Effects of Nordic walking on cardiovascular performance and quality of life in coronary artery disease.

BACKGROUND: Cardiometabolic effects of physical exercise depend on its intensity, duration, and type. Conventional cardiovascular rehabilitation (CCVR) programs have significant advantages, but non-conventional activities such as Nordic walking (NW) may offer additional health benefits. AIM: The aim of this study was to determine the feasibility and effectiveness of NW on cardiovascular performance and quality of life in patients with coronary artery disease (CAD) compared to a CCVR program. DESIGN: This was a pseudo-randomized, prospective, single-blinded, parallel-group trial. SETTING: The study was conducted at a resort/spa type facility located in a mountainous natural environment, 650 meters above sea level. POPULATION: Eighty-three CAD patients were allocated to either a Nordic walking or a control group. METHODS: The NW group (N.=53; age 59.1±7.0 years) underwent a three-week outdoor exercise program consisting of 40 minutes of walking four-times per week, whereas the controls performed traditional walking instead of NW. A patient's prescribed exercise intensity was according to exertion tolerance within 50-70% of peak oxygen consumption (VO2max); rating of perceived exertion 'mild/moderate' (12 to 14 points) on the 0-20 Borg Scale. Primary endpoint: cardiovascular and functional performance (exercise ergometry [EE], metabolic equivalent of tasks [METs], ejection fraction [EF], Six-Minute Walking Test [6MWT]). Secondary endpoint was quality of life (Short-Form 36 Health Survey). Statistical analysis was performed by generalized estimating equations with Cohen's d effect size (ES). RESULTS: NW led to higher cardiovascular performance compared to CCVR (ΔEE: +11.0% vs. +3.2%, small ES; ΔMETs: +9.8% vs. +1.5%, medium ES) and better functional performance (Δ6MWT: +8.3% vs. +5.1%, small ES). No significant differences were detected in EF (P=0.240) and SF-36 (PCS, P=0.425; MCS, P=0.400). CONCLUSIONS: A three-week NW training program had clinically important effects, above and beyond CCVR, on cardiovascular and functional performance in CAD patients. CLINICAL REHABILITATION IMPACT: Nordic walking is an accessible, safe, and effective low-threshold cardiac rehabilitation exercise training modality that seems to be particularly well-suited for people with limited functional and motivational capacities.

Associations between self-rated health, mental health problems and physical inactivity among urban adolescents.

Background: Self-rated health is a valid and reliable subjective indicator of general health. We aimed to assess the associations between self-rated health, mental health problems, physical activity, sedentary behaviour and BMI among Slovak urban adolescents. Methods: Data were collected within the EU-FP7: EURO-URHIS 2 (The European Health Indicator System Part 2) project in two largest Slovak cities: Bratislava and Kosice. Sample included 1111 adolescents (response rate 73.7%, mean age 14.32 ± 0.48 years, 52.8% boys). Self-rated health was measured with the first item from the Short Form Health Survey 36 questionnaire, mental health problems were assessed by the Strengths and Difficulties Questionnaire and for physical activity and sedentary behaviour questions from the WHO HBSC questionnaire were used. Logistic regression was performed to determine the associations between self-rated health and the independent variables. Results: Self-rated health was found to be significantly associated with mental health problems, sedentary behaviour and BMI. However, the strongest association was found with engagement in physical activity every day (OR 8.0; 95% CI 1.6-39.9). Conclusions: Previous research revealed that self-rated health was associated with various mental health problems. Our findings add to these results by showing that physical activity and sedentary behaviour are also very important additional factors related to self-rated health. Better understanding of these associations can help in developing more effective public health intervention programmes for adolescents.