Few studies have examined the effects of Nordic walking on cardiac rehab patients, yet other forms of exercise, namely HIIT workouts, have been extensively studied, said senior author Dr. Jennifer Reed, director of exercise physiology and cardiovascular health at the University of Ottawa Heart Institute in Canada. No other study has directly compared the above three exercise regimens.
“Our research showing the superior benefits of Nordic walking on functional capacity highlights an alternative exercise option that requires minimal cost and equipment to improve physical and mental health,” she said.
Total-body movement
During Reed’s study, researchers had 130 patients in a 12-week training program performing either 60 minutes of Nordic walking on an indoor track; 60 minutes of moderate-to-vigorous continuous training (e.g., cycling or rowing); or a 45-minute HIIT workout. At the end of the training program, and again after a 14-week post-regimen observation period, the participants took two six-minute walk tests to measure functional capacity.
All of the exercise regimens helped alleviate the patients’ depression and improved their quality of life, but functional capacity was greatest after Nordic walking, the researchers found. The walkers had a 19% boost in functional capacity versus 13% for those doing the HIIT workouts and 12% for those doing the moderate-to-vigorous continuous training.
“The six-minute walk test to measure functional capacity is an evidence-based and typically reproducible test,” said physician Dr. Jonathan H. Whiteson, associate professor of rehabilitation and medicine at NYU Langone Health in New York City. He was not involved in the study.
“However, as a walking test to measure improvements of different exercise regimens, it is important to recognize that training is task-specific, and so it is not such a surprise that the walking intervention, rather than the other two exercise interventions that did not focus only on walking, produced the greater increase.”
A more objective measure of aerobic training is a cardio-pulmonary exercise test, or metabolic stress test, which can measure fitness levels through metabolic analysis, said Whiteson, who also serves as medical director of cardiac rehabilitation at NYU Langone Health. “Use of CPET testing would have enhanced the results of this study. That being said, all modalities improved functional capacity, and that is the goal of a cardiac rehab program, as it correlates well with reduced risk for future cardiac events.”
The fact that Nordic walking is primarily a walking exercise and the other training programs included a variety of aerobic exercises may definitely be the reason why it came out No. 1 in the walk test, Reed acknowledged. The use of poles while walking may have improved speed and postural control, and increased walking-stride length.
Either way, Whiteson had one note of caution: To achieve an increase in functional capacity, Nordic walking must be done vigorously, and it takes coordination and balance, he said. Thus, it might not be a good choice for everyone.
Building off of the study, her team is poised to begin a clinical trial that will explore the effects of combining different exercise types on patients with cardiovascular disease, such as pairing HIIT workouts with Nordic walking.
Feel the burn
The positive study results have also piqued the team’s interest in further exploring the potential benefits of Nordic walking on other health measures, such as upper- and lower-body strength, and cardiovascular health indicators such as blood glucose and lipids. Positive results may point to its use for those with other conditions, such as obesity and diabetes.
In the United States, only 20% to 30% of the patients who qualify for, and can benefit from, cardiac rehabilitation are referred and participate, Whiteson said. This lack of active rehab participants makes research like Reed’s important, as it points to another exercise modality they can use — and a very practical one, as it can be done outside of a gym. “It also helps remind health care providers and patients that cardiac rehab is an essential part of their recovery regimen, future health and well-being.”
Perhaps the biggest takeaway from the study, both Reed and Whiteson said, is that everyone can benefit from exercise. “There is no magic pill for health, but exercise is medicine that simultaneously targets multiple health conditions,” Reed said. “When it comes to physical activity, I like to say, ‘Some is better than none, and more is better than some.'”
