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

Abstract

Nordic walking (NW) has been reported to be beneficial in various chronic diseases. 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. 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. 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). 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.