HIIT Exercise Could Improve Stroke Patient Rehabilitation

Credit: Pexels / RUN 4 FFWPU

The popular exercise program high-intensity interval training (HIIT) may provide greater benefit to rehabilitating stroke patients than a moderate-intensity continuous training (MICT) regimen, according to new research.

New analyses from a previous randomized controlled trial comparing HIIT to MICT over 12 week showed those randomized to short-interval HIIT experienced greater gains in peak VO₂ and better overall aerobic fitness.

“This is the first randomized trial to examine a time-efficient, high intensity interval training program to incorporate a phased and progressive approach,” senior investigator Ada Tang, PhD a physiotherapist, professor and assistant dean of Rehabilitation Science at McMaster University, said in a statement at the time of the new data's publication.

The current study led by Tang and colleagues was an analysis of secondary outcomes from a larger trial assessing the exercise regimens' effect on neuroplasticity.

Per trial protocol, participants exercised three times per week for 12 weeks at the Jewish Rehabilitation Hospital or McMaster University in exercise laboratories. Those randomized to HIIT protocol took part in 10x1-minute intervals of high-intensity exercise, interspersed with 9x1-minute low-intensity intervals, for 19 minutes. Of note, the high-intensity intervals targeted 80 percent heart rate reserve (HRR) and progressed by 10 percent every 4 weeks up to 100 percent HRR. Those randomized to the MICT protocol took part in targeted 40 percent HRR for 20 minutes and progressed by 10 percent HRR and five minutes every four weeks, up to 60 percent HRR for 30 minutes.

For inclusion, patients needed to be between 40 and 80 years old, be six to 60 months removed from a first-ever stroke confirmed by imaging, and be able to walk independently for at least 10 meters. Exclusion critics included having a score of two or greater on the modified Rankin Scale, any contraindications for exercise testing, and having other neurological or musculoskeletal comorbidities.

A total of 305 patients were screened and 82 were considered eligible for randomization. The study cohort had a mean age of 64.9 years, 39 percent were female, and the mean time post-stroke was 1.8 years. Among the 82 participants, 42 were randomized to HIIT and 40 to MICT, with no significant differences in baseline characteristics between groups. Investigators pointed out study participants attended 82 percent of all study visits and no adverse events occurred during the study period.

Upon analysis, investigates identified a significant group study time point interaction for peak VO₂ at 12 weeks, with the HIIT group experiencing greater gains in peak VO₂ relative to the MICT group. Further analysis revealed no between-group differences at the eight-week follow-up, nor were there any observed group study time point interactions found cardiovascular risk factors or mobility outcomes.

“This study shows that people with stroke can also benefit from high-intensity interval training,” said Kevin Moncion, PhD, a physiotherapist who led this study as part of his doctoral studies at McMaster University in Hamilton, Ontario, Canada. “With the right support and guidance, stroke survivors can safely and effectively engage in high-intensity interval training, significantly improving their overall health and recovery.”

An original version of this article was published on sister site HCPLive.