Introduction: Physical therapy interventions for patients with Parkinson's disease prioritize task-specific exercise to address gait and motor dysfunction. Nordic walking (NW) is a moderate intensity exercise promoting walking speed and rhythm. This case series describes the application of customized NW training in individuals with varied severity of Parkinson's gait dysfunction and the outcomes specific to gait, motor and non-motor symptoms; and NW engagement and retention in the follow-up phase.
Case description: Three individuals with idiopathic PD (two males and one female; ages 59-69; Hoehn & Yahr stages II-III) participated. Supervised NW training phase included 15 one-hour sessions over 6-weeks, individually progressed for each participant. During the 3-month follow-up phase independent NW exercise was prescribed 3 times a week. Primary outcome measures examined gait function and impairment-based measures assessed Parkinson's motor and nonmotor symptoms.
Outcomes: Participants improved in: 10-Meter walk-fast speed (0.13, 0.18, 0.15 m/s; respectively); 6-Minute Walk distance (137.5, 56.4, 129.4 m, respectively); Unified Parkinson's Disease Rating Scale-Motor Score (-6, -7, -14, respectively); and all Timed-Up-Go subtests. Participant 2 had 44.4% decline in freezing episodes and reduced fall rate. Participants' gains were retained at the 3-month follow-up.
Discussion: This case series suggests that NW has therapeutic benefits for three individuals with varied Parkinson's gait dysfunction. Independent NW exercise was sustained post-training and motor and gait function gains were retained.
Keywords: Parkinson’s disease; exercise; locomotor training; walking outcomes.