Feasibility of High-Intensity Interval Nordic Walking in Patients With Coronary Artery Disease

NCT05434117 | Active Not Recruiting

• 1 other identifier: 20220260
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Coronary revascularization, such as heart bypass surgery (CABG) and percutaneous coronary intervention (PCI \[inserting a stent to open up blood vessels\]) improve survival for people with coronary artery disease. Yet, many patients suffer from poor physical and mental health after coronary revascularization. Traditional cardiac rehabilitation involving moderate-to-vigorous intensity continuous training (MICT) improves physical and mental health. However, alternative exercise programs, such as high-intensity interval training (HIIT) and Nordic walking may provide superior benefits. Nordic walking is like Nordic skiing but uses specifically designed poles for walking. Nordic walking involved core, upper and lower body muscles, resulting in greater energy expenditure while reducing loading stress at the knee. To date, HIIT used in cardiac rehabilitation settings has focused on lower body (e.g., leg cycling). The investigators are not aware of HIIT protocols that target both upper and lower body at the same time. An exercise program that combines HIIT and Nordic walking (HIIT-NoW) may offer an alternative time-efficient whole-body exercise to improve physical and mental health. 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.

Conditions

Coronary Artery Disease

Keywords

High-intensity interval training; Nordic walking

Outcome Measures

Primary Outcomes (6)

• Recruitment

  Recruitment will be assessed for feasibility. Recruitment will be assessed by the proportion of patients remained interested and randomized after being informed of the requirements of the study

  Baseline to week 11 follow up

• Adherence

  Adherence will be assessed for feasibility. Adherence will be assessed by the attendance to the prescribed exercise sessions

  Baseline to week 11 follow up

• Compliance

  Compliance will be assessed for feasibility. Compliance will be assessed by the proportion of participants adhering to prescribed exercise intensity. All HIIT-NoW sessions will be monitored by study personnel and compliance to prescribed exercise intensity will be assessed for each exercise session.

  Baseline to week 11 follow up

• Adverse events

  Safety will be assessed for feasibility. All mild, moderate, and severe symptoms and adverse events throughout this study will be recorded.

  Baseline to week 11 follow up

• Subjective exercise experiences

  Subjective exercise experiences will be assessed for feasibility. Physical activity enjoyment will be collected using the PACES.

  Baseline to week 11 follow up

• Self-efficacy

  Self-efficacy will be assessed for feasibility. Exercise self-efficacy will be assessed using the MSES-R.

  Baseline to week 11 follow up

Secondary Outcomes (12)

• Cardiorespiratory fitness

  Baseline to week 11 follow up

• Functional capacity

  Baseline to week 11 follow up

• Fat mass

  Baseline to week 11 follow up

• Quality of life (QoL)

  Baseline to week 11 follow up

• Heart Disease specific Quality of life (HeartQoL)

  Baseline to week 11 follow up

Study Arms (2)

High-intensity interval Nordic walking

EXPERIMENTAL

Participants will receive high-intensity interval Nordic walking training.

Behavioral: High-intensity interval Nordic walking

Control

ACTIVE COMPARATOR

Participants will undergo standard cardiovascular rehabilitation.

Behavioral: Standard cardiovascular rehabilitation

Interventions

Standard cardiovascular rehabilitation BEHAVIORAL

Individuals assigned to standard CR will attend onsite exercise-based CR comprised of one onsite exercise session per week for 8-10 weeks. The onsite CR offers exercise sessions tailored to the fitness of patients and strengthening exercise.

Control

High-intensity interval Nordic walking BEHAVIORAL

Participants will complete supervised exercise sessions twice weekly for 10 weeks. Exercise specialists will educate participants in proper use of walking poles and basic Nordic walking techniques and supervise the exercise training sessions. HIIT-NoW will be 45 min in duration using Nordic poles and consists of (i) a 10-min warm-up at 30-59% heart rate reserve (HRR, light-to-moderate intensity); (ii) 4 × 4 min of high-intensity work periods at 60-89% HRR (vigorous intensity) interspersed with 3 min of low-intensity work periods at 30-59% HRR (light-to-moderate intensity); and, (iii) a 10-min cooldown at 30-39% HRR (light intensity). To allow participants to acclimatize to the HIIT-NoW protocol, the training intensity will target 60-69% HRR for the first week, 70-79% HRR in the second week, and 80-89% HRR from the third week onward. If participants do not tolerate 89% HRR well, they will exercise as close to 89% HRR as possible.

High-intensity interval Nordic walking

Eligibility Criteria

• Age: 40 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• patients with coronary artery disease treated with PCI or CABG;
• willing to come onsite for exercise sessions;
• able to perform a cardiopulmonary exercise testing (CPET); and,
• at least 40 years of age.

You may not qualify if:

• currently participating in a CR program;
• unstable angina or established diagnosis of atrial fibrillation, chronic obstructive pulmonary disease, severe mitral or aortic stenosis, or hypertrophic obstructive cardiomyopathy; or,
• unable to return for 10-week follow-up visit.

Sponsors & Collaborators

• Ottawa Heart Institute Research Corporation: lead

Study Sites (1)

University of Ottawa Heart Institute

Ottawa, Ontario, K1Y4W7, Canada

Location

MeSH Terms

Conditions

Coronary Artery Disease

Condition Hierarchy (Ancestors)

Coronary Disease; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

Study Officials

• Jennifer L Reed, PhD

  Ottawa Heart Institute Research Corporation

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Outcome variables will be assessed by study personnel who are blinded to patient allocation.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Parallel-group pilot RCT

Study Record Dates

• First Submitted: June 14, 2022
• First Posted: June 27, 2022
• Study Start: December 9, 2022
• Primary Completion: April 1, 2026
• Study Completion: April 1, 2026
• Last Updated: March 11, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)