Nordic walking in the process of rehabilitation in patients after breast cancer treatment

To participate in the study, patients were qualified by a physiotherapist under the supervision of a physician. Prior to the implementation of the experiment, all subjects were informed about its purpose, manner of conducting and the possibility of resignation at any time during the research project. The respondents gave written consent to participate in the research. In addition, there was an information meeting on the impact of Nordic walking on the function of the trunk flexors and extensors, and body posture in sagittal plane. The subjects were divided into two groups: group I: women subjected to Nordic walking. group II: patients subjected to the general exercise programme, which is the standard after a breast cancer treatment in Poland. Additionally, both groups divided into age subgroup: middle-aged (45-59 years old) and older (60-75 years old) breast cancer survivors. The 8-week Nordic walking and the standard general exercise trainings were conducted. The exercise programs consisted of 45-min sessions, performed two times per week over 8 weeks under the supervision of a Nordic walking instructor (in group I) or a physiotherapist (in group II).Exercise programmes were organised as individual training units that were similar. The initial (5-min) and final (5-min) parts of every unit were divided equally in terms of duration and types of exercises applied (stretching and breathing exercises). The main part of Nordic walking (40-min) aimed at learning and improving walking technique with the use of special poles. The main part of the standard general exercise (40-min) comprised free active exercising (performed independently by the patient, without the help of a physiotherapist or specialized equipment) of the upper and lower extremities (e.g squat, lunge), and activities strengthening the muscles of the back (e.g wall sits, back extensions) and abdomen (e.g partial crunches, knee to chest,), complemented by balance and coordination exercises (e.g single leg squat, balance walk). During 45–50% of each 45-min exercise session, the training intensity was kept below 70% of the participant’s maximum heart rate, calculated according to the formula: pulse 220 – age = maximum function. Polar pulsometers (RS 300 × G1 model) monitored the participant’s heart rate at least twice during each training unit and the exercise intensity was found to be within the desired limits. The intensity of training interventions in the both the groups was increased by gradually reducing the number of rest breaks. The number of rest breaks, including upper limb relaxation and respiratory exercises, was reduced every second week from five breaks (weeks 1–2) to two breaks (weeks 7–8). At the same time, the distance covered in the Nordic walking group was increased from 2400 m (weeks 1–2) to 3600 m (weeks 7–8). For the standard general exercise training group, the number of repetitions for each set of exercises was increased from 10 (weeks 1–2) to 16 repetitions (weeks 7–8).