Randomized Trial of Nordic Walking vs. Standard Cardiac Rehabilitation in Patients With Heart Failure (Nordic Walking)

Project Background

Heart failure (HF) is a serious health problem in Canada. Patients with HF often have markedly reduced exercise tolerance that contributes to difficulties in performing daily activities and reductions in health-related quality of life (HRQL). Guideline-recommended standard exercise therapy in patients with HF, intended to improve exercise tolerance and HRQL, consists of regular walking (or other aerobic training) and resistance exercise training. Nordic walking is a form of exercise in which participants walk with specially designed poles, simultaneously conditioning upper and lower body muscle groups. The effects of Nordic walking in HF patients have not been published. Our research group completed a pilot randomized controlled trial of Nordic walking vs. standard exercise therapy in a sample of 54 patients with chronic, stable HF. Our data indicate that a 12-week program of Nordic walking was superior to standard exercise therapy for increasing exercise tolerance (37% vs. 8%; P-Value = 0.001), as well as a number of secondary outcomes such as upper body strength, waist circumference, and depressive mood. These results require replication in a larger sample; additionally, other measures may enhance our understanding of other benefits and their mechanisms. The research team, led by Dr. Robert Reid, includes Canadian leaders in the medical management of patients with HF, clinical trials of non-pharmacological interventions, and cardiac rehabilitation (CR).

Study Design and Purpose

This study is a single-site, parallel group randomized controlled trial being conducted at the University of Ottawa Heart Institute (UOHI). The main purpose of the project is to see if a 12-week program of Nordic walking is better than standard exercise therapy for increasing exercise capacity (measured by how far people can walk in 6 minutes) and increasing quality of life (measured by having people fill out two questionnaires). We will also see if Nordic walking: improves heart performance (measured by heart ultrasound); improves how active people are (measured by an activity monitor); increases aerobic fitness (measured by a treadmill test); increases muscular fitness (measured by having people lift weights); improves body composition (measured by waist size); and reduces hormone levels in the blood.

Significance of the Research

This study is unique because Nordic walking has never been evaluated as an alternative to regular exercise therapy in people with Heart Failure (HF). If this study shows that Nordic walking can help people improve their ability to exercise and make their quality of life better than what is usually done, then doctors caring for people with HF will have new options to offer their patients. Nordic walking also requires very little equipment, can be done anywhere and patients seem to enjoy the extra stability that comes from walking with the poles.