A systematic review and meta-analysis of Nordic walking for chronic heart failure with low left ventricular ejection fraction

Open

Aulia Syavitri Dhamayanti, Rahmad Rahmad, Samiah Rachmawati, Yoga Waranugraha

2025 PM and R Vol. 17 Issue 2 Review Cited by 2 Quartile

Abstract

Background: Nordic walking (NW) has been reported to be beneficial in various chronic diseases. Objective: To determine whether NW improves function in patients with heart failure (HF) with low left ventricular ejection fraction more than conventional cardiac rehabilitation or usual care. Methods: Systematic literature searches in PubMed, ScienceDirect, and Web of Science were conducted. According to patient, intervention, comparison, and outcome (PICO) principles, a stepwise selection process was completed to identify eligible studies. Only randomized controlled trials (RCTs) were included in this systematic review and meta-analysis. Pooled effects were determined using a random effect analysis model for the meta-analysis. Results: A total of 282 participants from four RCTs were included. The improvement of peak oxygen consumption (peak VO2) was greater in the NW group than in the control group (mean difference [MD] = 2.18 mL/kg/min; 95% confidence interval [CI] = 1.35–3.01; p <.01). The improvement of the 6-minute walk test (6MWT) distance was also greater in the NW group than in the control group (MD = 16.51 meters; 95% CI = 3.23–29.80; p =.01). Conclusion: This systematic review highlights the benefits of NW training in patients with chronic HF, particularly those with systolic dysfunction. Specifically, NW walking was associated with increased peak VO2 and 6MWT improvement compared to conventional cardiac rehabilitation or usual care. These results suggest that NW may be a useful component of cardiac rehabilitation. However, additional larger studies with a wider range of patients are needed. © 2024 American Academy of Physical Medicine and Rehabilitation.

Affiliations

Faculty of Medicine, Universitas Muhammadiyah Malang, Malang, Indonesia; Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia