Staying Strong: Health and Fitness for Older Adults

Researchers in Finland recently studied the effects Nordic walking (or "pole walking") had on functional capacity in older adults. Functional capacity reflects one's ability to perform activities of daily living independently. Typical measurements for functional capacity are strength, flexibility, balance, and cardiovascular fitness (or endurance). The study examined whether a Nordic walking program contributed to improvements in these measures as well as walking gait, which plays a vital role along with balance in reducing instances of falls. A compromised walking gait is strongly associated with falls.

Participants were divided into two groups: 23 people were placed in a Nordic walking group and 14 were placed in the control group, which was sedentary. Beyond their current level of physical activity, members of the control group were asked not to participate in any new physical activity for the duration of the 9-week program.

Nordic walking or pole walking is a form of exercise that is very popular in Scandinavian countries and in Finland. In recent years, it has been gaining ground in North America, especially amongst older adults. It is a safe form of cardiovascular exercise, especially for those who like to walk as their main fitness routine. It also has benefits for strength gains, especially in the upper body. It involves walking with a set of poles, much like one would use for cross-country skiing, only participants walk in urban areas-- along bike and walking trails, sidewalks, and in some cases, hiking trails (with special tips).

Previous studies have shown increases in heart rate and oxygen uptake, both of which are important for maintaining independence and assisting with activities of daily living (ADL). Most of the previous studies, however, have focused on younger people (middle age) and those with chronic conditions that would be improved with stronger cardiovascular fitness. Studies of Nordic pole walking in older adults are limited, although a previous study (2007) showed Nordic walking to be an appropriate exercise method for older people because it has beneficial cardiovascular benefits. A study such as this is important if improvements are going to be made to the general older adult population's activity levels. Since walking is the most common leisure-time physical activity chosen by older adults, Nordic pole walking may be such an enhancement that could boost those activity levels. Another purpose of the study was to determine the effects Nordic walking had on the participant's gait. The researchers hypothesized that a 9-week Nordic walking exercise program would increase functional capacity and improve walking balance in older adults. It generally takes two months for enough physical changes from exercise to show up in a test.

The 37 participants were male and female age 65 and older and the two groups were controlled for equal portion gender and age. The participants were given fitness and gait assessments using a common battery of tests before and after the study's conclusion, one that I frequently use with my clients, called the Seniors' Fitness Test (Rickli and Jones, 2001).

The 9-week Nordic walking program consisted of twice weekly hour-long sessions, which included a 5 minute warm up (stretching and slow walking), 40 minutes of Nordic walking with 10-min stretching mid-point, followed by a 5 minute cool-down of slow walking and stretching. For the Nordic walking portion, the participants were instructed to walk as fast as comfortable. Training intensity was based on the participants' rate of perceived exertion. Participants also wore heart rate monitors during the first exercise session and had a target heart goal of 60% of the age-predicted maximum. The warm up and cool-down consisted of walking at low speed (without the poles) and stretching with the poles. All 23 participants in the Nordic walking group completed the 9-week program although there were some absences during the training period.

At the end of the nine weeks, both groups were re-assessed using the same test battery. Improvements were made across all measures in the Nordic walking group. Hip and leg strength as measured by the Chair Stand Test increased on average by 15.3% in the Nordic walking group whereas there was only a 2.2% increase in the control (sedentary) group. Arm strength as measured by the Arm Curl Test increased on average 19.7% vs. 1.9% in the control group. Other measures of functionality all showed significantly greater increases compared with the control group. The 2-Minute Step Test, which assesses cardiovascular fitness showed an average increase of 14.0% in the Nordic walking group vs. a 2.5% increase in the control group, the "Sit-and-reach" test, which assesses thigh and calf flexibility, showed a 92.5% increase vs. 2.9% increase in the control group. It was thought that the stretching exercises during warm-up and cool-down played a large role in contributing to this large increase in leg flexibility. However, since Nordic walking assumes a large stride length compared to regular walking, the walking pattern itself may have also been a large contributor to the increased flexibility.

The Nordic walking group experienced on average a 17.3% increase in upper body flexibility as measured by the "Back Scratch Test" compared with a 23% DECREASE in the control group. When it came to assessments of balance related capacity, there was only a 10% increase in the Nordic walking group as measured by the "Timed Up and Go" Test (a measure of dynamic balance) but there was no change observed in the control group. However, the results of the gait analysis tests, which measured ground-reaction forces (GRF) and walking speed, were disappointing. They showed no change in either group. Researchers had hoped to find an improvement in gait as a result of the pole walking program but any falls reduction benefit resulting from muscular strength increases may have been countered by reliance on the poles themselves as balance aids.

There were some limitations in the study. Because of early drop-out in a third group (a regular walking group), there were insufficient numbers to study them separately so they were combined with the Nordic walking group. Thus the test group was much larger than the control group (23 vs. 14). It also means that comparisons between the test group and the control group do not necessarily suggest that improvements were a result of Nordic walking in particular or regular walking in general which caused the greatest change. However, Nordic walking does require engagement of upper and lower body muscles that is not required with regular walking. As well, previous studies which compared Nordic walking with regular walking showed an increase in cardiovascular function, although these were done with a younger population. So there is no reason not to credit a portion of the cardiovascular increase to the Nordic walking program specifically. The cardiovascular benefits may have been the result of strength increases in upper body muscles, which improve lung functional capacity, circulation, and oxygen uptake, the researchers said.

Although no significant improvements in gait were corroborated by the exercise program, muscular strength, flexibility, cardiovascular capacity, and to an extent dynamic balance were all improved in the Nordic walking group after the 9-week program. It is safe to say that based on this study Nordic walking is a useful tool in an activity tool kit to keep vital and strong as one ages. Perhaps it is an exercise you'll pick up and enjoy. It's worth a try!

Parkatti, T, Perttunen, J, and Wacker, P. (2012). Improvements in Functional Capacity from Nordic Walking: A Randomized Controlled Trial Among Older Adults, Journal of Aging and Physical Activity, 20 (1), 93-105.

Can Nordic Walking increase your strength and cardio fitness?