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. At week 43 in 2023, we had Blended Intensive program (BIP) in Finland, Kuopio Savonia University of Applied Science about EBP. This BIP program opened with welcome words of the president of The European Network of Physiotherapy in Higher Education (ENPHE) and followed with the basis of EBP and teachers who highlighted the main challenges at different Physical Therapy fields week 43 in 2023 we had Blended Intensive program (BIP) in Finland, Kuopio Savonia University of applied science.

More than 40 physiotherapy students and 7 teachers from three universities (Savonia University of Applied Sciences, Finland, Universidade da Coruña, Spain, and Charles University Prague, actively participated this week and shared experiential group dynamics and social activities. Students worked together and wrote articles devoted to the following themes: Evidence Based in McKenzie, back pain, spinal cord injuries, aquatic therapy, ergonomics at work, Nordic walking, sport injuries, sport and young adults: Prevention of sport injuries and children with disabilities. In the following you can consult the works presented by the students on each topic.

Nordic Walking and our interest

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. This sport applies people with different ages. (UKK-instituutti.) Our interest was to figure out what kind of patient groups can use Nordic Walking (NW) in rehabilitation. We use in this article five different research articles in which titles were cardiovascular diseases, obesity, Parkinson-disease, elderly and health benefits of Nordic walking.

Evidence from different studies

One research was RCT and it was about Nordic walking in cardiovascular diseases. Inclusion criteria in this study was acute coronary syndrome and peripheral arterial occlusive disease. Participants also had to have undergone one or more transluminal angioplasties with stent placement. Question in this study was, is NW more effective than walking without poles for rehabilitation with those diseases. Result was that both groups get improvement in walk distance and it was significantly greater in NW group. Improvement was significant only in people with peripheral arterial occlusive disease. Patients told also that NW was more motivational. (Girold etc, 2017.)

The other study was systematic review about NW promoted weight loss in obese and overweight people. In this study there was ten research, but only two has high quality. According to this review NW effects on reduction in body fat mass after 6 and 12 weeks training. People how did this study suggest one training program to promote weight loss. NW was encouraging way to be physical active in individuals with lower exercise tolerance because of poles effect to reduce the lower limb muscular activity. Recommendation in this study was that obese or overweight people should walk with poles at least four times per week and at least sixty minutes per exercising session. They also recommended that exercising should be coupled with diet control. (Gobbo etc, 2019.)

One of studies which we found was systematic review and meta-analysis about NW in people with Parkinson´s disease. There were no clinically significant changes in global motor impairment, functional mobility, balance and physical fitness in this study, however those improved but not clinically significant. According to this study potential effects limit to improvements in quality of life and walking ability. (Salse-Batán, 2022.)

One study which deals the topic of health benefits of NW achieve effect on circulatory system and quality of life in people with different diseases. There was for example people with obesity, coronary artery disease, peripheral arterial disease and Parkinson´s. There was however small sampling those research of Parkinson´s which take part on this review. (Tschentscher etc, 2013.)

The last study focused on NW effective in the second half of life. This study notes that NW is easy and effective sport to improve physical activity in elderly people with different diseases. (Sko ́rkowska-Telichowska, 2016.) Results of this study are line on those other studies because participants ages were over fifty in many studies.

So, can be stated that NW is popular in Finland and also it represents a versatile and effective form of exercise with numerous health benefits for individuals with various medical conditions. It holds promise for improving cardiovascular health, reducing obesity, some benefits for Parkinson’s patients, and promoting well-being in the elderly. Overall, the body of research indicates that NW is a valuable addition to physical rehabilitation, offering a powerful tool for promoting health and well-being across different patient groups.

Our learning experiences

During the BIP-week we have deepened our knowledge with studies related to nordic walking. NW is something we are familiar with, but the research base for it was not very familiar before this. Our knowledge increased about the physiological benefits and health effects of walking with poles for different disease groups. We received new information for evaluating the quality of research in this course. Based on this information we can recommend nordic walking to different patient groups to part of rehabilitation.

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, PhD, Principal lecturer of gerontology and rehabilitation, Savonia University of Applied Sciences, Finland
Mari Tuppurainen, physiotherapy lecture, 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. https://pubmed.ncbi.nlm.nih.gov/35593147/. Referenced 26.10.2023.

Katarzyna Sko ́rkowska-Telichowska, Katarzyna Kropielnicka, Katarzyna Bulin ́ska, Urszula Pilch, Marek Woz ́niewski, Andrzej Szuba & Ryszard Jasin 2016. Aging clinical and Experimental Research. Nordic walking in the second half of life. https://nordicwalkingpoland.pl/uploads/feed/8b5876af81d0f62a39db96f5cf7d94c9.pdf. Referenced 26.10.2023.

Marcus Tschentscher, David Niederseer & Josef Niebauer, 2013. American Journal of Preventive Medicine Health benefits of Nordic walking: a systematic review https://pubmed.ncbi.nlm.nih.gov/23253654/. Referenced 26.10.2023

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. https://www.sciencedirect.com/science/article/pii/S1877065717300180?via%3Dihub. Referenced 26.10.2023.

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. https://pubmed-ncbi-nlm-nih-gov.ezproxy.savonia.fi/33467351/. Referenced 26.10.2023.

UKK-instituutti. Sauvakävely on monipuolinen ja tehokas liikuntamuoto. Verkkojulkaisu. https://ukkinstituutti.fi/liikkuminen/liikuntalajit-ja-liikkumismuodot/sauvakavely/. Referenced 26.10.2023.