Nordic walking training in elderly, a randomized clinical trial. Part II: Biomechanical and metabolic adaptations

Natalia Andrea Gomeñuka,Barbara Pellegrini,Rochelle Rocha Costa,Alberito Rodrigo Carvalho,Rodrigo Gomes Da Rosa,Edson Soares Da Silva,Leonardo Alexandre Peyré-Tartaruga,Henrique Bianchi Oliveira,Martín Cruz Rodríguez Paz,Elren Passos-Monteiro

doi:10.1186/s40798-019-0228-6

Abstract

BackgroundNordic walking is an attractive method of endurance training. Nevertheless, the biomechanic response due to the additional contribution of using poles in relation to free walking training has been less explored in the elderly. Purpose: This randomized parallel controlled trial aimed to assess the effects of 8 weeks of Nordic walking and free walking training on the walking economy, mechanical work, metabolically optimal speed, and electromyographic activation in elderly.MethodsThirty-three sedentary elderly were randomized into Nordic walking (n = 16) and free walking group (n = 17) with equalized loads. Submaximal walking tests were performed from 1 to 5 km h−1 on the treadmill.ResultsWalking economy was improved in both free and Nordic walking groups (x2 4.91, p = 0.014) and the metabolically optimal speed was increased by approximately 0.5 km h−1 changing the speed-cost profile. The electromyographic activation in lower and upper limbs, pendular recovery, and total, external, and internal mechanical work remained unchanged (p > 0.05). Interestingly, the internal mechanical work associated with arm movement was higher in the Nordic walking group than in the free walking group after training, while the co-contraction from upper limb muscles was reduced similarly to both groups.ConclusionsEight weeks of Nordic walking training effectively improved the walking economy and functionality as well as maintained the gait mechanics, similar to free walking training in elderly people. This enhancement in the metabolic economy may have been mediated by a reduction in the co-contraction from upper limb muscles.Trial registrationClinicalTrails.gov NCT03096964

Highlights

It is well established that the increased motor variability in elderly is associated with risk of falls and low functional mobility [1], and the lack of physical fitness is a strong predictor of mortality [2, 3]
The purpose of the present study was to assess, by means of a randomized clinical trial, the effects of 8 weeks of Nordic walking (NW) and free walking (FW) training on the following parameters evaluated during walking without poles: C; optimal walking speed; heart rate; rating of perceived exertion; Internal work (Wint); total mechanical work (Wtot), external mechanical work (Wext); Wint of trunk, legs, and arms (Wint_trunk, Wint_legs, Wint_arms); pendulum-like recovery (R); and surface electromyographic activation (EMG) and co-contraction from three pairs of muscles (deltoideus anterior (DA); triceps brachii (TB); vastus lateralis (VL); biceps femoris (BF); tibialis anterior (TA); and gastrocnemius medialis (GM)) in elderly people
To our knowledge, this is the first controlled and randomized trial reporting the effects of NW training and the adaptations in energetics and mechanics parameters and EMG at different walking speeds in sedentary elderly people

Summary

Introduction

It is well established that the increased motor variability in elderly is associated with risk of falls and low functional mobility [1], and the lack of physical fitness is a strong predictor of mortality [2, 3]. It has been determined that (2020) 6:3 the slower walking speed of the elderly is associated with the muscle weakness and in turn, the reduction on a range of joint motion and biomechanic changes resulting in a safer walking strategy [4]. Mian et al [5] showed that muscle coactivation explains the higher metabolic cost of walking (C) in elderly in contrast to young people. The biomechanic response due to the additional contribution of using poles in relation to free walking training has been less explored in the elderly. Purpose: This randomized parallel controlled trial aimed to assess the effects of 8 weeks of Nordic walking and free walking training on the walking economy, mechanical work, metabolically optimal speed, and electromyographic activation in elderly

Objectives

Methods

Results

Conclusion