High-Intensity Interval Training and Moderate-Intensity Continuous Training in Ambulatory Chronic Stroke: Feasibility...

Area of Science:

• Exercise physiology
• Neurological rehabilitation

Background:

• Current poststroke guidelines recommend moderate-intensity, continuous aerobic training (MCT) for improving aerobic capacity and mobility.
• High-intensity interval training (HIT) is more effective than MCT in healthy adults and those with heart disease.
• HIT and MCT have not been directly compared in individuals with stroke.

Purpose of the Study:

• To evaluate the feasibility and rationale for a definitive randomized controlled trial (RCT) comparing HIT and MCT in individuals with chronic stroke.

Main Methods:

• A preliminary RCT was conducted in laboratory settings with ambulatory individuals at least 6 months poststroke.
• Participants underwent 4 weeks of training (25 minutes, 3 times/week), with HIT involving intense bursts and MCT involving continuous walking.
• Outcomes included recruitment, attendance, acceptability, adverse events, peak oxygen uptake, ventilatory threshold, gait metrics, and walking tests.

Main Results:

• Twenty-six participants consented, and 18 were enrolled (13 in HIT, 5 in MCT).
• HIT was acceptable to participants, with high attendance and no serious adverse events.
• Moderate to very large effect sizes were observed for most outcomes, though only 30% of treadmill speed gains transferred to overground gait.

Conclusions:

• A definitive RCT comparing HIT and MCT in stroke survivors is feasible and warranted.
• Protocol optimization is necessary to enhance the translation of treadmill-based speed improvements to overground walking.
• The study was preliminary and not designed to assess definitive safety or efficacy.