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Nordic Walking – beneficial and safe for all Heart Failure patients?

Comment by Patrick Doherty, Jean-Paul Schmid and Massimo Piepoli, EACPR Cardiac Rehabilitation Section

Nordic walking enables a safe increase in exercise intensity and may be a more effective training method than walking without poles in patients with HF and healthy subjects
A. Lejczak et al.
Heart Failure Congress; Belgrade, Serbia: 19–22 May 2012
European Journal of Heart Failure Supplements (2012) 11 (S1), S165


The abstract by Lejczak and colleagues makes a positive contribution in terms of highlighting an alternative approach to increasing the intensity of exercise training in a patient group that is known to struggle with exercise. The study also reaffirms the relationship between the recruitment of more muscle groups and increased physiological demand.

There is however a need to be cautious about the conclusion that Nordic walking is safe and beneficial for all categories of heart failure. The study population was very small and included only males in New York Heart Association (NYHA) class II. It is clear from the literature that females respond differently to higher intensity exercise which limits generalisation of findings from this study. We also know that patients with class III and IV heart failure can gain substantially from exercise training but at the same time they show the poorest physiological response and carry a greater risk of cardiac events.

Based on the available literature we are unable to say that 'Nordic walking' is effective and safe for class III and IV patients but we do support the idea of offering greater choice, in the mode and intensity of exercise, for patients with less severe heart failure.