Systematic Review and Meta-analysis of Clinical Trials Examining the Benefit of Exercise Programmes Using Nordic Walking in Patients With Peripheral Artery Disease

Golledge, Jonathan; Maarij, Khyber; Moxon, Joseph V.; Beard, Jonathan; Girold, Sébastien; Wrang, Hans; Morris, Dylan

doi:10.1016/j.ejvs.2018.05.026

Cited by 16 publications

(15 citation statements)

References 33 publications

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“…In addition to reducing the strength of the lower limb muscles [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26], chronic lower limb ischemia also changes the gait pattern. Compared to a group of healthy individuals, people with PAD exhibit an extended stance phase while simultaneously shortening the swing phase [8].…”

Section: Discussionmentioning

confidence: 99%

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Effects of Physical Rehabilitation on Spatiotemporal Gait Parameters and Ground Reaction Forces of Patients with Intermittent Claudication

Dziubek

Stefańska

Bulińska

et al. 2020

JCM

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Chronic ischemia of the lower extremities often presents as intermittent claudication characterized by lower limb pain which subsides after a short break. This study aimed to provide an assessment of the spatiotemporal parameters of gait and ground reaction forces in patients with PAD participating in three forms of supervised physical training. A total of 80 subjects completed a three-month supervised physical rehabilitation program with three sessions per week. The subjects were assigned to one of three programs: group 1—standard walking training on a treadmill (TT); group 2—Nordic walking (NW) training; group 3—strength and endurance training comprised of NW with isokinetic resistance training (NW + ISO). Gait biomechanics tests (kinematic and kinetic parameters of gait) and a six-minute walk test were carried out before and after three months of physical training. Nordic walking training led to the greatest improvements in the gait pattern of patients with PAD and a significant increase in the absolute claudication distance and total gait distance. Combined training (NW + ISO) by strengthening the muscles of the lower extremities increased the amplitude of the general center of gravity oscillation to the greatest extent. Treadmill training had little effect on the gait pattern. Nordic walking training should be included in the rehabilitation of patients with PAD as a form of gait training, which can be conducted under supervised or unsupervised conditions.

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Section: Discussionmentioning

confidence: 99%

“…Regular physical exercise improves physical fitness, daily functioning, and quality of life in patients with PAD [17,18].…”

Section: Introductionmentioning

confidence: 99%

Effects of Physical Rehabilitation on Spatiotemporal Gait Parameters and Ground Reaction Forces of Patients with Intermittent Claudication

Dziubek

Stefańska

Bulińska

et al. 2020

JCM

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“…interventions targeting chronic conditions. [20][21][22][23] Due to the interest of NW as an exercise therapy for overweight and obese people, it is important that health and rehabilitation professionals can easily access all existing evidence regarding its effects on this population. Furthermore, it is also essential to have the knowledge on how to accurately prescribe NW programs to meet the requirements of this population, as well as the personal needs and abilities of specific individuals.…”

Section: Introductionmentioning

confidence: 99%

Nordic Walking for Overweight and Obese People: A Systematic Review and Meta-Analysis

Sánchez-Lastra¹,

Miller²,

Martínez-Lemos³

et al. 2020

Journal of Physical Activity and Health

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Background: Nordic walking (NW) is a potentially beneficial exercise strategy for overweight and obese people. To date, no reviews have synthesized the existing scientific evidence regarding the effects of NW on this population. This systematic review and meta-analysis aimed to identify the characteristics, methodological quality, and results of the investigations that have studied the effects of NW in overweight and obese individuals. Methods: Six electronic databases were searched up to June 2019 for studies that examined the effects of NW on people with a body mass index ≥ 25 kg/m2. The methodological quality of the included randomized controlled trials was retrieved from the physiotherapy evidence database or evaluated using the physiotherapy evidence database scale. Results: Twelve studies were included in the review. The investigations were mostly good-to-fair methodological quality. NW groups had a significant improvement on parameters such as fasting plasma glucose, abdominal adiposity, and body fat compared with the baseline, but no significant improvements were found when compared with control groups. Conclusions: NW can potentially lead to improvements in parameters related to major health outcomes in overweight and obese people. The lack of control for confounding variables in the analyzed studies prevents further elaboration on its potential benefits.

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“…We thank Dr. Ian Wee and colleagues for their letter regarding our recent systematic review on Nordic walking for peripheral artery disease. 1 As was pointed out in the review, 1 the findings of prior clinical trials of Nordic walking in patients with peripheral artery disease have varied. One trial reported that patients randomised to a supervised programme of standard walking had better outcomes than those allocated a supervised programme of Nordic walking.…”

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confidence: 99%

“…As pointed out by Dr. Ian Wee et al some of the treadmill data needed to be converted from time to distance, but this did not have any important influence on the findings of the analysis, as data from six minute walk tests (which did not require conversion) showed similar findings. 1 In general, meta-analyses of multiple randomised trials are considered to provide more reliable evidence than findings from a single randomised trial. As pointed out in the discussion, 1 this meta-analysis does not rule out a small or moderate benefit (or detriment) of Nordic walking vs. standard walking as prior clinical trials have been too small to rule this out.…”

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confidence: 99%

Response to ‘Re. Systematic Review and Meta-analysis of Clinical Trials Examining the Benefit of Exercise Programs Using Nordic Walking in Patients with Peripheral Artery Disease’

Golledge

Moxon

Morris

2019

European Journal of Vascular and Endovascular Surgery

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et al. 1 Although they reported no significant advantage to Nordic walking (NW) over standard exercise, other individual studies have suggested otherwise. 2e4 Girold et al. and Spafford et al. concluded that NW significantly improved walking distance after four and 12 weeks, respectively. 3,4 This discordance may explain the significant quantitative (I 2 54e99%), and qualitative heterogeneity between studies, 1 arising from control differences (medical therapy, supervised treadmill walking) and age. 2 In addition, mean walking distance was estimated by multiplying the treadmill speed by walking time for some studies; 2 however, Table 1 highlights an alternative method, as multiplying summary effects do not give the summary quotient or product.

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Systematic Review and Meta-analysis of Clinical Trials Examining the Benefit of Exercise Programmes Using Nordic Walking in Patients With Peripheral Artery Disease

Abstract: This systematic review suggests no benefit of Nordic over standard walking as supervised exercise for PAD. Favourable results were reported for one home based Nordic walking programme. A larger trial is needed to assess whether this finding can be replicated or not.

Cited by 16 publications

References 33 publications

Effects of Physical Rehabilitation on Spatiotemporal Gait Parameters and Ground Reaction Forces of Patients with Intermittent Claudication

Effects of Physical Rehabilitation on Spatiotemporal Gait Parameters and Ground Reaction Forces of Patients with Intermittent Claudication

Nordic Walking for Overweight and Obese People: A Systematic Review and Meta-Analysis

Response to ‘Re. Systematic Review and Meta-analysis of Clinical Trials Examining the Benefit of Exercise Programs Using Nordic Walking in Patients with Peripheral Artery Disease’

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