Authors (including presenting author) :
KWONG SSF1, AU AYY1, CHAN EYY1, TSUI VKY1, Ching KM2, LEE H2, Chan CKM1
Affiliation :
(1) Physiotherapy Department (2) Dietetic Department, Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Nordic Pole Walking (NPW) is a popular exercise in Europe and North America. Studies have proven its effects in cardiovascular benefits, weight management and Parkinsonism. It was estimated that 1 out of 3 Nordic populations pole-walk regularly. In Germany, the clinical evidence on the benefits of Nordic pole walking for diabetic management led to the coverage of poles within their Medicare. Incorporating 40% more muscle activities than regular walking; NPW also has a 40% reduction in stress on the knees. Osteoarthritis (OA) knee patient has relatively limited exercise choice to enhance their exercise capacity; are often entering a viscous cycle of inactivity-weight gain-pain. Therefore, a pilot program was initiated to explore its feasibility for the benefits of obese patients with OA Knee.
Objectives :
To pilot the feasibility of Nordic pole walking as a choice of regular exercise for obese OA Knee patients in Hong Kong To evaluate its clinical effectiveness To enhance activity level and knee-related function for weight management
Methodology :
Patients referred to TSKH PT Outpatient Department for OA Knee with BMI >25 were recruited. The program consisted of pole walking coaching, self-exercise intensity monitoring for cardiovascular / weight management benefits and education video prepared by dietitian. There were 4 sessions with a 3-month follow-up. Body composition, OA Knee functional outcomes, pain score and video gait assessment were performed. Knowledge based dietary choice was evaluated with the video information given by dietitian.
Result & Outcome :
From June 2019, 45 patients attended. 26 patients (mean age of 59.5) completed the post-assessment as of December 2020. There was significant improvement in all domains in Knee Osteoarthritis Outcome Score (KOOS) including pain (p< 0.46), physical score (p< 0.004) & quality of life (p< 0.005). Physical Performance (30-sec chair stand) test showed significant improvement (p< 0.000) from 9.5 to 13.08. Pain score was reduced from 5.04 to 3.52 (p< 0.000). Diet knowledge score (maximum 7) changed from 4.42 to 6.08 (p< 0.000). The mean Nordic Pole walking time was 160 minutes per week, with 64% of patients achieved 150 mins/week exercise time. Body fat% changed from 35.2% to 34.5%(p=0.052). Other body composition parameters showed improving trend.
Conclusion: The outcome was positive in implementing Nordic Pole Walking program for obese OA knee patients. With promotion and collaboration with community partners, and potential forming alumni groups, it can be a sustainable exercise choice for health benefits in Hong Kong.
