Evidence-Based Use of Walking Poles for Balance
Summary of a public talk given at a BC Balance and Dizziness Disorders Society (BADD) meeting at St. Paul’s Hospital in Vancouver on May 21, 2014.
Speaker: Mandy Shintani, Bsc (OT), MA (Gero). Mandy co-developed the Activator poles and technique specifically for those with conditions that affect their balance. An occupational therapist for over 25 years, Mandy is the co-founder of North Vancouver-based Urban Poling Inc.
About ten years ago Mandy became interested in healthy aging trends. She read a number of research studies that demonstrated the importance of exercise as we age, learning that:
- Strength, flexibility, balance, and reaction time are considered the most readily modifiable risk factors for falls.
- Impaired strength and balance contribute to most falls.
Mandy became intrigued with the idea of adapting Nordic walking as a rehabilitation tool for adults who need more stability, balance and confidence when walking in their neighbourhoods. She was impressed that over 50 research studies — now up to 96 —indicated positive impacts of using walking poles for health and exercise as well as rehabilitation for all ages and levels of fitness.
About eight years ago Mandy co-developed Urban Poling’s Activator poles. Using these poles combines the aerobic- and strength-building benefits of cross-country skiing with walking. Those using poles tend to walk more frequently and longer. Other benefits include:
- stability, mobility, and posture for older adults improved
- gait stability increased
- core strengthening increased
- coordination improved
- 20-46% more calories expended compared to regular walking
- neck and shoulder symptoms diminished
- mobility of the upper body increased
- impact on knee and hip joints reduced
- fall prevention enhanced
- gait speed increased compared to walking—in one study, gait speed was increased by 106%
- both left and right sides engaged — this bilateral and rhythmical movement is particularly useful for those recovering from a stroke
Ordinary walking works only the leg muscles. Urban poling engages 90% of muscles. Core muscles contract 1,800 times and lateral muscles 900 times per mile of urban poling. Mandy cautions novices to start off using the poles to go only 30% of maximum walking tolerance.
Based on the research and clinical observations of clients using walking poles as well as input from physiotherapists and occupational therapists, the Activator poles were developed with a number of safety and effectiveness features. These include:
- Large ergonomic left and right handles keep the wrists in a loose and neutral position to reduce joint strain. The handles provide greater comfort, especially for those with arthritis or repetitive strain injuries.
- Strapless handles reduce the risk of injury in the event of a fall or stumble. All Nordic walking poles with the exception of Urban Poles come with a strap. Research indicates that most Nordic walking injuries are related to when, in the event of a fall, the user is attached to the handle.
- Three anti-vibration features minimize stress on joints.
- Wide, bell-shaped rubber tip add to stability and balance when walking indoors or on pavement.
- Steel-carbide tips provide more traction when walking on uneven terrain, such as dirt trails, grass, sand, or gravel.
- Button-lock system allows greater weight bearing — up to 200 pounds per pole — for those needing additional upright support.
- Telescoping — poles can be adjusted for users up to 6’ in height and are collapsible for storage, travel, and shopping.
The basic Activator technique is easier to learn compared with the regular Urban poling/Nordic walking technique. To promote stability, the sturdy Activator poles are used with the following four-step technique:
- Make sure that the right and left poles are in the correct hands — there is an indicator at the top of each handle.
- Stand up straight, keeping elbows at a 90° angle. Ensure poles are always vertical. Keep elbows bent the entire time while walking.
- Step forward with the poles in the same manner as you walk. Put the left leg and right arm forward, then vice versa. Do not keep arms static; move them (with a bent elbow) forward and back.
- Do not grip the handle tightly. Push down on the base of the handle to increase stability and balance.
For many, Activator poles are preferable to using a cane or walker. Walker users assume a static pose and have limited range of motion. Core muscles relax and balance indicators get lazy. Conversely, poling promotes a more normal gait pattern. Urban pole users are forced to bear weight evenly on both sides. Posture improves as confidence grows. And as posture becomes more upright, less shuffling occurs. Pushing down with the poles while walking increases stability and balance. Pushing down also offloads about 25% of the pressure on the hips and knees.
Mandy emphasized that it is very important to talk to your doctor or therapist before considering using Activator poles if you are: currently using a cane or walker; have any medical condition which affects your balance, stability, grip strength, vision, depth judgement or co-ordination; or if you are currently recovering from injury or surgery.
Activator poles should not be used in icy or slippery conditions and are not designed for use on stairs.
Several members brought up challenges with using walking poles including:
- Carrying a bag can be problematical — Mandy suggested overcoming this challenge by using a backpack or cross-body bag. While grocery shopping, she suggested collapsing the poles and placing them in the shopping cart.
- Need to look down for obstacles — Mandy commented that the heel/toe gait pattern used with the Activator technique minimizes tripping over minor obstacles because the feet are picked up more instead of just shuffling along.
- Joint pain in hands — Mandy agreed this may be a limitation to using Activator poles, particularly for those with significant arthritis in their hands. Being mindful of maintaining a loose grip and pressing down with your body, rather than your hands, however, may alleviate pain. Listen to your body — poling may not be suitable for you.
Mandy concluded by demonstrating several exercises that can be done using the Activator poles. These exercises are adapted from the Otago Exercise Program to Prevent Falls in Older Adults [PDF].
To learn more about Activator poles, to order poles, or to find retailers in your area, go to Urban Poling.