# Is Nordic Walking evidence-based in different patient groups? - Savonia AMK > Nordic walking is one of the most popular exercise types in Finland. Over 1,5 million people in Finland take an interest in Nordic walking. ## Blended Intensive Program (BIP) on Evidence-Based Physical Therapy Evidence-Based Physical Therapy (EBP) uses the best research evidence with clinical expertise and user’s preferences to produce the most appropriate and effective care. During week 43 of 2023, Savonia University of Applied Sciences in Kuopio, Finland, hosted a Blended Intensive Program (BIP) focused on EBP. The program featured welcome words from the president of The European Network of Physiotherapy in Higher Education (ENPHE) and covered the foundations of EBP, highlighting challenges across various physical therapy fields. More than 40 physiotherapy students and 7 teachers from Savonia University of Applied Sciences (Finland), Universidade da Coruña (Spain), and Charles University Prague (Czech Republic) participated. Students collaborated on articles covering themes such as McKenzie methods, back pain, spinal cord injuries, aquatic therapy, ergonomics, Nordic walking, sport injuries, and children with disabilities. ## Nordic Walking in Rehabilitation Nordic walking (NW) is a popular exercise in Finland, with over 1.5 million participants across all age groups. This article examines five research studies regarding the use of NW in the rehabilitation of patients with cardiovascular diseases, obesity, Parkinson’s disease, and the elderly. ### Cardiovascular Diseases A Randomized Controlled Trial (RCT) investigated NW versus walking without poles for patients with acute coronary syndrome and peripheral arterial occlusive disease who had undergone stent placement. Results showed that while both groups improved their walking distance, the improvement was significantly greater in the NW group. The benefit was particularly significant for those with peripheral arterial occlusive disease, and patients reported that NW was more motivational (Girold et al., 2017). ### Obesity and Weight Loss A systematic review examined the effects of NW on weight loss in obese and overweight individuals. The review found that NW contributes to a reduction in body fat mass after 6 to 12 weeks of training. Because the poles reduce lower limb muscular activity, NW is an encouraging way for individuals with lower exercise tolerance to remain physically active. The study recommended walking with poles at least four times per week for at least sixty minutes per session, ideally coupled with diet control (Gobbo et al., 2019). ### Parkinson’s Disease A systematic review and meta-analysis on NW for people with Parkinson’s disease found no clinically significant changes in global motor impairment, functional mobility, balance, or physical fitness. However, the study noted potential improvements in quality of life and walking ability (Salse-Batán, 2022). ### Health Benefits and the Elderly A systematic review by Tschentscher et al. (2013) highlighted the health benefits of NW on the circulatory system and quality of life for people with various conditions, including obesity, coronary artery disease, peripheral arterial disease, and Parkinson’s. Additionally, research focusing on the second half of life indicates that NW is an easy and effective sport for improving physical activity in elderly people with various diseases (Skórkowska-Telichowska, 2016). ## Conclusion Nordic walking is a versatile and effective form of exercise with numerous health benefits. It holds promise for improving cardiovascular health, reducing obesity, and promoting well-being in the elderly and those with chronic conditions. The research indicates that NW is a valuable addition to physical rehabilitation. Through the BIP-week, participants deepened their understanding of the physiological benefits of pole walking and the importance of evaluating research quality, leading to a strong recommendation for incorporating NW into rehabilitation programs. ## Authors * **Noora Kupari**, Physiotherapy student, Savonia University of Applied Sciences, Finland * **Reetta Silvasti**, Physiotherapy student, Savonia University of Applied Sciences, Finland * **Sini Toikkanen**, Physiotherapy student, Savonia University of Applied Sciences, Finland * **Marja Äijö**, PhD, Principal lecturer of gerontology and rehabilitation, Savonia University of Applied Sciences, Finland * **Mari Tuppurainen**, Physiotherapy lecturer, Savonia University of Applied Sciences, Kuopio, Finland * **Dagmar Pavlu**, Physiotherapist, Assoc. Prof. Charles University, Czech Republic * **Ivana Vláčilová**, Professor, Charles University, Czech Republic * **Jamile Vivas Costa**, PhD, MSc, PT. Lecturer at Department of Physical Therapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy and Researcher at Psychosocial intervention and functional rehabilitation group, Universidade da Coruña, Spain * **Montserrat Fernández Pereira**, MSc, PT. Lecturer at Department of Physical Therapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy and Physiotherapist at Spinal Cord Injury Unit, A Coruña Hospital (CHUAC), Spain * **Verónica Robles García**, PhD, MSc, PT, OT. Lecturer at Department of Physical Therapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy and Researcher at the Neuroscience and motor control group, Universidade da Coruña and Biomedical Institute of A Coruña, Spain ## References * Jorge Salse-Batán, Miguel A Sanchez-Lastra, David Suarez-Iglesias, Silvia Varela, Carlos Ayán 2022. *Health and social care in the community. Effects of Nordic walking in people with Parkinson’s disease: A systematic review and meta-analysis.* [Link](https://pubmed.ncbi.nlm.nih.gov/35593147/) * Katarzyna Skórkowska-Telichowska, Katarzyna Kropielnicka, Katarzyna Bulińska, Urszula Pilch, Marek Woźniewski, Andrzej Szuba & Ryszard Jasin 2016. *Aging clinical and Experimental Research. Nordic walking in the second half of life.* [Link](https://nordicwalkingpoland.pl/uploads/feed/8b5876af81d0f62a39db96f5cf7d94c9.pdf) * Marcus Tschentscher, David Niederseer & Josef Niebauer, 2013. *American Journal of Preventive Medicine Health benefits of Nordic walking: a systematic review.* [Link](https://pubmed.ncbi.nlm.nih.gov/23253654/) * Sébastien Girold, Jérome Rousseau, Magalie Le Gal, Emmanuel Coudeyre, Jacqueline Le Henaff 2017. *Annals of Physical and Rehabilitation Medicine. Nordic walking versus walking without poles for rehabilitation with cardiovascular disease: Randomized controlled trial.* [Link](https://www.sciencedirect.com/science/article/pii/S1877065717300180?via%3Dihub) * Stefano Gobbo, Valentina Bullo, Enrico Roma, Federica Duregon, Danilo Sales Bocalini, Roberta Luksevicius Rica, Andrea Di Blasio, Lucia Cugusi, Barbara Vendramin, Manuele Bergamo, David Cruz-Diaz, Cristine Lima Alberton, Andrea Ermolao & Marco Bergamin, 2019. *Journal of Functional Morphology and Kinesiology. Nordic Walking Promoted Weight Loss in Overweight and Obese People: A Systematic Review for Future Exercise Prescription.* [Link](https://pubmed-ncbi-nlm-nih-gov.ezproxy.savonia.fi/33467351/) * UKK-instituutti. *Sauvakävely on monipuolinen ja tehokas liikuntamuoto.* [Link](https://ukkinstituutti.fi/liikkuminen/liikuntalajit-ja-liikkumismuodot/sauvakavely/)