The Physical and Psychological Benefits of Nordic Walking in Patients with Breast Cancer: A Systematic Review

Background and Objectives: Breast cancer survivors often experience long-term physical and psychological impairments that negatively affect quality of life. Exercise-based rehabilitation strategies are increasingly recommended in this population. This study aimed to analyze the physical and psychological benefits of Nordic walking (NW) in breast cancer survivors. Materials and Methods: A systematic review (registered in PROSPERO ref: CRD42024613292) was conducted in accordance with PRISMA guidelines. SPORTDiscus, CINAHL, Cochrane, Embase, Medline Ovid and PubMed were searched from database inception to 30 December 2025, with no restrictions applied regarding the language of the included studies, using the terms "breast cancer", "walking poles", "pole walking" and "Nordic walking". Studies involving adult women (≥18 years) with breast cancer were included. Data on study design, participant characteristics, intervention protocols and outcomes were extracted. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Results: From 281 records identified, 17 studies were included that evaluated NW alone or in combination with other exercise. Improvements in cardiovascular capacity were reported in five studies (four out of five reported significant improvement after NW), while gains in shoulder range of motion were observed in three out of four studies assessing this outcome, mainly after standalone NW interventions. Positive changes in body posture were significantly reported after NW in all three studies investigating this parameter. Improvements in strength were reported in five studies, while gains in flexibility were observed in one study, within multimodal interventions combining NW with other exercise. Among seven studies evaluating lymphedema, sustained reductions were primarily reported after multiweek programs, especially when NW was combined with the ISA method. Several studies also reported improvements in pain, psychological alterations, and quality of life. Conclusions: NW appears to be an effective, holistic exercise modality for enhancing both physical and psychological aspects for breast cancer survivors.