Title: Effectiveness of Nordic Walking on People with Parkinson’s Disease

Authors: Dr A. Kiran Kumar M.P.T (Neuro), Dr A. Hemchand, Dr Bindhu Keerthi, Dr M.V Naga Bhushanam

 DOI:  https://dx.doi.org/10.18535/jmscr/v4i12.74

Abstract

BACKGROUND: Parkinson’s disease is one of the most common neuro degenerative diseases with a prevalence of 100-200/100000 people worldwide. Nordic walking is walking with two poles using a reciprocal arm leg action to improve aerobic fitness body strength, mobility and coordination. The aim of Nordic walking is to develop the correct postural muscles, balance and co ordination required to produce a normal walking pattern.

OBJECTIVE: To find the  efficacy of Nordic walking in subjects with parkinsonism, and to compare the effects of Nordic walking treatment pattern with ordinary walking treatment pattern in patients with Parkinson’s disease.

MATERIALS AND METHODS: 30 subjects with Parkinson’s disease were selected in the study according to the inclusion and exclusion criteria and divided into two groups. Patients in interventional group were given Nordic walking treatment pattern. Patients in control group were given Ordinary walking treatment pattern. TUG test and PDQ39 will be used as clinical outcome measures to evaluate the effectiveness of training method in improving physical function and mobility respectively.

RESULTS: Comparison between the two groups was analyzed using the unpaired t-test. It revealed a statistically significant difference of ‘p’ value (p<0.001) between the TUG test scorings of group A and Group B. And also showed a statistically significant difference of ‘p’ value (p<0.001) between the PDQ39 test scorings of group A and Group B.

CONCLUSION: The results have shown that there is significant difference (p<0.001) when comparing the effectiveness of Nordic walking and ordinary walking treatment pattern in patients with Parkinson’s disease. Therefore Alternative hypothesis has been accepted.

KEYWORDS: Nordic walking in Parkinson’s disease, Gait training in Parkinsonism, Physical function training in Parkinson’s disease.

References

1.                  R.C. Chen, S.F. Chang, C.L. Suet.al., “Prevalence, incidence and mortality of PD Neurology, vol.57, no9, pp.1679-1686, 2001.

2.                  K.G. Lloyd, L.Davidson, and O.H. Hornykiewicz, “the neuro Chemistry of Parkinson’s disease: effect of L Dopa Therapy”.  Journal of Pharmac-ology and experimental therapeutics. Vol.195, No.3, PP. 453-464, 1975.

3.                  W.R.Gibb, “The neuropathology of Parkinson disorders,” in Parkinson’s disease and movement disorders, J.Jankovic and E.Tolosa, Eds., PP.205-233, Williams and Wilkins, Baltimore, Md, USA, 1993.

4.                  Landin S.Hagenfekdt L.Saltin B, Wahren J.Muscle Metabolism during exercise in patients with Parkinson’s disease.  Clin Sci and molecular Med 1974; 47:493-506.

5.                  Sasco AJ, Paffen barger RS Jr, Gendre I, Wing Al.  The role of physical exercise in the occurrence of PD. Arch Neurol 1992; 49:360-5.

6.                  M.Nallegowda, U.Singh, G.Handa. et.al., “Role of sensory input and muscle strength in maintenance of balance, gait, and posture in P.D. : American journal of physical medicine and Rehabilitation, vol.83, No.12, PP-898-908, 2004.

7.                  Porcari JP, Hendrickson TL, Walter PR, Terryl, Walskog.  Res Q exerc sport. 1997 jun; 68(2) : 161-6.  The Physiological responses to walking with and without powerpoles on treadmill exercise.

8.                  E.Brunelle and M.K.Miller, “The effects of walking poles on ground reaction forces, “Research Quarterly for exercise and Sport. Vol.3, p.p. 30-31, 1998.

9.                  J.P. Porcari, T.L. Hendrickson, P.R.Walter, L.Terry and G.Walsko, “The Physiological response to walking with and without power poles”.  Research Quarterly for exercise and sport, vol.68, no.2, P.P. – 161 – 166, 1997.

10.              F.J.M. Van Eijkeren, R.S.J. Reijmers, M.J. Kleinveld, A.Minten, J.P.ter Bruggen, and B.P.Bloem, Nordic walking improves mobility in Parkin-son’s disease, movement disorders, vol.23, no.15, PP.2239-2243, 2008.

11.              P.O. Mckeon, C.D. Ingersoll, DC. Kerrigan, E.Saliba, B.L.Bennet.  Balance Training improves function and postural control.  Medicine and science in sports and exercise, 2008.

12.              Morris S, Morris ME and Lansek R (20010 reliability of measurements obtained with timed up and go test in people with Parkinson’s disease.

13.              C.Jenkinson, R.Fitzpatrick, V.peto, K.Greenhall, and N.Hyman, “The Parkinson’s disease questionnaire (PDQ-39) : development and validation of Parkinson’s disease summary index score.  Age and Ageing, vol.26, No.5, PP.353-357, 1997.

14.              Kluding P and Mc ginnis PQ(2006)multi dimensional exercise for people with    Parkinson’s disease :a case report .physiotherapy and practice 22;153-162

15.              Reuter I,leone p,schwed m and oeschener M (2006)effect of Nordic walking in Parkinson’s disease. Movement disorders 21:S567

Corresponding Author

Dr A. Kiran Kumar M.P.T (Neuro)

Professor, Department of Physiotherapy

Narayana Medical College and Hospital