High-Intensity Interval Nordic Walking for Coronary Artery Disease

(HIIT-NoW Trial)

Overseen By Matheus Mistura, MSc

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Ottawa Heart Institute Research Corporation

Disqualifiers: Unstable angina, Atrial fibrillation, COPD, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 11 weeks

40 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method to help individuals with coronary artery disease feel better after heart procedures like bypass surgery or stent placement. It tests whether a workout combining high-intensity exercises with Nordic walking (using specially designed poles) can improve physical and mental health. Participants will either engage in this new workout, known as high-intensity interval Nordic walking, or follow standard heart rehab exercises. Ideal candidates have coronary artery disease, have undergone heart procedures, and are willing to participate in exercise sessions. As an unphased trial, this study provides a unique opportunity to explore innovative exercise methods that could enhance recovery and overall well-being.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that high-intensity interval Nordic walking (HIIT-NoW) is safe for individuals with coronary artery disease. Studies have found that exercise programs like HIIT-NoW are manageable and can enhance both physical and mental health. Importantly, this type of exercise carries a low risk of serious heart problems. Thus, it provides an effective workout while prioritizing heart safety. ^{1 2 3 4 5}

Why are researchers excited about this trial?

High-intensity interval Nordic walking is unique because it combines the benefits of aerobic exercise with the added resistance of walking poles, which helps engage more muscle groups. Unlike standard cardiovascular rehabilitation programs that often include moderate exercise routines, this method introduces short bursts of intense activity, potentially offering more significant improvements in cardiovascular fitness. Researchers are excited about this approach because it could enhance heart health and physical endurance more effectively than traditional rehab exercises, providing an innovative way to help those with coronary artery disease.

What evidence suggests that high-intensity interval Nordic walking is effective for coronary artery disease?

Research has shown that high-intensity interval Nordic walking (HIIT-NoW), a treatment in this trial, can greatly benefit people with coronary artery disease (CAD). Studies have found that 12 weeks of this exercise can improve heart and lung health and enhance quality of life. This walking style uses poles, engaging both the upper and lower body, and has been shown to safely boost physical and mental well-being. It also helps burn more calories while being gentle on the knees. Participants in this trial will either engage in HIIT-NoW or undergo standard cardiovascular rehabilitation, both of which have been shown to improve physical and mental health in people with CAD. ^{1 2 3 4 6}

Who Is on the Research Team?

Jennifer L Reed, PhD

Principal Investigator

Ottawa Heart Institute Research Corporation

Are You a Good Fit for This Trial?

This trial is for patients at least 40 years old with coronary artery disease who have had a stent inserted or heart bypass surgery. They must be willing to attend exercise sessions on-site, able to perform an exercise test measuring heart and lung function, and not currently in cardiac rehab.

Inclusion Criteria

You can do a special breathing and exercise test.

I am willing to attend exercise sessions in person.

I have had heart artery treatment with stenting or bypass surgery.

Exclusion Criteria

Unable to return for 10-week follow-up visit

I have heart or severe lung conditions like unstable angina or COPD.

You are currently taking part in a clinical research program.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo high-intensity interval Nordic walking training or standard cardiovascular rehabilitation

11 weeks

Weekly sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• High-intensity interval Nordic walking
• Standard cardiovascular rehabilitation

Trial Overview The study is testing if high-intensity interval Nordic walking can improve physical and mental health better than standard cardiovascular rehabilitation. It's a new way of exercising that works the whole body by using special poles while walking.

How Is the Trial Designed?

Group I: High-intensity interval Nordic walking Experimental Treatment 1 Intervention

Participants will receive high-intensity interval Nordic walking training.

Group II: Control Active Control 1 Intervention

Participants will undergo standard cardiovascular rehabilitation.

Who Is Running the Clinical Trial?

Ottawa Heart Institute Research Corporation

Lead Sponsor

Trials

200

Recruited

95,800+

Published Research Related to This Trial

The study found that the Polar H7, an ECG-based heart rate monitor, showed excellent accuracy in measuring heart rate during both Nordic and conventional walking, with a high concordance correlation coefficient of 0.96 compared to the reference ECG.

In contrast, the Fitbit Charge 2, which uses photoplethysmography, was less accurate during Nordic walking, showing a significantly higher mean absolute difference in heart rate measurements compared to the Polar H7, indicating that ECG-based devices are preferable for monitoring heart rate in this exercise method.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Accuracy of Wearable Devices for Measuring Heart Rate During Conventional and Nordic Walking. Baek, S., Ha, Y., Park, HW.[2021]

Nordic walking (NW) in patients rehabilitated after coronary events demonstrated an exercise intensity of 59% of their VO₂ reserve, indicating it is a safe and effective form of endurance training in cardiac rehabilitation.

The peak heart rate during NW reached similar levels to those observed during treadmill cardiopulmonary exercise tests, suggesting that NW can provide comparable cardiovascular benefits as traditional exercise testing.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Oxygen uptake during Nordic walking training in patients rehabilitated after coronary events. Rybicki, JR., Leszczyńska-Bolewska, BM., Grochulska, WE., et al.[2017]

High-intensity interval training (HIIT) is as effective, if not more so, than traditional moderate-intensity continuous training (MICT) for patients with cardiovascular disease, based on a systematic review of 23 studies involving 1117 participants.

The safety profile of HIIT in cardiac rehabilitation is promising, with only one major cardiovascular adverse event reported per 17,083 training sessions, indicating that HIIT can be safely implemented in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training for Patients With Cardiovascular Disease-Is It Safe? A Systematic Review. Wewege, MA., Ahn, D., Yu, J., et al.[2021]

In a study of 74 women over 55 years old, both Nordic Walking and conventional walking improved aerobic capacity and reduced total cholesterol levels after 12 weeks of training.

While Nordic Walking specifically led to significant improvements in low-density lipoprotein cholesterol, there were no significant differences in outcomes between the two walking methods, indicating both are beneficial for health in older women.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effects of Nordic Walking Compared to Conventional Walking on Aerobic Capacity and Lipid Profile in Women Over 55 Years of Age. Witkowska, A., Grabara, M., Kopeć, D., et al.[2022]

A 12-week exercise program of high-intensity interval training (HIIT), moderate-to-vigorous intensity continuous training (MICT), or Nordic walking (NW) led to significant improvements in functional capacity, quality of life, and depression symptoms in patients with coronary artery disease, with effects sustained up to 26 weeks after the program.

Nordic walking was particularly effective, resulting in a greater increase in functional capacity (measured by the 6-minute walk test) compared to HIIT and MICT, suggesting it may be a superior option for enhancing physical performance in these patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sustained Effects of Different Exercise Modalities on Physical and Mental Health in Patients With Coronary Artery Disease: A Randomized Clinical Trial. Terada, T., Cotie, LM., Tulloch, H., et al.[2022]

A one-year Nordic walking program for patients with uncontrolled cardiovascular risk factors led to a significant reduction in these risk factors, from an average of 4.78 to 3.

Participants also showed improvements in quality of life and better adherence to medical treatment, indicating that Nordic walking can be an effective intervention in managing cardiovascular health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nordic walking for cardiovascular prevention in patients with ischaemic heart disease or metabolic syndrome. Vehí, C., Falces, C., Sarlat, MÀ., et al.[2017]

In a study of 40 patients aged 56-70 with chronic coronary syndrome after PCI, adding Nordic Walking (NW) to standard cardiac rehabilitation significantly improved physical activity levels and aerobic efficiency compared to the control group.

Patients who participated in NW training reported better quality of life and showed positive changes in biochemical risk factors for atherosclerosis, indicating that NW is a beneficial addition to cardiac rehabilitation for enhancing recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effects of Cardiac Rehabilitation including Nordic Walking in Patients with Chronic Coronary Syndromes after Percutaneous Coronary Interventions in Elective Mode. Januszek, R., Kocik, B., Siłka, W., et al.[2023]

Citations

1. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0033062021000700

The effects of high-intensity interval training, Nordic ... The purpose of this randomized controlled trial (RCT) was to compare the effects of 12 weeks of HIIT, NW and MICT on functional capacity in CAD patients.

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/34245777/

The effects of high-intensity interval training, Nordic ... All exercise programmes (HIIT, NW, MICT) were well attended, safe and beneficial in improving physical and mental health for CAD patients.

3. clinicaltrials.gov clinicaltrials.gov/study/NCT05434117

Feasibility of High-Intensity Interval Nordic Walking in ... This study will test if HIIT-NoW can be an alternative exercise option to improve physical and mental health in patients with coronary artery disease. Detailed ...

4. nature.com nature.com/articles/s41598-022-21655-w

Feasibility and impact of whole-body high-intensity interval ... Twelve weeks of low-volume whole-body HIIT increased cardiorespiratory capacity and improved quality of life in patients with stable CAD compared to standard ...

5. bmcsportsscimedrehabil.biomedcentral.com bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-025-01176-5

The effectiveness of a high-intensity interval exercise on ... High-Intensity Interval and Resistance Training Improve Health Outcomes in Older Adults With Coronary Disease. J Am Med Dir Assoc. 2022;23 ...

6. withpower.com withpower.com/trial/phase-coronary-disease-6-2022-d397f

High-Intensity Interval Nordic Walking for Coronary Artery ... High-Intensity Interval Training (HIIT), which includes High-Intensity Interval Nordic Walking, has shown a low rate of major adverse cardiovascular events in ...