - Karen Yakushi
- Graduate School of Physical Education, National Institute of Fitness and Sports in Kanoya, 1 Shiromizucho,Kanoya, Kagoshima, Japan
| | - Masaki Takeda
- Faculty of Health and Sports Science, Doshisha University, 1–3 Tataramiyakodani, Kyotanabe, Kyoto, Japan
| | - Mohammod Monirul Islam
- Department of Sports and Life Science, National Institute of Fitness and Sports in Kanoya, 1 Shiromizucho, Kanoya, Kagoshima, Japan
| | - Masaki Nakagaichi
- Department of Sports and Life Science, National Institute of Fitness and Sports in Kanoya, 1 Shiromizucho, Kanoya, Kagoshima, Japan
| | - Dennis Robert Taaffe
- Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Nobuo Takeshima
- Department of Health and Sports Sciences, School of Health Sciences, Asahi University, 1851 Hozumi, Mizuho, Gifu, Japan
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