{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:06:20Z","timestamp":1791241580283,"version":"4.1.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008092","name":"Jinhua Science and Technology Bureau","doi-asserted-by":"publisher","award":["2021-4-228"],"award-info":[{"award-number":["2021-4-228"]}],"id":[{"id":"10.13039\/501100008092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec022\">\n<jats:title>Background<\/jats:title>\n<jats:p>Evaluating the effectiveness of Nordic walking in influencing walking ability in patients with peripheral arterial disease.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec023\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We searched 12 databases, including PubMed, Embase, Cochrane library, Web of Science, EBSCO host, Ovid, Scopus, ClinicalTrial.gov, and several top ranked Chinese databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data, CBMdisc, VIP Database, ChiCTR. The search has no starting time limit and the deadline is April 9, 2024. Randomized controlled trials and pseudo-random controlled trials were included. The two authors independently screened the literature and evaluated the quality of the study using the Cochrane risk of bias tool. Meta analysis was conducted using Review Manager 5.4 and Stata 17.0 software.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec024\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 8 studies involving 508 patients were included. Meta-analysis results showed that compared with supervised exercise therapy (SET), supervised NW was not associated with an increase in maximum walking distance (MWD) and claudication distance (CD) in PAD patients, whether during treadmill tests or 6-minute walk tests (6-MWT), and the results were not statistically significant. In terms of increasing exercise duration, SET was significantly higher than supervised NW and the results were statistically significant (SMD =\u2009 -0.41, 95% Cl: -0.72 to -0.09, Z =\u2009 2.54, P =\u2009 0.01 &lt;\u2009 0.05). Among the 8 studies included, 2 studies had control groups that were not part of the supervised exercise program and were different, therefore no meta-analysis was conducted.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec025\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In PAD patients, supervised NW is no significant difference in walking ability compared to SET. NW presents a viable option when SET is not available.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec026\">\n<jats:title>PROSPERO registration<\/jats:title>\n<jats:p><jats:bold>PROSPERO registration number:<\/jats:bold> CRD42024535828<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0316092","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T17:29:48Z","timestamp":1741627788000},"page":"e0316092","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of Nordic walking on walking ability in patients with peripheral arterial disease: a meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"given":"Zerong","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqun","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7535-7660","authenticated-orcid":true,"given":"Yongdong","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"issue":"15","key":"pone.0316092.ref001","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1093\/eurheartj\/ehad734","article-title":"Exercise therapy for chronic symptomatic peripheral artery disease","volume":"45","author":"L Mazzolai","year":"2024","journal-title":"Eur Heart J"},{"issue":"4","key":"pone.0316092.ref002","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.amepre.2006.12.010","article-title":"Ethnic-specific prevalence of peripheral arterial disease in the United States","volume":"32","author":"MA Allison","year":"2007","journal-title":"Am J Prev Med"},{"issue":"25","key":"pone.0316092.ref003","doi-asserted-by":"crossref","first-page":"2826","DOI":"10.1161\/CIRCULATIONAHA.108.191171","article-title":"Atherosclerotic peripheral vascular disease symposium II: nomenclature for vascular diseases","volume":"118","author":"WR Hiatt","year":"2008","journal-title":"Circulation"},{"issue":"3","key":"pone.0316092.ref004","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1161\/CIR.0000000000001153","article-title":"Health disparities in peripheral artery disease: a scientific statement from the American Heart Association","volume":"148","author":"MA Allison","year":"2023","journal-title":"Circulation"},{"issue":"2","key":"pone.0316092.ref005","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.jacbts.2020.08.012","article-title":"Exercise training and revascularization in the management of symptomatic peripheral artery disease","volume":"6","author":"MP Biswas","year":"2021","journal-title":"JACC Basic Transl Sci"},{"issue":"3","key":"pone.0316092.ref006","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.ejvs.2017.07.018","article-title":"Editor\u2019s choice - 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS)","volume":"55","author":"V Aboyans","year":"2018","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"12","key":"pone.0316092.ref007","first-page":"e686","article-title":"2016 AHA\/ACC guideline on the management of patients with lower extremity peripheral artery disease: executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"135","author":"MD Gerhard-Herman","year":"2017","journal-title":"Circulation"},{"issue":"14","key":"pone.0316092.ref008","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1001\/jama.2022.2457","article-title":"Home-based walking exercise for peripheral artery disease","volume":"327","author":"MM McDermott","year":"2022","journal-title":"JAMA"},{"issue":"9","key":"pone.0316092.ref009","doi-asserted-by":"crossref","first-page":"e2334590","DOI":"10.1001\/jamanetworkopen.2023.34590","article-title":"Home-based walking exercise and supervised treadmill exercise in patients with peripheral artery disease: an individual participant data meta-analysis","volume":"6","author":"ND Thangada","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"4","key":"pone.0316092.ref010","first-page":"CD005263","article-title":"Supervised exercise therapy versus home-based exercise therapy versus walking advice for intermittent claudication","volume":"4","author":"D Hageman","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"issue":"8","key":"pone.0316092.ref011","first-page":"CD009638","article-title":"Modes of exercise training for intermittent claudication","volume":"8","author":"SC Jansen","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"pone.0316092.ref012","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.rehab.2016.12.004","article-title":"Nordic walking versus walking without poles for rehabilitation with cardiovascular disease: randomized controlled trial","volume":"60","author":"S Girold","year":"2017","journal-title":"Ann Phys Rehabil Med"},{"issue":"5","key":"pone.0316092.ref013","doi-asserted-by":"crossref","first-page":"e1505","DOI":"10.1111\/hsc.13842","article-title":"Effects of Nordic walking in people with Parkinson\u2019s disease: a systematic review and meta-analysis","volume":"30","author":"J Salse-Bat\u00e1n","year":"2022","journal-title":"Health Soc Care Community"},{"issue":"16","key":"pone.0316092.ref014","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1177\/2047487319871215","article-title":"Nordic walking and standard exercise therapy in patients with chronic heart failure: a randomised controlled trial comparison","volume":"26","author":"SA Prince","year":"2019","journal-title":"Eur J Prev Cardiol"},{"key":"pone.0316092.ref015","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.proeng.2011.11.2750","article-title":"Load dynamics of joints in Nordic walking","volume":"13","author":"T Koizumi","year":"2011","journal-title":"Procedia Eng"},{"issue":"20","key":"pone.0316092.ref016","doi-asserted-by":"crossref","first-page":"15358","DOI":"10.3390\/ijms242015358","article-title":"The effect of a six-week Nordic walking training cycle on oxidative damage of macromolecules and iron metabolism in older patients with multiple myeloma in remission-randomized clinical trial","volume":"24","author":"O Czerwi\u0144ska-Ledwig","year":"2023","journal-title":"Int J Mol Sci"},{"issue":"18","key":"pone.0316092.ref017","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"},{"issue":"4","key":"pone.0316092.ref018","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.ejvs.2018.05.026","article-title":"Systematic review and meta-analysis of clinical trials examining the benefit of exercise programmes using Nordic walking in patients with peripheral artery disease","volume":"56","author":"J Golledge","year":"2018","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"8","key":"pone.0316092.ref019","first-page":"CD009638","article-title":"Modes of exercise training for intermittent claudication","volume":"8","author":"SC Jansen","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"pone.0316092.ref020","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1097\/HCR.0000000000000780","article-title":"The effect of exercise modalities on walking capacity in patients with intermittent claudication: a NETWORK META-ANALYSIS","volume":"43","author":"R Tremblay","year":"2023","journal-title":"J Cardiopulm Rehabil Prev"},{"issue":"4","key":"pone.0316092.ref021","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/HCR.0b013e31825828f4","article-title":"Comparison of walking with poles and traditional walking for peripheral arterial disease rehabilitation","volume":"32","author":"EG Collins","year":"2012","journal-title":"J Cardiopulm Rehabil Prev"},{"issue":"5","key":"pone.0316092.ref022","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1067\/mva.2002.123756","article-title":"Increasing exercise tolerance of persons limited by claudication pain using polestriding","volume":"35","author":"WE Langbein","year":"2002","journal-title":"J Vasc Surg"},{"key":"pone.0316092.ref023","first-page":"985025","article-title":"The effects of walking or walking-with-poles training on tissue oxygenation in patients with peripheral arterial disease","author":"EG Collins","year":"2012","journal-title":"Int J Vasc Med"},{"issue":"7","key":"pone.0316092.ref024","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1002\/bjs.9519","article-title":"Randomized clinical trial comparing Nordic pole walking and a standard home exercise programme in patients with intermittent claudication","volume":"101","author":"C Spafford","year":"2014","journal-title":"Br J Surg"},{"key":"pone.0316092.ref025","first-page":"1937527","article-title":"Influence of the physical training on muscle function and walking distance in symptomatic peripheral arterial disease in elderly","author":"K Kropielnicka","year":"2018","journal-title":"Biomed Res Int"},{"issue":"9","key":"pone.0316092.ref026","doi-asserted-by":"crossref","first-page":"2826","DOI":"10.3390\/jcm9092826","article-title":"Effects of physical rehabilitation on spatiotemporal gait parameters and ground reaction forces of patients with intermittent claudication","volume":"9","author":"W Dziubek","year":"2020","journal-title":"J Clin Med"},{"issue":"13","key":"pone.0316092.ref027","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.3109\/09638288.2015.1077398","article-title":"Nordic pole walking improves walking capacity in patients with intermittent claudication: a randomized controlled trial","volume":"38","author":"K Buli\u0144ska","year":"2016","journal-title":"Disabil Rehabil"},{"issue":"3","key":"pone.0316092.ref028","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/00008483-200305000-00002","article-title":"Peripheral arterial disease rehabilitation: a review","volume":"23","author":"RA Falcone","year":"2003","journal-title":"J Cardiopulm Rehabil"},{"issue":"1","key":"pone.0316092.ref029","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejvs.2006.12.030","article-title":"Exercise therapy and the additional effect of supervision on exercise therapy in patients with intermittent claudication. Systematic review of randomised controlled trials","volume":"34","author":"J Wind","year":"2007","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"8","key":"pone.0316092.ref030","first-page":"CD005263","article-title":"Supervised exercise therapy versus non-supervised exercise therapy for intermittent claudication","author":"HJP Fokkenrood","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"11","key":"pone.0316092.ref031","doi-asserted-by":"crossref","first-page":"1964","DOI":"10.1111\/jgs.12500","article-title":"High-intensity progressive resistance training improves flat-ground walking in older adults with symptomatic peripheral arterial disease","volume":"61","author":"BJ Parmenter","year":"2013","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"pone.0316092.ref032","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2174\/1568006043336195","article-title":"Exercise rehabilitation for the patient with intermittent claudication: a highly effective yet underutilized treatment","volume":"4","author":"JG Regensteiner","year":"2004","journal-title":"Curr Drug Targets Cardiovasc Haematol Disord"},{"issue":"16","key":"pone.0316092.ref033","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1161\/CIRCULATIONAHA.116.023691","article-title":"Home-based exercise: a therapeutic option for peripheral artery disease","volume":"134","author":"MM McDermott","year":"2016","journal-title":"Circulation"},{"issue":"4","key":"pone.0316092.ref034","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/j.jvs.2023.05.045","article-title":"High-intensity interval training in patients with intermittent claudication","volume":"78","author":"S Pymer","year":"2023","journal-title":"J Vasc Surg"},{"issue":"13","key":"pone.0316092.ref035","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1001\/jama.2021.2536","article-title":"Effect of low-intensity vs high-intensity home-based walking exercise on walk distance in patients with peripheral artery disease: the LITE randomized clinical trial","volume":"325","author":"MM McDermott","year":"2021","journal-title":"JAMA"},{"issue":"6","key":"pone.0316092.ref036","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/j.ejvs.2008.06.036","article-title":"Nordic poles immediately improve walking distance in patients with intermittent claudication","volume":"36","author":"C Oakley","year":"2008","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"3","key":"pone.0316092.ref037","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1249\/01.MSS.0000053658.82687.FF","article-title":"PoleStriding exercise and vitamin E for management of peripheral vascular disease","volume":"35","author":"EG Collins","year":"2003","journal-title":"Med Sci Sports Exerc"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0316092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T17:30:13Z","timestamp":1741627813000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0316092"}},"subtitle":[],"editor":[{"given":"Shukri","family":"AlSaif","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,3,10]]},"references-count":37,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0316092","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,10]]}}}