Researchers discovered a larger gain in functional capacity, or the ability to conduct everyday tasks, as a result of Nordic walking in patients with coronary heart disease when compared to regular high-intensity interval training and moderate-to-vigorous intensity continuous training. The findings of their randomized clinical trial were reported in the Canadian Journal of Cardiology.
Following a catastrophic cardiovascular incident, cardiovascular rehabilitation and exercise training programs are associated with significant gains in functional ability, cardiorespiratory fitness, and mental health. Some people, however, dislike boring types of exercise, such as walking and stationary cycling, and may stop exercising once their cardiovascular rehabilitation program is over. Researchers looked into more diverse exercise options that would appeal to more people in order to see whether they could persuade more people to exercise and what benefits they could obtain.
Non-traditional exercise interventions, such as high-intensity interval training and Nordic walking, appear to be more effective than traditional exercise approaches in improving functional capacity as measured by a six-minute walk test, which is an important predictor of cardiovascular events in patients with coronary artery disease. Nordic walking is a type of walking exercise that use specially built poles to train both the upper and lower body muscles.
“Patients with coronary artery disease frequently have diminished functional capacity, poor quality of life, and an increased risk of subsequent cardiovascular events and mortality,” said lead investigator Jennifer L. Reed, PhD, Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute; Faculty of Medicine; and School of Human Kinetics, Faculty of Health Sciences, University of Ottawa.
This is an important discovery since reduced functional ability indicates a higher risk of future cardiovascular events in persons with coronary artery disease. Nordic walking utilizes core, upper and lower body muscles while lowering loading stress at the knee, which may have resulted in higher increases in functional ability.
Dr. Jennifer L. Reed
Investigators compared the prolonged effects of 12-week rehabilitation with 1) high-intensity interval training; 2) moderate-to-vigorous intensity continuous training; and 3) Nordic walking, on functional capacity, quality of life and depression symptoms in patients with coronary artery disease. One hundred and thirty patients were randomized to a 12-week training in one of these three groups followed by a 14-week observation phase.
While all exercise programs improved depressive symptoms and quality of life, Nordic walking (+19%) enhanced functional capacity the most when compared to high-intensity interval training (+13%) and moderate-to-vigorous intensity continuous training (+12%).
“This is an important discovery since reduced functional ability indicates a higher risk of future cardiovascular events in persons with coronary artery disease,” Dr. Reed explained. “Nordic walking utilizes core, upper and lower body muscles while lowering loading stress at the knee, which may have resulted in higher increases in functional ability.”
“No previous study has directly compared the long-term effects of high-intensity interval training, moderate-to-vigorous intensity continuous training and Nordic walking,” commented Tasuku Terada, PhD, Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada.
“This study is novel in that it simultaneously compared the sustained effects (i.e., 14 weeks after the completion of cardiovascular rehabilitation) of different exercise programs that can readily be incorporated into daily exercise. When prescribing exercise for patients with coronary artery disease, patients’ preference should be considered. Our findings can impact patient care by providing alternative exercise options based on their interests and needs,” he concluded.
In an accompanying editorial, Carl J. Lavie, MD, Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, the University of Queensland School of Medicine, New Orleans, LA, USA, and colleagues noted that the addition of Nordic walking to a cardiovascular rehabilitation program could provide an ideal progression from standard moderate intensity continuous training or traditional walking, especially for deconditioned patients who may not tolerate high intensity exercise, or for patients in whom high-intensity interval training may be contraindicated.
“Adding Nordic poles to moderate to vigorous intensity walking is a simple, accessible choice to improve walking capacity, boost energy expenditure, activate upper body musculature, and improve other functional parameters such as posture, gait, and balance,” Dr. Lavie explained.
“Offering a choice of exercise options increases patient enjoyment and advancement, which is critical for adherence and maintenance. Exercise modalities should be prescribed with the patient’s goals, preferences, and capabilities in mind” He counseled.
