The low-impact exercise improved swelling, physical fitness, disability and quality of life, the study authors conclude in the European Journal of Cancer Care.
“The main strategy in rehabilitation for women with breast cancer is a change of habits, where physical exercise is a fundamental tool,” said study co-author Jorge Torres of the Faculty of Educational Sciences and Sports at the University of Vigo in Pontevedra, Spain.
“It’s not easy to turn a sedentary person into an amateur athlete, so sports such as Nordic walking are accepted more easily,” said Torres, particularly since the activity doesn’t require expensive equipment, can be done in a group with others, and is easy to learn.
Introduced in the 1980’s as a summer training exercise that was similar to cross-country, or Nordic, skiing, Nordic walking became more widespread in the 2000s. It’s now part of some exercise-based rehabilitation programs, especially in Northern Europe where it is more common, Torres noted.
He also owns a personal training company, Vigo Entrena, that creates physical activity programs for people with specific needs, including injuries, obesity, pregnancy, postpartum and women with breast cancer, and he specialises in Nordic walking training.
To see if this form of exercise helps women treated for breast cancer to reduce side effects like arm swelling, and offers other benefits of exercise, Torres and his colleagues analysed nine studies. Four studies were randomised controlled trials comparing Nordic walking to other activities; the other studies focused on specific effects of Nordic walking.
Periods of exercise in the studies ranged from 30 to 80 minutes and were performed on one to five days a week for up to 12 weeks.
In eight of the nine studies, Nordic walking had a positive effect on a number of breast cancer symptoms, including lymphedema, fitness, upper-body strength, disability and perceptions of pain and swelling.
A handful of studies also showed improvements in depression, self-efficacy for managing pain and improvements in physical activity levels. They didn’t find any adverse effects, and the study participants seemed to stick with the programs.
The biomechanical gesture of Nordic walking, compared to just walking, seemed to counteract some of the side effects that can come from cancer treatment, such as shoulder-arm mobility and postural problems, the study team writes.
“Many health professionals and therapists do not realize that there are contraindicated exercises during breast cancer rehabilitation and that alternatives such as Nordic walking can be very effective,” Torres said.
“Nordic walking is a structured form of physical activity which nowadays has been shown to be ‘more complete’ than basic walking,” said Marco Bergamin of the University of Padova in Italy, who wasn’t involved in the research review.
“Another important point that is less stressed by these authors: quality of life,” Bergamin said. “Nordic walking gives huge benefits because breast cancer patients are survivors, and from a socio-psychological point of view, that really impacts their life.”
Future studies should also investigate the intensity, frequency, duration, and length of exercise needed to help breast cancer patients, said Lucia Cugusi of the University of Cagliari in Italy, who also wasn’t involved in the review.
“What is most evident is the growing interest of the scientific community in tracking the needs, interests and preferences of patients,” Cugusi said. “Offering them novel forms of physical activity that are both effective and engaging has become one of the new and stimulating research fields in cancer therapy and management.”