PTOTSLPMeta-AnalysisJournal of rehabilitation medicine2025

Effects of Nordic Walking in people with respiratory diseases: a systematic review and meta-analysis.

María Vilanova-Pereira, Margarita Barral-Fernández, Noé Labata-Lezaun and 4 others

PMID 40947882

WHAT IT FOUND

Nordic walking did not beat other exercise on six-minute walk distance in the main analysis.

It outperformed no exercise, but the positive result relied on removing one outlier study. All included trials had high risk of bias.

Key findings

01The primary meta-analysis of six-minute walk distance found no significant difference between Nordic walking and control groups, with very high heterogeneity across the seven pooled studies.

02When the single outlier study was removed, Nordic walking showed a statistically significant improvement in walk distance, but this analysis was a post-hoc subgroup not pre-specified in the registration.

03Every included study was rated as having an overall high risk of bias, and the average methodological quality score was fair.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

All 13 included studies were rated as having an overall high risk of bias. The positive finding for exercise tolerance depended on removing one outlier study in a sensitivity analysis. Subgroup analyses were post-hoc and not pre-specified in the PROSPERO registration. Heterogeneity was extremely high for the primary outcome (I² = 94%). Sample sizes were small in most studies, with 11 of 13 including 40 or fewer participants. Only one study included children, so findings cannot be extrapolated to paediatric populations. Long-term effects are unknown because only two studies included follow-up assessments. Interventions varied widely in dosage, supervision, and whether Nordic walking was combined with other exercises. Missing data prevented meta-analysis for outcomes other than the six-minute walk test.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not conclude that Nordic walking is proven superior to other exercise for respiratory patients. The significant benefit seen in the sensitivity analysis was not the primary result and depended on excluding a single outlier study, while the main meta-analysis was null with 94% heterogeneity.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →