Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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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

Abstract

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

References (16)

  1. Mc Murray JJV, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Køber L, Lip G, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A: ESC Guidelines for the diagnosis and treatment of acute and chronić heart failure 2012. Eur Heart J 2012, 33, 1787–1847.
  2. Ponikowski P, Szełemej R, Sebzda T: Skuteczność i bezpieczeństwo rehabilitacji ruchowej u chorych z umiarkowaną i ciężką niewydolnością krążenia. Kardiol Pol 1995, 43, 473–480.
  3. Piepoli MF, Conraads V, Corra U, Dickstein K, Francis DP, Jaarsma T, McMurray J, Piotrowicz E, Pieske B, Schmid JP, Anker SD, Solal AC, Filippatos GS, Hoes AW, Gielen S, Giannuzzi P, Ponikowski PP: Exercise training in heart failure: from theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Heart Fail 2011, 13, 347–357.
  4. Piepoli MF, Corra U, Benzer W, Bjarnason-Wehrens B, Dendale P, Gaita D, McGee H, Mendes M, Niebauer J, Zwisler AD, Schmid JP: Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur J Cardiovasc Prev Rehabil 2010, 17, 1–17.
  5. Pina IL, Apstein CS, Balady GJ, Belardinelli R, Chaitman BR, Duscha BD, Fletcher BJ, Fleg JL, Myers JN, Sullivan MJ: Exercise and heart failure: a statement from the Committee on Exercise, Rehabilitation, and Prevention. Circulation 2003, 107, 1210–1225.
  6. Wisloff U, Stoylen A, Loennechen JP, Wisloff U, Stoylen A, Loennechen JP, Bruvold M, Rognmo O, Haram PM, Tjonna AE, Helgerud J, Slordahl SA, Lee SJ, Videm V, Bye A, Smith GL, Najjar SM, Ellingsen O, Skjaerpe T: Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation 2007, 115, 3086–3094.
  7. Hambrecht R, Gielen S, Linke A, Fiehn E, Yu J, Walther C, Schoene N, Schuler G: Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure: a randomized trial. JAMA 2000, 283, 3095–3101.
  8. Giannuzzi P, Temporelli PL, Corra U, Tavazzi L: ELVD-CHF Study Group. Antiremodeling effect of long-term exercise training in patients with stable chronic heart failure: results of the exercise in left ventricular dysfunction and chronic heart failure (ELVD-CHF) trial. Circulation 2003, 108, 554–559.
  9. Morgulec-Adamowicz N, Marszałek J, Jagustyn P: Nordic walking – a new form of adapted physical activity (a literature review). Human Movement 2011, 12, 124–132.
  10. Schiffer T, Knicker A, Montanarella M, Struder HK: Mechanical and physiological effects of varying pole weights during nordic walking compared to walking. Eur J Appl Physiol 2011, 111, 1121–1126.
  11. O’Connor CM, Whellan DJ, Lee KL, Keteyian SJ, Cooper LS, Ellis SJ, Leifer ES, Kraus WE, Kitzman DW, Blumenthal JA, Rendall DS, Miller NH, Fleg JL, Schulman KA, McKelvie RS, Zannad F, Pina IL: Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA 2009, 301, 1439–1450.
  12. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Schoite op Reimer WJ, Vrints C, Wood D, Zamorano JL, Zannad F: Europejskie wytyczne dotyczące zapobiegania chorobom serca I naczyń w praktyce klinicznej na 2012 rok. Kardiol Pol 2012, 70, Suppl 1, S1–S100.
  13. Meyer K, Schwaibold M, Westbrook S, Beneke R, Gornandt L, Lehmann M, Roskamm H: Effects of short-term exercise training and activity restriction on functional capacity in patients with severe chronic congestive heart failure. Am J Cardiol 1996, 78, 1017–1022.
  14. Guiraud T, Nigam A, Gremeaux V, Meyer P, Juneau M, Bosquet L: High-intensity interval training in cardiac rehabilitation. Sports Med 2012, 42, 587–605.
  15. Lee IM, Sesso HD, Oguma T: Relative intensity of physical activity and risk of coronary heart disease. Circulation 2003, 107, 1110–1116.
  16. Rognmo O, Hetland E, Helgerud J, Hoff J, Slordahl SA: High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil 2004, 11, 216–222.