Pole Walking Research Articles

Effects of the Pole Striding Intervention Program on Cardiovascular Fitness among Bronchial Asthma Patients

Background: Chronic inflammatory illnesses of the airways, such as bronchial hyper-reactivity and varyingdegrees of airway blockage, are known as bronchial asthma. Pole walking is a low-impact fitness walking usingspecially designed, light weighted pole. Nordic walking is a common outdoor physical activity.So in this studywe are going to find out the effectiveness of pole striding in bronchial asthma.Aim: The aim of the analysis is to appraise the impact of the pole striding intervention program on bronchialasthma, with regard to the potential improvements in cardiovascular fitness.Method: 40 Individuals who were admitted in IP for bronchial asthma and got discharged were selected randomlybased on inclusion and exclusion criteria from Saveetha Medical College And Hospital. The selected participantswere allocated into 2 groups. Pole striding group was treated with routine treatment along with pole striding.Calisthenic exercise group was treated with only routine treatment. Treatments were given to the groups accordingto the treatment protocol after discharge as home care therapy. Six-Minute Walk Test, Pulmonary Function Testwere the outcome measures used in this study.Result: The improvement was seen in both groups though statistically pole striding group was more significantthan calisthenic exercise group in 6 minute walk test and forced expiratory volume in one second (FEV1) withmean difference of 28.5m, 0.24L, respectively. P- value is <0.0001.Conclusion: Hereby, This study concludes that Pole-striding approach has a better effect in improving in Cardiovascularfitness among Bronchial asthma.

Cost-Effectiveness of Exercise Therapy in Patients with Intermittent Claudication-A Comparison of Supervised Exercise, Home-Based Structured Exercise, and Walk Advice from the SUNFIT Trial.

Hospital-based supervised exercise (SEP) is a guideline-recommended intervention for patients with intermittent claudication (IC). However, due to the limited availability of SEP, home-based structured exercise programs (HSEP) have become increasingly popular alongside the "go home and walk" advice. We evaluated the cost-effectiveness of walk advice (WA) with Nordic pole walking vs. SEP combined with WA or HSEP combined with WA. We used data from the SUNFIT RCT (NCT02341716) to measure quality-adjusted life-years (QALYs) over a 12-month follow-up, and economic costs were obtained from a hospital cost-per-patient accounting system. Incremental cost-effectiveness ratios (ICERs) were calculated, and uncertainty was assessed using nonparametric bootstrapping. The average health-care-cost per patient was similar in the WA (EUR 1781, n = 51) and HSEP (EUR 1820, n = 48) groups but higher in the SEP group (EUR 4619, n = 50, p-value < 0.01). Mean QALYs per patient during the follow-up were similar with no statistically significant differences. The findings do not support SEP as a cost-effective treatment for IC, as it incurred significantly higher costs without providing additional health improvements over WA with or without HSEP during the one-year observation period. The analysis also suggested that HSEP may be cost-effective compared to WA, but only with a 64% probability.

Do poles really "save the legs" during uphill pole walking at different intensities?

In sky- and trail-running competitions, many athletes use poles. The aims of this study were to investigate whether the use of poles affects the force exerted on the ground at the feet (Ffoot), cardiorespiratory variables and maximal performance during uphill walking. Fifteen male trail runners completed four testing sessions on different days. On the first two days, they performed two incremental uphill treadmill walking tests to exhaustion with (PWincr) and without poles (Wincr). On the following days, they performed submaximal and maximal tests with (PW80 and PWmax) and without (W80 and Wmax) poles on an outdoor trail course. We measured cardiorespiratory parameters, the rating of perceived exertion, the axial poling force and Ffoot. When walking on the treadmill, we found that poles reduced maximum Ffoot (- 2.8 ± 6.4%, p = 0.03) and average Ffoot (- 2.4 ± 3.3%, p = 0.0089). However, when outdoors, we found pole effect only for average Ffoot (p = 0.0051), which was lower when walking with poles (- 2.6 ± 3.9%, p = 0.0306 during submaximal trial and - 5.21 ± 5.51%, p = 0.0096 during maximal trial). We found no effects of poles on cardiorespiratory parameters across all tested conditions. Performance was faster in PWmax than in Wmax (+ 2.5 ± 3.4%, p = 0.025). The use of poles reduces the foot force both on the treadmill and outdoors at submaximal and maximal intensities. It is, therefore, reasonable to conclude that the use of poles "saves the legs" during uphill without affecting the metabolic cost.

Анализ и оценка эффективности методов физической реабилитации в восстановлении нарушений ходьбы, других моторных и немоторных нарушений при болезни Паркинсона

Parkinson’s disease is one of the most common neurodegenerative diseases of the central nervous system with a chronic progressive course. The disease pathogenesis is characterized by degradation of dopaminergic neurons of the substantia nigra, subsequently affecting other neurotransmitter systems of the brain. Clinical manifestations include impaired walking function and other motor and non-motor symptoms, a gradual deterioration in the quality of life and disability of patients. To date, there is no pathogenetic pharmacological therapy or surgical treatment that could have fully compensated for motor deficits and non-motor functions. This category of patients needs comprehensive rehabilitation using physical therapy. Effective modern methods of physical rehabilitation for Parkinson’s disease are walking on an anti-gravity treadmill, pole walking, and tai-chi gymnastics. Physical rehabilitation is an effective and promising direction in the treatment and rehabilitation of patients with Parkinson’s disease, since it contributes to the improvement of motor and non-motor manifestations of the disease.

The effects of walking training with poles on walking ability: A systematic review and meta-analysis of randomized controlled trials.

The purpose of this study was to consolidate the level of evidence for the effects of walking training with poles (pole walking; PW) on walking ability using a systematic review and meta-analysis. TYPE: Systematic review and meta-analysis. Databases including PubMed, Cochrane Library, Physiotherapy Evidence Database (PEDro), Cumulative Index to Nursing and Allied Health Literature databases, and Igaku Chuo Zasshi were searched on June 20, 2021. Data from randomized controlled trials (RCTs) comparing the effects of PW with walking without poles and/or other exercise interventions in disease-specific and aging populations were collected. Data on walking speed, functional mobility, and walking endurance were collected for the meta-analyses. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated from postintervention means and standard deviations. The PEDro scale was used for assessing the risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the quality of evidence. This study included 13 RCTs comprising 750 participants; of these, six RCTs were included in the meta-analysis. The results showed that moderate-quality evidence supports the positive effects of PW on walking speed in patients with Parkinson disease (walking speed: SMD=0.42, 95% CI=0.04-0.80). In contrast, PW did not significantly improve functional mobility in patients with Parkinson disease and walking speed in older adults. There was moderate-quality evidence that PW improved walking speed in patients with Parkinson disease.

The Influence of the Relative Timing between Pole and Heel Strike on Lower Limb Loading among Young and Older Naïve Pole Walkers.

Current research is unclear with respect to whether pole walking (PW) reduces lower limb loading when compared to regular walking (RW). Contradictory findings in the literature may be related to the relative timing between pole and foot contact events, which were examined in the current study among naïve pole walkers. Fourteen young (4 F; 25.3 ± 5.4 years) and 8 older adults (4 F; 68.5 ± 3.2 years) performed PW and RW trials along a force plate embedded walkway at two different visits. The time difference between pole and foot contact during both the onset of ground contact and the peak force application was calculated. Several kinetic measures were calculated for the lower limbs and poles. A significant decrease during PW, compared to RW, was found for foot impulse (2.1%; p < 0.01), peak vertical ground reaction force (vGRF) (3.4%; p < 0.01), rate of loading (5.2%; p=0.02), and peak push-off vGRF (2.1%; p=0.01). No difference in pole loading was found between age groups and visits. No significant correlations were found between the relative timing and foot loading measures. Significant low-to-moderate negative correlations were found between peak foot and pole vGRFs (p=0.04), peak foot vGRF and pole strike impulse (p=0.01), peak foot vGRF and pole impulse (p=0.02), and peak foot push-off vGRF and pole impulse (p=0.01), suggesting that as pole loading increased, foot loading decreased. Findings suggest timing between pole and heel contact may not be related to unloading the lower limbs but may be related to other aspects of pole use since PW reduced lower limb loading.

Pole Walking Is Faster but Not Cheaper During Steep Uphill Walking.

The aim of this study was to compare pole walking (PW) and walking without poles (W) on a steep uphill mountain path (1.3km, 433m of elevation gain) at 2 different intensities: a maximal effort that would simulate a vertical kilometer intensity and a lower intensity (80% of maximal) simulating an ultratrail race. On the first day, we tested the participants in the laboratory to determine their maximal physiological parameters, respiratory compensation point, and gas exchange threshold. Then, they completed 4 uphill tests along a mountain path on 4 separate days, 2 at their maximum effort (PWmax and Wmax, randomized order) and 2 at 80% of the mean vertical velocity maintained during the first 2 trials (PW80 and W80, randomized order). We collected metabolic data, heart rate, blood lactate concentration, and rating of perceived exertion at the end of each trial. We also collected rating of perceived exertion at every 100m of elevation gain during PW80 and W80. Participants completed the maximal effort faster with poles versus without poles (18:51 [03:12] vs 19:19 [03:01] in min:s, P = .013, d = 0.08, small). Twelve of the 15 participants (80%) improved their performance when they used poles. During PW80 and W80, none of the physiological or biomechanical parameters were different. In the examined condition, athletes should use poles during steep uphill maximal efforts to obtain the best performance. Conversely, during submaximal effort, the use of poles does not provide advantages in uphill PW.

Energetics and Mechanics of Steep Treadmill Versus Overground Pole Walking: A Pilot Study.

To compare energetics and spatiotemporal parameters of steep uphill pole walking on a treadmill and overground. First, the authors evaluated 6 male trail runners during an incremental graded test on a treadmill. Then, they performed a maximal overground test with poles and an overground test at 80% (OG80) of vertical velocity of maximal overground test with poles on an uphill mountain path (length = 1.3km, elevation gain = 433m). Finally, they covered the same elevation gain using poles on a customized treadmill at the average vertical velocity of the OG80. During all the tests, the authors measured oxygen uptake, carbon dioxide production, heart rate, blood lactate concentration, and rate of perceived exertion. Treadmills required lower metabolic power (15.3 [1.9] vs 16.6 [2.0]W/kg, P = .002) and vertical cost of transport (49.6 [2.7] vs 53.7 [2.1]J/kg·m, P < .001) compared with OG80. Also, oxygen uptake was lower on a treadmill (41.7 [5.0] vs 46.2 [5.0]mL/kg·min, P = .001). Conversely, respiratory quotient was higher on TR80 compared with OG80 (0.98 [0.02] vs 0.89 [0.04], P = .032). In addition, rate of perceived exertion was higher on a treadmill and increased with elevation (P < .001). The authors did not detect any differences in other physiological measurements or in spatiotemporal parameters. Researchers, coaches, and athletes should be aware that steep treadmill pole walking requires lower energy consumption but same heart rate and rate of perceived exertion than overground pole walking at the same average intensity.

Margins of stability and trunk coordination during Nordic walking

Although it has already been demonstrated that Nordic walking has some peculiar biomechanical features with respect to walking, the effects on balance and trunk coordination are still unknown. Our aim here was to compare margins of stability, hip stabilizer muscle activation and scapular-pelvis coordination (mean and variability of continuous relative phase) between walking and two different pole walking techniques (observational design). Eleven Nordic walking instructors were asked to walk at 5.5 km·h−1 on a flat treadmill while 1) walking, 2) Nordic walking and 3) pole walking with just elbow flexion–extension motion allowed and constrained shoulder motion (elbow technique). The 3D movements of limbs and poles were measured by an optoelectronic motion capture system, and gluteus medius activation was measured through surface electromyography. Both techniques using poles show larger mediolateral margins of stability and similar anterior-posterior margins of stability in comparison with walking (p < 0.001). The larger mediolateral margin of stability using poles (conditions 2 and 3) is accompanied by greater trunk coordination stability (greater continuous relative phase variability) than walking. Although the Nordic walking (condition 2) technique results in a similar range of scapular and pelvis transverse rotation, the general pattern of scapular-pelvis coordination was temporally delayed by approximately 20% of the gait cycle in relation to other conditions (1 and 3). In conclusion, Nordic walking provides enhanced mediolateral support and coordination stability of trunk compared with walking, suggesting that it could be proposed as a safer exercise modality than walking.

Walking Pole Gait to Reduce Joint Loading post Total Knee Athroplasty: Musculoskeletal modeling Approach.

Excessive knee contact loading is precursor to osteoarthritis and related knee ailment leading to knee athroplasty. Reducing contact loading through gait modifications using assisted pole walking offers noninvasive process of medial load offloading at knee joint. In this paper, we evaluate the efficacy of different configuration of pole walking for reducing contact force at the knee joint through musculoskeletal (MSK) modeling. We have developed a musculoskeletal model for a subject with knee athroplasty utilizing in-vivo implant data and computed tibio-femoral contact force for different pole walking conditions to evaluate the best possible configuration for guiding rehabilitation, correlated with different gait phases. Effect of gait speed variation on knee contact force, hip joint dynamics and muscle forces are simulated using the developed MSK model. Results indicate some interesting trend of load reduction, dependent on loading phases pertaining to different pole configuration. Insights gained from the simulation can aid in designing personalized rehabilitation therapy for subjects suffering from Osteoarthritis.

Spatiotemporal characteristics of locomotor adaptation of walking with two handheld poles.

Pole walking (PW) has received attention not only as a whole-body exercise that can be adapted for elderly people with poor physical fitness but also as a possible intervention for the restoration of gait function in normal walking without the use of poles (i.e., conventional walking CW). However, the characteristics of PW, especially how and why PW training affects CW, remain unclear. The purpose of this study was to examine the characteristics of locomotor adaptation in PW from the perspective of kinematic variables. For this purpose, we compared the locomotor adaptation in PW and CW to that when walking on a split-belt treadmill in terms of spatial and temporal coordination. The result showed that adaptations to the split-belt treadmill in PW and CW were found only in interlimb parameters (step length and double support time ratios (fast/slow limb)), not in intralimb parameters (stride length and stance time ratios). In these interlimb parameters, the movement patterns acquired through split-belt locomotor adaptations (i.e., the aftereffects) were transferred between CW and PW regardless of whether the novel movement patterns were learned in CW or PW. The aftereffects of double support time and step length learned in CW were completely washed out by the subsequent execution in PW. On the other hand, the aftereffect of double support time learned in PW was not completely washed out by the subsequent execution in CW, whereas the aftereffect of step length learned in PW was completely washed out by the subsequent execution in CW. These results suggest that the neural mechanisms related to controlling interlimb parameters are shared between CW and PW, and it is possible that, in interlimb coordination, temporal coordination is preferentially stored in adaptation during PW.

Nordic Pole Walking for Individuals With Cancer: A Feasibility Randomized Controlled Trial Assessing Physical Function and Health-Related Quality of Life

Background: Individuals with a diagnosis of cancer tend to be inactive and have symptoms that impact quality of life. An individualized, community-based Nordic pole walking (NPW) program may help. Methods: Primary Objective: To assess feasibility using the Thabane framework of a randomized controlled trial (RCT). Secondary Objective: To determine the effects of NPW on physical function (Six-Minute Walk Test [6MWT], 30-second [30-s] chair stand test, Unsupported Upper-Limb Exercise Test, handgrip strength, physical activity [PA]), and health-related quality of life (HRQOL, 36-item Short-Form Health Survey [SF-36]). The Study Design: An 8-week multicentered block RCT (no blinding) comparing a community-based NPW program (vs usual daily routine) for adults with non-small cell lung, prostate, colorectal, and endometrial cancer. Results: Eight individuals were enrolled in the study with n = 4 per group (1 dropout in the NPW arm; = 67 ± 6 years). The study was deemed “feasible with modifications.” NPW significantly improved (statistically and clinically) the 30-s chair stand test when compared with baseline. There was improved 6MWT, PA levels, and SF-36 when compared with the control group (not statistically significant). No adverse events occurred. Discussion, Limitations, and Conclusions: NPW was feasible for individuals with cancer and may improve physical function, PA, and HRQOL. Larger samples are required to determine efficacy and/or program effectiveness. Future programs should include collaboration with hospital cancer centers and support groups, promotion of participant and community engagement with NPW, and consideration of the population's unique characteristics. NPW programs should include individualized exercise prescriptions, behavior change techniques, social aspects, HRQOL assessments, and device-measured PA.

Nordic Walking Promoted Weight Loss in Overweight and Obese People: A Systematic Review for Future Exercise Prescription.

The aim of this systematic review was to analyze the effect of Nordic Walking (NW) on anthropometric parameters, body composition, cardiovascular parameters, aerobic capacity, blood sample, and glucose tolerance in overweight and obese subjects. The main keywords “Nordic Walking” or “Pole Walking”, associated with either “obese”, “obesity”, “overweight”, or “weight loss” were used on the online database MEDLINE, PubMed, SPORTDiscus and Scopus. Additionally, references of the studies included were screened to identify eligible articles. Applying the inclusion and exclusion criteria, ten manuscripts were considered as eligible for this review. The results of the studies were categorized in several domains with regard to “anthropometric parameters and body composition”, “cardiovascular parameters and aerobic capacity”, and “blood sample and glucose tolerance”. The results showed positive effects on the anthropometric parameters, body composition, cardiovascular parameters, blood sample, and glucose tolerance. The greatest improvements were observed in supervised and high weekly frequency of NW interventions. NW could be considered as an effective modality through which to involve the obese in physical activity. For weight loss, NW should be prescribed 4–5 times per week, at least 60 min per session, preferably combined with diet control.

Do poles save energy during steep uphill walking?

In trail running and in uphill races many athletes use poles. However, there are few data about pole walking on steep uphill. The aim of this study was to compare the energy expenditure during uphill walking with (PW) and without (W) poles at different slopes. Fourteen mountain running athletes walked on a treadmill in two conditions (PW and W) for 5min at seven different angles (10.1°, 15.5°, 19.8°, 25.4°, 29.8°, 35.5° and 38.9°). We measured cardiorespiratory parameters, blood lactate concentration (BLa) and rating of perceived exertion (RPE). Then, we calculated the vertical cost of transport (CoTvert). Using video analysis, we measured stride frequency (SF) and stride length (SL). Compared to W, CoTvert during PW was lower at 25.4°, 29.8° and 35.5° PW ([Formula: see text] 2.55 ± 3.97%; [Formula: see text] 2.79 ± 3.88% and [Formula: see text] 2.00 ± 3.41%, p < 0.05). RPE was significantly lower during PW at 15.5°, 19.8°, 29.8°, 35.5° and 38.9° ([Formula: see text] 14.4 ± 18.3%; [Formula: see text] 16.2 ± 15.2%; [Formula: see text] 16.6 ± 16.9%; [Formula: see text] 17.9 ± 18.7% and [Formula: see text] 18.5 ± 17.8%, p < 0.01). There was no effect of pole use on BLa. However, BLa was numerically lower with poles at every incline except for 10.1°. On average, SF for PW was lower than for W ([Formula: see text] 6.7 ± 5.8%, p = 0.006) and SL was longer in PW than in W (+ 8.6 ± 4.5%, p = 0.008). PW on steep inclines was only slightly more economical than W, but the substantially lower RPE during PW suggests that poles may delay fatigue effects during a prolonged effort. We advocate for the use of poles during steep uphill walking, although the energetic savings are small.

Unique controlling mechanisms underlying walking with two handheld poles in contrast to those of conventional walking as revealed by split-belt locomotor adaptation.

Pole walking (PW), a form of locomotion in which a person holds a pole in each hand, enhances the involvement of alternating upper-limb movement. While this quadruped-like walking increases postural stability for bipedal conventional walking (CW), in terms of the neural controlling mechanisms underlying the two locomotion forms (PW and CW), the similarities and differences remain unknown. The purpose of this study was to compare the neural control of PW and CW from the perspective of locomotor adaptation to a novel environment on a split-belt treadmill. We measured the anterior component of the ground reaction (braking) force during and after split-belt treadmill walking in 12 healthy subjects. The results demonstrated that (1) PW delayed locomotor adaptation when compared with CW; (2) the degrees of transfer of the acquired movement pattern to CW and PW were not different, regardless of whether the novel movement pattern was learned in CW or PW; and (3) the movement pattern learned in CW was washed out by subsequent execution in PW, whereas the movement pattern learned in PW was not completely washed out by subsequent execution in CW. These results suggest that the neural control mechanisms of PW and CW are not independent, and it is possible that PW could be a locomotor behavior built upon a basic locomotor pattern of CW.

人工股関節全置換術後患者に対するKobe Pole Walking Exerciseの効果に関する研究

人工股関節全置換術後患者に対するKobe Pole Walking Exerciseの効果に関する研究

Development and implementation of a community-based pole walking program for older adults

ABSTRACTBackground: To address the problem of physical inactivity among older adults and the desire of community-based groups to have access to innovative physical activity programs, a pole walking program was developed specifically for older adults living at home who visit community organizations. Methods: The Walking with Poles Program (WWPP) is based on a six-stage approach involving: (1) definition, (2) conceptualization, (3) creation and validation, (4) pilot test, (5) generalization, and (6) consolidation. Reach, dose delivered, and dose received of program implementation were documented. Results: To date, the five stages of this co-construction project have been successfully operationalized through the WWPP. The program was implemented by seven community organizations. It reached 76 older adults whose characteristics are typical of this type of community-based group physical activity program. For instructors, implementing the promotional activities was the most difficult part of the WWPP. Overall, the program was well received by the participants, instructors, and the organization managers. Conclusion: This approach ensured the rigor, relevance, and feasibility of the WWPP.

Patterns of trunk muscle activation during walking and pole walking using statistical non-parametric mapping

This study used surface electromyography (EMG) to investigate the regions and patterns of activity of the external oblique (EO), erector spinae longissimus (ES), multifidus (MU) and rectus abdominis (RA) muscles during walking (W) and pole walking (PW) performed at different speeds and grades. Eighteen healthy adults undertook W and PW on a motorized treadmill at 60% and 100% of their walk-to-run preferred transition speed at 0% and 7% treadmill grade. The Teager-Kaiser energy operator was employed to improve the muscle activity detection and statistical non-parametric mapping based on paired t-tests was used to highlight statistical differences in the EMG patterns corresponding to different trials. The activation amplitude of all trunk muscles increased at high speed, while no differences were recorded at 7% treadmill grade. ES and MU appeared to support the upper body at the heel-strike during both W and PW, with the latter resulting in elevated recruitment of EO and RA as required to control for the longer stride and the push of the pole. Accordingly, the greater activity of the abdominal muscles and the comparable intervention of the spine extensors supports the use of poles by walkers seeking higher engagement of the lower trunk region.

A Three Month Home Exercise Programme Augmented with Nordic Poles for Patients with Intermittent Claudication Enhances Quality of Life and Continues to Improve Walking Distance and Compliance After One Year

The objective of this study was to collect 1 year follow-up information on walking distance, speed, compliance, and cost in patients with intermittent claudication who took part in a previously reported 12 week randomised clinical trial of a home exercise programme augmented with Nordic pole walking versus controls who walked normally. A second objective was to look at quality of life and ankle brachial pressure indices (ABPIs) after a 12 week augmented home exercise programme. Thirty-two of the 38 patients who completed the original trial were followed-up after 6 and 12 months. Frequency, duration, speed, and distance of walking were recorded using diaries and pedometers. A new observational cohort of 29 patients was recruited to the same augmented home exercise programme. ABPIs, walking improvement, and quality of life questionnaire were recorded at baseline and 12 weeks (end of the programme). Both groups in the follow-up study continued to improve their walking distance and speed over the following year. Compliance was excellent: 98% of the augmented group were still walking with poles at both 6 and 12 months, while 74% of the control group were still walking at the same point. The augmented group increased their mean walking distance to 17.5km by 12 months, with a mean speed of 4.2km/hour. The control group only increased their mean walking distance from 4.2km to 5.6km, and speed to 3.3km/hour. Repeated ANOVA showed the results to be highly significant (p=.002). The 21/29 patients who completed the observational study showed a statistically significant increase in resting ABPIs from baseline (mean±SD 0.75±0.12) to week 12 (mean±SD 0.85±0.12) (t=(20)-8.89, p=.000 [two-tailed]). All their walking improvement and quality of life parameters improved significantly (p=.002 or less in the six categories) over the same period and their mean health scores improved by 79%. Following a 12 week augmented home exercise programme, most patients with intermittent claudication continued to significantly improve their walking distance and walking speed at 1 year compared with normal walking. Quality of life and ABPIs improved significantly after only 12 weeks and it is postulated that the improvement in ABPI was due to collateral development. These results justify the belief that an augmented home exercise programme will be as clinically effective as existing supervised exercise programmes, with the added benefits of lower cost and better compliance. Funding for a multicentre trial comparing an augmented home exercise programme with existing supervised exercise programme is now urgently required.

Effects of Aquatic Pole Walking on the Reduction of Spastic Hypertonia in a Patient with Hemiplegia: A Case Study

Here we report an acute effect of aquatic pole walking (PW) training intervention on a 64-year-old male patient with chronic hemiparesis and symptoms of spasticity in the right lower limb. A comparison of over ground walking before and after 20 minutes of aquatic PW training revealed a significant improvement in gait performance. As a main result, the average speed of walking after the intervention was 0.16 m/s after the intervention as compared to 0.04 m/s in the initial condition. The time taken for each stride cycle was drastically decreased, mainly due to shortening of the stance time. Underlying the improved gait performance was the emergence of functional muscle activity in the paralyzed and spastic leg muscles. The result observed in this patient should be further tested among a large population of patients presenting similar symptoms. Moreover, the basic mechanisms underlying aquatic PW intervention should be further elucidated.