Effects of Nordic Walking in Parkinson Disease Patients
Condition: Parkinson Disease; Parkinson Disease 10
MeSH terms: Parkinson Disease
Study type: Interventional

Summary: 
      The aim of this study was to evaluate and compare the effects of a Nordic and free walking
      training program on clinical, functional and biomechanical parameters of gait, in people with
      PD.

      Outcomes: Motor symptoms: Staging and severity of PD, balance, walking functional mobility,
      self-selected walking velocity, and rehabilitation index. Non-Motor symptoms: Cognitive
      function, depressive symptoms, and quality of life (QL). Outcomes Biomechanics: Kinematic
      parameters (spatiotemporal and dynamic stability of walking) and neuromuscular parameters
      (amplitude of the electromyography signal, initial and final activation threshold, activation
      time and co-contraction index, of the following muscles: Vastus Lateralis (VL), Biceps
      Femoris (BF), Tibialis Anterior (TA), Gastrocnemius Medialis (GM).
    

Detailed description: 
      Introduction: Changes in clinical, functional and biomechanical parameters of gait are
      remarkable features in Parkinson's disease (PD). Such changes are disabling for the
      performance of daily living activities (DLAs) as they represent a high risk of falls and
      impair quality of life (QL) in this population. Although exercise is recommended as an
      effective model of therapeutic intervention, to minimize the symptoms of this disease, little
      is known about the effects of Nordic walking on motor and non-motor symptoms in patients with
      PD. Purpose: The aim of this study was to evaluate and compare the effects of a Nordic and
      free walking training program on clinical, functional and biomechanical parameters of gait,
      in people with PD. Experimental Design: Randomized controlled clinical trial (RCT). Study
      Site: Physical Education School of the Federal University of Rio Grande do Sul and the
      Clinical Hospital of Porto Alegre, in Porto Alegre, Rio Grande do Sul, Brazil. Methods: The
      sample comprised 33 participants, aged above 50 years, of both sexes, with a clinical
      diagnosis of idiopathic PD, with the staging of 1-4 in the Hoehn and Yahr scale (H&Y). The
      participants received two types of intervention: Nordic walking training program (NW, n = 16)
      and free walking training program (FW, n = 17), during six weeks. Aiming to evaluate the
      effects of the training program, the participants underwent the tests in the following
      period: pre-training + pre-familiarization (T1); post-familiarization + pre-training (T2);
      post-training (T3).
    

Intervention name(s): Nordic Walking; Free Walking
Intervention type(s): Other; Other
Intervention description(s): Nordic walking Training the total period of training was composed by 9-week of walking with poles, two sessions per week. The cycles were divided into four microcycles composed of three training sessions. Each training session took 60 min. Free walking aerobics training was used during the training period. These exercises were performed alternating volume and intensity. The training session was divided into three stages: (a) stretching, joint mobility, and heating; (b) main part (FW); (c) return to the calm and ultimate stretching.; Free walking Training The total period of training was composed by 9-week of walking without poles, two sessions per week. The cycles were divided into four microcycles composed of three training sessions. Each training session took 60 min. Free walking aerobics training was used during the training period. These exercises were performed alternating volume and intensity. The training session was divided into three stages: (a) stretching, joint mobility, and heating; (b) main part (FW); (c) return to the calm and ultimate stretching.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Experimental: Nordic walking Experimental: Nordic walking Training The total period of training was composed by 9-week of walking with poles, two sessions per week. The cycles were divided into four microcycles composed of three training sessions. Each training session took 60 min. Nordic walking aerobics training was used during the training period. These exercises were performed alternating volume and intensity. The training session was divided into three stages: (a) stretching, joint mobility, and heating; (b) main part (FW or NW); (c) return to the calm and ultimate stretching. The participants were trained with individualized prescription according to their maximum distance. A heart rate monitor, Model FT4 attached to the chest of the xiphoid process, was used to control the progression of intensity for the training cycles ranging from 60% to 80% of heart rate reserve. Additionally, we used the Borg RPE for training intensity control, which ranged between 13 and 17 of that scale.
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: functionality; gait; kinematics; electromyographic activity; depressive symptoms; quality of life