Effects of short-term Nordic walking training on sarcopenia-related parameters in women with low bone mass: a preliminary study

Outdoor walking, genetic predisposition, and the risk of incident osteoporosis among older adults: A prospective large population-based cohort study

This large-scale prospective study showed that a significant association between longer duration of daily outdoor walking and reduced osteoporosis risk was found among older adults, particularly among those with a low genetic predisposition to osteoporosis, which highlighted the importance of outdoor walking as a simple, cost-effective adjunct for preventing osteoporosis.

PURPOSE

The available cross-sectional data and small-scale studies indicate that outdoor walking benefits bone metabolism. Nevertheless, there is a scarcity of comprehensive prospective research investigating the enduring correlation between outdoor walking and osteoporosis. This study aims to conduct a prospective analysis of the correlation between outdoor walking and osteoporosis while also examining potential variations influenced by genetic susceptibility to osteoporosis.

METHODS

24,700 older adults without osteoporosis at baseline were enrolled. These individuals were followed up until December 31, 2021, during which data on outdoor walking was gathered. The genetic risk score for osteoporosis was comprised of 14 single-nucleotide polymorphisms.

RESULTS

4,586 cases of osteoporosis were identified throughout a median follow-up period of 37.3 months. Those who walked outside for > 30 but ≤ 60 min per day had a hazard ratio (HR) of 0.83 (95% confidence interval (CI): 0.72-0.95) for incident osteoporosis, whereas those who walked outside for > 60 min per day had an HR of 0.60 (95% CI: 0.39-0.92). We found that osteoporosis risk exhibited a declining trend in individuals with low genetic risk. Individuals walking outside for > 60 min per day tended to have the lowest overall osteoporosis risk among those with high genetic risk.

CONCLUSIONS

A significant negative correlation exists between an extended period of daily outdoor walking and osteoporosis incidence risk. This correlation is particularly pronounced among individuals with low genetic risk. The results above underscore the significance of outdoor walking as a simple and economical adjunct to public health programs to prevent osteoporosis.

The Impact of Combination of Aerobic and Resistive Exercise on Activities of Daily Living and Risk of Fall in Osteosarcopenic Patients

Objectives

It is aimed to explain the impact of the combination of aerobic and resistive exercise on activities of daily living and the risk of falls in osteosarcopenic patients.

Methods

Female and male patients over 70 years of age followed up from the osteoporosis outpatient clinic were screened. Appropriate patients were evaluated for sarcopenia gait speed, grip strength and skeletal muscle mass. Patients with sarcopenia who did not have the exclusion criteria were included in the 3-month aerobic and resistive exercise program. Changes in skeletal muscle mass measurements, physical performance and balance tests were evaluated at 1 month and 3 months.

Results

Sarcopenia was screened in 91 patients with osteoporosis and osteopenia. Sarcopenia was detected in 27 patients and 23 completed the 3-month study. The mean age of the patients was 78.4±5.7 years and the number of female patients was 16 (69.6%). There was no significant change in skeletal muscle mass measurements and Katz Activities of Daily Living Scale performed at 1 and 3 months (p>0.05). Short Physical Performance Battery (SPPB), Timed Up and Go Test (TUGT) and Berg Balance Test (BBT) were found to improve significantly in the first month, and it continued to develop in the third month (p<0.05).

Conclusion

Although the combination of aerobic and resistive exercise in osteosarcopenic patients did not lead to a significant increase in skeletal muscle mass, It has a significant effect on physical performance and balance. It can be foreseen that this will increase the independence of the person while reducing the risk of falling.

Effect of Different Exercise Interventions on Grip Strength, Knee Extensor Strength, Appendicular Skeletal Muscle Index, and Skeletal Muscle Index Strength in Patients with Sarcopenia: A Meta-Analysis of Randomized Controlled Trials

Sarcopenia is a systemic skeletal muscle disease that is more prevalent in older adults. The role of exercise in improving the disease has been demonstrated. However, due to the variety of exercise modalities, it is not clear what type of exercise provides the best benefit. The aim of this meta-analysis was to analyze the effects of different exercise modalities on grip strength, appendicular skeletal muscle index, skeletal muscle index, and knee extensor strength in elderly patients with sarcopenia. The protocol for this evaluation was registered on the PROSPERO website and the databases PubMed, WOS, Cochrane Library, and Embase were searched. Thirteen studies were included in the analysis. The results showed that exercise interventions had positive effects on grip strength and knee extension muscle strength, with resistance training being the most effective. There was no significant improvement in appendicular skeletal muscle index or skeletal muscle index. This study still has limitations. For example, age group and exercise duration were not considered. Future studies should further explore benefits in age groups as well as other relevant outcome indicators.

Implementation and Core Components of a Multimodal Program including Exercise and Nutrition in Prevention and Treatment of Frailty in Community-Dwelling Older Adults: A Narrative Review

Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such as falls and mobility disability, and to improve quality of life. Strong evidence reports the effectiveness of exercise interventions to improve various physical parameters and muscle function that are cornerstones of frailty. Other findings also suggest that the interactions between nutrition and physical exercise with or without health behavior promotion prevent the development of frailty. Multimodal programs, including structured exercise, adequate dietary intervention and health behavior promotion, appear increasingly consensual. However, in order for implementation in real-life settings, some pitfalls need to be addressed. In this perspective, structuring and tailoring feasible, acceptable and sustainable interventions to optimize exercise training responses are essential conditions to warrant short, medium and long-term individual benefits. The different components of exercise programs appear to be fairly consensual and effective. However, specific composition of the programs proposed (frequency, intensity, type, time, volume and progressiveness) have to be tailored to individual characteristics and objectives in order to improve exercise responses. The intervention approaches, behavioral strategies and indications for these programs also need to be refined and framed. The main objective of this work is to guide the actions of healthcare professionals and enable them to widely and effectively implement multimodal programs including exercise, nutrition and behavioral strategies in real-life settings.

Effects of Two Short-Term Aerobic Exercises on Cognitive Function in Healthy Older Adults during COVID-19 Confinement in Japan: A Pilot Randomized Controlled Trial

Aerobic exercise improves executive function-which tends to decline with age-and dual-task training with aerobic exercise improves the global cognitive function. However, home-based older adults could not follow these programs due to social isolation during the coronavirus disease 2019 pandemic. Therefore, we conducted a single-blind randomized controlled trial with 88 healthy older adults without dementia or sarcopenia who were randomly assigned into the Nordic walking (aerobic exercise), dance (dual-task training with aerobic exercise), or control group. The participants in both exercise intervention groups trained for 30 min, three times per week, for 4 weeks. All groups consumed amino acid-containing foods three times per week. We found that both exercise intervention groups showed improvements in executive function, while the dance group showed additional improvement in global cognitive function. The dance group showed a higher maximum gait speed, greater improvement in imitation ability, and improved executive function and cognitive function than the Nordic walking group. The intervention programs did not significantly affect the muscle mass or muscle output than the control group; however, both programs improved the participant neurological functions such as the heel lift, with dance training being the most effective intervention. In conclusion, dance training effectively improves cognitive function.

Impact of 12-Week Moderate-Intensity Aerobic Training on Inflammasome Complex Activation in Elderly Women

Aging often associates with a chronic low-grade inflammatory status that can be consequent to the activation of Toll-like receptors (TLRs) and the downstream NLR family pyrin domain containing 3 (NLRP3) inflammasome and causes a chronic secretion of pro-inflammatory cytokines. Since exercise has known anti-inflammatory effects, we investigated the effect of Nordic walking training on inflammasome activation and downstream effectors in elderly women. A population of elderly women was divided into EXP (n = 29) that completed 12 weeks of the moderate-intensity aerobic training program and CTRL (n = 29), performing no activity. Blood samples were taken before and after the first (T1-pre and T1-post, respectively) and last (T2-pre and T2-post, respectively) exercise unit. Inflammasome activation status was assessed by whole blood NLRP3 and TLR4 expression by RT-qPCR. Serum levels of IL-1β, IL-6, TNFα, and IL-18 cytokines were assayed by multiplex fluorescent beads-based immunoassays or ELISA. NLRP3 and TLR4 levels were reduced 2 folds between T1-pre and T2-pre and induced at T2-post, compared to T2-pre, by 2.6- and 2.9-fold, respectively. A single exercise bout elicited a 1. 38-, 1. 5-, and 1.36-fold rise of IL-1β, TNFα, and IL-6 concentration, respectively, although not significant, at the beginning of the training (T1-pre vs. T1-post), a 1.4-fold decrease for IL-1β and TNFα at the end of the training (T1-pre vs. T2-pre), and a 2-, 1.8- and 1.26-fold increase after the last exercise session (T2-pre vs. T2-post) for the three cytokines. When stratifying the population based on BMI in normal weight (NW) and overweight (OW), NLRP3 and TLR4 expression was affected only in NW. As for inflammatory cytokines, IL-1β was modulated in NW at the beginning of the training, whereas in OW at the end of the training; for TNFα, this time-dependent modulation was significant only in OW. Applied aerobic training affected the resting expression of inflammasome constituents (NLRP3 and TLR4) and levels of downstream effectors (IL-1β, TNFα, and IL-6). However, at the end of the program, participants acquire an acute inflammatory response to exercise that was absent at baseline. Future studies would have to define the molecular mechanisms associated with, and how to potentiate, the exercise-associated inflammatory response.

Effect Of Exercise on Muscle Mass, Fat Mass, Bone Mass, Muscular Strength and Physical Performance in Community Dwelling Older Adults: Systematic Review and Meta-Analysis

The demographic transition makes it necessary to establish new recommendations about the components that are most affected by aging, such as: muscle mass, fat mass, bone mass, muscle strength, and physical performance. Exercise has been identified as a factor that improves those conditions. The aim of this review is to synthetize and analyze the results of exercise interventions on muscle mass, fat mass, bone mass, strength and physical performance in community dwelling older adults (OA). A systematic search was carried out in eleven databases, using validated terms as “aged”, “exercise” and others. For the meta-analysis, we differentiated by type of exercise and outcome. Twenty-nine randomized clinical trials were obtained for the review and 24 clinical trials for meta-analysis. This study identified an increase of 1.0 kg (95% Confidence Interval [CI] 0.3 -1.7) in total muscle mass (TMM) and 0.4 kg (95%CI 0.0,0.7) in appendicular muscle mass (AMM); a decrease of -3.7 kg (95% CI -5.8, -1.5) in total fat mass and -3.7% (95%CI -5.8, -1.5) in fat percentage after the resistance exercise intervention by 2-3 times per week. A -3.0% (95%CI -4.6, -1.3) decrease was observed in fat percentage after the aerobic exercise intervention. The quality of the evidence was ranked from high to very low; the risk of bias most common was performance bias and other bias. This study suggests that resistance exercise is the intervention that shows a positive effect on muscle fat mass, and bone mass. More research is needed for other exercise interventions.

Effects of an unsupervised Nordic walking intervention on cognitive and physical function among older women engaging in volunteer activity

Background

Nordic walking (NW) has been reported as a safe and effective exercise mode. However, the effects of NW on cognitive function are unknown. This study examined the effects of an unsupervised NW intervention on cognitive and physical function among older women engaging in volunteering.

Methods

Forty-seven women aged ≥70 years were enrolled and assigned into three groups (NW (n = 16); walking (n = 19); control group (n = 12)) based on residential areas. Participants in NW and walking groups received a pedometer and recorded daily step counts. The NW group received poles and 2 h of NW instruction. Participants were encouraged to perform the exercise individually more than once a week during the 3-month intervention. As baseline and follow-up assessments, cognitive function (Montreal Cognitive Assessment [MoCA-J] and Trail Making Test), physical function (handgrip strength, walking speed, balance ability, the Timed Up and Go test, and functional capacity), and objective physical activity were evaluated.

Results

In the NW group, physical activity, maximal walking speed, and MoCA-J scores were improved during the intervention period. In the walking group, physical activity was increased after the intervention. Analysis of covariance showed that maximal walking speed among the NW group significantly improved compared with the walking group. Sub-group analysis of participants who exercised more than once a week showed that handgrip strength, gait speed, and MoCA-J scores were significantly improved in the NW compared with the walking group.

Conclusion

NW intervention improved cognitive and physical function compared with simple walking among older women.

Can walking exercise programs improve health for women in menopause transition and postmenopausal? Findings from a scoping review

OBJECTIVE

Our goal was to explore the range and characteristics of published papers on therapeutic walking programs for menopausal women and to identify program features that resulted in successful outcomes including reduced symptoms and improved long-term wellness.

METHODS

We searched biomedical and exercise-related databases for articles published up to June 1, 2017, using keywords related to menopause and walking. Data were collected into EndNote X8 reference manager to identify and remove duplicates. The final selection included all articles that studied walking as a health intervention for women in menopause transition or postmenopausal.

RESULTS

A total of 3,244 papers were collected from the six databases. After removing duplicates and applying inclusion and exclusion criteria, 96 articles were charted, including 77 different walking programs. Walking interventions ranged from 4 weeks to 3 years with an average weekly frequency of 3.8 ± 1.8 and were applied to a variety of symptoms and their biological markers and risk factors. Overall, 91% of the programs showed a beneficial outcome in at least one menopause-related medical issue. Information on menopause-specific symptoms, especially vasomotor symptoms and sleep problems, was scarce.

CONCLUSION

The scoping review highlights the growing interest in walking programs as therapies for menopause and related symptoms and provides evidence of their possible benefit as a wellness option for women in menopause and beyond. Further research would be recommended to establish the therapeutic value of walking programs for women with specific focus on typical menopause symptoms at different stages of menopause. : Video Summary:http://links.lww.com/MENO/A587.

The Effects of Walking or Nordic Walking in Adults 50 Years and Older at Elevated Risk of Fractures: A Systematic Review and Meta-Analysis

Walking is a common activity among older adults. However, the effects of walking on health-related outcomes in people with low bone mineral density (BMD) are unknown. The authors included randomized controlled trials comparing walking to control in individuals aged ≥50 years with low BMD and at risk of fractures. The authors identified 13 randomized controlled trials: nine multicomponent interventions including walking, one that was walking only, and three Nordic walking trials. Most studies had a high risk of bias. Nordic walking may improve the Timed Up-and-Go values (1.39 s, 95% CI [1.00, 1.78], very low certainty). Multicomponent interventions including walking improved the 6-min walk test (39.37 m, 95% CI [21.83, 56.91], very low certainty) and lumbar spine BMD (0.01 g/cm2, 95% CI [0.00, 0.03], low certainty evidence). The effects on quality of life or femoral neck BMD were not significant. There were insufficient data on fractures, falls, or mortality. Nordic walking may improve physical functioning. The effects on other outcomes are less certain; one may need to combine walking with other exercises to be of benefit.

The Effect of Nordic Walking Training with Poles with an Integrated Resistance Shock Absorber on the Functional Fitness of Women over the Age of 60

Inadequate levels of physical activity among older people lead to a gradual decline in self-reliance and consequent dependence on other people. The aim of the study was to evaluate the impact of Nordic walking training with poles with an integrated resistance shock absorber on the functional fitness of older women. Forty-two women (M_age = 64.7 ± 3.15 years) were randomly assigned into the experimental group—training with poles with an integrated resistance shock absorber, EG (n = 21) and the control active group—training with classic poles, CG (n = 21). Functional fitness was measured with the Senior Fitness Test before and after an intervention lasting for 8 weeks (2 training sessions × 75 minutes per week). Two-way ANOVA revealed statistically significant interaction effects for aerobic endurance (F = 14.47, p < 0.001) and upper body strength (F = 5.98, p < 0.05), indicating greater improvement in the experimental group. Nordic walking training both with classic poles and with poles with an integrated resistance shock absorber is beneficial for older people and improves functional fitness over a short time period. However, the poles with an integrated resistance shock absorber provide additional resistance effort during marching, which causes increased muscle activation and results in improved muscle strength and aerobic endurance. Based on these results, it can be concluded that this kind of training could be applied in the complex health programs of seniors.

Vitamin D and Indices of Bone and Carbohydrate Metabolism in Postmenopausal Women Subjected to a 12-Week Aerobic Training Program-The Pilot Study

The purpose of this study was to assess the effect of Nordic walking training on the indices of bone and carbohydrate metabolism in relation to 25(OH)D levels in postmenopausal women that were subjected to the outdoor systematic physical activity. The study was performed in 10 postmenopausal women, who participated in a 12-week Nordic walking exercise program, taking place during spring months (March to June). Anthropometric and biochemical parameters were measured before and after the training program. Serum concentrations of 25-hydroksycholekalciferol (25(OH)D), parathyroid hormone (PTH), insulin, glucose, osteocalcin (OC), C-terminal telopeptide of type I collagen (CTX), and calcium were determined. After the Nordic walking exercise program, a significant increase in the serum levels of 25(OH)D and CTX and a decrease in body mass, body mass index (BMI), fat mass, and PTH concentrations were observed. The findings of the present study suggest that 25(OH)D, as important metabolic regulator, plays a role in the modification of bone markers’ responses after the outdoor training program, independent of the physical activity effects.

The effects of exercise and diet program in overweight people - Nordic walking versus walking

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 (VO_2peak), peak power output (PPO), 6-min walking test (6MWT)) and strength (maximal voluntary contraction of biceps brachialis (MVC_BB) and quadriceps femoris (MVC_QF), 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 VO_2peak 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 MVC_BB (14%), MVC_QF (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.

Dietary Sugars Alter Hepatic Fatty Acid Oxidation via Transcriptional and Post-translational Modifications of Mitochondrial Proteins

Dietary sugars, fructose and glucose, promote hepatic de novo lipogenesis and modify the effects of a high-fat diet (HFD) on the development of insulin resistance. Here, we show that fructose and glucose supplementation of an HFD exert divergent effects on hepatic mitochondrial function and fatty acid oxidation. This is mediated via three different nodes of regulation, including differential effects on malonyl-CoA levels, effects on mitochondrial size/protein abundance, and acetylation of mitochondrial proteins. HFD- and HFD plus fructose-fed mice have decreased CTP1a activity, the rate-limiting enzyme of fatty acid oxidation, whereas knockdown of fructose metabolism increases CPT1a and its acylcarnitine products. Furthermore, fructose-supplemented HFD leads to increased acetylation of ACADL and CPT1a, which is associated with decreased fat metabolism. In summary, dietary fructose, but not glucose, supplementation of HFD impairs mitochondrial size, function, and protein acetylation, resulting in decreased fatty acid oxidation and development of metabolic dysregulation.

Effect of 8-week Nordic walking training on nondominant hand grip and shoulder strength in middle-aged women

Nordic walking (NW) is a full body training that can be performed with special pole, and has been recognized as an effective out-door activity which can improve the strength of upper extremity. Most previous studies mainly analyzed the effect of NW on the strength of dominant (DN) hand-grip strength, however, a clear scientific examination is needed whether nondominant (NDN) extremity can also be ameliorated by the NW. Therefore, the aim of our study is to investigate the effectiveness of 8 weeks NW training on the NDN handgrip and shoulder strength in healthy middle-aged women. 29 subjects were randomly divided into three groups: Nordic walking group (NWG, n=10), brisk walking group (BWG, n=11), and control group (CG, n=8). Handgrip and shoulder strength were measured by the hand dynamometer and isokinetic machine. NW training was performed 3 times a week, and had 10-min warm-up, 40-min main program consisted of ALFA (Attention, Long arms, Flat poles, Adaptes) technique and Turbo walking, and 10-min cool-down. In handgrip strength of DN hand and the shoulder flexor strength in the both sides, NWG and BWG showed significantly higher value compared to CG. In the NDN hand, NWG also showed significantly higher strength compared to CG, however, there was no significant difference in the handgrip strength/weight among groups. In NDN shoulder extension, significantly higher improvement was found in NWG and BWG compared to that of CG. In conclusion, our study showed that NW can improve the strength of upper extremity in subjects, and can be better approach to improve the NDN handgrip strength than brisk walking method could.

Nordic walking training and nutritional supplementation in pre-frail older Indians: an open-labelled experimental pre-test and post-test pilot study to develop intervention model

Background

Identifying and treating people in a pre-frail state may be an effective way to prevent or delay frailty and preserve their functional capacity. This study aimed to assess the efficacy of, and compliance with, a 12 week individualized nutritional supplementation (INS) and Nordic walking (NW) program in pre-frail older Indians. The primary measure is physical performance, as indicated by Fried’s Frailty scale. Other measures include: cognition, as indicated by the Hindi Mental Status Examination; mood, by the Geriatric Depression Scale; and nutritional status, by the Mini Nutritional Assessment.

Methods

This is an open-labeled experimental pre-test and post-test study, which took place from October 2012 to December 2014. The study was approved by Institute Ethics committee (IEC/NP-350/2012/RP-26/2012) at the All India Institute of Medical Sciences (AIIMS), New Delhi. Participants were sixty-six pre-frail elderly, who were randomly allocated into three subgroups, namely: A (NW only), B (INS only), and C (NW and INS). One-way ANOVA was used to statistically assess differences in baseline characteristics for quantitative variables, with the Chi-Square/Fischer exact test utilized for qualitative variables. Paired t-tests were used to assess pre and post intervention difference within the group for quantitative variables, with McNemar’s Chi-Square test used for qualitative variables. Kruskal Wallis test was used to assess significant intervention effects among the groups. A p-value < 0.05 was considered as statistically significant.

Results

There was significant effect of intervention in gait speed in group A (p = 0.001) and C (p = 0.002), but not in group B (p = 0.926). While there was no significant change in grip strength in Group A (p = 0.488) and B (p = 0.852), a statistically significant increase was observed in group C (p = 0.013). Mood significantly improved in group B (p = 0.025) and C (p = 0.021). No significant difference was noted in cognitive status across groups. Following the interventions, a total of 18.18% of pre-frail participants were classified as non-frail.

Conclusions

Combining NW and INS provides a simple, pragmatic intervention with efficacy in the management of functionally vulnerable older adults, and allows their maintained independence. Future studies should replicate this readily applicable intervention in a larger cohort with a longer follow-up period.

Trial registration

Clinical Trial Registry-India CTRI/2016/05/006937 [Registered on: 16/05/2016]; Trial was Registered Retrospectively.

The Effect of Nordic Walking Training Combined with Vitamin D Supplementation on Postural Control and Muscle Strength in Elderly People-A Randomized Controlled Trial

Nordic Walking (NW) and Vitamin D concentration (Vit D) alone have been shown to contribute to the health and performance of elderly people. However, the interaction between these two factors has yet to be explored. In this study 42 women over 60 years of age (69.02 ± 5.56 years) were recruited and divided in two NW groups: a high-intensity interval training group (HI-NW) and a moderate-intensity continuous training group (MI-NW). Individuals from each group completed a 12-week NW training program (3 times a week/2 hours) combined with randomized Vitamin D supplementation (HD = high dose: 4000 IU/day or LD = low dose: 800 IU/day). Body composition, postural control, muscle strength and Vitamin D serum concentration were measured twice; before and after the intervention. To investigate the interaction between supplementation and training a mixed-design analysis of variance (ANOVA) was performed. The HI-NW group, regardless of supplementation dose, increased their Vit D and elbow torque performance. On the other hand, in the MI-NW group the same Vit D outcome was seen only with HD supplementation and was also associated with increased leg muscle mass. In conclusion, beneficial effects of both HI-NW and MI-NW training regimes were seen. The impact of the dose supplementation on Vit D and body composition was related to the type of NW training.

Muscular and metabolic responses to different Nordic walking techniques, when style matters

Due to poling action and upper body engagement, Nordic walking (NW) has additional health benefits with respect to conventional walking. The aim of this study was to evaluate the differences in muscle activation and metabolic responses between NW, performed with the technique suggested by NW instructors, and with some modifications in the way to move upper limb and poles. Ten NW instructors volunteered to walk on a treadmill at 5.5 km•h-1 in five conditions: walking (W), Nordic walking (NW), NW with a weak poling action (NWweak), with straight-upper limbs moving the shoulders (NWshoulder) and with elbow flexion-extension pattern and shoulder freezed (NWelbow). Poling forces, body segments and poles movement, upper and lower body muscle activation, as well as metabolic parameters were measured.All modified NW techniques elicited lower muscular activation and metabolic responses with respect to the suggested NW technique (P < 0.05). All NW techniques elicited higher muscular activation and metabolic responses than W. All parameters observed with the NWweak were lower than NW. A decreased activation of shoulder extensor muscles and increased activation of anterior deltoid muscle were the main features of NWshoulder. Lower triceps brachii muscle activation and reduced propulsive poling action with respect to NW were seen for NWelbow, resulting also in shorter steps.Nordic walking instructors, sport technicians and practitioners should be aware that any deviation from the technique usually suggested might lead to lower benefits. However it is worth to note that any walking technique with poles elicits higher metabolic responses and muscular activation than walking.

l-Carnitine Supplementation in Older Women. A Pilot Study on Aging Skeletal Muscle Mass and Function

Skeletal muscle wasting, associated with aging, may be regulated by the inflammatory cytokines as well as by insulin-like growth factor 1 (IGF-1). l-carnitine possesses anti-inflammatory properties and increases plasma IGF-1 concentration, leading to the regulation of the genes responsible for protein catabolism and anabolism. The purpose of the present study was to evaluate the effect of a 24-week l-carnitine supplementation on serum inflammatory markers, IGF-1, body composition and skeletal muscle strength in healthy human subjects over 65 years of age. Women between 65 and 70 years of age were supplemented for 24 weeks with either 1500 mg l-carnitine-l-tartrate or an isonitrogenous placebo per day in a double-blind fashion. Before and after the supplementation protocol, body mass and composition, as well as knee extensor and flexor muscle strength were determined. In the blood samples, free carnitine, interleukin-6, tumor necrosis factor-α, C-reactive protein and IGF-1 were determined. A marked increase in free plasma carnitine concentration was observed due to l-carnitine supplementation. No substantial changes in other parameters were noted. In the current study, supplementation for 24 weeks affected neither the skeletal muscle strength nor circulating markers in healthy women over 65 years of age. Positive and negative aspects of l-carnitine supplementation need to be clarified.

The Effects of Nordic Walking and Slope of the Ground on Lower Limb Muscle Activity

Psurny, M, Svoboda, Z, Janura, M, Kubonova, E, Bizovska, L, Martinez Lemos, RI, and Abrantes, J. The effects of Nordic walking and slope of the ground on lower limb muscle activity. J Strength Cond Res 32(1): 217-222, 2018-Nordic walking (NW) has proven to be a simple and safe mode of exercise that can be used in various types of sport, recreation, and rehabilitation activities. The aim of this study was to assess the effect of Nordic walking and slope of the ground on lower limb muscle activity. The experimental group consisted of 22 healthy men (aged 22.8 ± 1.4 years). The subjects walked on a treadmill at a self-selected speed. Two walking conditions (NW and walking) and 2 ground slopes (level ground and uphill walking at an 8% incline) were used. The surface electromyographic signals of the gastrocnemius lateralis, tibialis anterior, vastus medialis, rectus femoris, biceps femoris and gluteus medius were recorded. Nordic walking resulted in increased activity of some lower limb muscles, particularly during the first half of the stance phase, and decreased muscle activity during the first half of the swing phase. Uphill walking elicited increased muscle activity compared with level walking, particularly during the stance phase and the second half of the swing phase during both walking and NW, and the change was more pronounced during walking. We concluded that NW increased muscle activity in the lower extremities compared with walking, particularly on level ground. Increasing the ground slope enhanced the muscle activity to a much greater extent than NW.

Nordic Walking Can Be Incorporated in the Exercise Prescription to Increase Aerobic Capacity, Strength, and Quality of Life for Elderly: A Systematic Review and Meta-Analysis

The aim of this systematic review and meta-analysis was to summarize and analyze the effects of Nordic Walking on physical fitness, body composition, and quality of life in the elderly. Keyword "Nordic Walking" associated with "elderly" AND/OR "aging" AND/OR "old subjects" AND/OR "aged" AND/OR "older adults" were used in the online database MEDLINE, Embase, PubMed, Scopus, PsycINFO, and SPORTDiscus. Only studies written in English language and published in peer-reviewed journals were considered. A meta-analysis was performed and effect sizes calculated. Fifteen studies were identified; age of participants ranged from 60 to 92 years old. Comparing with a sedentary group, effect sizes showed that Nordic Walking was able to improve dynamic balance (0.30), functional balance (0.62), muscle strength of upper (0.66) and lower limbs (0.43), aerobic capacity (0.92), cardiovascular outcomes (0.23), body composition (0.30), and lipid profile (0.67). It seemed that Nordic Walking had a negative effect on static balance (-0.72). Comparing with a walking (alone) training, effect sizes showed that Nordic Walking improved the dynamic balance (0.30), flexibility of the lower body (0.47), and quality of life (0.53). Walking training was more effective in improving aerobic capacity (-0.21). Comparing Nordic Walking with resistance training, effect sizes showed that Nordic Walking improved dynamic balance (0.33), muscle strength of the lower body (0.39), aerobic capacity (0.75), flexibility of the upper body (0.41), and the quality of life (0.93). Nordic Walking can be considered as a safe and accessible form of aerobic exercise for the elderly population, able to improve cardiovascular outcomes, muscle strength, balance ability, and quality of life.

Changes in pro-inflammatory markers and leucine concentrations in response to Nordic Walking training combined with vitamin D supplementation in elderly women

Mechanisms underpinning age-related decreases in muscle strength and muscle mass relate to chronic inflammation. Physical activity induces an anti-inflammatory effect, but it is modulated by additional factors. We hypothesized that vitamin D, which has also anti-inflammatory activity will modify adaptation to exercise and reduce inflammation in elderly women. Twenty-seven women aged 67 ± 8 years were included and divided into groups with baseline vitamin D concentration more than 20 ng mL⁻¹ (MVD) and less than 20 ng mL⁻¹ (LVD). Both groups performed 1 h Nordic Walking (NW) training combined with vitamin D supplementation for 12 weeks. Serum concentrations of inflammation markers, branched amino acids, vitamin D, muscle strength and balance were assessed at the baseline and three days after intervention. The training caused the significant decrease in concentration of pro-inflammatory proteins HMGB1 (30 ± 156%; 90% CI) and IL-6 (−10 ± 66%; 90% CI) in MVD group. This effects in group MVD were moderate, indicating vitamin D as one of the modifiers of these exercise-induced changes. Rise of myokine irisin induced by exercise correlated inversely with HMGB1 and the correlation was more pronounced at the baseline as well as after training among MVD participants. Although the intervention caused the leucine level to rise, a comparison of the recorded response between groups and the adjusted effect indicated that the effect was 20% lower in the LVD group. Overall the applied training program was effective in reducing HMGB1 concentration. This drop was accompanied by the rise of myokine irisin and better uptake of leucine among women with higher baseline vitamin D.