“Four legs instead of two” – perspectives on a Nordic walking-based walking programme among people with arthritis

The Impact of Nordic Walking Pole Length on Gait Kinematic Parameters

Nordic walking (NW) is a popular physical activity used to manage chronic diseases and maintain overall health and fitness status. This study aimed to compare NW to ordinary walking (W) with regard to pole length and to identify kinematic differences associated with different poles' length (55%, 65% and 75% of the subject's height, respectively). Twelve male volunteers (21.1 ± 0.7 years; 1.74 ± 0.05 m; 68.9 ± 6.1 kg) were tested in four conditions (W, NW55, NW65 and NW75) at three different speeds (4-5-6 km∗h^-1). Each subject performed a total of twelve tests in a random order. Three-dimensional kinematics of upper and lower body were measured for both W and NW, while oxygen consumption levels (VO₂) and rating of perceived exertion (RPE) were measured only for NW trials with different poles' length. NW showed a higher step length, lower elbow motion and higher trunk motion (p < 0.05) compared to W. Additionally, NW65 did not show any kinematic or RPE differences compared to NW55 and NW75. Only NW75 showed a higher elbow joint (p < 0.05) and lower pole (p < 0.05) range of motion compared to NW55 and a higher VO₂ (p < 0.05) compared to NW55 and NW65 at 6 km∗h^-1. In conclusion, the use of the poles affects the motion of the upper and lower body during gait. Poles with shorter or longer length do not produce particular changes in NW kinematics. However, increasing the length of the pole can be a smart variation in NW to increase exercise metabolic demand without significantly affecting the kinematics and the RPE.

Effectiveness of nordic walking in patients with asthma: A study protocol of a randomized controlled trial

BACKGROUND

Patients with asthma often consider their symptomatology a barrier to exercise, leading to a reduced physical activity level. This study aims to determine whether the effect of a Nordic walking (NW) training program plus education and usual care is superior to educational and usual care only, in terms of exercise tolerance and other health-related outcomes in patients with asthma. The second aim is to explore the patients' experience with the NW program.

METHODS

A randomized controlled trial will be conducted with 114 adults with asthma recruited in sanitary area of A Coruña, Spain. Participants will be randomized to NW or control groups in blocks of six and in the same proportion in each group. Participants in the NW group will enrol in supervised sessions during eight weeks, three times/week. All participants will receive three educational sessions on asthma self-management plus usual care (S1 Appendix). Outcomes such as exercise tolerance (primary outcome), physical activity level, asthma-related symptoms and asthma control, dyspnea, lung function, handgrip strength, health related quality of life, quality of sleep, treatment adherence and healthcare resources use will be measured pre and postintervention, and at three and six months of follow-up. Participants in the NW group will additionally participate in focus groups.

DISCUSSION

This is the first study analysing the effect of NW in patients with asthma. NW combined with education and usual care is expected to improve exercise tolerance, but also asthma-related outcomes. If this hypothesis is confirmed, a new community-based therapeutic approach will be available for patients with asthma.

TRIAL REGISTRATION

Study registered in ClinicalTrials.gov with number of register NCT05482620.

Perceived benefits and barriers of walking among overweight and obese adults

The current study aimed to explore perceived barriers and benefits of walking of overweight and obese adults. Fifteen face-to-face, semistructured interviews were conducted. Content and thematic analyses were used. Findings revealed that informants were aware of more benefits from walking than barriers. Gaining health and fitness, losing weight, the opportunity to walk in a group, and setting goals and sharing achievements were more sited benefits of walking. Confusion about walking guidelines and walking location perceived as barriers to walking. The findings of this study would be applied to develop walking intervention.

Hiking with DiabetesRisks and Benefits

BACKGROUND

Exercise is highly beneficial for persons with diabetes. Similar to many other patients, those with diabetes may be reluctant to exercise given a lack of motivation and proper instruction regarding an exercise prescription. In general, medical providers are poorly equipped to develop an exercise prescription and furnish motivation. Attempts to find activities that not only provide effective aerobic challenges but also are enjoyable to participate in are fraught with difficulty. Hiking as a potential option for a safe and enjoyable activity is discussed, including the possible downsides.

METHODS

Multiple publications were reviewed using key words.

RESULTS

A review of the literature uncovered limited publications or controlled trials that discussed the use of hiking per se as an activity for the management of diabetes. Newer studies reviewing weightbearing exercise and diabetic polyneuropathy and those discussing the advantages of trekking poles for balance and proprioception are cited in support of the recommendation for hiking as an activity for those with diabetes.

CONCLUSIONS

Exercise has been shown to substantially benefit individuals with diabetes, but convincing patients with diabetes to exercise is daunting. Hiking, unlike other, more tedious exercise programs, may be an exercise option that persons with diabetes might find enjoyable. Hiking may encourage balance training and reduced ground reaction forces. These benefits may be augmented by trekking poles, which may likewise counter the concerns of the uneven surfaces that present challenges to the hiker with diabetes.