NORDIC WALKING AND STANDARD EXERCISE THERAPY IN PATIENTS WITH CHRONIC HEART FAILURE: A RANDOMIZED, CONTROLLED-TRIAL COMPARISON

Abstract

Nordic walking (NW) is a form of exercise training that may be advantageous for patients with heart failure (HF). The objective of this study was to determine whether a 12-week program of NW is more effective than standardized exercise therapy (SET) in increasing exercise capacity and HF-specific health-related quality of life (HRQL) in such patients. A two-arm randomized controlled trial allocated 77 patients with HF to either SET or NW for a 12-week intervention period. Primary outcomes included changes in distance walked in the six-minute walk test (6MWT) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) at 12-weeks. Secondary outcomes included changes in symptoms of anxiety and depression, general HRQL, body composition, physical activity, fitness, and N-terminal pro b-type Natriuretic Peptide (NTproBNP). Both groups achieved similar significant improvements in their 6MWT distance (NW = +68.2 m ± 47.8 m vs. SET = +54.6 m ± 62.3 m, mean difference = -13.6 m, 95% CI: -42.6, 15.4) and MLHFQ scores (NW = -10.9 ± 18.0 vs. SET = -12.9 ± 16.3, mean difference = 2.0, 95% CI: -7.3, 11.3). A significant improvement was found in both trial arms for self-reported physical functioning, anxiety and depression scores, as well as NTproBNP levels. Improvements in the mental component subscale of the SF-36 generic-HRQL instrument were significantly higher in the NW group compared to SET. NW is as effective as SET for improving functional fitness, HF-specific HRQL, symptoms of anxiety and depression and reducing NTproBNP levels in individuals with HF. NW can be offered as an alternative to SET.