Design Recommendations for Nordic Walking Pole & Cane Combination
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Design Recommendations for Nordic Walking Pole & Cane Combination Hannah Nolte DfHV Individual Project October 28, 2019 Introduction: The percentage of older adults in the current population of the United States is increasing at an unprecedented rate and this increase has led to an intensified focus on “successful ageing” techniques [1]. There are many components to “successful ageing” and the design being proposed here will assist with the goal of high physical function (one of the three main components of the original successful ageing theory) [2,3]. Ageing contributes to a wide array of physical, cognitive, and perceptual changes throughout the lifespan, many of which become noticeable during middle or late stage adulthood [4]. The rate of physical function decline due to ageing can be reduced by exercise intervention [5,6]. Exercise intervention can also reduce the prominence and severity of ageing effects [5]. A commonly recommended exercise intervention is walking because it has been shown to improve physical and cognitive function [6–8]. It is recommended that healthy older adults get 7,000-10,000 steps a day [9]. A more full-body workout, Nordic walking, is growing in popularity in the United States [10] and has many health benefits for older adults [11,12]. Nordic walking involves using two sticks or poles that are similar to ski poles (ski poles are longer in length) while walking. Walkers apply force to the ground through the poles. Greater improvement in shoulder, arm, and trunk strength can be seen from Nordic walking compared to free walking (i.e., regular walking) [11]. Health benefits in older adults observed while participating in regular Nordic walking include improved indicators of aerobic fitness, more lumbar flexibility (compared to inactive older adults), lower mass, and smaller hip to waist ratio [12]. This proposal suggests a product design that combines Nordic walking poles with a cane because both can serve as mobility aids for older adults. Almost a quarter of older adults (65+ years) reported the use of a mobility aid (e.g. canes, walkers, wheelchairs) within the last month when surveyed [13]. Walking with Nordic walking poles has many health benefits [12], but canes are the preferred walking aid of older adults [14]. A cane and Nordic walking pole combination would allow older adults the flexibility of using a cane when they prefer but the chance to use walking poles when it is convenient, without having to replace one device for the other. Thus, allowing them the opportunity to moderate the effects of ageing and stay healthy through Nordic walking while having the cane option when the cane is more ideal for the situation. Existing Products: Nordic walking sticks come in two broad categories, one-piece or adjustable. One-piece Nordic walking poles come in varying lengths. They are usually stronger and lighter, but each person must be custom fit with the correct walking pole length. Decathlon sells their NW Nordic Walking Poles P100 ($24.99) in six sizes including 102.62cm, 106.68cm, 109.22cm, 114.30cm, 124.46cm, and 127.00cm (Fig. 1) [15]. Ski Walking: American Nordic Walking System sells their SWIX Carbon Nordic Walking poles (Fig. 2) by stature with their options ranging 4’0”- 6’10” (121.92cm-208.28cm) but their poles are much more expensive ($149.99) [16]. Another company, LEKI, sells their Flash Carbon poles ($119.95) in lengths 100cm-130cm at 5cm intervals (e.g. 100, 105, 110… 130) (Fig. 3) [17]. Figure 2. Ski Walking: American Nordic Walking Figure 1. Decathlon NW System SWIX Carbon Nordic Figure 3. LEKI Flash Nordic Walking Poles Walking Poles [16]. Carbon Nordic walking P100 [15]. poles [17]. Adjustable Nordic walking poles are commonly one-size-fits-all and they usually collapse for easy travel. Some are telescoping in design while others have a twist and lock mechanism, usually 2-3 segments. Montem, who claims to sell the #1 rated Nordic walking poles, sells three types of adjustable walking poles (Fig. 4) [18]. The Pro Walker Nordic Fitness pole ($69.99) has two twist and lock segments and the adjustability ranges from 81cm-137cm [18]. The 3K Carbon Fiber Trekking Pole ($119.99) has three telescoping segments and the adjustability ranges from 61cm-135cm [18]. Montem’s Ultra Z Folding Trekking Poles ($79.99) folds/collapses into three segments and the range of accommodation is only 113cm-135cm. Leader Accessories sells their trekking poles ($29.99) with three telescoping segments and an adjustability range of 66.04cm-34.62cm (Fig. 5) [19]. The Alpenstock trekking poles ($24.99) have three telescoping segments and an adjustability range of 63.5cm-135.89cm (Fig. 6) [20]. Figure 4: Montem adjustable Nordic walking poles [18]. Figure 6: Alpenstock trekking Figure 5: Leader Accessories poles [20]. Trekking Poles [19]. There are many more options for canes (e.g., more sizes, types, grips) compared to Nordic walking poles. Custom canes can be bought easily on the internet but there are also more standard, mass-produced cane options, as well. The Sky Med Stand Alone Cane ($27.00) and has adjustability of 76.2cm-99.06cm (Fig. 7) [21]. The Days Steel Bariatric Offset Handle Adjustable Cane comes in two sizes, standard ($89.99) and tall ($52.99), with adjustability ranges 72.39cm-95.25cm (2.54 cm increments) and 95.89cm– 118.75cm (Fig. 8) [22]. The AliMed Stable Base Quad Cane ($29.00) and has an adjustability of 73.66cm-96.52cm (2.54 cm increments) (Fig. 9) [23]. Figure 8. Days Steel Bariatric Offset Figure 7. Sky Med Stand Alone Handle Adjustable Cane [22]. Cane [21]. Figure 9. AliMed Stable Base Quad Cane [23]. The existing product most similar to the product this design proposes is the Trolax Nordic walking stick and cane combination ($35.99) [24]. The Trolax combination (Fig. 10) has an adjustability of 51cm– 110cm by utilizing a four segment telescoping design [24]. It has both a cane and a walking stick grip, but the product does not have the ability to become two walking sticks, it can only extend into one walking stick. Figure 10. Trolax Nordic walking stick and can combo [24]. Target Population: The target population for this design proposal is persons of 60+ years of age in the United States (58.8% female and 41.2% male according to the 2010 census for 65+ years of age [25,26]). 60 years of age was selected as the minimum age because that is when functioning motor units in the muscles start to deteriorate at a noticeable rate causing muscle wasting and weakness (a key point in which Nordic walking could be beneficial) [27]. No maximum age was chosen because all adults age at different rates and maintain different levels of physical activity. Realistically there may be an age at which free walking is better suited for older adults than Nordic walking, but it is unlikely to be consistent for all individuals. Also, all healthy adults 20+ years of age are recommended to get at least 7,000 steps a day and this recommendation is only reduced due to illness, not according to age [9]. Since physical activity recommendations are consistent for all adults, this design did not want to limit the use of this product by limiting the age. In addition, the gender ratio of the entire US 65+ years age group will be used because both genders can benefit from Nordic walking, thus the product should work well for as much of the population as possible. There was no information found regarding whether US men or women are more likely to participate in Nordic walking. The product will be designed with older adults generally in mind. This design will be based on a model created using the ANSUR II data and applied to the NHANES data of the appropriate ages. The NHANES data does have a maximum age of 80 years. NHANES data is still reasonable to use because it is the most representative set of data for adults in the US and Nordic walking would logically become less suitable for many individuals older than 80 years of age due to the effects of ageing (muscle weakness, decreased bone density, loss of flexibility- see primer for more details on the effects of ageing). Using ANSUR II to create a model is reasonable because the greatest anthropological measurement difference for older adults is stature [28], which will be used as a predictor in the model. Relevant Anthropometry: There are a few suggested ways to make sure that a person’s Nordic walking poles are the correct length. Nordic Walking suggests two methods for adjusting the lengths of adjustable Nordic walking poles, either eye-ball or measure [29]. Eye-balling involves adjusting the pole heights until they touch the ground when you hold them comfortably with your elbows at 90 degrees [29]. Measuring includes adjusting the pole until it is 0.68 times your height [29]. Total Nordic Walking [30] and Nordic Academy [31] both suggest multiplying stature by 0.68 and rounding down to the nearest size. This design will use 0.68 times the stature as the correct length of a Nordic walking pole as seen in the following equation, 푃ₗ = 퐻 ∗ 0.68 eq. 1 where 푃ₗ is the pole length and H is stature. The length of the pole can also be adjusted by up to ±10 cm when going up/down hill or to change the intensity of the activity [17]. The design will include a margin for this [29]. The Canadian Family Physician recommends that the cane should be roughly the height of the greater trochanter/wrist crease when the patient is standing with their arms at their side (measured from the ground) or the cane should be long enough to reach the ground when the elbow is at a 20-30 degree flexion [32].