The motor and the non-motor outcomes of Nordic Walking in Parkinson's disease: A systematic review

Background: The current study investigated the motor and the non-motor outcomes of Nordic Walking (NW) in Parkinson's disease (PD) using a systematic review of studies with any design. Methods: The search of PubMed, PsycInfo, Medline and SCOPUS until November 2018 identified k = 13 relevant studies: five randomised controlled-trials (RCTs) and eight observational studies. Study designs, intervention, patient and outcome details were coded. Study quality was assessed with the Physiotherapy Evidence Database scale. Results: All studies reported either benefits or no effects of NW in 318 patients at the early stages of PD with low to moderate severity. NW was well accepted and relatively safe. Symptom severity, walking speed and gait pattern consistently improved after 4 - 24 weeks of NW relative to baseline or any control condition during the ON-phases of pharmacotherapy. The NW benefits were less consistent during the OFF-phases and at the follow-up in the absence of regular training. Conclusions: NW may contribute to the maintenance of the overall mobility in addition to pharmacotherapy. Since the quality of studies was poor to moderate, future single-blind RCTs should investigate the clinical relevance of the NW outcomes and the training parameters necessary to optimise the benefits of NW in PD. (C) 2020 Elsevier Ltd. All rights reserved.