{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T23:19:33Z","timestamp":1781133573027,"version":"3.54.1"},"reference-count":71,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007509","name":"Sociedad Espa\u00f1ola de Neumolog\u00eda y Cirug\u00eda Tor\u00e1cica","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007509","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Colexio Oficial de Fisioterapeutas de Galicia"},{"DOI":"10.13039\/501100014597","name":"Universidade da Coru\u00f1a","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014597","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Decathlon"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Patients with asthma often consider their symptomatology a barrier to exercise, leading to a reduced physical activity level. This study aims to determine whether the effect of a Nordic walking (NW) training program plus education and usual care is superior to educational and usual care only, in terms of exercise tolerance and other health-related outcomes in patients with asthma. The second aim is to explore the patients\u2019 experience with the NW program.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A randomized controlled trial will be conducted with 114 adults with asthma recruited in sanitary area of A Coru\u00f1a, Spain. Participants will be randomized to NW or control groups in blocks of six and in the same proportion in each group. Participants in the NW group will enrol in supervised sessions during eight weeks, three times\/week. All participants will receive three educational sessions on asthma self-management plus usual care (S1 Appendix). Outcomes such as exercise tolerance (primary outcome), physical activity level, asthma-related symptoms and asthma control, dyspnea, lung function, handgrip strength, health related quality of life, quality of sleep, treatment adherence and healthcare resources use will be measured pre and postintervention, and at three and six months of follow-up. Participants in the NW group will additionally participate in focus groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>This is the first study analysing the effect of NW in patients with asthma. NW combined with education and usual care is expected to improve exercise tolerance, but also asthma-related outcomes. If this hypothesis is confirmed, a new community-based therapeutic approach will be available for patients with asthma.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>Study registered in ClinicalTrials.gov with number of register <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT05482620\" xlink:type=\"simple\">NCT05482620<\/jats:ext-link>.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0281007","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T18:47:16Z","timestamp":1678387636000},"page":"e0281007","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effectiveness of nordic walking in patients with asthma: A study protocol of a randomized controlled trial"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3782-8878","authenticated-orcid":true,"given":"Mar\u00eda","family":"Vilanova-Pereira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"J\u00e1come","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel Jorge","family":"Rial Prado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Barral-Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Blanco Aparicio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Font\u00e1n Garc\u00eda-Boente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8458-6285","authenticated-orcid":true,"given":"Ana","family":"Lista-Paz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"pone.0281007.ref001","volume-title":"In: World Health Organization [Internet]","author":"World Health Organization"},{"key":"pone.0281007.ref002","volume-title":"In: Global Asthma Report [Internet].","author":"Global Asthma Network"},{"issue":"4","key":"pone.0281007.ref003","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1183\/09031936.96.09040636","article-title":"The costs of asthma","volume":"9","author":"PJ Barnes","year":"1996","journal-title":"Eur Respir J"},{"issue":"6","key":"pone.0281007.ref004","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1111\/cea.13153","article-title":"Working while unwell: Workplace impairment in people with severe asthma","volume":"48","author":"SA Hiles","year":"2018","journal-title":"Clin Exp Allergy"},{"issue":"1","key":"pone.0281007.ref005","first-page":"23","article-title":"Asthma. 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The History of Nordic Walking. [cited 2022 Apr 12]. In: International Nordic Walking Federation\u2014INWA [Internet] Helsinki: International Nordic Walking Federation. Available from: https:\/\/www.inwa-nordicwalking.com\/the-history-of-nordic-walking\/#:~:text=In%202000%20Aki%20Karihtala%20founded,and%20some%20started%20working%20independently."},{"key":"pone.0281007.ref021","unstructured":"World Ranking\u2014National and World Race Walking\u2014WR-NW. Nordic Walking [cited 2022 Apr 12]. In: WR-NW [Internet]. Available from: https:\/\/www.wr-nw.com\/nordic-walking.html"},{"issue":"5","key":"pone.0281007.ref022","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.ft.2016.03.003","article-title":"Evidencia cient\u00edfica de la marcha n\u00f3rdica en Fisioterapia: revisi\u00f3n bibliogr\u00e1fica","volume":"38","author":"ME V\u00edlchez Barrera","year":"2016","journal-title":"Fisioterapia"},{"key":"pone.0281007.ref023","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.parkreldis.2017.02.004","article-title":"Walking on four limbs: A systematic review of Nordic Walking in Parkinson disease.","volume":"38","author":"F Bombieri","year":"2017","journal-title":"Park Relat Disord"},{"issue":"11","key":"pone.0281007.ref024","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1016\/j.pmrj.2017.06.021","article-title":"Nordic Walking for the Management of People With Parkinson Disease: A Systematic Review","volume":"9","author":"L Cugusi","year":"2017","journal-title":"PM R."},{"issue":"18","key":"pone.0281007.ref025","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1177\/2047487317738592","article-title":"Nordic walking for individuals with cardiovascular disease: A systematic review and meta-analysis of randomized controlled trials","volume":"24","author":"L Cugusi","year":"2017","journal-title":"Eur J Prev Cardiol"},{"key":"pone.0281007.ref026","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1465-9921-11-112","article-title":"Nordic Walking improves daily physical activities in COPD: A randomised controlled trial","volume":"11","author":"MK Breyer","year":"2010","journal-title":"Respir Res"},{"issue":"12","key":"pone.0281007.ref027","first-page":"1895","article-title":"SPIRIT 2013 statement: Defining standard protocol items for clinical trials","volume":"45","author":"AW Chan","year":"2017","journal-title":"Japanese Pharmacol Ther"},{"issue":"4","key":"pone.0281007.ref028","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1159\/000315142","article-title":"Improvements in symptoms and quality of life following exercise training in older adults with moderate\/severe persistent asthma","volume":"81","author":"S Turner","year":"2011","journal-title":"Respiration"},{"key":"pone.0281007.ref029","author":"D Riebe","year":"2018"},{"issue":"6","key":"pone.0281007.ref030","first-page":"1857","article-title":"Time course of loss of adaptations after stopping prolonged intense endurance training","volume":"57","author":"EF Coyle","year":"1984","journal-title":"J Appl Physiol Respir Environ Exerc Physiol"},{"issue":"8","key":"pone.0281007.ref031","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1161\/CIR.0b013e31829b5b44","article-title":"Exercise standards for testing and training: A scientific statement from the American heart association","volume":"128","author":"GF Fletcher","year":"2013","journal-title":"Circulation"},{"issue":"6","key":"pone.0281007.ref032","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1183\/09031936.00150314","article-title":"An official European respiratory society\/American thoracic society technical standard: Field walking tests in chronic respiratory disease","volume":"44","author":"AE Holland","year":"2014","journal-title":"Eur Respir J"},{"issue":"3","key":"pone.0281007.ref033","doi-asserted-by":"crossref","first-page":"215","DOI":"10.5588\/ijtld.20.0928","article-title":"Minimal clinically important difference of the 6-min walking test in patients with asthma","volume":"24","author":"E Zampogna","year":"2021","journal-title":"Int J Tuberc Lung Dis"},{"key":"pone.0281007.ref034","article-title":"Feasibility study of a Nordic walking program in patients with asthma. En: Poster presented at: FTP22 Congreso Internacional de Fisioterapia [Internet].","author":"M Vilanova-Pereira","journal-title":"Barcelona, Spain"},{"issue":"8","key":"pone.0281007.ref035","doi-asserted-by":"crossref","DOI":"10.1164\/rccm.201309-1634ST","article-title":"An official American thoracic society\/European respiratory society statement: Key concepts and advances in pulmonary rehabilitation","volume":"188","author":"MA Spruit","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"issue":"5","key":"pone.0281007.ref036","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1097\/mss.0b013e31803349c6","article-title":"Longitudinal modeling of the relationship between age and maximal heart rate","volume":"39","author":"RL Gellish","year":"2007","journal-title":"Med Sci Sports Exerc"},{"issue":"Suppl. 65","key":"pone.0281007.ref037","first-page":"PA313","article-title":"Reliability, construct validity and determinants of 6-minute walk distance in patients with asthma","volume":"58","author":"R Meys","year":"2021","journal-title":"Eur Respir J"},{"issue":"12","key":"pone.0281007.ref038","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1016\/j.apmr.2015.07.017","article-title":"Simple Lower Limb Functional Tests in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review","volume":"96","author":"GW Bisca","year":"2015","journal-title":"Arch Phys Med Rehabil"},{"issue":"3","key":"pone.0281007.ref039","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1097\/HCR.0000000000000318","article-title":"Effect of Inspiratory Muscle Training in the Management of Patients With Asthma: A Randomized Controlled Trial","volume":"38","author":"N Duruturk","year":"2018","journal-title":"J Cardiopulm Rehabil Prev"},{"issue":"3","key":"pone.0281007.ref040","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/S0099-1767(00)90093-X","article-title":"Usefulness of the modified 0\u201310 Borg scale in assessing the degree of dyspnea in patients with COPD and asthma","volume":"26","author":"KR Kendrick","year":"2000","journal-title":"J Emerg Nurs."},{"issue":"1","key":"pone.0281007.ref041","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/HCR.0000000000000336","article-title":"1-Minute Sit-To-Stand Test: Systematic review of procedures, performance, and clinimetric properties","volume":"39","author":"RW Bohannon","year":"2019","journal-title":"J Cardiopulm Rehabil Prev"},{"issue":"1","key":"pone.0281007.ref042","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/02770903.2020.1838540","article-title":"Functional tests for adults with asthma: validity, reliability, minimal detectable change, and feasibility","volume":"59","author":"JM de Oliveira","year":"2020","journal-title":"J Asthma."},{"issue":"6","key":"pone.0281007.ref043","first-page":"1","article-title":"Validity of six activity monitors in chronic obstructive pulmonary disease: A comparison with indirect calorimetry","volume":"7","author":"H van Remoortel","year":"2012","journal-title":"PLoS On"},{"key":"pone.0281007.ref044","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.rmed.2016.03.016","article-title":"Decreased physical activity in adults with bronchial asthma","volume":"114","author":"AJ Van\u2019t Hul","year":"2016","journal-title":"Respir Med"},{"issue":"5","key":"pone.0281007.ref045","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1080\/17461390903426667","article-title":"International physical activity questionnaire: Reliability and validity in a Spanish population","volume":"10","author":"B Roman-Vi\u00f1as","year":"2010","journal-title":"Eur J Sport Sci"},{"key":"pone.0281007.ref046","article-title":"Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ)\u2014Short and Long Forms","author":"International Physical Activity Questionnaire Group","year":"2005"},{"issue":"8","key":"pone.0281007.ref047","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1111\/j.1398-9995.2009.02310.x","article-title":"Validation of a questionnaire (CARAT10) to assess rhinitis and asthma in patients with asthma.","volume":"65","author":"JA Fonseca","year":"2010","journal-title":"Allergy Eur J Allergy Clin Immunol"},{"issue":"1","key":"pone.0281007.ref048","doi-asserted-by":"crossref","first-page":"112","DOI":"10.4104\/pcrj.2013.00012","article-title":"Control of Allergic Rhinitis and Asthma Test (CARAT): Dissemination and applications in primary care","volume":"22","author":"P Azevedo","year":"2013","journal-title":"Prim Care Respir J"},{"key":"pone.0281007.ref049","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1164\/ajrccm.158.4.9802091","article-title":"Analysis of Clinical Methods Used to Evaluate Dyspnea","volume":"158","author":"T Hajiro","year":"1998","journal-title":"Am J Respir Crit Care Med"},{"issue":"8","key":"pone.0281007.ref050","doi-asserted-by":"crossref","first-page":"E70","DOI":"10.1164\/rccm.201908-1590ST","article-title":"Standardization of Spirometry 2019 Update. 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Calidad de sue\u00f1o en pacientes ansiosos y depresivos.","author":"A Royuela Rico","year":"1997","journal-title":"Psiquiatr\u00eda Biol\u00f3gica"},{"issue":"7","key":"pone.0281007.ref058","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.arbres.2016.08.006","article-title":"El test de adhesi\u00f3n a los inhaladores.","volume":"53","author":"V Plaza","year":"2017","journal-title":"Arch Bronconeumol"},{"key":"pone.0281007.ref059","first-page":"134","article-title":"Medici\u00f3n de las presiones respiratorias m\u00e1ximas [cited 2022 Apr 12]. In: Comit\u00e9 cient\u00edfico SEPAR Manual SEPAR de procedimientos: procedimientos de evaluaci\u00f3n de la funci\u00f3n pulmonar II [Internet].","author":"N. Calaf","year":"2004","journal-title":"Barcelona"},{"key":"pone.0281007.ref060","doi-asserted-by":"crossref","DOI":"10.4135\/9781412991841","volume-title":"Focus groups: theory and practice","author":"D Stewart","year":"2007"},{"issue":"2","key":"pone.0281007.ref061","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"V Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"pone.0281007.ref062","doi-asserted-by":"crossref","DOI":"10.1016\/0147-1767(85)90062-8","volume-title":"Naturalistic inquiry.","author":"YS Lincoln","year":"1985"},{"key":"pone.0281007.ref063","article-title":"Interrater reliability: the kappa statistic","author":"ML McHugh","year":"2012","journal-title":"Biochem Med."},{"issue":"11","key":"pone.0281007.ref064","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1016\/j.cjca.2013.03.008","article-title":"Randomized trial of nordic walking in patients with moderate to severe heart failure","volume":"29","author":"ML Keast","year":"2013","journal-title":"Can J Cardiol"},{"issue":"12","key":"pone.0281007.ref065","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1080\/02770903.2019.1646271","article-title":"Effectiveness of pulmonary rehabilitation in severe asthma: a retrospective data analysis","volume":"57","author":"E Zampogna","year":"2020","journal-title":"J Asthma"},{"issue":"8","key":"pone.0281007.ref066","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1136\/thoraxjnl-2014-206070","article-title":"Aerobic training decreases bronchial hyperresponsiveness and systemic inflammation in patients with moderate or severe asthma: A randomised controlled trial","volume":"70","author":"A Fran\u00e7a-Pinto","year":"2015","journal-title":"Thorax"},{"issue":"4","key":"pone.0281007.ref067","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.00063-2018","article-title":"Long-term efficacy and effectiveness of a behavioural and community-based exercise intervention (Urban Training) to increase physical activity in patients with COPD: A randomised controlled trial","volume":"52","author":"A Arbillaga-Etxarri","year":"2018","journal-title":"Eur Respir J"},{"issue":"10","key":"pone.0281007.ref068","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1007\/s00484-021-02128-7","article-title":"A systematic review of the effects of temperature and precipitation on pollen concentrations and season timing, and implications for human health","volume":"65","author":"PJ Schramm","year":"2021","journal-title":"Int J Biometeorol"},{"issue":"3","key":"pone.0281007.ref069","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0301-0546(04)79297-6","article-title":"P\u00f3lenes alerg\u00e9nicos en Espa\u00f1a","volume":"32","author":"J. 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