Effects of Nordic walking training on quality of life, balance and functional mobility in elderly: A randomized clinical trial

Abstract

Purpose: There is physiological and biomechanical evidence suggesting a possible advantage of using poles in walking training programs. The purpose of this proof-of-concept study was to test the hypothesis that untrained elderly training Nordic walking for eight weeks will show higher improvements on the functional mobility, quality of life and postural balance than that training without poles; more likely to occur in self-selected walking speed (primary outcome), and the locomotor rehabilitation index than the quality of life, the static balance and the dynamic stability. It was a two-arm randomized sample- and load-controlled study.

Methods: Thirty-three untrained older people were randomly assigned into Nordic walking (n = 16, age: 64.6±4.1 years old) and free walking (n = 17, age: 68.6±3.9 years old) training groups.

Results: Improvements in the self-selected walking speed (primary outcome, p = 0.011, ES = 0.42 95%CI -0.31 to 1.16), locomotor rehabilitation index (p = 0.013, ES = 0.36; (95%CI -0.39 to 1.10), quality of life (p<0.05), static balance (p<0.05) and dynamic variability (p<0.05) were found in both groups.

Conclusions: The hypothesis was not supported, our findings indicated that after 8 weeks, the Nordic walking training did not result in greater improvements than free walking training for the primary outcome (self-selected walking speed) and most of the secondary outcomes (including locomotor rehabilitation index, static balance, dynamic stability, and psychological and social participation domains of quality of life).

Trial registration: ClinicalTrials.gov NCT03096964.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Flowchart of the study participants.

Fig 2. Definition of a stride cycle.

The Contact Time (CT) is the time, during the stride cycle, in which the feet (right or left) is in contact with the ground (A). Swing phase time (ST) is the time, during stride cycle, in which the feet (right or left) is not in contact with the ground (B), adapted from Oliveira et al. (2013).

Fig 3. Model of training periodization.

The average effort intensity (% heart rate at the second ventilatory threshold, %HR2VT) and training volume (in minutes) at every session during the first (I Mesocycle) and second (II Mesocycle) mesocycles.

Fig 4. Results of the self-selected walking speed (SWS, top panel) and the locomotor rehabilitation index (LRI, bottom panel).

Free walking group (FW, white column) and Nordic walking group (NW, black column) in pre- and post-training moments. Mean and standard errors. * Symbols represent significant differences in time factor (p = 0.011 and p = 0.013, respectively).

Fig 5. Results of gait variability through the coefficient of variation (CoV) of spatiotemporal parameters.

Left side, CoV of stride length (CoVSL, top panel) and CoV of stride frequency (CoVSF, bottom panel), and, in the right side, the CoV of stride time (CoVST, top panel), and CoV of contact time (CoVCT, bottom panel). FW group results of pre- and post-training moments are observed in white and black columns, respectively. NW group results of pre- and post-training moments are observed in light grey and dark grey, respectively. Data presented in mean and SE. Different letters represent significant differences (p<0.001) between speeds.