Research Papers
The scientific evidence on Nordic Walking. (These pages are reproduced by kind permission of the International Nordic Walking Association (INWA) and are copyright INWA.) They are broken into 3 groups - health (7 studies on sedentary people) - fitness (10 studies on physically fit people)- sports (athletes), there's a summary afterwards, and I have added a brief glossary at the end.
After that, there follows details of a study into "The Effects of Walking Poles on Shoulder Function in Breast Cancer Survivors" supplied to me by INWA.
Summaries of Nordic Walking studies published between 1992 – 2004:
- Nordic walking studies related to health and health-related fitness (on sedentary, or elderly individuals or patients)
- Study of psychological profiles (mood states) and muscular and aerobic fitness responses in sedentary women – Stoughton, Larkin and Karavan, (1992) University of Oregon
- Study of coronary heart patients (Walter et al. 1996)
- Comparison of Exel polewalking with regular walking training in female office workers - Anttila et al. (1999) Finland
- Study of elderly males with Parkinson’s Disease – Baatile et al. (2000)
- Study of the benefits of Nordic walking on functions important to everyday life among older sedentary individuals – Parkatti et al. (2002), Virginia, USA
- Study of pole walking and patients with peripheral vascular diseases – Collins et al. (2003)
- Study of the impact of training by brisk walking on cardiorespiratory fitness and other indicators of health-related fitness, in health middle-aged women – Kukkonen-Harjula et al. (2004)
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- Nordic walking studies related to fitness (physically active individuals)
- Study of physiological responses to walking with and without Power Poles™ – Hendrickson (1993) and Porcari et al. (1997)
- Study of the cross walk dual-motion treadmill – Knox (1993), Foley (1994) and by Butts et al. (1995).
- Study of energy expenditure during submaximal walking with Exerstriders ® in 24-year old physically fit women – Rogers et al. (1995)
- Comparison of heart rate during normal and fast walking speeds with and without Exel poles – Laukkanen (1998 unpublished)
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- Study of the acute physiological effects of walking on a treadmill with or without poles – Gullstrand & Svedenhag (2001), Sweden
- Study of the effects of Exel’s Nordic walker pole training on heart rate responses – Laukkanen (1998).
- Study of the metabolic cost of Nordic walking compared to normal walking in 31 year-old men and women – Morss et al. (2001) Church et al. (2002), the Cooper Institute group from Texas, USA, Jordan et al 2001
- Study to determine whether walking poles reduces loading to the lower extremities during level overground walking on 13 healthy adults – Willson et al. (2001)
- Study of Nordic walking and endurance capacity – Ripatti (2002) Germany.
- Pilot study for the intervention study by Kukkonen-Harjula et al. (2004), comparing cardio respiratory and musculoskeletal responses in middle aged women –Mänttäri et al. (2004)
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- Nordic walking studies related to sports type of performance (athletes)
- Other – various groups or reviews
- Glossary – (not supplied by INWA)
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1. Nordic walking studies related to health
The first research results on responses to pole walking training were published in 1992 by Stoughton, Larkin and Karavan from the University of Oregon. They studied both psychological profiles (mood states) and muscular and aerobic fitness responses before and after 12 weeks of “Exerstriding” or walking training in sedentary women. Exerstriding is a modified form of walking that incorporates the use of specially designed walking sticks (Exerstriders ®) in a standard walking workout. This study group consisted of 86 20-50 year old women whose fitness was at moderate level. Maximal aerobic power (VO2 max)varied between 34-37 ml/kg/min. The study group was divided into three sub-groups. The control group continued with all their previous exercise habits, while the normal-walking and Exerstrider groups went walking for 30-45 minutes four times a week for twelve weeks at an intensity corresponding to 70-85% maximum heart rate. In the Exerstrider group both the walking speed and the distance walked were slightly less than in the normal-walking group.
In both groups, the maximal aerobic power and maximal treadmill time increased significantly, by 8 and 19% respectively. A slight increase in maximal ventilation occurred in the Exerstrider group by 37% and in the walking group by 14%. Muscular strength, assessed using triceps pushdown and a modified lateral pull-down, did not improve in either group. The Exerstrider walkers showed significant improvements in depression, anger, vigor, fatique , total mood disturbances and total body-cathexis. It was speculated that the Exerstrider group may have felt more special because of their opportunity to engage in a new and more enjoyable method of walking.^ top research papers
Exerstriders were also compared to weighted vests, ankle weights, hand and wrist weights, weighted gloves and powerbelts TM by Porcari (1999), with similar results as above.
The effort involved during Nordic Walking has also been investigated in coronary heart patients (Walter et al. 1996). In this study, fourteen men aged 61 years walked two eight minute repetitions: the first consisted of normal walking while during the second the subjects used half-kilogram poles. The subjects walked at the maximum pace allowed in the light of their symptoms. All subjects had undergone either heart bypass or angioplasty operations or had suffered cardiac infarctions. During pole walking, the average energy consumption increased by 21%, the heart rate by 14 beats/minute and the highest systolic/diastolic blood pressure figures by 16 and 4 mmHg respectively compared with figures during normal walking. The oxygen pulse figures (i.e. oxygen consumption multiplied by heart rate) are indicative of changes in oxygen consumption and are not connected with undesirable rises in blood pressure. The research group concluded that pole walking is a safe form of rehabilitation for heart patients.^ top research papers
A Finnish study (Anttila et al. 1999) compared Exel polewalking with regular walking training for 12 weeks in 55 female office workers. The EMG measurement showed that electrical activities of the muscles in the upper body neck-shoulder-upper back) were significantly higher when walking with poles. Polewalking training diminished neck and shoulder symptoms and subjective feeling of pain. Mobility of the upper body increased as well. Similar results were also obtained in a study by Karvonen et al. (2000), who investigated neck-shoulder area pain on 31 persons aged 44-50 years who had no previous experience of Nordic walking. The group trained for 60 minutes per session twice a week for ten weeks. Nordic walking reduced neck and shoulder pain in general and at work. In addition, the disturbance caused by neck and shoulder stiffness and pain in the movement of the head were significantly decreased. A third study (Koskinen et al. 2003) examined the effectiveness of Nordic walking on postural control and muscular strength of the lower extremities and the middle trunk in ageing employees. The subjects (n=24) were 45-61 years old, the majority of them being women. They engaged in Nordic walking three times weekly, partly under instruction. The subjects improved on health-related fitness parameters evaluated by the Fitness Test battery developed by the UKK Institute. ^ top research papers
In a study by Baatile et al. (2000), 16 x 72-year old veteran males with Parkinson’s Disease carried out an 8 week-training programme three times weekly for 60 minutes per session. The researchers concluded that a regular nordic walking exercise program increased the perceived functional independence and quality of life in individuals with Parkinson’s Disease.
The aim in the study by Parkatti et al. (2002) was to examine the benefits of Nordic walking on functions important to everyday life among older sedentary individuals in Virginia, USA Altogether 18 x 73-year old (62-87 years) persons participated. They exercised by Nordic walking for 60 minutes twice a week for 12 weeks (10 minutes warm-up, stretching in the middle and cool-down at the end). The functional capacity battery of tests before/after intervention included: chair stand, chair sit and reach, arm curl, scratch test, 2 minutes step in place and “up and go” used. A health questionnaire was also used. The results on all the functional tests were statistically significantly better after training. The study showed that Nordic walking is suitable for elderly persons, and had a positive impact on functional capacity.
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In 2003 Collins et al. published a study where they 52 patients (65-70 years) with peripheral vascular diseases (PVD). The program consisted of three weekly sessions of pole walking for 30-45 minutes. The effect of Vitamin E (dose 400 IU daily) was also studied. The data collected included pre- and post-peak oxygen uptake, a Quality of Life interview, and biweekly tests of ankle blood pressure. The pole group improved significantly in exercise tolerance, and also had less claudication pain after exercise. Additionally, distance and walking speed improvement were observed in the pole group. The investigators concluded that pole walking effectively improved both the exercise tolerance and perceived quality of life of patients with PVD. E-vitamin contributed little additional benefit.
The purpose of a study by Kukkonen-Harjula et al. (2004) was to study the impact of training by brisk walking, with or without poles, on cardiorespiratory fitness (both in submaximal and maximal exercise) and on some other indicators of health-related fitness in healthy middle-aged women. The training prescription was designed for moderate intensity (50-85% of HR reserve, HRR). 212 women volunteered (age 50-60 years, no major health problems, BMI 20-30 kg x m-2 previous leisure exercise training no more than twice weekly). After screening examinations, 121 women were accepted and randomized into a nordic walking or a walking group, who were instructed in walking and Nordic walking techniques. The training was held 4 x weekly for 40 minutes, intensity 53% HRR, Borg 13.7. The increase in peak VO2 during 13 weeks’ training was modest (about 8 % in both groups). The study also showed that the mode of maximal exercise testing (with or without poles) had no influence on peak VO2 values or on the extent of change during training in these women with little initial familiarity with the Nordic walking technique.
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In a study by Aigner et al. (2004), 20 untrained healthy individuals (average age 47 years) were studied while walking with and without poles on separate days. The speeds of walking was on average 7.9 km/h, and mean heart rates 165 and 158 bpm with and without poles. The corresponding blood lactate levels were 5.7 and 5.0 mmol/l. In all speeds between 3 to 7 km/h, the heart rates and lactates measurements were significantly higher in Nordic walking than in regular walking.
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2. Studies related to fitness
Physiological responses to walking with and without Power Poles TM were studied by Hendrickson (1993) and by Porcari et al. (1997). Power Poles TM are specially constructed, rubber-tipped ski poles designed for use during walking. Hendrickson’s study group consisted of sixteen fit women (VO2 max 50 ml/kg/min) and men (59), who walked with and without poles on a treadmill with the speeds of 6-7.5 km/h. There were no differences in response between males and females. It was found that the use of poles significantly increased oxygen uptake, heart rate and energy expenditure by approximately 20 percent compared to walking without poles in fit subjects. In Porcari’s treadmill study on 32 healthy men and women, walking with poles resulted in an average 23% higher oxygen uptake, 22% higher calorific expenditure and 16% higher heart rate responses compared to walking without poles. RPE values averaged 1.5 units higher with the use of the poles, and the pattern of response was similar for men and women.
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The Cross Walk dual-motion treadmill has been studied by Knox (1993), Foley (1994) and by Butts et al. (1995). The Cross Walk Dual Motion Cross Trainer is a motorized treadmill designed to increase the energy cost of walking by incorporating arm activity during walking, thus increasing the muscle mass used during exercise. The activity is not the same as field walking with poles, but can be used as a reference for Nordic walking. Knox studied thirty seven 17-35 year old women, who all performed six 5-minute steady-state exercises with and without arm activity. Walking with arm activity significantly increased heart rate, ventilation, oxygen uptake and energy expenditure compared to walking without arm activity: e.g. heart rate increased by 17-31 beats per minute. The rating of perceived exertion and of energy expenditure increased by an average of 14 percent. In Butt’s study, 24-year old women and men were studied with a similar design. In this study armwork increased energy expenditure by 55% on average compared to regular walking, but the rating of perceived exertion increased only slightly. This was consistent with the results from Foley, who studied the Cross Walk with 24-year old men.
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Rogers et al. (1995) compared energy expenditure during submaximal walking with Exerstriders® in ten 24-year old, physically fit women. Mean maximal aerobic power (21 vs. 18ml/kg/min) and heart rate (133 vs 122 bpm) were significantly greater during walking with poles compared to walking without; also the total calorific expenditure in a 30 minute session was significantly greater during pole walking (174 vs. 141 kcal). In contrast, the rating of perceived exertion did not differ significantly between the two conditions.
Laukkanen (1998, unpublished) compared heart rate during normal and fast walking speeds with and without Exel Walker poles. Ten middle-aged men and women were studied on an indoor hall track. The heart rate increase, measured with a telemetric Polar HR monitor, was between 5-12 bpm and 5-17 bpm in the women and men respectively.
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Gullstrand & Svedenhag (2001) from Sweden examined the acute physiological effects of walking on a treadmill with or without poles. This study of thirteen 55-year old subjects showed that VO2 max, VE, blood lactate and HR all increased, but the RPE (rating of perceived exertion) remained unchanged in Nordic walking compared to regular walking.
The effects of Exel’s Nordic walker pole training on heart rate resposes was also studied in ten men and women. Their heart rates were 5-12 and 5-17 beats per minute -1 higher for moderate and vigorous Nordic walking in an indoor sports hall in comparison with walking without poles (Laukkanen 1998).
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In a study published by the Cooper Institute group from Texas, USA, the metabolic cost of Nordic walking was compared to normal walking in 22 31-year old men and women (Morss et al, 2001, Church et al. 2002). The participants in this study walked on an outdoor 200-m track with a Cosmed K4b for measuring oxygen consumption and a Polar Vantage heart rate monitor for HR measurements. The study indicated significant increases in oxygen consumption (20% on average), caloric expenditure and HR in Nordic walking compared to normal walking. The range of increase in oxygen consumption was wide (5-63%), reflecting differences in poling intensity and technique. Perceived exertion did not differ between the two modes of walking. The same group also compared separately the metabolic cost of high intensity poling (Jordan et al., 2001). In high intensity poling, Nordic walking increased HR 35 bpm on average compared to regular walking.
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In a study by Willson et al. (2001), the purpose was to determine whether walking with poles reduces loading to the lower extremities during level overground walking. Three-dimensional gait analysis was conducted on 13 healthy adults who completed 10 walking trials using three different poling conditions (selected poles, poles back, and poles front) and without the use of poles (no poles). The results showed that there were differences in kinetic variables between walking with and without poles. The use of walking poles enabled subjects to walk at a faster speed with reduced vertical ground reaction forces, vertical knee joint reaction forces, and reduction in the knee extensor angular impulse and support moment, depending on the poling condition used.
In a study carried out in Germany by Ripatti (2002), 24 individuals (48 +/- 8 years) did Nordic walking 2 times weekly for 60 minutes (65 – 85% HRmax) for 6 weeks. This improved their endurance capacity even walking at lower speed.
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Mänttäri et al. (2004) conducted a pilot study for the intervention study by Kukkonen-Harjula et al. (2004). In this pilot, they compared the cardiorespiratory and musculoskeletal responses to Nordic walking and walking in field conditions in middle-aged women, with three self-guided exercise intensities. After screening examinations, 20 middle-aged women performed a maximal exercise test on a treadmill with poles. All the subjects were familiar with Nordic walking or cross-country skiing. These results showed that Nordic walking increased the mean HR compared to regular walking only from 2.6% to 4.9%, and the mean VO2 from 2.5% to 10.8%, during the three different self-guided walking intensities. This increase seems to be due to the increased muscle activity in the upper-body muscle groups. Compared to previous studies the statistically significant mean differences between Nordic walking and walking were modest.
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- Studies related to sports
In a Norwegian study by Haugan and Sollesnes (2003), 16 sports students (22 years) were measured in a laboratory, walking at speeds of 5.5, 6.0 and 6.5 km/h with or without poles on an elevated treadmill. Half of the subjects were cross-country skiers. Oxygen uptake increased significantly at all speeds when using poles in walking in the other subjects, but not in the cross-country skiers.
- Other
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Nordic walking has also been under study in the Netherlands. In 2003 Lande et al. published a systematic review of the physiological effects of pole walking.
Parkkari et al. (2004) evaluated injury risk in various commuting and lifestyle activities in a cohort of 3657 15-74-year old Finns. The individual injury risk per exposure time was overall relatively low, ranging from 0.19 to 1.5 per 1000 hours of participation. The highest risk in all recreational and competitive sports was in squash (18.3), judo (16.3) and orienteering (13.6). In nordic walking (pole walking) the risk 1.7. In the cohort 11% participated actively in this sport.
In a questionnaire study by Schmidt et al. (2004), 226 German adults (66% women) who practiced nordic walking regularly were interviewed during winter 2003-2004. The average age was 52 years and BMI 25kg/m2 . The main motivation for nordic walking was health, 12% wanted to try out something new, and 6% did it as an alternative to cross-country skiing in summer. 71% worked out for arm and trunk muscles, 23% in order to reduce joint load. 54% expressed a wish for the establishment of a similar network of walking trails like those for hiking.
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Nordic walking has also been studied from the consumer perspective (Shove and Pantzar 2004), the authors conclude that popularity of nordic walking has arisen through the active and ongoing interaction of images, artifacts and forms of competence: a process in which both consumers and producers are involved.
Summary
To summarize the immediate physiological effects of nordic walking, it increases the energy consumption of the body compared to regular walking without poles at the same speed both in women and men, and in fit and less fit individuals. The increase is due to larger working muscle mass in the upper body. The increase varies individually according to the walking speed and technique. If the speed is very fast, there is less time for efficient pushing off with poles, and thus there is decreased upper body muscular involvement. Similarly, the increase in heart rate is variable. Because the perceived exertion in pole walking is often less than the true physiological strain, monitoring the heart rate may be beneficial for those tending to over-exert themselves. The resulting increases in energy consumption and heart rate in nordic walking mean that the cardiovascular strain induced by nordic walking is greater compared to walking without poles at the same speed. This is desirable for those people who have difficulty reaching their training heart rate by walking – instead of having to start running, they can start using walking poles. Walking involves less harmful impacts to the lower extremities compared to running, and therefore may prevent injuries.
In middle-aged and elderly women, the training effects of nordic walking on cardiorespiratory fitness and endurance have been shown to be similar to those achievedf by other forms of walking training. For fit individuals and for men, intervention studies are not available. In the studies so far, the improvement achieved in nordic walking was reached at lower speeds and thus over shorter distances walked, because the cardiovascular strain was greater in nordic walking than in ordinary walking without poles at the same speed. Walking with poles particularly improves aerobic fitness and muscular endurance, reduces neck-shoulder area disabilities and pain, and can have positive effects on mood state. In order to improve muscle power, uphill walking is required. Little has been published on the impact of pole walking affecting on body coordination and motor fitness. Nordic walking is a safe activity and individuals who take it up are mainly motivated by health reasons.
Although rather strong scientific evidence on both the immediate and the long-term effects of nordic walking is now available, some research challenges still remain. Randomised controlled trials on dose-responses, on health and fitness improvement in men and women, in the healthy, the physically fit, and in individuals with only minor health problems (body weight, insulin-resistance, blood pressure, osteoporosis*) are still lacking. Moreover, research on motivation and adherence, and on the participating population (walkers, their demographics and their social and other status) in nordic walking activity is still missing.
Copyright: INWA
^ top research papers * >research paper on osteoporosis
References - taken from the International Nordic Walking Association Instructor Manual 2005 by kind permission of Nordic Health Ltd t/a Nordic Walking UK, the UK National Nordic Walking Assocation for INWA
Copyright INWA
Anttila, Holopainen, Jokinen. Polewalking and the effect of regular 12-week polewalking exercise on neck and shoulder symptoms, the mobility of the cervical and thoracic spine and aerobic capacity. Final project work for the Helsinki IV College for Health Care Professionals, Helsinki 1999
Baatile J, Langbein W, Weaver F, Maloney C, Jost M. Effect of exercise on perceived quality of life of individuals with Parkinson’s Disease. J of Rehabilitation Research and Development 37 (5), September/October 2000.
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Borg. Psychophysical bases of perceived exertion. Med. Sci Sports exercises 14:377-381, 1982
Borodulin K, Lakka T, Laatikainen T, Laukanen R, Kinnunen H, Jousilahti P. Associations of self- rated fitness and different types of leisure time physical activity with predicted aerobic fitness in 5346 Finnish adults. Journal of Physical Activity and Health 1,142-153, 2004
Butts, Knox, Foley. Energy cost of walking on a dual-action treadmill in men and women. Med Sci Sports Exerc 27, 121-125, 1995
Church, Earnest, Morss. Field testing of physiological responses associated with nordic walking. Res Quart Exerc Sports 73; 296-300, 2002
Collin E, Langbein W, Orebaugh C, Bammert C, Hanson K, Reda D, Edwards L, Littooy F. PoleStriding exercise and vitamin E for management of peripheral vascular disease. Med Sci Sports Exerc 3: 384-393, 2003
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Crumptom S, Williford H, O’Mailia S, Olson M, Woolen L. Validity of the Polar M52 heart rate monitor in predicting VO2 max. Med Sci Sports Exerc 35,5 (Suppl), 1078, May 2003
Foley. The effects of Cross Walk resistive arm poles on the metabolic costs of treadmill walking. M.Sc. Thesis. University of Wisconsin-Lacrosse, 1994
Gullstrand L, Svedenhag J. Training effects after 7 weeks of pole- and normal walking. 8th Annual Congress of the European College of Sport Science. Salzburg, Austria 09.-12.07.2003. In:Abstract book. Ed. Mueller E, Schwameder H, Zallinger G, Fastenbauer V. Institute of Sport Science, University of Salzburg, Austria 2003, p 33-34 (abstract).
Haugan A, Sollesnes B. Does submaximal oxygen uptake increase when using nordic walking poles? Academic degree study. Sogn og Fjordane University College Faculty of Teacher Education, Sogndal, Norway. May 2003.
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Henrickson. The physiological responses to walking with and without Power Poles on treadmill exercise. M.Sc.Thesis. University of Wisconsin-Lacrosse, 1993.
Jordan, Olson, Earnest, Morss, Church. Metabolic cost of high intensity poling while nordic walking versus normal walking. Med Sci Sports Exerc 33 (5). S86, 2001
Karawan. The effects of twelve weeks of walking or Exerstriding on upper body muscular strength and endurance. Thesis. University of M. Sc. Wisconsin-Lacrosse, 1992.
Karvonen, Morksy, Tolppala, Varis. The effects of stick walking on neck and shoulder pain in office workers. Final project work at Mikkeli Polytechnic School. Degree programme of Physiotherapy. Mikkeli 2001.
Kinnunen, Hautala, Makikallio, Tulppo, Nissila. Artificial neural network in predicting maximal aerobic power. Med Sci Sports Exerc 32,5,1535, 2000
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Knox. Energy cost of walking with and without arm activity of the Cross Walk dual motion cross trainer. M. Sc. Thesis. University of Wisconsin-Lacrosse, 1993.
Koskinen J, Kärki M, Virtanen M. Power and Balance from nordic walking – effects of regular nordic walking to muscular strength and postural control of ageing employees who are unaccustomed to regular physical exercise. Bachelor of Physiotherapy degree. Helsinki Polytechnic Health Care and Social Services, Helsinki, 2003.
Kukkonen-Harjula, Laukkanen, Nenonen, Oja, Uusi-Rasi, Vuori. Effect of walking training on health-related fitness in healthy middle-aged adults – a randomised controlled study. Scand J Med Sci Sports 8, 236-242, 1998.
Kukkonen-Harjula, Mänttäri A, Hiilloskorpi H, Pasanen M, Laukkanen r, Suni J, fogelholm M, Parkkari J. Training responses of self-guided brisk walking with or without poles – a randomised controlled trial in middle-aged women. 9th Annual Congress of the European College of Sport Science. Clermont-Ferrand, France, 03.-06.07.2004. Book of abstracts. P 157.
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Langbein WE, Collins EG, Orebauch C et al. Increasing exercise tolerance of persons limited by claudication pain using polestriding. J Vase Surg 2002;35:887-893.
Lande W, Hermansen B, Stamland O, Nordaune P. The physiological – and additional effects of pole walking. A systematic review. Research report at Fontys University of Professional Education Eindhoven, Department of Physiotherapy. Eindhoven, the Netherlands. 2003.
Laukkanen, R. Development and evaluation of a 2-km walking test for assessing maximal aerobic power of adults in field conditions. Kuopio University Finland, May 1993.
Laukkanen R. HR response to Nordic Walking compared to regular walking. 1998 (unpublished).
Larkin. Aerobic responses to 12 weeks of Exerstriding or walking training in sedentary adult women. Thesis University of Wisconsin-Lacrosse, 1992.
Laukkanen R. Non-exercise test for aerobic fitness assessment. Proc 8th Annual Congress of the ECSS, Salzburg, Austria, 9-12 July 2003, p 383.
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Morris, Hardman. Walking to health. Sports Med 23, 306-332, 1997.
Morss, Church, Earnest, Jordan. Field test comparing the metabolic cost of normal walking versus walking with nordic walking. Med Sci Sports Exerc 33(5), S23, 2001.
Mänttäri A, Hannola A, Laukkanen R, Hiilloskorpi H, Alikoski J, Valve R, Pekkarinen H, Parkkari J. Cardiorespiratory and musculoskeletal responses of walking with and without poles in field conditions in middle-aged women. 9th Annual Congress of the European College of Sport Science. Clermont-Ferrand, France, 03-06.07.2004. Book if abstracts, p 157.
Parkatti T, Wacker P, Andrews N. Functional capacity from nordic walking among elderly people. Seminar poster at University of Jyväskylä, Finland, 2002.
Parkkari J, Kannus P, Natri A, Lapinleimu I, Palvanen M, Heiskanen M, Vuori I, Järvinen M, Active living and Injury Risk. International Journal of Sports Medicine 25:209-216, 2004.
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Peltola, Hannula, Held, Kinnunen, Nissilä, Laukkanen, Marti. Validity of Polar Fitness Test based on heart rate variability in assessing VO2 max in trained individuals. Proceedings of 5th Annual Congress of ECSS, Jyväskylä, Finland, 19-23 July 2000. p 565.
Porcari, Hendrickson, Walter, Terry, Walsko. The physiological responses to walking with and without Power Poles on treadmill exercise. Res. Quart Exerc sports 68, 161-166, 1997.
Porcari. Pump up your walk. ACSM’s Health and Fitness Journal Jan/Feb, 25-29, 1999.
Ripatti T. Effect of nordic walking training program on cardiovascular fitness. Academic degree study. Sportartspezifische Leistungsfähigkeit Deutsche Sportshochschule Koln, Germany, 2002.
Rodgers, Vanheest, Schachter. Energy expenditure during submaximal walking with Exerstriders. Med Sci Sports Exerc 27, 607-611, 1995.
Ross, Jackson. Exercise concepts, calculations, and computer applications. Carmel, IN, Benchmark Press, 1990, pp 95-103,109.
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Schmidt A, Sonnen J, Krämer A, Roth R. Nordic walking – an analysis of target groups and perspectives. 9th Annual Congress of the European College of Sport Science. Clermont-Ferrand, France, 03.-06.07.2004. Book of abstracts.
Shove E, Pantzar M. Consumers, producers and practices: understanding the invention and reinvention of nordic walking. Journal of Consumer Culture (in press 2004).
Stoughton. Psychological profiles before and after 12 week of walking or Exerstrider training in adult women. M. Sc. Thesis University of Wisconsin-Lacrosse, 1992.
Tshopp, Peltola, Held, Kinnunen, Hannula, Laukkanen, Marti. Traditionelle and neue Ansätze zür Schätzung der maximalen Sauerstoffaufnahme in Ruhe. Schweizerische Zeitschrift für Sportmedizin und Sporttraumatologie 48 (2), 58-63, 2000.
Walter, Porcari, Brice, Terry. Acute responses to using walking poles in patients with coronary artery disease. J Cardiopulm Rehabil Jul-Aug; 16(4), 245-50, 1996.
Willson J, Torry M, Decker M, Kernozek T, Steadman J. Effects of walking poles on lower extremity gait mechanics. Journal: Medicine and Science in Sports and Exercise 33 (1): p 142-147, January 2001.
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Glossary:
BMI – body mass index – a method of estimating and classifying body composition based on weight and height
Cardiorespiratory – relating to the heart and lungs
Cardiovascular – relating to the heart and blood vessels
Heart rate – the number of times the heart beats per minute
HRR – heart resting rate
BPM – beats per minute - A strong heart can pump out more blood per beat and per minute than a weak underused one. A stronger heart can have the effect of lowering blood pressure and a lower resting heart rate,( the heart doesn’t have to work so hard).
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Lactic acid – a natural by-product of anaerobic metabolism
Lactate threshold – the point at which blood lactate begins to accumulate more quickly than it can be dissipated- when you feel your muscles are leaden, your breathing is laboured and you feel dizzy or nauseous and you have to slow down or stop.
Lactate tolerance – the ability to delay lactate accumulation to a later stage of exercise and deal with it more efficiently
Musculoskeletal – relating to muscles and bones and connective tissues. Increased muscle mass maintains your metabolic rate and is important for weight control.
RPE – rate of perceived exertion
Submaximal – below maximum intensity or effort
VO2 max – maximal oxygen uptake or maximal aerobic capacity – a widely used measurement to determine the endurance of aerobic fitness. It measures the endurance capacity of the cardiovascular system (heart, lungs and blood circulation) to transport oxygen to the organs and muscles, and also gives an indication of the capacity of muscles to take up and use oxygen. The weaker the general physical condition of the body, the lower the maximal oxygen uptake rate.
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The Effects of Walking Poles on Shoulder Function in Breast Cancer Survivors
Breast cancer treatment often results in impaired shoulder function, in particular, decrements in muscular endurance and range of motion, which may lead to decreased quality of life. The purpose of this investigation was to determine the effects of walking pole use on shoulder function in female breast cancer survivors. Participants had previously been treated with one or a combination of the following: mastectomy, breast conservation therapy, axillary lymph node dissection, chemotherapy, or radiation.
Participants were randomly placed in experimental (n=6) and control (n=6) groups and met with a cancer exercise specialist 2 times each week for 8 weeks. The experimental group used walking poles during the 20-minute aerobic portion of their workout, whereas the control group did not use walking poles but performed 20 minutes of aerobic exercise per workout session. Both groups participated in similar resistance training programs. Testing was done pre- and postexercise intervention to determine upper body muscular endurance and active range of motion at the glenohumeral joint.
Repeated-measures analysis of variance (ANOVA) revealed significant improvements in muscular endurance as measured by the bench press (P=.046) and lat pull down (P=.013) in the walking pole group. No within-group improvements were found in the group that did not use walking poles.
The data suggest that using a walking pole exercise routine for 8 weeks significantly improved muscular endurance of the upper body, which would clearly be beneficial in helping breast cancer survivors perform activities of daily living and regain an independent lifestyle.
Lisa K. Sprod, MS University of Northern Colorado, Rocky Mountain Cancer Rehabilitation Institute, Greeley, Colorado
Scott N. Drum, MS University of Northern Colorado, Rocky Mountain Cancer Rehabilitation Institute, Greeley, Colorado
Ann T. Bentz, PhD University of Northern Colorado, Rocky Mountain Cancer Rehabilitation Institute, Greeley, Colorado
Susan D. Carter, MD University of Northern Colorado, Rocky Mountain Cancer Rehabilitation Institute, Greeley, Colorado
Carole M. Schneider, PhD University of Northern Colorado, Rocky Mountain Cancer Rehabilitation Institute, Greeley, Colorado,
PMID: 16282505 [PubMed – in process]
http://online.sagepub.com/cgi/gca?allch=&gca=spict;4/4/287&
Integrative Cancer Therapies online. 2005 Dec: 4(4):287-93
DOI: 10.1177/1534735405282212 © 2005 SAGE Publications
(The glenohumeral joint is a ball-and-socket joint that is formed between the humerus and the scapula. This joint allows the arm to move in a circular rotation as well as movement of the arm towards and away from the body. The motion that the glenohumeral joint provides is flexion, extension, abduction and adduction. The glenohumeral joint is the most mobile joint in the body.)
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