Nordic Walking and Parkinson’s
Nordic Walking is a popular activity for people living with Parkinson's and many of our instructors either run groups especially for local Parkinson's UK branches or teach people living with Parkinson's in their regular classes.
Why is Nordic Walking an effective and enjoyable exercise for people with Parkinson’s?
Nordic Walking is a valuable exercise tool for people with Parkinson’s because of:
- The focus on the correct gait technique.
- Large amplitude training from the intensification of normal walking.
- The repetitive movements driving neuroplasticity.
- Exposure to outdoor environments to build confidence.
- Cardiovascular and general fitness benefits.
- Increased stability from the use of two poles on the ground.
- Challenging coordination to help build dual tasking abilities.
- Improvement in upper limb strength as well as lower limb strength.
- Weight bearing exercise improving bone density.
- The social interaction of group activities… and it is FUN.
What is the evidence to support Nordic Walking as suitable for people living with Parkinson’s?
There been several specific research studies published on Nordic Walking and Parkinson's. All the results have been promising with significant improvements in different aspects.
- Significant improvements in quality of life (Baatile et al, 2000)
- Increase in walking speed (Van Eijkeren et al, 2008).
- Increased stride length, postural stability and improved gait pattern (Reuter et al, 2011).
- Nordic Walking is associated with improvement in cognitive aspects of movement preparation (Ebersbach et al 2014).
Effects of a flexibility and relaxation programme, walking and Nordic walking on Parkinson disease. Reuter et al 2011
This research study involved 90 Parkinson's patients who were experiencing mild to moderate effect. It aimed to assess the effects of doing regular exercise for people with Parkinson's and whether Nordic Walking is more effective than normal walking. These patients were randomly allocated into one of 3 training groups:
- Nordic Walking – 3 x 70min sessions a week for 6 months.
- Walking – 3 x 70min sessions a week for 6 months.
- Flexibility and relaxation exercises – 3 x 70min sessions a week for 6 months.
The results showed that all three groups were similar at assessment, and there was a good compliance with all three groups with all patients attending at least 70 of 78 training sessions.
Pain was eased by both the Nordic Walking and walking groups.
Parkinson Disease–specific Disability
Both Nordic Walking and walking groups saw improvements in posture, reduced freezing and faster alternating movements. The Nordic Walking group significantly improved postural stability and gait pattern.
Quality of Life
The Nordic Walking and walking groups felt that their memory had improved and concentration.
The Nordic Walking group significantly increased their stride length over both the walking group and flexibility group. The Nordic Walking group was also significantly better at maintaining the same stride length. Stride length variability has been associated with increased risk of falling and instability. Further gait improvements were also seen in the Nordic Walking group being able to decrease stride time and a decrease in double stance phrase.
Both the walking and Nordic Walking groups increased their walking velocity significantly however there was no difference between the two groups. The Nordic Walking group demonstrated significantly lower heart rate than the other two groups.
All three exercise groups made improvements from initial testing, however the walking and Nordic Walking groups made significantly greater improvements in all aspects tested. The Nordic Walking group was superior in improving gait pattern and style and postural stability. This is an important result as gait changes are a significant primary symptom of Parkinson's and changes can lead to increased risk of falls and reduced mobility resulting in reduced quality of life.
- Nordic Walking is superior to just walking in improving gait pattern, reducing heart rate and postural stability.
- Exercise has been shown to improve neural plasticity, promoting axon outgrowth and increasing synapses in the brain. Nordic Walking has the ability to stimulate an increase in the above changes due to the increased demands on coordination with the poles.
- Nordic Walking technique was difficult for patients to learn: 17 patients performed great technique, 10 performed good technique and 3 performed poorly. This highlights the need to be taught how to Nordic Walking correctly and to have regular reviews by an International Nordic Walking Association (INWA) instructor or coach. Learning is also best achieved with intensive input – regularly 3 x a week.
- All patients that learned Nordic Walking continued regularly after the research project was completed and set up their own social groups to walk in, including their partners and friends.
How is Nordic Walking different from other “walking with poles” techniques?
The INWA Nordic Walking technique can be safely adapted for people living with Parkinson’s to accommodate each individual’s level of ability. Unlike other “walking with poles” methods, such as with trekking poles or Activator poles, Nordic Walking does not limit those who are capable of more than basic pole walking but can safely be used by those whose symptoms do not allow them to use the full Nordic Walking technique.
As individuals become more confident in their Nordic Walking, the INWA technique gives them scope to progress to their optimum level, increasing motivation and satisfaction with the activity.
Nordic Walking has clear benefits for many other health conditions that have not been demonstrated for other “pole walking” techniques. Where an individual with Parkinson’s has additional health conditions, Nordic Walking can help to address these too.
The design of the poles enables individuals to use the strap to maintain their grip, in turn sustaining their good technique. There is no evidence of that there is a greater chance of falling than using other “pole walking” techniques.
But what do Nordic Walkers who are living with Parkinson's have to say?
Richard Clifft, INWA Nordic Walking Instructor and Champion for Parkinsons UK shares his experience:
Why Nordic Walking?
Before the ‘why’, and for the benefit of those unfamiliar with the term, what is Nordic Walking?
Put very, very simply, it’s walking with the addition of two specially designed poles that enhance regular natural walking. It’s a very accessible activity and can be shared by people of differing fitness, and has no age limits.
So the question, why, and what are the benefits?
Well, it’s a recognised fact that exercise does play an important role in slowing the effects of Parkinsons, and Nordic Walking has growing evidence of its suitability for both movement, stature, and boosting self-confidence.
From one who knows, the benefits have been impressive. It has increased my awareness when walking to use the whole body and improves my posture, keeping me up straight, and gives me a better stride (or gait) to my walking. For me, I found that within a short space of time I had developed a better awareness of my posture and walk even without the poles, a point noted by both family and friends.
So yes, I’m absolutely convinced it’s a fun form of beneficial exercise which will get you off the sofa and with self-confidence to come into the big outdoors!