BACKGROUND: Patients with heart failure are a growing population within cardiac rehabilitation. The purpose of this study was to compare, through a single-centre, parallel-group, randomized controlled trial, the effects of Nordic walking and standard cardiac rehabilitation care on functional capacity and other outcomes in patients with moderate to severe heart failure. METHODS: Between 2008 and 2009, 54 patients (aged 62.4 +/- 11.4 years) with heart failure (mean ejection fraction 26.9% +/- 5.0%) were randomly assigned to standard cardiac rehabilitation care (n = 27) or Nordic walking (n = 27); both groups performed 200 to 400 minutes of exercise per week for 12 weeks. The primary outcome, measured after 12 weeks, was functional capacity assessed by a 6-minute walk test (6MWT). RESULTS: Compared with standard care, Nordic walking led to higher functional capacity (125.6 +/- 59.4 m versus 57.0 +/- 71.3 m travelled during 6MWT; p = 0.001), greater self-reported physical activity (158.5 +/- 118.5 minutes versus 155.5 +/- 125.6 minutes; p = 0.049), increased right grip strength (2.3 +/- 3.5 kg versus 0.3 +/- 3.1 kg; p = 0.026), and fewer depressive symptoms (Hospital Anxiety and Depression Scale score -1.7 +/- 2.4 versus -0.8 +/- 3.1; p = 0.014). No significant differences were found for peak aerobic capacity, left-hand grip strength, body weight, waist circumference, or symptoms of anxiety. CONCLUSIONS: Nordic walking was superior to standard cardiac rehabilitation care in improving functional capacity and other important outcomes in patients with heart failure. This exercise modality is a promising alternative for this population.

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