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22-05-2012 | Article

Poles lead the way for heart failure patients


Conference website

MedWire News: Nordic walking could allow heart failure (HF) patients to exercise more effectively than walking without poles, researchers say.

The preliminary findings, presented at the Heart Failure Congress in Belgrade, Serbia, show that Nordic walking increases the intensity of training and enables patients to gain additional cardiorespiratory benefits from exercise.

Nordic walking involves poles and the use of the arms to mimic the motion of cross-country skiing. It is one of the fastest developing forms of physical activity in Europe.

Although aerobic exercise improves the quality of life and reduces HF-related hospitalizations in HF patients, many find it difficult, said Andrzej Lejczak (Military Hospital, Krakow, Poland) and team in a press statement. Nordic walking, which is considered safe in individuals aged over 65 years, could therefore be appropriate.

The study involved 12 stable systolic HF patients (mean age 63 years, New York Heart Association class II, median left ventricular ejection fraction 30%) and 12 healthy individuals (mean age 30 years). The median oxygen consumption (VO2) in the HF patients was 18.2 mL/kg per min and in the controls was 29.3 mL/kg per min.

All participants completed two submaximal 6-minute walking tests, one with poles and one without, on a level treadmill at a constant speed of 5 km per hour.

When the control participants did Nordic walking, their median VO2 was 4.9 mL/kg per min higher (increase of 37%) and respiratory quotient 5% higher than when they walked without poles.

In addition, their peak heart rate was 20 beats per minute higher, maximal systolic blood pressure (BP) 15 mmHg higher, and fatigue level increased by 2 points on the Borg scale.

When HF patients did Nordic walking, their mean VO2 increased by 2.9 mL/kg per minute, a median increase of 14.7%, and their respiratory quotient increased by 18% compared with when they walked without poles.

In addition, their peak heart rate increased by 15 beats per minute, maximal systolic BP by 10 mmHg, and fatigue level by 2 points on the Borg scale.

There were no signs of cardiac ischemia or significant arrhythmias during the tests in either group.

"In Nordic walking we have a big workload because we use additional muscle groups," commented Lejczak. "We walk with four limbs, so we're exercising our arms and legs at the same time - that's why we have such a beneficial response."

He added: "The implication is that Nordic walking is safe to include in cardiac rehabilitation programs for patients with HF."

The authors said that patients interested in using Nordic walking as part of their exercise regime can purchase Nordic walking poles for approximately € 50 (US$ 63) and must take two or three 1-hour lessons before exercising without supervision.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Piriya Mahendra