Abstract
BackgroundIn patients with COPD progressive dyspnoea leads to a sedentary lifestyle. To date, no studies exist investigating the effects of Nordic Walking in patients with COPD. Therefore, the aim was to determine the feasibility of Nordic Walking in COPD patients at different disease stages. Furthermore we aimed to determine the short- and long-term effects of Nordic Walking on COPD patients' daily physical activity pattern as well as on patients exercise capacity.MethodsSixty COPD patients were randomised to either Nordic Walking or to a control group. Patients of the Nordic Walking group (n = 30; age: 62 ± 9 years; FEV1: 48 ± 19% predicted) underwent a three-month outdoor Nordic Walking exercise program consisting of one hour walking at 75% of their initial maximum heart rate three times per week, whereas controls had no exercise intervention. Primary endpoint: daily physical activities (measured by a validated tri-axial accelerometer); secondary endpoint: functional exercise capacity (measured by the six-minute walking distance; 6MWD). Assessment time points in both groups: baseline, after three, six and nine months.ResultsAfter three month training period, in the Nordic Walking group time spent walking and standing as well as intensity of walking increased (Δ walking time: +14.9 ± 1.9 min/day; Δ standing time: +129 ± 26 min/day; Δ movement intensity: +0.40 ± 0.14 m/s2) while time spent sitting decreased (Δ sitting time: -128 ± 15 min/day) compared to baseline (all: p < 0.01) as well as compared to controls (all: p < 0.01). Furthermore, 6MWD significantly increased compared to baseline (Δ 6MWD: +79 ± 28 meters) as well as compared to controls (both: p < 0.01). These significant improvements were sustained six and nine months after baseline. In contrast, controls showed unchanged daily physical activities and 6MWD compared to baseline for all time points.ConclusionsNordic Walking is a feasible, simple and effective physical training modality in COPD. In addition, Nordic Walking has proven to positively impact the daily physical activity pattern of COPD patients under short- and long-term observation.Clinical trial registrationNordic Walking improves daily physical activities in COPD: a randomised controlled trial - ISRCTN31525632
Highlights
Despite optimal pulmonary drug treatment, patients with chronic obstructive pulmonary disease (COPD) frequently experience dyspnoea and fatigue during everyday life, which may result in daily physical inactivity [1]
None of the patients had any difficulties in performing Nordic Walking adequately
Primary endpoint Feasibility of Nordic Walking All patients achieved the preset goal for maximum heart rate (HR) to ensure training efficiency (> 75% of the initial maximum HR), even though walking at different speed levels according to the severity of COPD
Summary
Despite optimal pulmonary drug treatment, patients with chronic obstructive pulmonary disease (COPD) frequently experience dyspnoea and fatigue during everyday life, which may result in daily physical inactivity [1]. Comprehensive pulmonary rehabilitation programs improve COPD patients’ peripheral muscle function, functional exercise capacity, daily symptoms of dyspnoea, fatigue, anxiety and depression, and health status [10]. The effects of pulmonary rehabilitation on daily physical activity level in COPD have been scarcely studied in non-randomised and/or non-controlled trial designs with no or modest effects [12,13,14]. In patients with COPD progressive dyspnoea leads to a sedentary lifestyle. No studies exist investigating the effects of Nordic Walking in patients with COPD. The aim was to determine the feasibility of Nordic Walking in COPD patients at different disease stages. We aimed to determine the short- and long-term effects of Nordic Walking on COPD patients’ daily physical activity pattern as well as on patients exercise capacity
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