Acute effects of walking with Nordic poles in persons with mild to moderate low-back pain

Regular walking with or without Nordic poles is effective over time at reducing discomfort in individuals with chronic low back pain (LBP). Nordic pole use increases balance and stability, distributes weight through the arms and torso, and decreases loading of the spine and lower limbs. The purpose of this study was to determine if Nordic poles would reduce perceived acute discomfort while self-paced walking in individuals with LBP. We also examined whether walking with or without poles increased heart rate (HR) and ratings of perceived exertion (RPE) or speed of movement. Subjects included 20 adults (12 males, 8 females; mean age of 45.1±16.3) who were experiencing LBP of at least six months' duration (Oswestry Disability Index (ODI): mean 17 ± 8%, range 6-36% indicating minimal to moderate disability) with no current active flare-up. Participants walked a predetermined dirt-path course (805 m or 0.5 mi) with and without poles in randomized order. Data were analyzed using a 2 X 2 repeated measures ANOVA (Condition X Time), where Condition was poles vs no poles and Time was pre- and post-walk. HR and RPE increased significantly from walking the course, whereas pain did not change. There were also no differences between walking with or without poles for pain (ODI Sec #1: 0.2 points, p=0.324), HR (4 bpm, p=0.522) and RPE (0 points, p=0.759). The mean course time (sec) was slower with poles: 617±87 vs 566±65 (p<0.001). Unexpectedly, there was a noticeable drop in pain following the warm up which was done using poles (0.9 points, p<0.001). Nordic pole use is well tolerated in those with current back pain and can be encouraged, however it cannot be recommended as a superior method of addressing acute symptoms when walking.