Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial

Abstract

IntroductionThe 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).MethodsA 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.ResultsA 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.ConclusionsModerate-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 registrationClinicaltrials.gov identifier NCT00643006.

Physiological Adaptation in Women Presenting Fibromyalgia: Comparison with Healthy Controls

“…The FM patients in the present study were only able to perform exercise up to an average of 82 W before the rated exertion achieved extreme levels while the healthy control group maintained the ability to continue performing up to an average of 122 W. This observation implies that FM patients may experience difficulty in the performance of particular physical activity and exercise programs designed for healthy women. For FM patients to be able to exercise on a moderate to high intensity (the Borg scale: RPE 15) without increased pain, 2 minute interval training has been shown to be appropriate [40].…”

Effectiveness and Economic Evaluation of Therapeutic Nordic Walking in Patients with Psychosomatic Disorders: A Pragmatic Randomized Controlled Trial

“…In our study training speed was in general very low, in studies with medium effects group worked with patients who had abilities to participate in a high intensity Nordic walking program (Mannerkorpi et al, 2010). Therapists should work with patients at a maximum of intensity, if they decide to apply a Nordic walking program.…”

“…Those studies evaluating medium to high training intensities reported large or medium effect sizes (Long & Van Stavel, 1995;Mead et al, 2010;Mannerkorpi et al, 2010). The participants in these studies were less affected by their complaints or had no or few co-morbidities (Long & Van Stavel, 1995;Mead et al, 2010;Hartvigsen, Morsø, Bendix, & Manniche, 2010).…”

“…Mannerkorpi et al (2010) compared two types of NW programs; they detected small effects and asked whether the contrast between the two different interventions were large enough. This is the reason why the CG in the present study had no additional supervised therapies.…”

“…Studies about walking programs showed positive effects for different typical disorders in a psychosomatic clinic: chronic low back pain patients (Craft & Perna, 2004;O'Connor et al, 2014) and fibromyalgia (Jones & Liptan, 2009;Mannerkorpi, Nordeman, Cider, & Jonsson, 2010). Another advantage of walking programs is that they are relatively low-cost interventions.…”