Research Article; Effects of a flexibility and relaxation programme, walking and Nordic walking on Parkinson disease. 2011. Journal of Aging Research Reuter, I., Mehnert, S., Leone, P., Kaps, M., Oechsner, M., and Engelhardt, M.
This research study involved 90 Parkinson Disease (PD) patients who were mild to moderate effect. They aimed to assess the effects of doing regular exercise for people with PD and whether Nordic Walking (NW) is more effective than normal walking. These patients were randomly allocated into one of 3 training groups;
- Nordic Walking – 3 x 70min sessions a week for 6 months
- Walking – 3 x 70min sessions a week for 6 months
- Flexibility and relaxation exercises – 3 x 70min sessions a week for 6 months
The results showed that all three groups were similar at assessment, and there was a good compliance with all three groups with all patients attending at least 70 of 78 training session.
Pain was eased by both the NW and walking groups.
- PD – Specific Disability
Significant decrease in both NW and walking groups, with improvements in posture, reduced freezing and faster alternating movements. The NW group significantly improved postural stability and gait pattern.
- Quality of Life
The NW and walking groups felt that they memory had improved and concentration.
The NW group significantly increased their stride length over both the walking group and flexibility group. The NW group was also significantly better at maintaining the same stride length. Stride length variability as been associated with increased risk of falling and instability. Further gait improvements were also seen in the NW group being able to decrease stride time and a decrease in double stance phase.
Both the walking and NW groups increased their walking velocity significantly however there was no difference between the two groups. The NW group demonstrated significantly lower heart rate than the other two groups.
All three exercise groups made improvements from initial testing, however the walking and NW groups made significantly greater improvements in all aspects tested. The NW group was superior in improving gait pattern and style and postural stability. This is an important result as gait changes are a significant primary symptom of PD and changes can lead to increased risk of falls and reduced mobility resulting in reduced quality of life.
- NW is superior to just walking in improving gait pattern, reducing heart rate and postural stability.
- NW is specific to walking which is related to one of the major goals clients are focused on – improving their walking or maintaining their ability to walk.
- Exercise has been shown to improve neural plasticity, promoting axon outgrowth and increasing synapses in the brain. NW has the ability to stimulate an increase of the above changes due to the increased demands on coordination with the poles.
- NW technique was difficult for PD patients to learn, with 17 patients performing great technique, 10 performed good technique and 3 performed poorly. This highlights the need to be taught how to NW correctly and to have regular reviews by an International Nordic Walking Association (INWA) instructor or coach. Learning is also best achieved with intensive input – regularly 3 x a week.
- All patients that learnt NW continued regularly after the research project was completed and set up their own social groups to walk in, including their partners and friends.
- The NW style is very similar to the large amplitude gait technique that our PD clients are taught in the clinic and helps to improve carryover of the techniques into everyday life.