Nordic Walking and Free Walking Improve the Quality of Life, Cognitive Function, and Depressive Symptoms in Individuals with Parkinson's Disease: A Randomized Clinical Trial.

Elren Passos-Monteiro,Aline S Pagnussat,Marindia Becker,Leonardo A Peyré-Tartaruga,Felipe B Schuch,Alberito R Carvalho,Leandro T Franzoni,Carlos R M Rieder,Flávia G Martinez,Alexandro Andrade,Natalia A Gomeñuka

doi:10.3390/jfmk5040082

Abstract

Nordic walking’s (NW) degree of effectiveness regarding health-related parameters in people with Parkinson’s Disease (PD) is a subject of debate. While NW seems to improve functionality, a clear non-motor benefit has not been demonstrated. The aim of this randomized controlled trial was to compare the effects of 9-week NW and free walking (FW) training programs on quality of life, cognitive function, and depressive symptoms in individuals with PD. Thirty-three people with PD, (Hoehn and Yahr 1–4) were randomized into two groups: NW (n = 16) and FW (n = 17). We analyzed quality of life, cognitive function, depressive symptoms, and motor symptoms. Significant improvements were found in the overall, physical, psychological, social participation, and intimacy domains of quality of life, as well as in cognitive function and depressive symptoms for both groups. Only the NW group showed improvement in the autonomy domain. Individuals with PD had a similar enhancement of non-motor symptoms after walking training, with or without poles. However, the NW group showed a more significant improvement in the autonomy domain, strengthening the applied and clinical potential of NW in people with PD. Future studies are needed to determine the efficacy of walking training without poles in subjects with PD.

Highlights

Changes in the central nervous system resulting from Parkinson’s disease (PD) lead to the manifestation of non-motor symptoms, such as cognitive deficits and increased depressive symptoms [1,2]
82% of the Nordic walking group participants and 75% of the free walking group participants had comparatively mild PD, modified Hoehn and Yahr stage 1–2.5, whereas 18% were in stage 3, and 25% were in stage 4, which represents moderate to severe disease
The cognitive impairment assessed by Montreal Cognitive Assessment (MoCA) shows a worse result for Nordic walking in comparison to free walking at baseline, but these values indicate that both groups initially had mild cognitive impairment

Summary

Introduction

Changes in the central nervous system resulting from Parkinson’s disease (PD) lead to the manifestation of non-motor symptoms, such as cognitive deficits and increased depressive symptoms [1,2]. The severity of non-motor and motor symptoms, in turn, is causally related to deficits in quality of life (QoL) [3,4]. In addition to drug therapy, exercise has been considered as a therapeutic tool for treating depression and improving QoL in people with PD [5,6]. In PD, compelling evidence suggests that exercise can improve non-motor symptoms such as cognitive deficits, depression, and apathy [7,8,9]. It is not clear whether exercise can improve QoL

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