Nordic walking enhances oxygen uptake without increasing the rate of perceived exertion in patients with chronic obstructive pulmonary disease

Background: In healthy subjects, Nordic walking (NW) generates higher oxygen uptake (VO₂) than standard walking at an equal rate of perceived exertion (RPE). The feasibility and positive outcomes of NW in patients with chronic obstructive pulmonary disease (COPD) have been reported. Objectives: The aim of the current study is to assess the physiological responses and RPE during NW in COPD patients. Methods: In 15 COPD patients [mean (SD) age 67 (9) years] with a forced expiratory volume in the 1st s of 55% (15)], VO₂, minute ventilation and heart rate were measured with a portable system during the 6-min walking test (6MWT), incremental shuttle walking test (SWT), 6-min NW on solid ground (6mNW_ground) and 6-min NW on soft dry beach sand (6mNW_sand). The RPE using a modified Borg scale was assessed after each test. Results: 6mNW_ground and 6mNW_sand showed a higher VO₂ plateau compared with the 6MWT and peak VO₂ measured during SWT [mean (SD) VO₂ 21 (3), 22 (4), 18 (4) and 19 (5) ml·kg^-1·min^-1, respectively; p < 0.05 each]. However, no differences in RPE were observed among 6mNW_ground, 6MWT and SWT [modified Borg scale score for dyspnea 4.2 (2.0), 4.1 (1.8) and 4.3 (1.7), respectively; nonsignificant]. However, RPE in 6mNW_sand was significantly higher than in all the other exercise protocols [modified Borg scale score for dyspnea 5.2 (2.2); p < 0.05]. Conclusions: In COPD patients, the use of Nordic poles generates higher VO₂ than standard walking with no differences in the dyspnea score. The results indicate the potential to enhance community-based training programs in these patients.