Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 1, January-February, p. 145–149

doi: 10.17219/acem/35094

Publication type: original article

Language: English

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Nordic Walking May Safely Increase the Intensity of Exercise Training in Healthy Subjects and in Patients with Chronic Heart Failure

Andrzej Lejczak1,2,A,B,D,F, Krystian Josiak3,4,A,D,E,F, Kinga Węgrzynowska-Teodorczyk1,2,B,E, Eliza Rudzińska2,E,F, Ewa A. Jankowska3,4,E, Waldemar Banasiak4,E,F, Massimo F. Piepoli5,E,F, Marek Woźniewski2,E,F, Piotr Ponikowski3,4,A,C,E,F

1 Department of Cardiac Rehabilitation, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland

2 Department of Physiotherapy, University School of Physical Education, Wrocław, Poland

3 Faculty of Health Science, Clinic of Cardiac Diseases, Wroclaw Medical University, Poland

4 Department of Heart Diseases, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland

5 Cardiac Department, Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy


Background. Physical activity in patients with chronic heart failure (HF) improves the exercise capacity and quality of life, and may also reduce mortality and hospitalizations. The greatest benefits are achieved through highintensity aerobic exercises resulting in a stronger cardiorespiratory response. Nordic walking (NW), a walking technique using two poles and mimicking the movements performed while cross-country skiing, is associated with the involvement of more muscle groups than in the case of classic walking, and should therefore make it possible to increase exercise intensity, resulting in more effective training for patients with HF
Objectives. The aim of the study was to assess the feasibility and safety of the NW technique, and to compare the effort intensity while walking with and without the NW technique in both healthy subjects and in patients with chronic HF.
Material and Methods. The study involved 12 healthy individuals (aged 30 ± 10 years, 5 men) and 12 men with stable chronic systolic HF (aged 63 ± 11 years, all categorized in New York Heart Association class II, median LVEF 30%, median peak VO2 18.25 mL/kg/min). All the participants completed two randomly assigned submaximal walking tests (one with NW poles and one without) conducted on a level treadmill for 6 min at a constant speed of 5 km/h.
Results. Walking with the NW technique was feasible, safe and well tolerated in all subjects. In both the control group and the chronic HF group, walking with the NW technique increased peak VO2, RER, VE, PET CO2, HR and SBP over walking without the poles; and the fatigue grade according to the abridged Borg scale was higher. Dyspnea did not increase significantly with the NW technique.
Conclusion. The NW technique can increase the intensity of aerobic training in a safe and well-tolerated way in both healthy individuals and in patients with chronic HF.

Key words

Nordic walking, heart failure, new training concepts, total body workload, high intensity training

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