Integrating ankle weights into Nordic walking to improve muscle strength and functional outcomes in community-dwelling older adults: A randomized controlled trial

Introduction: Sarcopenia represents a leading cause of functional decline in older adults. This randomized controlled trial examined whether the addition of ankle weights to a Nordic walking protocol yields superior outcomes compared with standard Nordic walking alone. Methods: Thirty-six older adults were randomly allocated to either Nordic walking with ankle weights (n=18) or Nordic walking without additional loading (n=18), with twice-weekly sessions conducted over a 12-week period. The primary outcome was bilateral handgrip strength. Secondary outcomes comprised skeletal muscle mass percentage (%SMM), SARC-F score, the Chair Stand Test (CST), and gait speed. Between-group differences were assessed using analysis of covariance (ANCOVA), with adjustments for baseline values, age, and sex. Results: The ankle-weight group demonstrated significantly greater improvements in right handgrip strength (β_adj=4.69kg; p=0.012) and left handgrip strength (β_adj=5.56kg; p=0.007), total body %SMM (β_adj=0.93%; p=0.017), lower-limb %SMM (β_adj=0.54%; p=0.011), and SARC-F score (β_adj=−1.17; p<0.001). No statistically significant between-group differences were identified for the CST (p=0.339) or gait speed (p=0.149), although changes over time were observed in both groups. Conclusions: The incorporation of ankle weights into a Nordic walking program improved handgrip strength, skeletal muscle mass percentage, and SARC-F scores in older adults, without conferring statistically significant additional benefits in functional physical performance outcomes.