title: Effects of Nordic walking on health-related quality of life in overweight individuals with type 2 diabetes mellitus, impaired or normal glucose tolerance.
abstract: OBJECTIVE
  To assess the effects of 4 months of increased physical activity on health-related quality of life in overweight individuals with Type 2 diabetes mellitus, normal or impaired glucose tolerance.
  
  
  METHODS
  We included 212 individuals without severe physical or cardiovascular impairments aged 61 (57-64) years, with BMI of 29 (27.5-32) kg/m². Numbers are median (25th-75th percentile). Subjects were stratified based on normal glucose tolerance (n = 128), impaired glucose tolerance (n = 34) or Type 2 diabetes mellitus (n = 50). They were randomized into either a control group (n= 125), who maintained unaltered habitual lifestyle, or an exercise intervention group (n = 87), who were directed to engage in Nordic walking with walking poles, 5 h per week over 4 months. Self-reported physical activity and health-related quality of life was assessed at the time of inclusion and after 4 months.
  
  
  RESULTS
  Baseline health-related quality of life of this study cohort was similar to, or better than, an age- and sex-matched Swedish population sample, for 12 of 13 scales. 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. No correlation was evident between improved quality of sleep and improved BMI.
  
  
  CONCLUSIONS
  Quality of sleep improved in the group with normal glucose tolerance following 4 months of Nordic walking. BMI reduction did not account for this improvement. Nordic walking can be introduced in a primary health care setting as a low-cost mode of exercise that promotes weight loss and improved health satisfaction.
authors.affiliation: Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Fritz
authors.forename: K
authors.initials: K
authors.lastname: Caidahl
authors.forename: M
authors.initials: M
authors.lastname: Osler
authors.forename: C G
authors.initials: CG
authors.lastname: Ostenson
authors.forename: J R
authors.initials: JR
authors.lastname: Zierath
authors.forename: P
authors.initials: P
authors.lastname: Wändell
mesh_terms: D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D012890:Sleep; D011795:Surveys and Questionnaires; D013548:Sweden; D016896:Treatment Outcome; D016138:Walking