Manolya ACAR, Nur Sena YARIMKAYA, Mustafa Agah TEKİNDAL

Sigara İçen Bireylerde Kuzey Yürüyüş Egzersiz Eğitiminin, Fiziksel Uygunluk, Fiziksel Aktivite Düzeyi, Anksiyete-Depresyon ve Yaşam Kalitesi Üzerine Etkisi: Randomize Kontrollü Bir Çalışma

Amaç: Çalışmanın amacı sigara içen bireylerde kuzey yürüyüş egzersizinin (KYE) fiziksel uygunluk, fiziksel aktivite, anksiyete-depresyon düzeyi ve yaşam kalitesi üzerine etkisini belirlemektir. Gereç ve Yöntemler: Yaş ortalaması 31,45±12,75 yıl olan 30 sigara içen birey rastgele olarak iki gruba ayrıldı: KYE (n=15) veya kontrol grubu (n=15). KYE grubu, 6 hafta ve dereceli olarak artarak günde 45 dakika boyunca haftada üç kez KYE yaptı. Kontrol grubuna herhangi bir müdahale yapılmadı. Sağlıkla ilgili fiziksel uygunluk düzeyi, kol bükme testi (üst ekstremite enduransı) ve sandalyede otur kalk testi (alt ekstremite enduransı), iki dakika adım testi (aerobik endurans) otur ve uzan ve sırt kaşıma testi (esneklik), sekiz adım kalk ve yürü testi (denge), 6 dakikalık yürüme testi (DYT) (kardiyopulmoner endurans) ile değerlendirildi. Fiziksel aktivite seviyeleri, Uluslararası Fiziksel Aktivite Anketinin (UFAA) kısa formu, anksiyete-depresyon düzeyi Beck Depresyon Anketi, yaşam kalitesi Nottingham Sağlık Profili (NSP) ile değerlendirildi. Bulgular: KYE grubunda, 6 DYT mesafesi (p=0.005), iki dakika adım (p=0.022), UFAA yürüme (p=0.028) skorlarında istatistiksel olarak anlamlı iyileşmeler gözlendi. Kontrol grubunda 6 DYT mesafesi (p=0.025), iki dakika adım (p=0.032), otur-uzan (p=0.043) test skorları istatistiksel olarak anlamlı şekilde azaldı. 6 DYT mesafesi (p=0.006), iki dakika adım (p=0.021), 8 adım kalk yürü (p=0.005) testleri, UFAA yürüme (p=0.045), UFAA orta şiddetli aktivite (p=0.038), toplam puan (p=0,013), NSP duygusal (p=0,045) ve toplam (p=0,045) puan alt parametreleri iki grup arasında KYE grubu lehine istatistiksel olarak anlamlı farklıydı. Sonuç: KYE’nin sigara içen kişilerde fiziksel uygunluk, fiziksel aktivite düzeyi ve yaşam kalitesini artırmada etkili ve alternatif bir egzersiz yaklaşımı olabileceği ve rehabilitasyon programlarına yön vereceği düşünülmektedir.

Anahtar Kelimeler:

kuzey yürüyüşü, sigara, fiziksel uygunluk, fiziksel aktivite, yaşam kalitesi

The Effect of Nordic Walking Exercise Training on Physical Fitness, Physical Activity Level, Anxiety-Depression and Quality of Life in Smokers: A Randomized Controlled Trial

Aim: The aim of study was to investigate effects of nordic walking exercise (NWE) on physical fitness, physical activity, anxiety-depression level and quality of life in smokers. Material and Methods: 30 smoking individuals with a mean age of 31.45±12.75 years were assigned randomly into two groups: NWE (n=15) or control group (n=15). NWE group performed NWE three times a week for 6 weeks and gradually increasing to 45 min a day. No intervention was made in control group. The health-related physical fitness level was assessed with arm curl test (upper extremity endurance), chair sit and stand test (lower extremity endurance), two minutes step test (aerobic endurance), sit and reach and back scratch test (flexibility), eight foot up and go test (balance), 6-minute walk test (MWT) (cardiopulmonary endurance). Physical activity levels with International Physical Activity Questionnaire (IPAQ) short form, anxiety-depression level with Beck Depression Questionnaire, quality of life with Nottingham Health Profile (NHP) were evaluated. The differences in measurement parameters between two groups were evaluated by the Mann Whitney U Test since the data distribution was nonparametric. The distinction between categorical variables were determined by Chi-square test. Results: 6-MWT distance (p=0.005), two minutes step (p=0.022), IPAQ walking scores (p=0.028) statistically significant improvements were observed in NWE group. In control group, 6 MWT distance (p=0.025), two minutes step (p=0.032), sit and reach (p=0.043) scores decreased statistically significantly. 6 MWT distance (p=0.006), two minutes step (p=0.021), 8 foot up and go (p=0.005), IPAQ walking (p=0.045), moderate intensity activity (p=0.038), total scores (p=0.013), NHP emotional (p=0.045), total (p=0.045) scores significantly differed in favor of NWE group. Conclusion: It is thought that NWE may be effective and alternative exercise approache in increasing physical fitness, physical activity level and quality of life in smokers and guided to rehabilitation programme.

Keywords:

nordic waliking, smoking, physical fitness, physical activity, quality of life,

PDF

___

1)World Health Organization. Report on the Global Tobacco Epidemic. (2008) Geneva. http://www.who.int/tobacco/mpower/mpower report_full_2008.pd.
2) Conway T, Cronan, TA. Smoking, exercise and physical fitness. Prev Med. 1992; 21:723-34.
3) Goldberg MS, Scott SC, Mayo NE. A review of the association between cigarette smoking and the development of nonspecific back pain and related outcomes. Spine. 2000;25(8):995-1014.
4) Durutürk N, Acar M. Üniversite öğrencilerinde sigara tüketiminin egzersiz kapasitesi ve sağlıkla ilgili fiziksel uygunluk düzeyi üzerine etkisi. Başkent Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2016;(2):34-45.
5) Kumar N, Singh A, Sinha N, Tripathi VM. Comparison of physical fitness between tobacco chewer and non-tobacco chewer. Saudi J Sports Med. 2015; 15(2):137-41.
6) Vranceanu AM, Bachoura A, Weening A, Vrahas M, Smith RM, Ring D. Psychological Factors Predict Disability and Pain Intensity After Skeletal Trauma. The Journal of Bone & Joint Surgery. 2014; 96(3): e20.
7) Chasandra M, Marios G, Yiannis T. Exercise and smoking: a literature overview. Health. 2015; 7. 8) Kocur P, Wilk G. Nordic Walking-a new form of exercise in rehabilitation. Medical Rehabilitation. 2007; 10 (2):1- 8.
9) Cugusi L, Manca A, Yeo TJ, Bassareo PP, Mercuro G, Kaski JC. Nordic walking for individuals with cardiovascular disease: a systematic review and meta-analysis of randomized controlled trials. European journal of preventive cardiology, 2017; 24(18):1938-55.
10) De Santis KK, Kaplan I. The motor and the non-motor outcomes of Nordic Walking in Parkinson's disease: A systematic review. J Bodyw Mov Ther. 2020; 24(2):4-10.
11) Prince SA, Wooding E, Mielniczuk L, Pipe AL, Chan KL, Keast ML, et al. Nordic walking and standard exercise therapy in patients with chronic heart failure: A randomised controlled trial comparison. European journal of preventive cardiology. 2019; 26(16):1790–94.
12) Golledge J, Maarij K, Moxon JV, Beard JD, Girold S, Wrang H, et al. Systematic Review and Meta-analysis of Clinical Trials Examining the Benefit of Exercise Programmes Using Nordic Walking in Patients With Peripheral Artery Disease. Eur J Vasc Endovasc Surg. 2018; 56(4):534-43.
13) Özdamar M, Özdamar HÇ, Kılıç Erkek Ö, Tümkaya S. Examination of the effectiveness of 12-week Nordic Walking exercise in prediabetic individuals. Pamukkale Tıp Dergisi. 2022;15(2):285-301.
14) Tekin E. Prehipertansif Postmenopozal Kadınlarda 8 Haftalık Nordic Walking Eğitimi ile Geleneksel Yürüme Antrenmanının Fizyolojik ve Fonksiyonel Parametrelere Etkilerinin Karşılaştırılması (Yayımlanmış Yüksek Lisans Tezi). Pamukkale Üniversitesi Sağlık Bilimleri Enstitüsü Fizyoloji Anabilim Dalı, Denizli. 2020.
15) Nemoto Y, Sakurai R, Ogawa S, Maruo K, Fujiwara Y. Effects of an unsupervised Nordic walking intervention on cognitive and physical function among older women engaging in volunteer activity. Journal of Exercise Science & Fitness.2021;19(4), 209-215.
16) Heathorn TF, Kozlowski LT, Frecker RC, Fagerström K.O. The Fagerstrom test for nicotine dependence: A revision of the Fagerstrom tolerence questionnaire. Br J Addict. 1991; 86:1119-27.
17) Uysal MA, Kadakal F, Karşidağ C, Bayram NG, Uysal O, Yilmaz V. Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberkuloz ve toraks. 2004; 52(2):115–21.
18) T Rimmer, J. H. Fitness and rehabilitation programs for special populations. McGraw-Hill Humanities, Social Sciences & World Languages. 1994.
19) Millor N, Lecumberri P, Gomez M, Martinez A, Martinikorena J, Rodriguez-Manas L, Garcia-Garcia FJ, Izquierdo M. Gait Velocity and Chair Sit-Stand-Sit Performance Improves Current Frailty-Status Identification. IEEE Trans Neural Syst Rehabil Eng. 2017 Nov;25(11):2018-2025. 20) Dunsky A, Ayalon M, Netz Y. Arm-curl field test for older women: is it a measure of arm strength? J Strength Cond Res. 2011 Jan;25(1):193-7. doi: 10.1519/JSC.0b013e3181bac36a. PMID: 19966580.
21) Węgrzynowska-Teodorczyk K, Mozdzanowska D, Josiak K, et al. Could the two-minute step test be an alternative to the six-minute walk test for patients with systolic heart failure? Eur J Prev Cardiol. 2016;23(12):1307–1313.
22) Miyamoto N, Hirata K, Kimura N, Miyamoto-Mikami E. Contributions of Hamstring Stiffness to Straight-Leg-Raise and Sit-and-Reach Test Scores. Int J Sports Med. 2018 Feb;39(2):110-114. doi: 10.1055/s-0043-117411. Epub 2017 Nov 30. PMID: 29190853.
23) Bassey EJ. Longitudinal changes in selected physical capabilities: muscle strength, flexibility and body size. Age Ageing. 1998;27(3):12–16.
24) Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002 Feb;82(2):128-37. doi: 10.1093/ptj/82.2.128. PMID: 11856064.
25) ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. American journal of respiratory and critical care medicine. 2002;166(1):111–17.
26) Enright PL. The six-minute walk test. Respiratory care. 2003; 48(8): 783–5.
27) Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010;111(1):278-84.
28) Savcı S, Öztürk M, Arıkan H, İnce İnal D, Tokgözoğlu L.Physical activity levels of university students. Turk Kardiyol Dern Ars. 2006; 34(3): 166-72.
29) Hisli N. Beck Depresyon Ölçeği’nin bir Türk örnekleminde geçerlilik ve güvenilirliği. Psikoloji Dergisi. 1988;6:118–22.
30) Beck AT, Ward C, Mendelson M et al. Beck depression inventory (BDI). Arch Gen Psychiatry.1961:4(6); 561-71.
31) Kücükdeveci A, McKenna S, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. International journal of rehabilitation research Internationale Zeitschrift fur Rehabilitationsforschung Revue internationale de recherches de readaptation. 2000;23(1):31-8.
32) Marciniak K, Maciaszek J, Cyma-Wejchenig M, Szeklicki R, Maćkowiak Z, Sadowska D, et al. The Effect of Nordic Walking Training with Poles with an Integrated Resistance Shock Absorber on the Functional Fitness of Women over the Age of 60. International journal of environmental research and public health. 2020:17(7);2197.
33) Prince SA, Wooding E, Mielniczuk L, Pipe AL, Chan KL, Keast ML, et al. Nordic walking and standard exercise therapy in patients with chronic heart failure: A randomised controlled trial comparison. European journal of preventive cardiology.2019:26(16);1790–4.
34) Saulicz M, Saulicz E, Myśliwiec A, Wolny T, Linek P, Knapik A, et al. Effect of a 4-week Nordic walking training on the physical fitness and self-assessment of the quality of health of women of the perimenopausal age. Przeglad menopauzalny=Menopause review.2015:14(2);105–111.
35) Reed JL, Terada T, Cotie LM, Tulloch HE, Leenen FH, Mistura M, et al. The effects of high-intensity interval training, Nordic walking and moderate-to-vigorous intensity continuous training on functional capacity, depression and quality of life in patients with coronary artery disease enrolled in cardiac rehabilitation: A randomized controlled trial (CRX study). Prog Cardiovasc Dis. 2022;70;73-83.