title: Nordic Walking May Safely Increase the Intensity of Exercise Training in Healthy Subjects and in Patients with Chronic Heart Failure.
abstract: BACKGROUND
  Physical activity in patients with chronic heart failure (HF) improves the exercise capacity and quality of life, and may also reduce mortality and hospitalizations. The greatest benefits are achieved through high-intensity aerobic exercises resulting in a stronger cardiorespiratory response. Nordic walking (NW), a walking technique using two poles and mimicking the movements performed while cross-country skiing, is associated with the involvement of more muscle groups than in the case of classic walking, and should therefore make it possible to increase exercise intensity, resulting in more effective training for patients with HF.
  
  
  OBJECTIVE
  The aim of the study was to assess the feasibility and safety of the NW technique, and to compare the effort intensity while walking with and without the NW technique in both healthy subjects and in patients with chronic HF.
  
  
  METHODS
  The study involved 12 healthy individuals (aged 30 ± 10 years, 5 men) and 12 men with stable chronic systolic HF (aged 63 ± 11 years, all categorized in New York Heart Association class II, median LVEF 30%, median peak VO(2) 18.25 mL/kg/min). All the participants completed two randomly assigned submaximal walking tests (one with NW poles and one without) conducted on a level treadmill for 6 min at a constant speed of 5 km/h.
  
  
  RESULTS
  Walking with the NW technique was feasible, safe and well tolerated in all subjects. In both the control group and the chronic HF group, walking with the NW technique increased peak VO(2), RER, VE, PET CO(2), HR and SBP over walking without the poles; and the fatigue grade according to the abridged Borg scale was higher. Dyspnea did not increase significantly with the NW technique.
  
  
  CONCLUSIONS
  The NW technique can increase the intensity of aerobic training in a safe and well-tolerated way in both healthy individuals and in patients with chronic HF.
authors.affiliation: Department of Cardiac Rehabilitation, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland; Department of Physiotherapy, University School of Physical Education, Wrocław, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lejczak
authors.affiliation: Faculty of Health Science, Clinic of Cardiac Diseases, Wroclaw Medical University, Poland; Department of Heart Diseases, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland.
authors.forename: Krystian
authors.initials: K
authors.lastname: Josiak
authors.affiliation: Department of Cardiac Rehabilitation, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland; Department of Physiotherapy, University School of Physical Education, Wrocław, Poland.
authors.forename: Kinga
authors.initials: K
authors.lastname: Węgrzynowska-Teodorczyk
authors.affiliation: Department of Physiotherapy, University School of Physical Education, Wrocław, Poland.
authors.forename: Eliza
authors.initials: E
authors.lastname: Rudzińska
authors.affiliation: Faculty of Health Science, Clinic of Cardiac Diseases, Wroclaw Medical University, Poland; Department of Heart Diseases, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland.
authors.forename: Ewa A
authors.initials: EA
authors.lastname: Jankowska
authors.affiliation: Department of Heart Diseases, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Banasiak
authors.affiliation: Cardiac Department, Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy.
authors.forename: Massimo F
authors.initials: MF
authors.lastname: Piepoli
authors.affiliation: Department of Physiotherapy, University School of Physical Education, Wrocław, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Woźniewski
authors.affiliation: Faculty of Health Science, Clinic of Cardiac Diseases, Wroclaw Medical University, Poland; Department of Heart Diseases, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005240:Feasibility Studies; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking; D055815:Young Adult