1. Mélanie Le Berre,1,2 LizFerland,3 Shawn Robbins,4,5
The effectiveness and feasibility of a Nordic walking pole program for institutionalized older adults
Mélanie Le Berre,1,2 LizFerland,3 Shawn Robbins,4,5
1Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Canada
2School of Rehabilitation, Université de Montréal, Montreal, Canada
31Saint-Anne’s Veterans Hospital, Quebec, Canada
4School of Physical and Occupational Therapy, McGill University, Quebec, Canada
5Centre for Interdisciplinary Research in Rehabilitation, Constance Lethbridge Rehabilitation Centre, Quebec, Canada

2. Background
Objective
Physical activity helps maintain functional independence and decreases fall risk.1
Nordic pole walking (NW) programs were shown to be beneficial for improving mobility in community-dwelling adults.2,3
Similar programs have however not been tested in much older institutionalized adults.
Determine the feasibility and effectiveness for improving walking and balance of a Nordic pole walking program in institutionalized older adults.
1. El-Khoury et al, 2013; 2. Figueiredo et al, 2013; 3. Virag et al, 2015

3. Methods Design Intervention: NW program Participants
Pre-post pilot study.
12 weeks, 20 minutes sessions, 2 days/week
Using NW “Activator” poles (Urban poling, Vancouver, BC)
Number of pauses and walking distance were adapted to the needs and preferences of each participant
Participants were accompanied by an experienced physical rehabilitation therapist and a physical rehabilitation therapist trainee for the walk
Set inside due to weather (winter)
Participants
Eligibility criteria:
Berg Balance Scale score over 30/56
Walking endurance of at least 30m with usual gait aid and supervision
Exclusion criteria:
Unable to learn NW technique and to cooperate well
Any weight bearing precautions, fractures or surgeries in the past 12 months
Any myocardial infarction in the past 12 months or any other health condition that would prevent participation in the program

4. Methods Results Outcome measures Satisfaction Sociodemographic data
Mean (SD)
Minimum, Maximum
Age (y)
93 (3)
89, 96
Height (m)
1.60 (0.06)
1.52, 1.68
Mass (kg)
68 (16)
45, 89
Body mass index (kg/m2)
26.59 (5.75)
19.40, 36.10
Charlson Comorbidity Index
6 (1)
5, 8
POST
Satisfaction questionnaire
PRE, POST and 3 months follow-up:
Stepscan Pedway gait and standing balance analysis
10-Meter Gait Speed test
Berg Balance Scale
Falls history
Table 1. Demographics for the study participants (n=7, 6 men)
Satisfaction
Two participants rated their satisfaction as 10/10 and one as 8/10 respectively.
Five participants had difficult using the numeric rating, but expressed enjoyment and a desire to continue the program.

5. Results
Measure Type
Variable
PRE Program
POST Program
Follow-Up
p value
Gait - Stepscan
Walking Speed (m/s)
0.45
(0.26, 0.63)
0.47
0.36
(0.11, 0.56)
0.16
Stride Length (cm)
66.80
( )
67.94
(50.83, 83.03)
63.17
(47.47, 72.54)
0.57
Cadence (steps/min)
79.36
(59.10, )
82.74
(59.27, )
66.74
(29.21, )
Gait - Clinical
10-Meter Gait Speed (m/s)
0.60
(0.40, 0.77)
0.66
(0.47, 0.91)
0.63
(0.45, 0.79)
0.20
Balance - Stepscan
COP Speed (cm/s)
4.32
(3.12, 6.34)
3.35
(2.69, 4.53)
3.77
(2.75, 5.18)
0.11
COP Area (cm2)
2.51
(1.56, 4.56)
2.59
(1.38, 3.92)
3.25
(1.71, 4.66)
0.14
Balance - Clinical
Berg Balance Scale (/56) 38
(30, 44) 43
(34, 48) 39
(28, 45)
<0.01
Adverse Events
Falls
0.9
(0, 2)
0.0
(0, 0)
0.4
(0, 1)
0.17
Conclusion
NW program is feasible and safe in older institutionalized adults
NW improved balance, although the changes were not maintained 3 months after the program cessation
No improvements in gait metrics
Future studies should examine NW impact on falls, general function and the cardiovascular system in larger samples
Table 2. Means (minimum, maximum) for the study variables at each assessment
COP, Center of pressure