Nordic walking in medical rehabilitation of elderly patients

Authors:

Krysyuk Oleg Bogdanovich, doctor of medical Sciences (Dr. Med. Sci), Head of rehabilitation Department No. 26 of the Hospital of war veterans, Narodnaya St. 21, 2, 195067 Saint-Petersburg, Russian Federation; Professor of the Department of Hospital Therapy of the St. Petersburg University, Universitetskaya Embankment. 7-9, 193079 Saint- Petersburg, Russian Federation; Professor of the Department of Medical Rehabilitation and Sports Medicine of the FSBI НРЕ «SPbSPMU» МОН Russia, Litovskaya St., 2, Professor of the Department of Therapy of the Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation, е-mail: doctor_kob@mail.ru; phone: 8-921-940-92-37.

Kantemirova Raisa Kantemirovna, doctor of medical Sciences (Dr. Med. Sci), Associate Professor, Professor of the Department of Hospital Therapy of the St. Petersburg University, Universitetskaya Embankment. 7-9, 193079 Saint-Petersburg, Russian Federation; Head of Department of Therapy of the of the Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation; Professor of the North-Western State Medical University named after I.I. Mechnikov, Piskarevsky Ave, 47, 195067 Saint-Petersburg, Russian Federation, е-mail: terapium@yandex.ru; phone: (812) 543-65-05, (812) 764-96-69, 8-921-933-07-99.

Fidarova Zalina Danilovna, candidate of medical Sciences (PhD Med. Sci), Associate Professor of the Department of Therapy of the of the Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht; doctor- therapist of the therapeutic Department of the of the Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation, Phone: (812) 544-07-74, 8-911-008-22-23.

Annotation:

Introduction. Since the 90s of the last century, Nordic walking (walking with sticks, pole walking, Finnish walking, Nordic walking) has gained popularity not only in Finland, but also in many other countries around the world. People who practice walking with sticks can be found anywhere: in the Scandinavian countries and in Eastern, Central and southern Europe, Canada and the United States, Mexico, Australia, New Zealand and other places. In Finland itself, more than 1.5 million Finns regularly engage in Nordic walking, while the population of this country is just over 5 million people. There are more than 15 million people around the world who practice walking with sticks. In Russia Nordic walking appeared not so long ago – in the first decade of this century. It is noteworthy that the elderly people living in St. Petersburg began to practice it as a form of physical activity and medical rehabilitation. Currently, there are many scientific studies on the positive effect of walking with sticks on the human body, but there are a number of unresolved problems. In particular, there is still insufficient data on the impact of Nordic walking on the cardiological status and quality of life of Russian pensioners who are the most susceptible to this type of physical activity, and moreover having a combined comorbid pathology (cardiovascular diseases, overweight, arthrosis, osteochondrosis, etc.).

The aim of the present study was to study the impact of Nordic walking on some indicators of the somatic status of elderly patients, residents of St. Petersburg, the most committed to this type of physical activity and medical rehabilitation persons, who practiced Nordic walking under the guidance of a specially trained instructor for one year.

Materials and methods. 20 patients aged 65 to 85 years old, average age 72.5 + 3.6 years. All patients performed Nordic walking under the guidance of a certified instructor 2-3 times a week. The duration of the lesson was 90-100 minutes. All 20 participants (100%) at the start of classes were tested: cardiovascular diseases, diffuse dystrophic spinal disease (DSD) – osteochondrosis, in 15 patients (75%) deforming osteoarthritis (DOA) was confirmed. All participants kept blood pressure diaries (BP), completed the QoL questionnaire (QOL) – a specialized Minnesota questionnaire for patients with chronic heart failure and the general population questionnaire MOS SF-36. The structure of the class included a warm-up complex, the main part (walking with an intensity of 55–65% of the maximum heart rate) and a complex of restoring exercises.

Results. The dynamics of blood pressure showed a significant decrease in both systolic blood pressure (141.8±3.01 before classes versus 127.9±1.74 after 1 year of classes, p = 0.0016), and diastolic blood pressure (85.7±1.18 before class versus 80.5±0.83 after 1 year of class, p = 0.0032). In the groups under study, none of the patients had an elevated stage of hypertension and a degree of hypertension, and more than half of those who worked 65% managed to reduce the daily dose of prescribed antihypertensive drugs during the year. The Minnesota QOL showed a clear tendency to improve the quality of life (28.7±2.39 before the start of classes versus 22.7±1.64 after half a year of classes, p = 0.0617) and the improvement of QOL by the end of the first year of classes (28, 7±2.39 before the start of classes versus 10.6±1.46 after 1 year of classes, p = 0.0001). On the pain scale, the MOS SF-36 questionnaire revealed a significant improvement after six months (99.4±3.28 before the start of classes versus 92.6±3.48 after half a year of classes, p = 0.001) and by the end of the first year of classes (99.4±3.28 before the start of classes versus 83.0±3.49 after 1 year of classes, p = 0.0001).

Conclusion. As a result of group classes of Nordic walking, QL improved significantly after only six months in elderly patients, according to the pain scale of the MOS SF-36 questionnaire, and there was a tendency to improve QOL on the Minnesota questionnaire. This characterizes Scandinavian walking as a rehabilitation technology with a pronounced rehabilitation potential for such comorbid diseases as GB, CHD, DZP and DOA.

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