Nordic walking provides sustained health benefits to heart patients

June 15, 2022

All exercise is good, and some is better than none, but the health benefits of Nordic walking are superior, study finds.

Cardiovascular rehab programs and exercise in general is known to improve the health of people with heart disease. However, less is known about whether such improvements are sustained after a program ends. That is, until now.

Researchers comparing the sustained effects of cardiovascular rehab exercises in patients with coronary artery disease have determined Nordic walking confers additional health benefits.

“Statistically and clinically superior”

Dr. Jennifer Reed is the director of the Exercise Physiology and Cardiovascular Health Laboratory at the University of Ottawa Heart Institute (UOHI), and the recent author of a study that found Nordic walking is “statistically and clinically superior” to high-intensity interval training (HIIT) and moderate-to-vigorous intensity continuous training (MICT) in increasing functional capacity in patients with coronary artery disease enrolled in cardiac rehabilitation.

Dr. Jennifer Reed, Exercise Physiology and Cardiovascular Health Laboratory, University of Ottawa Heart Institute
In the Exercise Physiology and Cardiovascular Health Laboratory at the UOHI, Dr. Jennifer Reed and her team perform clinical research in exercise science, cardiovascular rehabilitation and prevention, and women’s health. Among her research interests are ways to manage and treat arrhythmias with exercise, new exercise training strategies for women with cardiovascular disease, and workplace interventions to improve cardiovascular health.

Tasuku Terada, a postdoctoral fellow under Dr. Reed’s supervision at the UOHI, has since published a second, follow-up study with similar findings, only focusing on the sustainability of the exercise’s effects over time.

When compared directly, HIIT, MICT and Nordic walking have similar prolonged effects on disease-specific and general quality of life and depression symptoms. Yet, for increasing functional capacity, the prolonged effects of Nordic walking are, again, superior.

Functional capacity refers to a person’s ability to perform physical tasks and is an important predictor of future cardiovascular events.

“Our research is novel in that it is the first to simultaneously compare the sustained effects of different exercise programs that can readily be incorporated into daily exercise. Our findings can impact patient care by providing alternative exercise options based on their interests and needs.”

- Tasuku Terada, postdoctoral fellow, UOHI

“Patient preference should be considered”

If getting active is the closest thing to a magic pill for good health, then healthcare professionals may prescribe Nordic walking to people with coronary artery disease. However, despite their findings, both Terada and Reed maintain that “Any exercise is good, and some exercise is better than none.”

Tasuku Terada, Exercise Physiology and Cardiovascular Health Laboratory, University of Ottawa Heart Institute
Tasuku Terada has studied a variety of approaches to optimize the use of exercise for improving cardiovascular health, including high-intensity interval exercise and fasted-state exercise. His future research interests lie in exploring the role of exercise in counteracting the development or progression of chronic health conditions including, but not limited to, obesity, diabetes and the risks associated with these conditions.

While patients are encouraged to maintain an active lifestyle following the completion of exercise-based cardiovascular rehab, adherence to structured exercise remains low, and physical activity engagement decreases significantly in the year after programming ends.

“We want to see more patients adhering to cardiovascular rehab and incorporating physical activity as part of an everyday exercise regime,” said Terada. “Getting active is the single most effective tool a person can use to improve their overall health.” 

When prescribing exercise for cardiovascular rehabilitation, Terada, Reed et al. conclude: “Patient preference should be considered.”

So, what is Nordic walking, anyway?

Nordic walking is a “total-body” version of conventional walking. It is performed with the use of walking poles similar to ski poles.

The technique is simple: Nordic walkers grip their pole and push down as it meets the ground. As the pole trails behind the body, the walker releases their grip. The walker swings the pole by the wrist strap as they propel forward on their leading leg. Keeping the arms relaxed and the poles behind the body are key elements of the proper “grip and release” technique.

The exercise recruits core, upper and lower body muscles while reducing loading stress at the knee, which, Terada said, may explain why it resulted in greater improvements in functional capacity in study participants.

Nordic walkers consume more oxygen, burn more calories, and have a quicker heart rate response than conventional walking.

Nordic walking poles come in non-adjustable shaft versions available in different lengths, and telescoping versions with twist-locks for adjusting the length. Non-adjustable, one-piece poles are stronger and lighter but must be matched to the user. Telescoping poles are more transportable.

Nordic walking is a low impact exercise suitable for people of any age and all fitness levels. It can be performed on any walkable surface and in any climate, making it a versatile physical activity for any time of year.

Thanks to our donors and grant agencies for making this research possible

The authors acknowledge support received from the Innovation Fund of the Alternate Funding Plan for the Academic Health Sciences Centres of the Ontario Ministry of Health; Heart and Stroke Foundation of Canada; and the Canadian Institutes of Health Research postdoctoral fellowship, as well as the Jan & Ian Craig Cardiac Prevention and Rehabilitation endowed fellowship from the University of Ottawa Heart Institute.

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