{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:37:58Z","timestamp":1781195878707,"version":"3.54.1"},"reference-count":47,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"tasks for the development of young scientists","award":["91\/MN\/KRK\/2018"],"award-info":[{"award-number":["91\/MN\/KRK\/2018"]}]},{"name":"tasks for the development of young scientists","award":["1\/BP\/RID\/2019"],"award-info":[{"award-number":["1\/BP\/RID\/2019"]}]},{"name":"Ministry of Science and Higher Education","award":["91\/MN\/KRK\/2018"],"award-info":[{"award-number":["91\/MN\/KRK\/2018"]}]},{"name":"Ministry of Science and Higher Education","award":["1\/BP\/RID\/2019"],"award-info":[{"award-number":["1\/BP\/RID\/2019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: Percutaneous coronary intervention (PCI) in patients with chronic coronary syndrome (CCS) is a worldwide method of coronary revascularisation. The aim of this study was to assess the immediate and long-term effects of Nordic Walking (NW) training added to a standard cardiac rehabilitation programme on physical activity (PA) and capacity and life quality, as well as selected proatherogenic risk factors. Methods: The studied group comprised 50 patients (considering exclusion criteria, 40 patients), aged 56\u201370, with CCS after elective PCI qualified them for a 6-weeks-long cardiac rehabilitation. The follow-up period lasted 4 months, and control visits occurred at 2 and 4 months. The studied patients were randomly divided into two groups: control group\u2014standard cardiac rehabilitation programme and experimental group\u2014standard cardiac rehabilitation programme additionally combined with NW training. Results: The cardiac rehabilitation programme in the experimental, compared to the control group, increased intense PA (from 731.43 \u00b1 909.9 to 2740 \u00b1 2875.96 vs. from 211.43 \u00b1 259.43 to 582.86 \u00b1 1289.74 MET min\/week) and aerobic efficiency\u2014VO2peak (from 8.67 \u00b1 0.88 to 9.96 \u00b1 1.35 vs. from 7.39 \u00b1 2 to 7.41 \u00b1 2.46 METs), as well as quality of life according to the WHOQOL-BREF questionnaire (from 3.57 \u00b1 0.51 to 4.14 \u00b1 0.36 vs. from 3.29 \u00b1 0.47 to 3.57 \u00b1 0.51 points). The walking distance assessed with the 6-min walk test did not differ between the groups before the beginning of the rehabilitation programme. Both at the I follow-up and II follow-up time points, a significant increase in the walking distance was noted in the control and experimental groups compared to baseline, and the difference between both groups was significant at the end of follow-up (378.57 \u00b1 71.35 vs. 469.29 \u00b1 58.07, p = 0.003). Moreover, NW had a positive effect on the modulation within selected biochemical risk factors of atherosclerosis, as well as subjective quality of life and well-being. Conclusions: Introducing NW training into the cardiac rehabilitation process proved to be a more effective form of therapy in patients with CCS treated via PCI, as compared to the standard cardiac rehabilitation programme alone.<\/jats:p>","DOI":"10.3390\/medicina59071355","type":"journal-article","created":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T01:21:27Z","timestamp":1690248087000},"page":"1355","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Effects of Cardiac Rehabilitation including Nordic Walking in Patients with Chronic Coronary Syndromes after Percutaneous Coronary Interventions in Elective Mode"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6591-1919","authenticated-orcid":false,"given":"Rafa\u0142","family":"Januszek","sequence":"first","affiliation":[{"name":"Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo\u017cena","family":"Kocik","sequence":"additional","affiliation":[{"name":"Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3548-9024","authenticated-orcid":false,"given":"Wojciech","family":"Si\u0142ka","sequence":"additional","affiliation":[{"name":"Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1384-9439","authenticated-orcid":false,"given":"Iwona","family":"Gregorczyk-Maga","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Mika","sequence":"additional","affiliation":[{"name":"Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1097\/HJR.0b013e32833bo969","article-title":"Cardiovascular evaluation of middle-aged\/ senior individuals engaged in leisure-time sport activities: Position stand from the sections of exercise physiology and sports cardiology of the European Association of Cardiovascular Prevention and Rehabilitation","volume":"18","author":"Borjesson","year":"2011","journal-title":"Eur. J. Cardiovasc. Prev. Rehabil."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3095","DOI":"10.1001\/jama.283.23.3095","article-title":"Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure: A randomized trial","volume":"283","author":"Hambrecht","year":"2000","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.ahj.2011.07.017","article-title":"Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction: A systematic review and meta-analysis of randomized controlled trials","volume":"162","author":"Lawler","year":"2011","journal-title":"Am. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/j.ijcard.2012.10.003","article-title":"Comparison of two treadmill training programs on walking ability and endothelial function in intermittent claudication","volume":"168","author":"Mika","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1056\/NEJMra1011670","article-title":"The Hemostatic System as a Modulator of Atherosclerosis","volume":"364","author":"Borissoff","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1161\/01.HYP.0000130484.20501.df","article-title":"C-reactive protein: Risk marker or mediator in atherothrombosis?","volume":"44","author":"Jialal","year":"2004","journal-title":"Hypertension"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1177\/2047487314529349","article-title":"High frequency home-based exercise decreases levels of vascular endothelial growth factor in patients with stable angina pectoris","volume":"22","author":"DuttaRoy","year":"2015","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1136\/hrt.2008.153510","article-title":"Effect of cardiac rehabilitation on angiogenic cytokines in postinfarction patients","volume":"95","author":"Lee","year":"2009","journal-title":"Heart"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jjcc.2013.12.002","article-title":"The effect of treadmill training on endothelial function and walking abilities in patients with peripheral arterial disease","volume":"64","author":"Januszek","year":"2014","journal-title":"J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2951","DOI":"10.1161\/CIR.0b013e31823b21e2","article-title":"Referral, enrollment, and delivery of cardiac rehabilitation\/secondary prevention programs at clinical centers and beyond: A presidential advisory from the american heart association","volume":"124","author":"Balady","year":"2011","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1177\/2047487320913379","article-title":"Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update: A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology","volume":"28","author":"Ambrosetti","year":"2021","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_12","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":"Girold","year":"2017","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/eurheartj\/ehaa605","article-title":"2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease","volume":"42","author":"Pelliccia","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","article-title":"2021 ESC Guidelines on cardiovascular disease prevention in clinical practice","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_15","unstructured":"(2013). Mi\u0119dzynarodowy Kwesionariusz Aktywno\u015bci Fizycznej\u2014Polska d\u0142uga wersja. Med. Sport., 1, 1\u201315."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1080\/02701367.2000.11082794","article-title":"Assessment of physical activity: An international perspective","volume":"71","author":"Booth","year":"2000","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1249\/mss.0b013e3180616aa2","article-title":"Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association","volume":"39","author":"Nelson","year":"2007","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2458","DOI":"10.1161\/CIR.0b013e318235eb4d","article-title":"AHA\/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation","volume":"124","author":"Smith","year":"2011","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/eurheartj\/ehz425","article-title":"2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes","volume":"41","author":"Knuuti","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/eurheartj\/ehy394","article-title":"2018 ESC\/EACTS Guidelines on myocardial revascularization","volume":"40","author":"Neumann","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_21","first-page":"134","article-title":"Efficacy of cardiac rehabilitation after percutaneous coronary intervention","volume":"9","author":"Hassan","year":"2016","journal-title":"Int. J. Pharmtech Res."},{"key":"ref_22","first-page":"47","article-title":"International Physical Activity Questionnaire (IPAQ)\u2014Polish version","volume":"51","author":"Biernat","year":"2007","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Giugliano, G., Sannino, A., Brevetti, L., Perrino, C., Schiattarella, G.G., Franzone, A., Serino, F., Ferrone, M., Scudiero, F., and Carbone, A. (2012). Ankle\/brachial index to everyone. BMC Surg., 12.","DOI":"10.1186\/1471-2482-12-S1-S18"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1042\/CS20070080","article-title":"Arterial stiffness: Clinical relevance, measurement and treatment","volume":"113","author":"Hamilton","year":"2007","journal-title":"Clin. Sci."},{"key":"ref_25","first-page":"531","article-title":"Assessment of reliability of the whoqol-bref questionnaire in a study of quality of life among adults, the economically active population of the Silesian agglomeration","volume":"66","author":"Kowalska","year":"2012","journal-title":"Prz. Epidemiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3389\/fcvm.2019.00069","article-title":"Effects of Exercise to Improve Cardiovascular Health","volume":"6","author":"Pinckard","year":"2019","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.repc.2016.12.016","article-title":"Parameters influencing the physical activity of patients with a history of coronary revascularization","volume":"36","author":"Acar","year":"2017","journal-title":"Rev. Port. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2344","DOI":"10.1161\/CIRCULATIONAHA.110.983536","article-title":"Impact of cardiac rehabilitation on mortality and cardiovascular events after percutaneous coronary intervention in the community","volume":"123","author":"Goel","year":"2011","journal-title":"Circulation"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"995","DOI":"10.5603\/KP.2013.0246","article-title":"Optimal model of comprehensive rehabilitation and secondary prevention","volume":"71","author":"Jankowski","year":"2013","journal-title":"Kardiol. Pol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.tcm.2021.10.011","article-title":"Clinical application of results of the ISCHEMIA trial","volume":"33","author":"Achim","year":"2023","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1161\/CIRCULATIONAHA.120.049755","article-title":"Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity","volume":"144","author":"Reynolds","year":"2021","journal-title":"Circulation"},{"key":"ref_32","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":"Cugusi","year":"2017","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1001\/archinternmed.2011.1311","article-title":"A randomized controlled trial of positive-affect induction to promote physical activity after percutaneous coronary intervention","volume":"172","author":"Peterson","year":"2012","journal-title":"Arch. Intern. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"689","DOI":"10.20344\/amp.1742","article-title":"What factors determine the levels of physical activity after Cardiac Rehabilitation Program? TT\u2014Que fatores determinam os niveis de atividade fisica apos Programa de Reabilitacao Cardiaca?","volume":"26","author":"Soares","year":"2013","journal-title":"Acta Med. Port."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"730","DOI":"10.33963\/KP.14889","article-title":"Cardiopulmonary exercise testing in adult cardiology: Expert opinion of the Working Group of Cardiac Rehabilitation and Exercise Physiology of the Polish Cardiac Society","volume":"77","author":"Chwyczko","year":"2019","journal-title":"Kardiol. Pol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1055\/s-2008-1047636","article-title":"Spiroergometrie: Indikationen, Methodik, Relevanz","volume":"122","author":"Breuer","year":"2008","journal-title":"DMW\u2014Dtsch. Med. Wochenschr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/S1062-1458(01)00581-5","article-title":"Exercise training intervention after coronary angioplasty: The etica trial","volume":"11","author":"Belardinelli","year":"2002","journal-title":"ACC Curr. J. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"302","DOI":"10.3389\/fphys.2013.00302","article-title":"Cardiac rehabilitation outcomes following a 6-week program of PCI and CABG Patients","volume":"4","author":"Jelinek","year":"2013","journal-title":"Front. Physiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/00002060-200205000-00003","article-title":"Improvement of cardiorespiratory function after percutaneous transluminal coronary angioplasty or coronary artery bypass grafting","volume":"81","author":"Lan","year":"2002","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.amepre.2012.09.043","article-title":"Health benefits of nordic walking: A systematic review","volume":"44","author":"Tschentscher","year":"2013","journal-title":"Am. J. Prev. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1080\/02701367.2002.10609023","article-title":"Field Testing of Physiological Responses Associated with Nordic Walking","volume":"73","author":"Church","year":"2002","journal-title":"Res. Q. Exerc. Sport."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Baek, S., and Ha, Y. (2021). Estimation of energy expenditure of Nordic walking: A crossover trial. BMC Sports Sci. Med. Rehabil., 13.","DOI":"10.1186\/s13102-021-00240-0"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/S0828-282X(10)70395-0","article-title":"Improvements in heart rate variability with exercise therapy","volume":"26","author":"Routledge","year":"2010","journal-title":"Can. J. Cardiol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Casanova-Liz\u00f3n, A., Sarabia, J.M., Pastor, D., Javaloyes, A., Pe\u00f1a-Gonz\u00e1lez, I., and Moya-Ram\u00f3n, M. (2023). Designing an App to Promote Physical Exercise in Sedentary People Using a Day-to-Day Algorithm to Ensure a Healthy Self-Programmed Exercise Training. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20021528"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1161\/01.CIR.102.11.1239","article-title":"Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: The ARIC study","volume":"102","author":"Dekker","year":"2000","journal-title":"Circulation"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/S0002-9149(97)89199-0","article-title":"Short- and long-term assessment of heart rate variability for risk stratification after acute myocardial infarction","volume":"77","author":"Fei","year":"1996","journal-title":"Am. J. Cardiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1136\/heartjnl-2015-307778","article-title":"Cochrane corner: Cardiac rehabilitation for people with heart disease","volume":"101","author":"Taylor","year":"2015","journal-title":"Heart"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/7\/1355\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:18:03Z","timestamp":1760127483000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/7\/1355"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,24]]},"references-count":47,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["medicina59071355"],"URL":"https:\/\/doi.org\/10.3390\/medicina59071355","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,24]]}}}