High-Intensity Interval Nordic Walking for Coronary Artery Disease
(HIIT-NoW Trial)
Recruiting in Palo Alto (17 mi)
Overseen byJennifer L Reed, PhD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Ottawa Heart Institute Research Corporation
Disqualifiers: Unstable angina, Atrial fibrillation, COPD, others
No Placebo Group
Trial Summary
What is the purpose of this trial?Coronary revascularization, such as heart bypass surgery (CABG) and percutaneous coronary intervention (PCI \[inserting a stent to open up blood vessels\]) improve survival for people with coronary artery disease. Yet, many patients suffer from poor physical and mental health after coronary revascularization. Traditional cardiac rehabilitation involving moderate-to-vigorous intensity continuous training (MICT) improves physical and mental health. However, alternative exercise programs, such as high-intensity interval training (HIIT) and Nordic walking may provide superior benefits. Nordic walking is like Nordic skiing but uses specifically designed poles for walking. Nordic walking involved core, upper and lower body muscles, resulting in greater energy expenditure while reducing loading stress at the knee. To date, HIIT used in cardiac rehabilitation settings has focused on lower body (e.g., leg cycling). The investigators are not aware of HIIT protocols that target both upper and lower body at the same time. An exercise program that combines HIIT and Nordic walking (HIIT-NoW) may offer an alternative time-efficient whole-body exercise to improve physical and mental health. This study will test if HIIT-NoW can be an alternative exercise option to improve physical and mental health in patients with coronary artery disease.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment High-Intensity Interval Nordic Walking for Coronary Artery Disease?
Research shows that Nordic walking, when combined with standard cardiac rehabilitation, improves physical activity levels, aerobic efficiency, and quality of life in patients with coronary artery disease. It also positively affects certain risk factors for heart disease, making it a more effective therapy than standard cardiac rehabilitation alone.
12345Is High-Intensity Interval Nordic Walking safe for people with coronary artery disease?
High-Intensity Interval Training (HIIT), which includes High-Intensity Interval Nordic Walking, has shown a low rate of major adverse cardiovascular events in patients with coronary artery disease when used in cardiac rehabilitation settings, with only one major event occurring per 17,083 training sessions.
12456How is high-intensity interval Nordic walking different from other treatments for coronary artery disease?
High-intensity interval Nordic walking is unique because it combines the benefits of high-intensity interval training (HIIT) with the full-body engagement of Nordic walking, which uses poles to work more muscle groups. This approach not only improves cardiovascular health but also enhances functional capacity and quality of life, making it a novel option compared to traditional exercise therapies.
12357Eligibility Criteria
This trial is for patients at least 40 years old with coronary artery disease who have had a stent inserted or heart bypass surgery. They must be willing to attend exercise sessions on-site, able to perform an exercise test measuring heart and lung function, and not currently in cardiac rehab.Inclusion Criteria
You can do a special breathing and exercise test.
I am willing to attend exercise sessions in person.
I have had heart artery treatment with stenting or bypass surgery.
+1 more
Exclusion Criteria
Unable to return for 10-week follow-up visit
I have heart or severe lung conditions like unstable angina or COPD.
You are currently taking part in a clinical research program.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants undergo high-intensity interval Nordic walking training or standard cardiovascular rehabilitation
11 weeks
Weekly sessions
Follow-up
Participants are monitored for safety and effectiveness after treatment
4 weeks
Participant Groups
The study is testing if high-intensity interval Nordic walking can improve physical and mental health better than standard cardiovascular rehabilitation. It's a new way of exercising that works the whole body by using special poles while walking.
2Treatment groups
Experimental Treatment
Active Control
Group I: High-intensity interval Nordic walkingExperimental Treatment1 Intervention
Participants will receive high-intensity interval Nordic walking training.
Group II: ControlActive Control1 Intervention
Participants will undergo standard cardiovascular rehabilitation.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of Ottawa Heart InstituteOttawa, Canada
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Who Is Running the Clinical Trial?
Ottawa Heart Institute Research CorporationLead Sponsor
References
Oxygen uptake during Nordic walking training in patients rehabilitated after coronary events. [2017]Nordic walking (NW) is an effective form of endurance training in cardiac rehabilitation (CR). The key parameter for the safety and effectiveness of the training is its intensity. Training intensity may be directly measured by the volume of oxygen consumption (VO₂), and indirectly by chronotropic cardiac response to exercise. No data have been published on the rates of VO₂ during NW in field conditions among patients rehabilitated after coronary events.
Accuracy of Wearable Devices for Measuring Heart Rate During Conventional and Nordic Walking. [2021]Nordic walking is being used increasingly as an exercise method in many clinical disorders. To apply Nordic walking in cases of fragile or deconditioned patients, monitoring of exercise intensity such as heart rate (HR) measurement is required. The accuracy of wearable HR monitors during Nordic walking has not yet been reported.
Sustained Effects of Different Exercise Modalities on Physical and Mental Health in Patients With Coronary Artery Disease: A Randomized Clinical Trial. [2022]Twelve-week high-intensity interval training (HIIT), moderate-to-vigorousintensity continuous training (MICT), and Nordic walking (NW) have been shown to improve functional capacity, quality of life (QoL), and depression symptoms in patients with coronary artery disease. However, their prolonged effects or whether the improvements can be sustained remains unknown. In this study we compared the effects of 12 weeks of HIIT, MICT, and NW on functional capacity, QoL, and depression symptoms at week 26.
The Effects of Cardiac Rehabilitation including Nordic Walking in Patients with Chronic Coronary Syndromes after Percutaneous Coronary Interventions in Elective Mode. [2023]Background: Percutaneous coronary intervention (PCI) in patients with chronic coronary syndrome (CCS) is a worldwide method of coronary revascularisation. The aim of this study was to assess the immediate and long-term effects of Nordic Walking (NW) training added to a standard cardiac rehabilitation programme on physical activity (PA) and capacity and life quality, as well as selected proatherogenic risk factors. Methods: The studied group comprised 50 patients (considering exclusion criteria, 40 patients), aged 56-70, with CCS after elective PCI qualified them for a 6-weeks-long cardiac rehabilitation. The follow-up period lasted 4 months, and control visits occurred at 2 and 4 months. The studied patients were randomly divided into two groups: control group-standard cardiac rehabilitation programme and experimental group-standard cardiac rehabilitation programme additionally combined with NW training. Results: The cardiac rehabilitation programme in the experimental, compared to the control group, increased intense PA (from 731.43 ± 909.9 to 2740 ± 2875.96 vs. from 211.43 ± 259.43 to 582.86 ± 1289.74 MET min/week) and aerobic efficiency-VO2peak (from 8.67 ± 0.88 to 9.96 ± 1.35 vs. from 7.39 ± 2 to 7.41 ± 2.46 METs), as well as quality of life according to the WHOQOL-BREF questionnaire (from 3.57 ± 0.51 to 4.14 ± 0.36 vs. from 3.29 ± 0.47 to 3.57 ± 0.51 points). The walking distance assessed with the 6-min walk test did not differ between the groups before the beginning of the rehabilitation programme. Both at the I follow-up and II follow-up time points, a significant increase in the walking distance was noted in the control and experimental groups compared to baseline, and the difference between both groups was significant at the end of follow-up (378.57 ± 71.35 vs. 469.29 ± 58.07, p = 0.003). Moreover, NW had a positive effect on the modulation within selected biochemical risk factors of atherosclerosis, as well as subjective quality of life and well-being. Conclusions: Introducing NW training into the cardiac rehabilitation process proved to be a more effective form of therapy in patients with CCS treated via PCI, as compared to the standard cardiac rehabilitation programme alone.
Nordic walking for cardiovascular prevention in patients with ischaemic heart disease or metabolic syndrome. [2017]The incidence of atherosclerotic diseases has increased in Europe due in part to the population's sedentary lifestyle. Physical activity is useful for cardiovascular prevention. Nordic walking (NW) mobilizes a great number of muscular groups and is very popular in northern Europe. There is no data available on its impact in the healthcare system of the Mediterranean area. We propose the implementation of a NW program to promote physical activity and control cardiovascular risk factors (CVRF), as well as to improve quality of life and the adherence to medical treatment in patients with a chronic ischemic heart disease or metabolic syndrome.
High-Intensity Interval Training for Patients With Cardiovascular Disease-Is It Safe? A Systematic Review. [2021]Background Cardiac rehabilitation ( CR ) for patients with cardiovascular disease has traditionally involved low- to moderate-intensity continuous aerobic exercise training ( MICT ). There is growing and robust evidence that high-intensity interval training ( HIIT ) shows similar or greater efficacy compared with MICT across a range of cardiovascular and metabolic measures, in both healthy populations and populations with a chronic illness. However, there is understandable concern about the safety aspects of applying HIIT in CR settings. This systematic review analyzed safety data drawn from recent proof-of-concept studies of HIIT during CR among patients with cardiovascular disease. Methods and Results We included trials comparing HIIT with either MICT or usual care in patients with coronary artery disease or heart failure participating in tertiary care services, such as phase 2 (outpatient) CR . Adverse events occurring during or up to 4 hours after an exercise training session were collated. There were 23 studies included, which analyzed 1117 participants ( HIIT =547; MICT =570). One major cardiovascular adverse event occurred in relation to an HIIT session, equating to 1 major cardiovascular event per 17 083 training sessions (11 333 training hours). One minor cardiovascular adverse events and 3 noncardiovascular adverse events (primarily musculoskeletal complaints) were also reported for HIIT . Two noncardiovascular events were reported in relation to MICT . Conclusions HIIT has shown a relatively low rate of major adverse cardiovascular events for patients with coronary artery disease or heart failure when applied within CR settings.
The Effects of Nordic Walking Compared to Conventional Walking on Aerobic Capacity and Lipid Profile in Women Over 55 Years of Age. [2022]The purpose of this study was to investigate the effects of Nordic Walking compared to conventional walking on aerobic capacity, the lipid profile, left ventricular ejection fraction, body mass, and body mass index in women over 55 years old.