title: Nordic walking versus walking without poles for rehabilitation with cardiovascular disease: Randomized controlled trial.
abstract: BACKGROUND
  With Nordic walking, or walking with poles, one can travel a greater distance and at a higher rate than with walking without poles, but whether the activity is beneficial for patients with cardiovascular disease is unknown.
  
  
  OBJECTIVE
  This randomized controlled trial was undertaken to determine whether Nordic walking was more effective than walking without poles on walk distance to support rehabilitation training for patients with acute coronary syndrome (ACS) and peripheral arterial occlusive disease (PAOD).
  
  
  METHODS
  Patients were recruited in a private specialized rehabilitation centre for cardiovascular diseases. The entire protocol, including patient recruitment, took place over 2 months, from September to October 2013. We divided patients into 2 groups: Nordic Walking Group (NWG, n=21) and Walking Group without poles (WG, n=21). All patients followed the same program over 4 weeks, except for the walk performed with or without poles. The main outcome was walk distance on the 6-min walk test. Secondary outcomes were maximum heart rate during exercise and walk distance and power output on a treadmill stress test.
  
  
  RESULTS
  We included 42 patients (35 men; mean age 57.2±11 years and BMI 26.5±4.5kg/m2). At the end of the training period, both groups showed improved walk distance on the 6-min walk test and treatment stress test as well as power on the treadmill stress test (P<0.05). The NWG showed significantly greater walk distance than the WG (P<0.05). Both ACS and PAOD groups showed improvement, but improvement was significant for only PAOD patients.
  
  
  CONCLUSIONS
  After a 4-week training period, Nordic walking training appeared more efficient than training without poles for increasing walk distance on the 6-min walk test for patients with ACS and PAOD.
authors.affiliation: Department of Physical and rehabilitation Medicine, Clermont-Ferrand University Hospital, Hospital of Clermont-Ferrand, Cébazat, France. Electronic address: sgirold@chu-clermontferrand.fr.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Girold
authors.affiliation: The Moulin Vert Rehabilitation Center, 86340 Nieuil L'Espoir, France.
authors.forename: Jérome
authors.initials: J
authors.lastname: Rousseau
authors.affiliation: The Moulin Vert Rehabilitation Center, 86340 Nieuil L'Espoir, France.
authors.forename: Magalie
authors.initials: M
authors.lastname: Le Gal
authors.affiliation: Department of Physical and rehabilitation Medicine, Clermont-Ferrand University Hospital, Hospital of Clermont-Ferrand, Cébazat, France; Clermont Auvergne University, 63000 Clermont-Ferrand, France; Human nutrition unit, INRA, 63000 Clermont-Ferrand, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Coudeyre
authors.affiliation: The Moulin Vert Rehabilitation Center, 86340 Nieuil L'Espoir, France.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Le Henaff
mesh_terms: D054058:Acute Coronary Syndrome / Q000534:rehabilitation; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000534:rehabilitation; D000072038:Cardiac Rehabilitation / Q000379:methods*; D005080:Exercise Test; D005081:Exercise Therapy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000534:rehabilitation; D019876:Sports Equipment; D016896:Treatment Outcome; D000070857:Walk Test; D016138:Walking
keywords: 6-min walk test; Cardiovascular disease; Nordic walking; Rehabilitation