Few studies have examined the effects of Nordic walking on cardiac rehab patients, but 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 demonstrating 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.
During Reed’s study, researchers had 130 patients in a 12-week exercise program who performed either 60 minutes of Nordic walking on an indoor track; 60 minutes of moderate-to-vigorous continuous exercise (eg, cycling or rowing); or a 45-minute HIIT workout. At the end of the training program, and again after a 14-week observation period after the regimen, participants took two six-minute walk tests to measure functional capacity.
All of the exercise regimens helped relieve the patients’ depression and improve their quality of life, but functional capacity was greatest after Nordic walking, the researchers found. The walkers had a 19% increase in functional capacity versus 13% for those who did the HIIT workouts and 12% for those who did the moderate-to-vigorous continuous workout.
“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 investigation.
“However, as a walking test to measure improvements from different exercise regimens, it is important to recognize that training is task specific, and so it comes as no surprise that the walking intervention, rather than the other two exercise interventions that don’t focus on walking alone, produced the greater increase.”
A more objective measure of aerobic exercise is a cardiopulmonary 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. “Using CPET testing would have improved the results of this study. That said, all modalities improved functional capacity, which is the goal of a cardiac rehabilitation program because it correlates well with a reduced risk of future cardiac events.”
The fact that Nordic walking is primarily a walking exercise and the other training programs include a variety of aerobic exercises could certainly be why it came in at number 1 in the walking test, Reed acknowledged. Using canes while walking can lead to improved speed and postural control and increased stride length.
Regardless, Whiteson had one caveat: To achieve an increase in functional capacity, Nordic walking must be done vigorously, and it requires coordination and balance, he said. So it may not be a good choice for everyone.
Building on the study, her team is poised to begin a clinical trial investigating the effects of combining different types of exercise on patients with cardiovascular disease, such as combining HIIT workouts with Nordic walking.
feel the fire
The positive study results have also sparked the team’s interest in further exploring the potential benefits of Nordic walking for other health measures, such as upper and lower body strength, and cardiovascular health indicators such as blood glucose and lipids. Positive results may indicate its use for people with other conditions, such as obesity and diabetes.
In the United States, only 20% to 30% of patients who qualify and could benefit from cardiac rehabilitation are referred and enrolled, Whiteson said. This lack of active rehab participants makes research like Reed’s important, because it points to another exercise modality they can use — and a very practical one, because it can be done outside of a gym. “It also helps to remind caregivers and patients that cardiac rehabilitation is an essential part of their recovery regimen, future health and well-being.”
Perhaps the greatest benefit of the study, both Reed and Whiteson said, is that everyone can benefit from exercise. “There is no magic pill for health, but exercise is a drug that targets multiple health problems at once,” Reed said. “When it comes to physical activity, I like to say, ‘Some is better than nothing, and more is better than some.'”