Nordic Walking Research

– Back Pain

Person-Centered, Physical Activity for Patients with Low Back Pain: Piloting Service Delivery. Bloxham, Barter et al. Healthcare. 2016. Study concluded that a person-centered, multicomponent approach to physical activity (including aerobic fitness, core activation, muscular strength & endurance, Nordic walking and Flexibility) may be optimal for supporting patients who self-manage LBP.

Effect of Power Nordic Walking on Spine Deformation and Visual Analog Pain Scale in Elderly Women with Low Back Pain. Park HS, Lee SN, Sung DH,  Choi HS,   Kwon TD,  and  Park GD. J Phys Ther Sci. 2014 ; 26: 1809–1812. Results showed that low back pain decreased because the upper extremities were used together with the lower extremities during the exercises performed using the Nordic poles (neutral position).

Supervised and non-supervised Nordic walking in the treatment of chronic low back pain a single blind randomized clinical trial.
For pain, disability, and patient specific function the supervised Nordic walking group generally faired best however no statistically significant differences were found compared to the non supervised NW group. Hartvigisen et al., 2010

Self-guided brisk walking training with or without poles: a randomized-controlled trial in middle-aged women. Kukkonen-Harjula et al. 2007. Scand J Med Sci Sports. 2007 ;17:316-23. Both NW and W similarly improved self enhancing physical fitness while being both feasible and safe.

Health benefits of Nordic walking: a systematic review.
A study by Henkel et al. (2008) found effect of selected prevention concepts on functional health of persons with nonspecific chronic recurrent neck pain. Observed a reduced in unspecific, chronic neck pain and increased quality of life Tschentscher et al., 2013

– Shoulder Conditions

The effects of Nordic Walking training on selected upper-body muscle groups in female-office workers: A randomized trial.Kocur, Pospieszna et al.,2017 Work.  12 weeks of Nordic Walking training displayed improvements in shoulder mobility while reducing tenderness in the following shoulder muscles in female office workers; trapezius pars descendens and middle trapezius, infraspinatus and latissimus dorsi.

Comparison of Shoulder Ranges of Motion During Nordic Pole Walking and General Walking in the Elderly. Kim, Shim, et al., 2017.
Upper Limb Muscles and Shoulder Range of Motion (ROM) displayed significant improvements after 6 weeks of Nordic Pole walking in elderly participants 65 years + in age compared to their general walking counterparts.

Effects of Walking Technique on Knee Joint Loading – OA
Dynamic knee joint loading is effected by the walking pole technique adopted.  Decrease in dynamic knee joint loading was observed with participants with OA when poles were held away from the body and a downward force was applied  similar to the ACTIVATOR ℗ poles walking technique. Bechard et al., 2015 (unpublished) University of Western Ontario

Effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force
Compared with the walking group, the Nordic walking group showed an increase in cadence, stride length, and step length, and a decrease in stride time, step time, and vertical ground reaction force.  Park et al. 2015

Changes in in vivo knee contact forces through gait modification
The results of this study suggest that an optimal configuration of bilateral hiking poles may significantly reduce both medial and lateral compartment knee forces in individuals with medial knee osteoarthritis.  Kinney et al., 2013

Effects of walking poles on lower extremity gait mechanics.
There were differences in kinetic variables between walking with and without poles. The use of walking poles enabled subjects to walk at a faster speed with reduced vertical ground reaction forces, vertical knee joint reaction forces, and reduction in the knee extensor angular impulse and support moment, depending on the poling condition used. Willson et al., 2001

– Hip OA

– Stroke

Six-Week Nordic Treadmill Training Compared with Treadmill Training on Balance, Gait, and Activities of Daily Living for Stroke Patients: A Randomized Controlled Trial.
After 6 weeks of training, balance, gait, and ADL improved significantly in both groups, but NTT was associated with greater improvements compared to TT for all 3 measures. Kang et al., 2016

– Parkinson’s Disease

Does Nordic Walking restore the temporal organization of gait variability in Parkinson’s disease?Warlop et al., 2017
Nordic Walking for 12 min sessions over ground at a self-selected speed around a 42m oval indoor track displayed significant improvements in step length while reducing gait cadence without affecting gait speed in participants with Parkinson’s Disease.

Nordic Pole Walking, Gait Pattern and Postural Control in Parkinson’s Diease.Based on the results, 16 self-directed sessions of NW can help improve certain gait spatial-temporal characteristics as well as some aspect of the gait pattern kinetics, especially at the knee. Moreover it seems that a 16 sessions (45 minutes per session) or even longer practice period is necessary for NW beginner, in order to gain perfect technique and restore gait to a more normal pattern than novice. Zhou, 2016 Thesis University of Ottawa (unpublished)

Impact of physical exercise on reaction time in patients with Parkinson’s disease-data from the Berlin BIG Study.
Supervised physical exercise with Lee Silverman Voice Treatment-BIG or Nordic walking is associated with improvement in cognitive aspects of movement preparation. Ebersbach et al., 2014

Effects of a flexibility and relaxation programme, walking, and nordic walking on Parkinson’s disease.
Assessment after completion of the training showed that pain was reduced in all groups, and balance and health-related quality of life were improved. Nordic walking was superior to the flexibility and relaxation programme and walking in improving postural stability, stride length, gait pattern and gait variability. Reuter et al., 2011

Nordic walking improves mobility in Parkinson’s disease.
These preliminary findings suggest that Nordic walking could provide a safe, effective, and enjoyable way to reduce physical inactivity in PD and to improve the quality of life. A large randomized clinical trial now appears justified. van Eijkeren et al., 2008

– Nordic walking Injuries

Nordic Pole Walking Injuries – Nordic Walking Thumb as Novel Injury Entity
Nordic walking is safe.  The most frequent injury in Nordic walking is a distortion of the ulnar collateral ligament of the thumb after a fall which the poles acts as hypomochlium.  Modifying the construction of the Nordic Walking pole handle, avoiding holding onto the pole in the event of a fall, as well as education could be preventive measures.  Knobloch et al., 2006 Translated

Comments on the Urban Poles from Dr. Knobloch, 2014.  “The Urban poles appear light with a good grip. The hand design of the grip offer even more support and thus, provide safety. The hand piece and length adjustments are convenient. Overall, the chance to suffer a Nordic walking thumb is probably reduced with your urban poles, especially among patients with Diabetes; with a potential impairment of balance and proprioception”.  Prof. Dr. med. Karsten Knobloch

– Diabetes

Effects of Nordic Walking and Pilates exercise programs on blood glucose and lipid profile in overweight and obese postmenopausal women in an experimental, nonrandomized, open-label, prospective controlled trial
Exercise training in accordance with the NW model causes statistically and clinically more significant changes in glucose and basic blood lipid levels than do Pilates and dietary intervention alone. Hagner-Derengowska et al., 2015

Effects of Nordic walking on cardiovascular risk factors in overweight individuals with type 2 diabetes, impaired or normal glucose tolerance.
Nordic walking improved anthropometric measurements and exercise capacity. However, unsupervised Nordic walking may not provide a sufficient increase in exercise intensity to achieve ultimate health-promoting benefits on the cardiovascular parameters assessed in this study, particularly for those with disturbed glucose regulation. Fritz et al., 2013

12 weeks’ aerobic and resistance training without dietary intervention did not influence oxidative stress but aerobic training decreased atherogenic index in middle-aged men with impaired glucose regulation.
Nordic walking decreased prevalence of metabolic syndrome (MetS) and MetS score. Improved lipid profile remained a predictor of decreased MetS score only in NW group and it seems that Nordic walking has more beneficial effects on cardiovascular disease risks than RT training.  Venojärvi M et al., 2013

Health Benefits of Nordic walking: a systematic review. Nordic walking exerts beneficial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases and can thus be recommended to a wide range of people as primary and secondary prevention. Tschentscher, 2013

Effects of Nordic walking on health-related quality of life in overweight individuals with type 2 diabetes mellitus, impaired or normal glucose tolerance.
Quality of sleep and BMI were improved for participants with normal glucose tolerance after 4 months of Nordic walking, with little or no musculoskeletal pain as compared with control subjects. Fritz T et al., 2011

Physical activity in pregnancy and in breast-feeding period in obese mothers. Considering common recommendations for training, as well as careful measures and contraindications, a moderate individual training to maintain physical and psychic fitness is desirable. Many kinds of sports like jogging, Nordic walking, swimming and cycling, for example, can be carried out in a pregnancy without any risks and furthermore promote the health of the future mother and child. Korsten-Reck et al, 2010

– Fall Prevention

Exploring the Effects of a Health Care Provider Led Physical Activity and Education Program on the Physical and Psychological Indicators of Fall Prevention and Subsequent Independent Living
The study was conducted with older adults in rural settings who used walking poles and participated in exercises over a 9-week time span.  The exercise sessions were based on the “Otago Falls Prevention Program” but modified with using the ACTIVATOR^TM poles. There was a significant change in the following tests: Timed Up and Go, Stride Length, and Single Leg Stork Stand, which are all indicators for falls risk.  Gwynn-Brett & Hudec, 2017 (current) Cape Breton University

– Older Adults

Analysis of balance and gait pattern with Stepscan Pedway© technology, in individuals 80 years and older before and after a 12 week Nordic walking program with Activator poles©.
Hypothesis -Participants in the Activator Pole© Nordic walking program are expected to improve their balance as measured by the BERG balance test and static sway measured by Stepscan Pedway©. It is also projected that they will improve their gait speed and step length. In improving these variables it is estimated that they will improve their functional autonomy and also decrease their number of falls.  Ferland & Robbins, 2017 (current) Ste-Anne’s hospital

Short-term and long-term effects of Nordic Walking training on balance, functional mobility, muscle strength and aerobic endurance among Hungarian community-living older people: a feasibility study.
Balance, functional mobility and aerobic endurance significantly improved in the Nordic walking group.  This study showed that Nordic Walking is a simple, well–tolerated and effective physical activity for older people in Hungary. Viraq et al., 2014

Effects of Nordic walking compared to conventional walking and band-based resistance exercise on fitness in older adults.
While all modes of exercise improved various components of fitness, Nordic walking provided the best well-rounded benefits by improving upper-body strength, cardiovascular endurance, and flexibility. Therefore,  Nordic walking is recommended as an effective and efficient mode of concurrent exercise to improve overall functional fitness in older adults. Takeshima et al., 2013

The effects of pole walking on health in adults: A systematic Review
he effects of pole walking (PW) on cardiorespiratory fitness were most extensively studied. The most frequently examined psychosocial measure was quality of life. All studies reported at least one beneficial effect of PW compared with the control group. The results of this systematic review indicate that PW  programs have some beneficial effects on both physical and psychosocial health in adults with and without clinical conditions.  Fritschi et al., 2012.

Effect Of Walking Poles On Dynamic Gait Stability on the Elderly
Texas Women’s University study, which concluded that walking poles provided increased gait stability at both preferred and fast speed. Kwon, Silver, Ryu, Yoon, Newton & Shim, 2006 (unpublished)

– Spinal Stenosis

Is there a place for Activator poles in rehabilitation following Spinal surgery? UK Pilot Study
This pilot study will evaluate healthy adults’ posture when walking with Activator Poles in comparison to elbow crutches and walking sticks with the aim to achieve the most upright posture. If found to improve posture, Activator poles may therefore be the desired walking aid following spinal surgery with the aim to increase mobility distance and exercise levels. Dependent on the outcome of the pilot, further studies will take place with patients using the poles.   Bruce (current), Royal National Orthopedic Hospital, UK

– Fibromyalgia

Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial.
Moderate-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. Mannerkorpi et al., 2010

– COPD

Nordic Walking Using Activator Poles Increases Exercise Tolerance in Individuals with COPD Compared to Healthy Controls
VO2, energy expenditure, heart rate, and minute ventilation were all significantly higher for participants using Activator poles.  However, the distance walked during a 6MWT was shorter when patients with COPD walked with ACTIVATOR℗ poles.  Dyspnea and leg fatigue ratings were similar walking with or without poles.

Antoniades, Lim, Gandhi, Montambault, Ricci & Spahija, 2015 (current study) McGill University

– Cancer

Stick Together: A Nordic Walking group intervention for breast cancer survivors.
Patients’ vitality had improved, whereas perceived shoulder symptom severity and limitations in daily activities had decreased. Goniometric data indicated that range of motion (forward flexion, abduction and external rotation) of the affected shoulder improved significantly within ten weeks of training. Results from this explorative study suggest that Nordic Walking is a feasible and potentially valuable tool in the rehabilitation of patients with breast cancer. Fischer et al., 2015

The effects of pole walking on arm lymphedema and cardiovascular fitness in women treated for breast cancer: a pilot and feasibility study.
The results indicated a significant reduction in total arm volume of the lymphedema arm, in lymphedema absolute volume and lymphedema relative volume. Significant decreases of heart rate and rating of tightness in the arm were found.  Jönsson & Johansson, 2014

Effects of selected forms of physical activity on body posture in the sagittal plane in women post breast cancer treatment.
Balanced postural changes were only identified among the women in the Nordic Walking group. Hanuszkiewicz et al., 2014

Exercise effects on HRV in cancer patients
Exercise enhances cardiac autonomic regulation of tumour patients during and after acute treatment. Because of the association of higher HRV-parameters and prolonged survival in cancer patients, improvement in autonomic control may be an important goal of exercise. Niederer et al., 2012

The effects of walking poles on shoulder function in breast cancer survivors. 
The data suggest that using a walking pole exercise routine for 8 weeks significantly improved muscular endurance of the upper body. Sprod et al., 2005

Encourages upright posture and activation of posterior shoulder/trunk muscles 
(Hanuszkiewicz et al 2015, Sprod et al 2005)

Improved shoulder and upper body strength and ROM (Sanchez-Lastra et al 2019)

Encourages muscle pump activation for lymphatic drainage

Assists weight management (Tschentscher et al 2013)

May offload painful joints in aromatase inhibitor associated arthralgia (Fields et al 2016)

Weight bearing and resistance exercise may benefit bone density

May improve stability in patients with peripheral neuropathy affecting feet

Can be sociable, supportive and continued as part of a healthy lifestyle (Fischer et al 2015)

Cardiac

Randomized trial of Nordic walking in patients with moderate to severe heart failure.
A study published by the University of Ottawa Heart Institute, concluded that walking with poles is superior to standard cardiac rehab, even for those following mild to moderate heart failure.  Keast et al., 2013

The influence of systematic pulse-limited physical exercise on the parameters of the cardiovascular system in patients over 65 years of age.
Systematic NW physical exercise limited by the pulse had a beneficial effect on the physical performance of elderly persons as assessed with main parameters.  A short 6-week programme of endurance exercises had a hypotensive effect in elderly persons over 65 years of age.  Chomiuk et al., 2013

Effects of Nordic walking training on exercise capacity and fitness in men participating in early, short-term inpatient cardiac rehabilitation after an acute coronary syndrome–a controlled trial.
Nordic Walking may improve exercise capacity, lower body endurance and coordination of movements in patients with good exercise tolerance participating in early, short-term rehabilitation after an acute coronary syndrome. Kocur et al., 2009

Changes in level of VO2max, blood lipids, and waist circumference in the response to moderate endurance training as a function of ovarian aging.
A 12-week moderate intensity Nordic walking program was administered to the cohort. Significant decreases in BMI, TF, LDL, TGs, and WC and increase in HDL in premenopausal and perimenopausal women indicate the outstanding role the appropriately chosen moderate endurance training may play in the quality of daily life in perimenopausal women. Hagner et al., 2009

– Work Place Wellness

Walk Away Stress: Urban Poling on Campus Research Study
New ongoing study to determine if urban poling (also known as Nordic walking) is a suitable workplace fitness program to address overall well-being of employees at the University of Guelph-Humber and Humber College. Coutinho (current) HUMBER COMMUNIQUÉ

– Obesity

The influence of a ten-week Nordic walking training-rehabilitation program on the level of lipids in blood in overweight and obese postmenopausal women.
After 10 weeks of NW rehabilitation it was observed that participants lost weight and their body mass index dropped. Rehabilitation carried out according to the NW model resulted in statistically significant changes in basic lipids in blood which, considerably increased the percentage of persons who achieved the recommended level of blood lipids. Obese persons were characterised by a smaller rehabilitation weight loss. Hagner-Derengowska M et al, 2015

Efficacy of Nordic walking in obesity management
NW activity in obese women allows an increase in exercise intensity and adherence to a training program without increasing the perception of effort leading to enhanced aerobic capacity. Figard-Fabre H¹ et al., 2011

Physiological and perceptual responses to Nordic walking in obese middle-aged women in comparison with the normal walk.
Use of NW (Nordic walking) poles increased physiological responses at a given speed but decreased RPE (rate of perceived exertion) in comparison with W (walking) during inclined level. Moreover, this is the first study showing that a learning period of NW technique permitted to enhance the difference between EC (energy cost) with NW poles versus the Walking condition and to decrease the RPE when using NW poles. Thus, although it requires a specific learning of the technique, the NW might be considered like an attractive physical activity with an important public health application. Figard-Fabre et al, 2010.

Health benefits of Nordic walking: a systematic review.
The current analysis revealed that with regard to short- and long-term effects on heart rate, oxygen consumption, quality of life, and other measures, Nordic walking is superior to brisk walking without poles and in some endpoints to jogging.  Nordic walking exerts beneficial effects on resting heart rate, blood pressure, exercise capacity, maximal oxygen consumption, and quality of life in patients with various diseases and can thus be recommended to a wide range of people as primary and secondary prevention.  Tschentscher et al., 2013

– Mental Health

Physical activity of depressed patients and their motivation to exercise: Nordic Walking in family practice.
Nordic walking increased the patients’ physical activity and improved their mood. Suija et al., 2009

Acute effects of a single bout of moderate exercise on psychological well-being in patients with affective disorder during hospital treatment.
A self-paced but supervised single Nordic walking session seems to be effective in improving acute psychological well-being in patients with affective disorder. Stark et al., 2012

– Menopause

Effects of Nordic Walking and Pilates exercise programs on blood glucose and lipid profile in overweight and obese postmenopausal women in an experimental, nonrandomized, open-label, prospective controlled trial.
Exercise training in accordance with the NW model causes statistically and clinically more significant changes in glucose and basic blood lipid levels than do Pilates and dietary intervention alone. Hagner-Derengowska et al., 2015

– Dementia

Clinical Feasibility Project: Outdoor Walking Program with Activator^TM Poles and Their Impact on Balance, Muscle Strength, the Risk of Falls and Bone Health of Veteran Inhabitants in a Long-Term Care Centre
Outdoor walkers with dementia used ACTIVATOR ℗ poles in an innovative geriatric rehabilitation approach. These data suggest that the use of ACTIVATOR℗ walking poles contribute to the strengthening of the upper limbs while improving balance and could reduce the risk of falls from users. Bone density, walking speed and strength in the lower limbs were maintained, which is clinically significant for individuals in this population. Chassé, Germain, Ferland & Gareau, 2015 (current) Hospital Ste-Anne

– Peripheral Arterial Disease

Nordic poles immediately improve walking distance in patients with intermittent claudication.
These results show that Nordic Pole Walking (NPW) immediately enables patients with intermittent claudication to walk further with less pain, despite a higher workload. NPW might also be a useful exercise strategy for improving the cardiovascular fitness of patients with intermittent claudication. Oakley et al., 2008

– LTC

Effectiveness of Urban Poling with ACTIVATOR℗ Poles for Residents of Long-Term Care Facilities

Although the sample size was too small to find significant results, there were improvements in participant’s leg and core strength, flexibility, balancing abilities, and perceived physical functioning in an eight-week urban poling program with ACTIVATOR℗ poles.  MacPhee & Unwin, 2009 thesis (unpublished) Wilfrid Laurier University