It is well known that physical exercise is the main therapeutic element of rehabilitation programs for people with Parkinson’s disease (PD). As traditional forms of exercise can guarantee significant health benefits, the emergence of non-conventional physical activities, such as Nordic walking (NW), may add positive effects.

To appraise the available evidence on the main effects of NW in the rehabilitation programs for people with PD and to propose a design for upcoming research that might improve the uniformity of future trials.

Systematic review

A literature search of five established databases (PubMed, MEDLINE, Scopus, Web of Science and Cochrane) was conducted.

ology. Any relevant randomized controlled trials (RCTs) pertinent to NW in PD published in English from inception to February 2017, were included. PRISMA guidelines were followed and the methodological quality of each study was assessed by the PEDro scale.

Sixty-six studies were retrieved and 6 RCTs (221 subjects) entered the qualitative synthesis. Overall, these studies portrayed NW as feasible and likely to be effective in improving the functional and clinical outcomes of people with PD. When comparing NW with other exercise-based interventions such as treadmill training, free walking, a program of standardized whole-body movements with maximal amplitude (LSVT®BIG training) or a home-based exercise program, the findings proved controversial.

High heterogeneity and methodological discrepancies among the studies prevent from drawing firm conclusions on the effectiveness of NW in comparison with other exercise-based interventions currently employed in people with PD. Further investigations with a common design are necessary to verify whether NW may be included within conventional rehabilitation programs commonly recommended to people with PD.