An experimental study in adults with moderate to severe depression found that a 10-week moderate-intensity supervised Nordic walking program significantly reduced symptoms of depression within the first 5 weeks compared to an inactive control group. Participants in the experimental group received two Nordic walking sessions per week. The paper was published in. Affective Disorders Journal.
Supervised Nordic walking is a structured form of walking in which participants exercise using specially designed poles and under the guidance of a trained instructor or medical professional. Pole moves your arms, shoulders, and upper body, so it typically requires more muscle groups than regular walking. Supervision will help participants learn the correct technique, choose an appropriate walking pace, and gradually increase intensity.
In a clinical setting, programs may be adapted to a person’s age, physical fitness, symptoms, and medical conditions. Nordic walking can be used as a type of aerobic exercise in rehabilitation programs for the elderly and people with cardiovascular disease. It also helps improve walking ability, balance, muscle strength, and general fitness.
Research suggests potential benefits for people with type 2 diabetes, chronic respiratory disease, Parkinson’s disease, and chronic pain, but the quality and strength of evidence varies by condition. It is sometimes incorporated into cardiac rehabilitation after treatment for coronary artery disease, and may be a practical alternative for those who prefer outdoor exercise to gym training.
Study author Clement Ginoux and his colleagues looked at how quickly 10 weeks of Nordic walking, which is considered a type of aerobic exercise, reduced symptoms of depression. They hypothesized that improvement in symptom severity would be greatest during the first 5 weeks of training.
Study participants were 64 adults with moderate to severe depression recruited through ‘Je Bouge Pour Mon Moral’ (JBPMM). This is a French non-profit organization dedicated to supporting people with depression through regular physical activity. Medical professionals involved in the JBPMM spoke to, emailed, and texted patients whose electronic files listed them as depressed, inviting them to participate in the study. Ninety-one percent (58 of 64) of participants were female. 84% were employed and the average age was approximately 50 years.
Study participants were randomly divided into two groups in a 3:1 ratio, a design choice intended to encourage enrollment. The first group consisted of 48 participants who underwent a structured Nordic walking session under the supervision of a well-trained instructor. Of these participants, 20 had severe depressive symptoms at the start of the study and 28 had moderate symptoms. Training sessions occurred twice weekly and were performed at 65–75% of participants’ maximum heart rate. Each session lasted 1 hour and had 4 to 10 participants.
The remaining 16 participants served as the control group. They received regular newsletters about depression and depression prevention, but received no exercise training intervention and did not modify their physical activity behaviors during the study. Eight of these participants had severe depression and eight had moderate depression.
Participants completed a depression assessment (Beck Depression Inventory-II) the day before the intervention, at week 5, and at the end of the intervention (week 10). Although four participants in the Nordic walking group failed to complete at least half of the training sessions, the researchers used a therapeutic statistical approach. This means that all 64 randomized participants will be included in the final data analysis.
Results showed that the Nordic walking group had significantly reduced symptoms of depression by the middle of the intervention (i.e., after 5 weeks of training). This symptom reduction was classified as greater compared to both the participants’ symptom severity at the start of the study and the control group. By week 5, about half of the Nordic walking group achieved a clinical response (more than 50% reduction in symptoms), compared with 0% of the control group. Furthermore, initial symptom reduction was significantly greater for participants who initially suffered from severe depressive symptoms than for those who initially had moderate symptoms.
Symptom reduction continued during the second half of the intervention, but to a much smaller extent. The study authors reported that there was a small to moderate non-significant reduction in symptom levels for participants in the Nordic walking group at the end of the intervention compared to symptom levels after 5 weeks. By the end of the study, remission and clinical response rates were significantly higher in the Nordic walking group compared to the control group.
“The current trial provides promising evidence that supervised Nordic walking can reduce symptoms of depression within 5 weeks, especially in patients with severe baseline depression. Addressing the patient-first goal of early recovery, these findings suggest that physical activity is a compelling, cost-effective, and accessible addition to the treatment arsenal for depression,” the study authors concluded.
This study contributes to scientific knowledge regarding the potential of physical exercise to reduce symptoms of depression. However, it should be noted that this was an open-label study. That is, the study participants knew what the goal of the study was and which group they belonged to, but all data were collected using self-report. This leaves open the possibility that expectancy effects, demand characteristics, and the Hawthorne effect influenced participants’ responses (because they likely expected improvement, knew what the goal of the study was, and knew they were being observed).
Furthermore, due to France’s strict privacy laws, the researchers were not allowed to collect information on the participants’ ongoing use of antidepressants or psychotherapy, leaving the possibility that concurrent treatments may have influenced the results.
The paper, “Early antidepressant effects of supervised Nordic walking in adults with moderate to severe depression: a randomized controlled trial,” was authored by Clément Ginoux, Brendon Stubbs, Matthew P. Herring, Mohammad Farris Iman Leong Bin Abdullah, and Fabien D. Legrand.
