Effectiveness of 6-Week Nordic Walking Training on Functional Performance, Gait Quality, and Quality of Life in Parkinson's Disease

Abstract

Background and objectives: Motor rehabilitation improves physical mobility and quality of life in Parkinson's disease (PD). As specialized rehabilitation is expensive and resource-consuming, there is a need for simpler, cost-effective methods. The purpose of the study was to determine whether Nordic Walking (NW) training may support the management of motor disability in PD. Materials and Methods: Forty patients (median age 64.0 years, range 50-75 years) with idiopathic PD, Hoehn and Yahr stages II-III, were randomly assigned to NW or standard rehabilitation (SR) programs, comprising twelve rehabilitation sessions conducted bi-weekly throughout the 6-week study period. Results: Median Unified Parkinson's Disease Rating Scale part III scores were significantly reduced with NW, by 8.5, and with SR, by 6.0 points (both p < 0.001), with significantly greater improvement with NW than with SR (p = 0.047). Gait quality and balance control, measured using the Dynamic Gait Index, improved with NW by a median of 8.0 and with SR by 5.5 points (both p < 0.001), with slightly greater improvement with NW, compared to the SR group (p = 0.064). Quality of life, assessed using the Parkinson's Disease Questionnaire (PDQ-39), improved with NW by a median of 15 and with SR by 12 points, p = 0.001 and p = 0.008, respectively. Conclusions: The 6-week Nordic Walking program improves functional performance, quality of gait, and quality of life in patients with PD and has comparable effectiveness to standard rehabilitation.

Keywords: Nordic Walking; Parkinson’s disease; disability; gait; quality of life; rehabilitation exercise.

Figure 1

Box and whisker plots of median change in (a) Unified Parkinson’s Disease Rating Scale (UPDRS) part III scores, (b) Dynamic Gait Index (DGI) scores, (c) timed up-and-go test (TUG) results and (d) 39-item Parkinson’s Disease Questionnaire (PDQ-39) scores in patients with Parkinson’s disease after 6 weeks of Nordic Walking program or standard rehabilitation (n = 20 in each group). Central line of the box represents the median, top and bottom margins of the box represent the 1^st and 3^rd quartiles, and the ends of the whiskers represent the minimum and maximum values; significant outliers are presented with asterisks. Pairwise comparisons performed with Mann–Whitney U test.