Preventing falls and disability through Nordic walking
Each year, over one-third of older Canadians experience a fall. These falls can have devastating consequences and even if it doesn’t result in disability, can cause a lack of confidence and a “fear of falling” that can have negative long-term health effects.
Dr. Mohammed Auais, Assistant Professor, School of Rehabilitation Therapy, is a registered physiotherapist who is dedicated to helping older adults achieve high quality of life. One of his research areas is in preventing falls and disability in older adults, and how the fear of falling compounds the problem. His studies have shown that this fear can cause people over time to become more sedentary and less active, which often leads to more falls and increased disability.
“Fear of falling is an emerging factor that people didn’t pay much attention to before,” says Dr. Auais. “It prevents an individual from doing an activity they are physically capable of doing. This is beyond being cautious—it becomes a barrier from going outside and doing usual activities. It causes older adults to become more dependent on others and limited in movement; eventually becoming at a higher risk of falling.”
It is a tragic irony, he says, and one he has been trying to mitigate through the right interventions to help increase physical activity and mobility in older adults. This led him and his colleagues to look at Nordic walking.
The benefits of Nordic walking, which uses lightweight walking poles to help propel the walker similar to how a cross-country skier uses poles to ski, are well-documented. Many studies have shown that Nordic walking helps increase overall fitness in older adults than walking unaided by increasing cardiovascular activity, correcting posture, and engaging more muscle groups. By using poles, the walker widens their base of support—providing four points of contact with the ground instead of just two feet. This can lead walkers to feel more stable and confident in their stride, making it more enjoyable. It’s an exercise that’s easy to learn, accessible and inexpensive.
“People like it. It’s fun. It’s a treatment that doesn’t feel like a treatment, and they can use it anywhere,” says Dr. Auais.
The Nordic walking study is a randomized controlled pilot trial to test Nordic walking’s feasibility and safety among older adults at risk of falling and/or have a fear of falling. The study assigns participants by chance into one of two groups: a 10-week intervention group which offers regular coaching sessions, or a control group. Dr. Auais is the primary investigator with Drs. Dorothy Kessler, Catherine Donnelly and Vincent DePaul from the School of Rehabilitation Therapy working as co-investigators. This pilot test, funded by Queen’s, is anticipated to run until the end of the year. Following this, Dr. Auais hopes to launch a larger study to fully explore how Nordic walking can help prevent falls and disability in older adults. The study is conducted in partnership with the Oasis program (watch Dr. Donnelly’s Cinq à Sept Research Talk about Oasis).
Participants in the study who are chosen to engage in Nordic walking work with a trained physiotherapist five times over a 10-week period in practice/coaching sessions, to ensure they have the right form and to help tailor a program of intensity and ability. Participants are required to engage in Nordic walking sessions on their own at least three times a week and track their progress and experiences. Participants in the control group are offered Nordic walking training sessions at the end of the 10 weeks so they can pursue the activity on their own.
Chengying Feng, who earned her Master’s in Rehabilitation Science at Queen’s in 2022, works as a physiotherapist and leads the Nordic walking study groups. She says that in her practice, she often sees patients with severe arthritic pain or balance issues who may benefit from using a walking aid like a cane but hesitate to use them. However, it seems more acceptable among patients when she suggests Nordic walking as an alternative which many feel is a more enjoyable and active form of exercise and does not have the same stigma of using a cane or a walker. “People seem to like it and it promotes increased physical activity, fostering a positive self-image among patients,” says Feng.
Watch this short clip with Chengying Feng on how to use Nordic walking poles:
Dr. Auais and his team are continuing to seek study participants. Interested people in the Kingston area who are at least 60 years or older, have a fear of falling or at risk of falling and not using walking poles regularly are encouraged to sign up through this form or by contacting email@example.com.