Research

The thought behind the walk ..

RESEARCH PROVES IT!
THE BENEFITS OF NORDIC WALKING
Courtesy of AECC Bournemouth, David Downer & the NWUK Tutor team

Since 1989, major research has been conducted to determine the benefits of Nordic Walking. Can Nordic Walking help those with serious health issues, or the elderly? Does it increase fitness levels in individuals who are already active and healthy? Could it improve an athlete’s performance?

RESEARCH RELATED TO HEALTH ISSUES

Nordic walking practice might improve plantar pressure distribution.
Pérez-Soriano P, Llana-Belloch S, Martínez-Nova A, Morey-Klapsing G, Encarnación-Martínez A.
Source
Department of Sport and Physical Education, University of Valencia, Spain. pedro.perez-soriano@uv.es
Abstract
Nordic walking (NW), characterized by the use of two walking poles, is becoming increasingly popular (Morgulec-Adamowicz, Marszalek, & Jagustyn, 2011). We studied walking pressure patterns of 20 experienced and 30 beginner Nordic walkers. Plantar pressures from nine foot zones were measured during trials performed at two walking speeds (preferred and 20% faster), and under two walking conditions (NW vs. normal walking). In comparison to normal walking, NW experience led to a significant (p < .05) pressure reduction of about 50% on the central metatarsals. No significant increases were detected in other foot regions. The differences between experienced and beginners during normal walking including a 40% pressure reduction on the metatarsal area, suggests that regular NW practice might also have a beneficial effect on plantar pressure when walking without poles.
PMID:
22276400
[PubMed - indexed for MEDLINE]



Coll Antropol. 2011 Sep;35(3):889-94.
EFFECT OF NORDIC WALKING ON FUNCTIONAL ABILITY AND BLOOD PRESSURE IN ELDERLY WOMEN.
Mikalacki M, Cokorilo N, Katiæ R.
Source
University of Novi Sad, Faculty of Sport and Physical Education, Novi Sad, Serbia.
Abstract
The aim of the study was to analyze the effects produced by the use of experimental program (Nordic polewalking) on functional abilities in elderly women. Three-month polewalking led to reduction in the pulse rate at rest, diastolic and systolic blood pressure at the level of significance of 0.01 (p = 0.000). Polewalking improved the values of fitness index (FITIND) and maximal oxygen consumption (VO2max) at the level of significance of 0.01 (p = 0.000). On final measurement, three variables, i.e. pulse rate at rest - HRR (E = 73.42 vs. C = 79.68), systolic blood pressure - BPS (E = 118.42 vs. C = 123.65) and diastolic blood pressure - BPD (E = 79.04 vs. C = 83.54), showed lower results in experimental group compared with control group. On final measurement, experimental group showed higher values of the FITIND (E = 81.79 vs. C = 62.66) and VO2max (E = 21.83 vs. C = 16.81) variables as compared to control group. Accordingly, such a moderate physical activity, which is not too vigorous yet intensive enough to induce favorable changes, appears to be recommendable for elderly women. The present study included 60 women from the Novi Sad community, mean age 58.5 +/- 6.90 years, mean body mass 70.9 +/- 15.32 kg and mean body height 164.8 +/- 7.24 cm. Study population was divided into two groups of 30 subjects: experimental (E) group and control (C) group. The experimental program was performed three times a week for three months. The Nordic walking program was so designed for the performers to be in the aerobic work zone throughout the exercise. Nordic walking with poles was performed over three months. Study results revealed functional abilities of the study women to have modified during the longitudinal process.
PMID:
22053573
[PubMed - indexed for MEDLINE]



J Aging Phys Act. 2012 Jan;20(1):93-105. Epub 2011 Sep 15.
IMPROVEMENT IN FUNCTIONAL CAPACITY FROM NORDIC WALKING: a randomized-controlled trial among elderly people.

Parkatti T, Perttunen J, Wacker P.
Source
Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Abstract
This study examined the effects of an instructed structured Nordic walking (NW) exercise program on the functional capacity of older sedentary people. Volunteers were randomly assigned to an NW group (68.2 ± 3.8 yr old) or control group (69.9 ± 3.0 yr old). Before and at the end of the 9-wk intervention, functional tests and 2-dimensional ground-reaction-force (GRF) patterns of normal (1.40 m/s) and fast (1.94 m/s) walking speeds were measured. The intervention included a 60-min supervised NW session on an inside track twice a week for 9 wk. The mean changes in functional tests differed between groups significantly. Gait analyses showed no significant differences between the groups on any GRF parameters for walking speed either before or after the intervention. The study showed that NW has favorable effects on functional capacity in older people and is a suitable form of exercise for them.
PMID:
21949243
[PubMed - in process]



Gait Posture. 2011 Jun;34(2):234-8. Epub 2011 Jun 2.
THE INFLUENCE OF NORDIC WALKING ON SIT TO STAND TRANSFER IN PARKINSONS PATIENTS.

Fritz B, Rombach S, Godau J, Berg D, Horstmann T, Grau S.
Source
Medical Clinic, Department of Sports Medicine, University of Tuebingen, Silcherstrasse 5, 72076 Tuebingen, Germany. bettina.fritz@med.uni-tuebingen.de
Abstract
Neurodegenerative processes in Parkinson's disease (PD) particularly affect activities of daily living (ADL). Problems of patients with PD in sit-to-stand (STS) performance have been verified before, but not the effects of training on biomechanical measures of STS function. This pilot study aimed to analyse effects of 12 weeks of Nordic Walking training and severity of PD: healthy controls (CO), least (UPDRS A) and more severe (UPDRS B) affected PA on selected functional outcome measures. We expected improvements in PD similar to CO, with better performance of the unstable second phase and faster execution of the entire movement with higher velocities of centre of gravity (COG). 3D kinematics of 22 PD and 18 CO subjects before and after training, were recorded using a motion analysis system (Vicon, Oxford). We compared five outcome measures for STS in 11 PD and 11 CO, matched according to age, gender, height, and weight. Effects of Nordic Walking training were not statistically significant but indicated different patterns which depended on the values of patient's UPDRS score (part III, motor functions). Time required for STS performance increased and horizontal and vertical velocity of COG decreased in UPDRS B, which could be due to progression of PD during the training period. In contrast, UPDRS A showed similar effects as CO. The effects of Nordic Walking as an easy, economic and low-risk intervention on STS in PD depend on the degree of PD. Our findings may help scientists, patients, and therapists to adjust sport-physiological interventions.
Copyright © 2011 Elsevier B.V. All rights reserved.
PMID:
21640591
[PubMed - indexed for MEDLINE]



Int J Sports Med. 2011 Jun;32(6):407-14. Epub 2011 Apr 6.

EFFICACY OF NORDIC WALKING IN OBESITY MANAGEMENT.

Figard-Fabre H, Fabre N, Leonardi A, Schena F.
Source
Center of Bioengineering and Motor Science, University of Trento, Rovereto, Italy. helene.fi gard@aliceadsl.fr
Abstract
The effects of a Nordic walking (NW) program compared to those of a walking (W) program on physiological and perceptual variables in obese middle-aged women were investigated. Subjects (n=12 NW group, n=11 W group) trained over 12 weeks 3 times.week (-1). Body mass, body mass index (BMI), body fat, heart rate (HR), resting blood pressure, peak oxygen consumption (VÿO (2peak)) were measured before and after the training period. Moreover, HR, rating of perceived exertion (RPE) and adherence were recorded during all training sessions. After the training period body mass, body fat and diastolic blood pressure decreased in both groups (P<0.05) whereas VÿO (2peak) increased in the NW group (+3.7 ml.min (-1).kg (-1); P=0.005). During the training sessions, mean HR (P=0.021), HR at preferred walking speed (P=0.020) and % of time at high intensity (P=0.031) were higher in NW than in the W group. Finally, RPE was not influenced by the modality of exercise and NW group showed a higher rate of adherence (91±19% vs. 81±29%; P=0.011). To conclude, NW activity in obese women allows an increase in exercise intensity and adherence to a training program without increasing the perception of effort leading to enhanced aerobic capacity.
© Georg Thieme Verlag KG Stuttgart • New York.
PMID:
21472629
[PubMed - indexed for MEDLINE]



J Aging Res. 2011;2011:232473. Epub 2011 Mar 30.
EFFECTS OF A FLEXIBILITY AND RELAXATION PROGRAMME with WALKING AND NORDIC WALKING ON PARKINSONS DISEASE.
Reuter I, Mehnert S, Leone P, Kaps M, Oechsner M, Engelhardt M.
Source
Department of Neurology, Justus Liebig University, Am Steg 14, 35392 Giessen, Germany.
Abstract
Symptoms of Parkinson's disease (PD) progress despite optimized medical treatment. The present study investigated the effects of a flexibility and relaxation programme, walking, and Nordic walking (NW) on walking speed, stride length, stride length variability, Parkinson-specific disability (UPDRS), and health-related quality of life (PDQ 39). 90 PD patients were randomly allocated to the 3 treatment groups. Patients participated in a 6-month study with 3 exercise sessions per week, each lasting 70 min. Assessment after completion of the training showed that pain was reduced in all groups, and balance and health-related quality of life were improved. Furthermore, walking, and Nordic walking improved stride length, gait variability, maximal walking speed, exercise capacity at submaximal level, and PD disease-specific disability on the UPDRS in addition. Nordic walking was superior to the flexibility and relaxation programme and walking in improving postural stability, stride length, gait pattern and gait variability. No significant injuries occurred during the training. All patients of the Nordic walking group continued Nordic walking after completing the study.


J Appl Biomech. 2011 Feb;27(1):22-31.
LOWER AND UPPER EXTREMITY LOADING IN NORDIC WALKING IN COMPARISON WITH WALKING AND RUNNING.
Hagen M, Hennig EM, Stieldorf P.
Source
Biomechanics Laboratory, Department of Sport and Movement Sciences, University of Duisburg-Essen, Germany.
Abstract
Nordic walking (NW) was compared with walking (W) and running (R) with respect to upper and lower limb injury risks. 24 NW-instructors performed W, NW, and R trials on a runway covered with artificial turf at controlled speeds. Foot pronation and ground reaction forces were measured as well as shock wave transmission to the right wrist. Comparison of NW and W shows similar results for all of the four chosen velocities (5 km/h, 7 km/h, 8 km/h, 8.5 km/h). Except for the 2nd peak of the vertical ground reaction force, NW results in higher loading rates and horizontal forces as well as higher pronation and pronation velocity values as compared with W. Wrist acceleration values up to 7.6 times gravitational acceleration were recorded in NW. Compared with R at the same speeds (8 km/h and 8.5 km/h), NW can be recommended as low impact sport with 36% lower loading rates and 59% lower pronation velocities. However, the high wrist accelerations in NW reveal that the upper extremities are exposed to considerable repetitive shocks, which may cause overuse injuries of the upper extremities. Thus, additional preventive exercises for the upper limb muscles are recommended as well as using shock absorbing walking poles.
PMID:
21451179
[PubMed - indexed for MEDLINE]


Arthritis Res Ther. 2011 Feb 16;13(1):103.

NORDIC WALKING IN FIBROMYALGIA: a means of promoting fitness that is easy for busy clinicians to recommend.
Jones KD.
Abstract
A total of 67 women with fibromyalgia were recruited to an exercise study and were randomized to moderate-to-high-intensity Nordic walking (age 48 ± 7.8 years) or to a control group engaging in supervised low-intensity walking (age 50 ± 7.6 years). A total of 58 patients completed. Significantly greater improvement in the 6-minute walk test was found in the Nordic walking group (P = 0.009), compared with the low-intensity walking group. A significantly larger decrease in exercise heart rate (P = 0.020) and significantly improved scores on the Fibromyalgia Impact Questionnaire Physical function (P = 0.027) were found in the Nordic walking group as compared with the low-intensity walking group. No between-group difference was found for the Fibromyalgia Impact Questionnaire total or pain scores. The authors conclude that moderate-to-high intensity aerobic exercise by means of Nordic walking twice a week for 15 weeks was found to be a feasible mode of exercise, resulting in improved functional capacity and a decreased level of activity limitations.
PMID:
21345243
[PubMed - indexed for MEDLINE]
PMCID:
PMC3157638
Free PMC Article



Eur J Appl Physiol. 2011 Jun;111(6):1121-6. Epub 2010 Nov 28.
MECHANICAL AND PHYSIOLOGICAL EFFECTS OF VARYING POLE WEIGHTS DURING NORDIC WALKING compared to walking.

Schiffer T, Knicker A, Montanarella M, Strüder HK.
Source
Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany. t.schiffer@dshs-koeln.de
Abstract
The study investigated the effect of varying pole weights on energy expenditure, upper limb muscle activation and on forces transmitted to the poles during Nordic walking (NW). Twelve women [age = 21 (2) years, body mass = 60.8 (6) kg, height = 1.71 (0.06) m] participated in five 7-min walking tests randomly chosen without poles (W), with normal NW poles (NW) or with added masses of 0.5 kg (NW + 0.5) 1.0 kg (NW + 1.0) or 1.5 kg (NW + 1.5) at a speed of 2 m s(-1). Heart rate (HR), relative oxygen uptake ([Formula: see text]), blood lactate (La) and rate of perceived exertion (RPE) were registered along with surface EMG (SEMG) from biceps brachii, triceps brachii, trapecius and deltoideus muscles. Inbuilt force transducers measured reaction forces along the long axes of the poles. NW + 0.5 and NW + 1.5 showed significant increases for [Formula: see text] and RPE compared with W (p < 0.05) but with no respective differences within NW. SEMG revealed higher activation of biceps brachii for all NW tests plus added masses compared to W (p < 0.05). Additionally the activation of biceps brachii was higher for NW + 1.5 compared to NW (p < 0.05). The contribution to overall activation duration of triceps brachii became lower but increased for biceps brachii with heavier poles. The increased energy expenditure during NW can be attributed to intensified muscle activation during forward swing of the poles. Heavier poles have no effect on energy expenditure compared to NW with usual poles but enhance muscular activity. Since there are no benefits concerning physiological and biomechanical parameters we do not recommend the use of heavier NW poles.

Arthritis Res Ther. 2010;12(5):R189. Epub 2010 Oct 13.
Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial.

Mannerkorpi K, Nordeman L, Cider A, Jonsson G.
Source
Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, Box 480, 40530 Göteborg, Sweden. kaisa.mannerkorpi@rheuma.gu.se
Abstract
INTRODUCTION:
The objective of this study was to investigate the effects of moderate-to-high intensity Nordic walking (NW) on functional capacity and pain in fibromyalgia (FM).
METHODS:
A total of 67 women with FM were recruited to the study and randomized either to moderate-to-high intensity Nordic Walking (n = 34, age 48 ± 7.8 years) or to a control group engaging in supervised low-intensity walking (LIW, n = 33, age 50 ± 7.6 years). Primary outcomes were the six-minute walk test (6MWT) and the Fibromyalgia Impact Questionnaire Pain scale (FIQ Pain). Secondary outcomes were: exercise heart rate in a submaximal ergometer bicycle test, the FIQ Physical (activity limitations) and the FIQ total score.
RESULTS:
A total of 58 patients completed the post-test. Significantly greater improvement in the 6MWT was found in the NW group (P = 0.009), as compared with the LIW group. No between-group difference was found for the FIQ Pain (P = 0.626). A significantly larger decrease in exercise heart rate (P = 0.020) and significantly improved scores on the FIQ Physical (P = 0.027) were found in the NW group as compared with the LIW group. No between-group difference was found for the change in the FIQ total. The effect sizes were moderate for the above mentioned outcomes.
CONCLUSIONS:
Moderate-to-high intensity aerobic exercise by means of Nordic walking twice a week for 15 weeks was found to be a feasible mode of exercise, resulting in improved functional capacity and a decreased level of activity limitations. Pain severity did not change over time during the exercise period.
TRIAL REGISTRATION:
Clinicaltrials.gov identifier NCT00643006.

Clin J Sport Med. 2010 Sep;20(5):355-61.
EFFECTS OF NORDIC WALKING AND EXERCISE IN TYPE 2 DIABETES MELLITUS : a randomized controlled trial.
Gram B, Christensen R, Christiansen C, Gram J.
Source
Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark. bgram@health.sdu.dk
Abstract
OBJECTIVE:
Both Nordic walking and Exercise on Prescription have potential as elements in the management of type 2 diabetes mellitus. These programs are recommended, but their effectiveness has not yet been established. The aim was to evaluate the efficacy of these 2 interventions compared with standard information on physical activity.
DESIGN:
Single-blinded, randomized, controlled intervention study.
SETTING:
Sixty-eight patients (37 men and 31 women) were randomized into 3 groups: Nordic walking (NW; n = 22), Exercise on Prescription (EP; n = 24), and control (CG; n = 22).
PATIENTS:
: Patients were recruited from a diabetes outpatient clinic and via newspaper advertisement.
INTERVENTIONS:
Consisted of a 4-month intervention period followed by an 8-month follow-up, during which the participants were recommended to train on their own.
MAIN OUTCOME MEASURES:
: HbA1c.
RESULTS:
: There was no difference in HbA1c when comparing the intervention groups relative to the control group: DeltaNW = -0.4% [95% confidence intervals (CI), -0.9% to 0.1%] and DeltaEP = -0.2% (95% CI, -0.6% to 0.2%) after 4 months; DeltaNW = 0.0% (95% CI, -0.6% to 0.5%) and DeltaEP = 0.3% (95% CI, -0.3% to 0.9%) after 12 months. However, fat mass assessed by dual energy X-ray absorptiometry (DXA) decreased significantly in the NW group after 4 months [-1.0 kg (95% CI, -1.7 to 0.1)] and after 12 months in both NW [-1.8 kg (95% CI, -3.2 to -0.4)] and EP [-1.5 kg (95% CI, -2.9 to -0.05)] groups. No significant changes in other variables.
CONCLUSIONS:
Four-month exercise programs at moderate intensity of either Nordic walking or Exercise on Prescription did not significantly improve HbA1c in patients with type 2 diabetes either at the end of the program or at the follow-up.

Respir Res. 2010 Aug 22;11:112.
NORDIC WALKING IMPROVES DAILY PHYSICAL ACTIVITIES IN COPD: a randomised controlled trial.
Breyer MK, Breyer-Kohansal R, Funk GC, Dornhofer N, Spruit MA, Wouters EF, Burghuber OC, Hartl S.
Source
Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Otto Wagner Hospital, Sanatoriumstreet 2, 1140 Vienna, Austria. marie.breyer@gmx.at
Abstract
BACKGROUND:
In patients with COPD progressive dyspnoea leads to a sedentary lifestyle. To date, no studies exist investigating the effects of Nordic Walking in patients with COPD. Therefore, the aim was to determine the feasibility of Nordic Walking in COPD patients at different disease stages. Furthermore we aimed to determine the short- and long-term effects of Nordic Walking on COPD patients' daily physical activity pattern as well as on patients exercise capacity.
METHODS:
Sixty COPD patients were randomised to either Nordic Walking or to a control group. Patients of the Nordic Walking group (n = 30; age: 62 +/- 9 years; FEV1: 48 +/- 19% predicted) underwent a three-month outdoor Nordic Walking exercise program consisting of one hour walking at 75% of their initial maximum heart rate three times per week, whereas controls had no exercise intervention. Primary endpoint: daily physical activities (measured by a validated tri-axial accelerometer); secondary endpoint: functional exercise capacity (measured by the six-minute walking distance; 6MWD). Assessment time points in both groups: baseline, after three, six and nine months.
RESULTS:
After three month training period, in the Nordic Walking group time spent walking and standing as well as intensity of walking increased (Delta walking time: +14.9 +/- 1.9 min/day; Delta standing time: +129 +/- 26 min/day; Delta movement intensity: +0.40 +/- 0.14 m/s2) while time spent sitting decreased (Delta sitting time: -128 +/- 15 min/day) compared to baseline (all: p < 0.01) as well as compared to controls (all: p < 0.01). Furthermore, 6MWD significantly increased compared to baseline (Delta 6MWD: +79 +/- 28 meters) as well as compared to controls (both: p < 0.01). These significant improvements were sustained six and nine months after baseline. In contrast, controls showed unchanged daily physical activities and 6MWD compared to baseline for all time points.
CONCLUSIONS:
Nordic Walking is a feasible, simple and effective physical training modality in COPD. In addition, Nordic Walking has proven to positively impact the daily physical activity pattern of COPD patients under short- and long-term observation.


Psychological Health
In 1992, Stoughton, Larkin, and Karawan, a group of researchers from the University of Wisconsin-LaCrosse, studied three groups of participants: a control group, a group of pole walkers (using Exerstrider® poles), and a group of regular walkers. After twelve weeks of walking thirty to forty-five minutes four times a week, the group using Exerstrider® poles showed a great deal of improvement psychologically. There was a significant decrease in depression, anger, fatigue, and other mood disturbances.
There was some speculation that the participants felt unique and special because they were given the opportunity to do a “new,” enjoyable form of walking, which also increased their positive moods. Additionally, researchers speculated that the cross-patterning that occurs (arms and legs working in opposition to each other) might stimulate a greater number of nerves and muscles, creating a more tranquil and rhythmic exercise. However, the conclusion was that using Exerstrider® poles possibly could enhance self-acceptance and promote a favorable attitude toward exercise.

Coronary Heart Patients
Walter et al (1996) investigated the effects of Nordic Walking on coronary heart patients. All of the subjects were 61-year-old men who had had either heart bypass surgeries or angioplasty procedures or had suffered heart attacks. The researchers concluded that walking with poles is a safe form of rehabilitation for heart patients.
Wilk et al (2005) studied sixteen acute coronary disease patients in Poland. They also concluded that Nordic Walking is an effective activity for cardiac rehabilitation.

Neck and Shoulder Pain
A Finnish study conducted by Anttila et al in 1999 compared Nordic Walking using Exel Nordic Walker® poles with regular walking. After twelve weeks, the study found that walking with poles decreased neck and shoulder pain, and upper body mobility increased as well.
Similar results were obtained by another team of researchers led by Karvonen in 2000 when they studied neck and shoulder pain with a group who had no previous experience with Nordic Walking.

The Elderly
In 2003, Koskinen et al. studied aging employees, focusing on their postural control as well as the muscular strength of their middle trunk and lower bodies. The participants walked with poles three times a week, and at the end of the study the entire group improved in health-related fitness parameters using the Fitness Test battery developed by UKK Institute (Urho Kaleva Kekkonen Institute) in Finland.
The goal of another study, done by Parkatti et al. in 2002, was to examine the benefits of Nordic Walking on everyday life functions in older, sedentary individuals. A group of 73-year-olds, exercised by Nordic Walking twice a week for sixty minutes at a time. The results showed significant improvement in functionality at the end of the twelve-week study and the researchers concluded that Nordic Walking is suitable for the elderly and positively affects an elderly person’s function capacity.
A group of MSC Rehabilitation Science students at the University of Brighton, England, are part of an ongoing project to find out if Nordic Walking offered cardiovascular benefits for older people. Led by Dr Raija Kuisma, a Nordic Walker and instructor herself, the student research showed that Nordic Walking raised heart rates by about 13% and burned 25% more calories than normal walking at the same speed. The students are conducting further studies to investigate the effects of Nordic Walking on lower limbs, joints, spinal mobility and muscle tension in the elderly.

Breast Cancer
Lisa Kay Sprod’s thesis, published at the University of Northern Colorado in 2003, measured the effects of walking with poles on shoulder function in breast cancer survivors. The data showed that walking with poles for eight weeks significantly improved upper body muscular endurance in breast cancer patients following treatment.
Osteoporosis
Dr. Pusch, a professor at the University of Graz, Austria, conducted a study (unpublished) to determine the effects of Nordic Walking on women with osteoporosis. Participants increased hip bone density and there was an even greater improvement in the density of their spines. Dr. Pusch concluded that Nordic Walking is a valuable component of prevention and treatment of osteoporosis.
Parkinson’s Disease
A study by Baatile et al. 2000 researched 72-year-old males with Parkinson’s disease. The participants walked with poles three times a week (for sixty minutes per session) in a supervised, eight-week training program. The purpose of the study was to determine if Nordic Walking improved cognitive skills, daily activities, motor function, and quality of life in those with Parkinson’s disease. The researchers concluded that a regular Nordic Walking program did in fact increase the perceived functional independence and quality of life for individuals with Parkinson’s disease.

Vascular Diseases
In 2003, Eileen Collins and her team of researchers studied fifty-two patients with vascular disease, ages 65-70 years old. The participants Nordic Walked three times a week for thirty to forty-five minutes. They were also given 400 IU of Vitamin E daily. The researchers concluded that while Vitamin E seemed to cause little added benefit, Nordic Walking effectively improved both the tolerance for exercise and the perceived quality of life for patients with PAD (peripheral arterial disease).

Weight Loss/Body Fat Loss
Heikkilä et al (in an unpublished study conducted in 2004) studied the effect of Nordic Walking on overweight adults over a four-month period. The participants lost on average eleven pounds, showed a decrease in body fat, and their aerobic fitness levels improved on average 29%. According to the researchers, key factors were that the Nordic Walking training was moderate to high in intensity and progressive in nature.

RESEARCH RELATED TO FITNESS

Cardio-respiratory FitnessKukkonen-Harjula et al 2004 did research to determine the effects of brisk walking with and without poles on cardio-respiratory fitness in healthy middle-aged women (ages 50-60). Both the regular walkers and the Nordic Walkers trained four times each week for forty minutes per session. The increase in peak VO2 (the volume of oxygen consumed while exercising at maximum capacity) was modest in both groups of walkers, indicating that no more effort was required to walk with poles than without them.
In 2004, Mänttäri and several other researchers conducted a pilot study for the Kukkonen-Harjula intervention study (see above). This pilot compared cardio-respiratory and musculoskeletal responses in both middle-aged women Nordic Walkers and regular walkers. The subjects, who walked on treadmills, were all familiar with Nordic Walking or cross-country skiing. Nordic Walking increased the participant’s mean heart rate (2.6% to 4.9%) compared to regular walking. The researchers attributed the increase to increased muscle activity in the upper body.
In an unpublished study using Exerstrider® poles led by Dr. Fran Nagle at the University of Wisconsin in 1989, increases in O2 consumption in a pole walking group averaged 37% and reached as high as 94% (versus walking without poles).

Note: There is usually a direct correlation to increases in O2 consumption and increases in energy expenditure.
Physiological Effects
Hendrickson (1993) and Porcari et al (1997) both studied the physiological effects of Nordic Walking on already fit men and women. The participants were divided into two groups walking on treadmills: regular walkers and Nordic Walkers using Power Poles™.
Hendrickson’s study showed that using poles significantly increased oxygen uptake, heart rate and energy expenditure – approximately 20% compared to those walking without poles.
Porcari’s study showed similar results: an average of 23% higher oxygen uptake, 22% higher caloric expenditure, and 16% increase in heart rate compared to the non-pole walkers. There was also a 38% increase in endurance in the Nordic Walkers. Porcari concluded that Nordic Walking can result in increased muscular endurance.
In 2001, Swedish researchers Gullstrand & Svedenhag studied acute physiological effects while walking on a treadmill, with or without poles. The results shown by the fifty-five year old participants showed that VO2, VE, blood lactate, and HR all increased in the pole walkers, but the rate of perceived exertion (RPE) was no different in Nordic Walkers compared to regular walkers.
Heart Rate/Blood Lactate Levels
In a study conducted by Aigner et al in 2004, participants walked with and without poles on alternate days. The results of this study showed that heart rates and blood lactate levels were significantly higher during Nordic Walking compared to regular walking—the benefits being increased energy expenditure and a more strenuous cardiovascular session.
Laukkanen also studied heart rate during normal and fast walking speeds, both with and without Exel Nordic Walker® poles. In a 1998 unpublished study, the results showed an increase in heart rate using the poles. This shows that Nordic Walking produces a greater cardiovascular strain, which is good news for people who cannot run, but have trouble reaching their training heart rate by regular walking.
Metabolic Cost
In a study conducted by the Cooper Institute in Dallas, Texas (Morss et al 2001; Church et al 2002), the metabolic cost (the higher the metabolic rate, the more calories consumed) of Nordic Walking was compared to normal walking. This important study showed significant increases in oxygen consumption (up to 20% on average), caloric expenditure, and heart rate in the Nordic Walkers when compared to the regular walkers. There was no difference in perceived exertion between the groups.
The same group of researchers (Jordan et al 2001) compared separately the metabolic cost of high intensity poling. The results showed that during high intensity Nordic Walking, heart rates increased an average of 35 bpm when compared to walking without poles, which means more energy was expended and thus more benefits reaped.
Gait analysis (lower extremities)
Willson et al 2001 conducted a study to determine whether walking with poles reduces lower extremity loading. A three-dimensional gait analysis showed that there were indeed variables in range of motion between walking with and without poles. The subjects walking with poles were able to walk at a faster speed, while reducing vertical ground reaction forces, vertical knee joint reaction forces, and knee extensor angular impulses.
Endurance capacity
A German study led by Ripatti in 2002 showed that even while walking at lower speeds with poles, the participants increased their endurance.
Incorporating Arm Activity in Walking
Knox (1993), Foley (1994), Butts et al (1995) all conducted research using CrossWalk Dual Motion Cross Trainer motorized treadmills to determine the energy expended when incorporating arm activity during walking. Their results all showed that walking with arm activity significantly increased heart rate, ventilation, oxygen uptake as well as the amount of energy expended. For instance, in Butts study, energy expenditure increased by 55% with the arm activity, while the rate of perceived exertion was about the same compared to regular walking. While arm activity on a treadmill is not the same as walking outside with poles, this study can definitely correlates as a reference for Nordic Walking.

Energy Expenditure

In 1995, researchers at the University of Michigan in East Lansing (Rodgers et al) studied how much energy was expended in participants walking with Exerstriders® on motorized treadmills. This research showed that aerobic power and heart rate were significantly greater when walking with poles compared to walking without poles. And even though the perceived rate of exertion didn’t differ between the groups, the Nordic Walkers burned significantly more calories.

RESEARCH RELATED TO SPORTS AND ATHLETES

Cross Country Skiers
In 2003, a Norwegian study by Haugan and Sollesnes focused on twenty-two-year-old sports students. Half of the participants were cross-country skiers. While Nordic Walking, the oxygen uptake (signifying increased exertion and conditioning) did not increase in the group of already seasoned cross-country skiers, but it was significantly higher in the other subjects who were not familiar with pole walking.

MISCELLANEOUS RESEARCH
Risk of Injury
A team of researchers led by Parkkari in 2004 studied the risk of injury in a variety of competitive and recreational sports. He studied risks ranging from 0.19 to 1.5 per 1000 of participation. The highest risk was shown to be in squash at 18.3, judo at 16.3, and orienteering as 13.6. But in Nordic Walking, the risk of injury was only 1.7.
Correct Technique
In May 2006 at the German Nordic Fitness Association Conference, it was reported that a study conducted by Dr. Thorwesten of the University of Munster, Germany, showed that muscle exertion in the arms (11-14%), core, and legs increased when walking with poles, as opposed to regular walking, and the participant’s endurance increased significantly. However, the benefits were seen only in those who used the correct Nordic Walking technique.

Also reported at the same conference, a study conducted by Dr. Schwameder of the University of Salzburg, Austria, found that Nordic Walking increased metabolic rates by 12-25% compared to walking without poles, but again, only if the correct technique was used. Muscle activity was also significantly higher, and there was an increase of 23-33% in oxygen usage. Nordic Walking at 7.7 km per hour provided benefits similar to jogging at 9.8 km per hour – with 30% less stress on the knees. This study also noted that the shorter the pole, the greater the muscle exertion and the more stress on the knees.
Consumer Popularity
Shove and Pantzar conducted some research in 2004 from the consumer’s perspective. They found that Nordic Walking’s popularity has increased due to the active and ongoing exposure and availability to Nordic Walkers, equipment and education and training.

SUMMARY
Based on solid research, Nordic Walking has been shown to provide many health and fitness benefits. This unique and increasingly popular form of exercise has many advantages, both for healthy and fit individuals who want to increase their workouts and gain additional cardiovascular benefits as well as for those with medical conditions that restrict them from jogging or running. And those who have arthritis or other conditions that prevent them from walking without support can now get the advantages of a real workout.
New research studies are being conducted all the time as more and more health and fitness professionals realize the potential of Nordic Walking. Explore it for yourself – do your own research and experience personally the benefits of Nordic Walking!
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David Downer is the author of Nordic Walking Step by Step. To view the first 4 chapters visit: www.nordicwalkingstepbystep.com
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REFERENCES
Aigner, Ledl-Kurkowski, Hörl, Salzmann. Effecte von Nordic Walking bzw. Normalen Gehen auf Herzfrequenz und atrerielle Laktatkonzentration. Österreichisches Journal fur Sportmedizin, 2004:34, H.3, pp 32-36.
Anttila, Holopainen, Jokinen. Effect of pole walking on neck and shoulder symptoms, mobility of cervical and thoracic spine and aerobic capacity. Final project work for Helsinki IV College for health care professionals, 1999.
Baatile, Langbein, Weaver, Maloney, Jost. Effect of Nordic Walking on perceived quality of life in Parkinson’s disease patients. Journal of Rehabilitation Research and Development, September/October 2000: 37(5).
Butts, Knox, Foley. Energy expenditure walking on dual-action treadmills. Medicine and Science in Sports and Exercise, 1995:27(1), pp 121-125.
Church, Earnest, Morss. Field testing of physiological responses to Nordic Walking, Cooper Institute, Dallas, TX. Research Quarterly for Exercise and Sport, 2002:73, pp 296-300.
Collins, Langbein, Orebaugh, Bammert, Hanson, Reda, Edwards, Littooy. Nordic Walking and Vitamin E for management of peripheral vascular disease. Medicine and Science in Sports and Exercise, 1995:27(1), pp 121-125.
Foley. The effects of CrossWalk Dual Motion Cross Trainer’s resistive arm poles on the metabolic costs of walking on treadmills. Thesis. University of Wisconsin-LaCrosse, 1994.
Gullstrand, Svedenhag. Training effects after seven weeks of pole and normal walking. 8th Annual Congress of the European College of Sport Science, Salzburg, Austria, 2003. Book of Abstacts (Ed: Mueller, Schwameder, Zallinger, Fastenbauer), Institute of Sport Science, University of Salzburg, Austria, 2003, pp 33-34.
Haugan, Sollesnes. Academic degree study to determine submaximal oxygen uptake increase when using poles. Sogn og Fjordane University College Faculty of Teacher Education, Sogndal, Norway, May 2003.
Heikkilä, Kettunen, Vasankari. Improved fitness and reduced weight with Nordic Walking. Unpublished report December 2004, Finland.
Hendrickson. The physiological responses to walking on a treadmill with and without Power Poles™. Thesis. University of Wisconsin-LaCrosse, 1992.
Jordan, Olson, Earnest, Morss, Church. Metabolic cost of high-intensity poling while Nordic Walking vs regular walking. Medicine and Science in Sports and Exercise, 2001:33(5), S86.
Karvonen, Mörsky, Tolppala, Varis. Effects of walking with poles on neck and shoulder pain in office workers. Final project work at Mikkeli Polytechnic School, 2001.
Knox. Energy expenditure walking with and without arm activity on CrossWalk Dual Motion Cross Trainers. Thesis. University of Wisconsin-LaCrosse, 1993.
Kuisma. Unpublished study of cardiovascular benefits of Nordic Walking in the elderly, 2005.
Kukkonen-Harjula, Mänttäri, Hiilloskorpi, Pasanen, Laukkanen, Suni, Fogelhom, Parkkari. Training responses of brisk walking with or without poles in a randomized controlled trial with middle-aged women. 9th Annual Congress of the European College of Sport Science. Clermont-Ferrand, France, 2004. Book of Abstracts, p. 157.
Laukkanen. Heart rate response to Nordic Walking with Exel Walker poles vs regular walking. Unpublished study, 1998.
Mänttäri, Hannola, Laukkanen, Hiilloskorpi, Alikoski, Valve, Pekkarinen, Parkkari. Cardiorespiratory and musculoskeletal responses of walking with and without poles in field conditions with midde-aged women. 9th Annual Congress of the European College of Sport Science. Clermont-Ferrand, France, 2004. Book of Abstracts, p. 157.
Nagle, Fran. Unpublished study, University of Wisconsin, 1989. The increase of 02 consumption using Exerstrider® poles.
Parkatti, Wacker, Andrews. Functional capacity from Nordic Walking among the elderly. Seminar posted University of Jyväskylä, Finland, 2002.
Parkkari, Kannus, Natri, Lapinleimu, Palvanen, Heiskanen, Vuori, Järvinen. Risk of injury in competitive and recreational sports. “Active Living and Injury Risk.” International Journal of Sports Medicine, 2004:25, pp 209-216.
Porcari, Hendrickson, Walter, Terry, Walsko. Physiological responses to walking and without Power Poles™ on treadmills. Research Quarterly for Exercise and Sport, 1997:68(2), pp 161-166.
Porcari. “Pump Up Your Walk.” ACSM’s Health and Fitness Journal, 1999:Jan/Feb, pp 25-29.
Pusch. Unpublished study of effects of Nordic Walking on women with osteoporosis. University of Graz, Austria.
Ripatti. Effects of Nordic Walking program on cardiovascular fitness. Academic degree study. Sportartspezifische Leistungsfähigkeit Deutsche Sporthochschule Köln, Germany, 2002.
Rogers, Vanheest, Schachter. Energy expenditure during submaximal walking with Exerstrider® poles. Medicine and Science in Sports and Exercise, 1995:27(4), pp 607-611.
Schwameder. Unpublished study on metabolic rate while Nordic Walking. University of Salzburg, Austria, 2003.
Shove, Pantzar. “Consumers, Producers and Practices: Understanding the Invention and Reinvention of Nordic Walking. Journal of Consumer Culture, 2004.
Sprod, Lisa Kay. Thesis measuring effects of pole walking on shoulder function in breast cancer survivors, 2003.
Stoughton. Psychological profiles before and after twelve weeks of walking with and without Exerstrider® poles in adult women. Thesis. University of Wisconsin-LaCrosse, 1992.
Thorwesten. Unpublished study on muscle exertion on arms, core and legs while Nordic Walking. University of Munster, Germany.
Walter, Porcari, Brice,Terry. Acute responses to using walking poles in patients with coronary artery disease. Journal of Cardiopulminary Rehabilitation, Jul-Aug 1996:16(4), pp245-50.
Wilk, Kocur, Przywarska, Rozanska, Owczarski, Dylewicz. 2005 (unpublished). Study of acute coronary disease patients in Poland.
Wilson, Torry, Decker, Kernozek, Steadman. Effects of walking with poles on lower extremity gait mechanics. Medicine and Science in Sports and Exercise, January 2001:33(1), pp 142-147.

THE EFFECT OF OUTDOOR EXERCISE ON MOOD

There have been a number of recent studies that prove that outdoor or 'green' exercise has a pronounced effect on the mood and health of an individual.

The three major benefits are:
1. Being outdoors generally leads to increasing activity levels
2. The connection with nature is proven to have a positive effect on mood and to reduce stress levels.
3. Taking part in outdoor activiites increases the opportunity for social interaction - those with increased levels of of social interaction tend to be in better health than those who have very little.

see Natural England - green Exercise for more info.

RESEARCH PROVES POLES DO HELP

Recent research by Northumberland University recorded a dramatic difference in the performance of walkers who used trekking poles. The added benefit of Nordic Walking poles is that they can be used for trekking and also provide FURTHER propulsion and upper body work. A simple trekking pole can not be used to gain a complete Nordic Walking technique.

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