Practicing moderate-intensity Nordic walking reduces depression symptoms, study suggests

An experimental study involving adults with moderate to severe depression found that a 10-week supervised Nordic walking program of moderate intensity produced substantial reductions in depressive symptoms within the first 5 weeks compared to a non-active control group. Experimental group participants had two Nordic walking sessions per week. The paper was published in the Journal of Affective Disorders.

Supervised Nordic walking is a structured form of walking in which participants use specially designed poles and exercise under the guidance of a trained instructor or healthcare professional. The poles engage the arms, shoulders, and upper body, so the activity usually involves more muscle groups than ordinary walking. Supervision helps participants learn the correct technique, select an appropriate walking pace, and increase the intensity gradually.

In clinical settings, the program may be adapted to a person’s age, physical fitness, symptoms, and medical condition. Nordic walking can be used as a form of aerobic exercise in rehabilitation programs for older adults and people with cardiovascular disease. It may also help improve walking capacity, balance, muscular strength, and general physical fitness.

Studies suggest potential benefits for people with type 2 diabetes, chronic respiratory disease, Parkinson’s disease, and chronic pain, although the quality and strength of the evidence vary across conditions. It is sometimes included in cardiac rehabilitation after treatment for coronary disease and may be a practical alternative for people who prefer outdoor exercise to gym-based training.

Study author Clément Ginoux and his colleagues examined the speed with which depressive symptoms may decrease over a 10-week long Nordic walking practice, which they consider a type of aerobic exercise. They hypothesized that the improvement in symptom severity would be highest in the first five weeks of training.

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Study participants were 64 adults with moderate to severe depression recruited via “Je Bouge Pour Mon Moral” (JBPMM). This is a French not-for-profit organization dedicated to supporting individuals with depression through regular physical activity. Health care professionals involved in JBPMM spoke to, emailed, or texted patients listed as depressed on their electronic files, and invited them to join the study. Ninety-one percent of the participants were women (58 out of the 64). Eighty-four percent were employed, and their average age was around 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 received structured sessions of Nordic walking supervised by a fully trained instructor. Of these participants, 20 had severe depressive symptoms at the start of the study, and 28 had moderate symptoms. Training sessions occurred two times per week and were performed at 65-75% of participants’ maximal heart rate. Each session lasted 1 hour and included between 4 and 10 participants.

The remaining 16 participants served as the control group. They periodically received newsletters on depression and depression prevention, but did not receive any 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.

A day before the intervention, at five weeks, and at the end of the intervention (10 weeks), participants completed an assessment of depression (the Beck Depression Inventory-II). While four participants in the Nordic walking group failed to complete at least half of the training sessions, the researchers used an intent-to-treat statistical approach, meaning all 64 randomized participants were included in the final data analysis.

Results showed that the Nordic walking group experienced a marked reduction in depression symptoms by the middle of the intervention (i.e., after 5 weeks of training). This reduction in symptoms was classified as large compared to both the participants’ symptom severity at the start of the study and to the control group. By week 5, about half of the Nordic walking group had achieved a clinical response (a 50% or greater reduction in symptoms), compared to 0% in the control group. Furthermore, the early reduction in symptoms was significantly larger in participants who initially suffered from severe depressive symptoms than in those who initially had moderate symptoms.

Reduction in symptoms continued in the second half of the intervention, but it was much smaller. The study authors report that compared to symptom levels at 5 weeks, Nordic walking group participants’ symptom levels at the end of the intervention saw a small-to-moderate, non-significant decrease. 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 present trial provides promising evidence that supervised Nordic walking can reduce depressive symptoms within five weeks, particularly in individuals with severe baseline depression. By addressing the patient-prioritized goal of fast recovery, these findings posit physical activity as a compelling, cost-effective, and accessible addition to the therapeutic arsenal for depression,” the study authors concluded.

The study contributes to the scientific knowledge about the potential of physical exercise in reducing depression symptoms. However, it should be noted that this was an open-label study, meaning that study participants knew what the goal of the study was and which group they were in, while all the data were collected using self-reports. This leaves open the possibility that expectancy effects, demand characteristics, and the Hawthorne effect might have affected participants’ responses (as participants likely expected improvement, knew what the goal of the study was, and knew they were being observed).

Additionally, due to stringent French privacy laws, the researchers were not permitted to collect information regarding participants’ ongoing use of antidepressant medications or psychotherapy, leaving open the possibility that concurrent treatments 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.