Related Experiment Video
Updated: Oct 29, 2025
A Real-World High-Intensity Interval Training Protocol for Cardiorespiratory Fitness Improvement
Published on: February 22, 2022
Cost-Effectiveness of High-intensity Training vs Conventional Therapy for Individuals With Subacute Stroke
T George Hornby1, Miriam R Rafferty2, Daniel Pinto3
1Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN; Rehabilitation Hospital of Indiana, Indianapolis, IN; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL.
Objective:
This investigation estimated the incremental cost-effectiveness of high-intensity training (HIT) compared with conventional physical therapy in individuals with subacute stroke, based on the additional personnel required to deliver the therapy.
Design:
Secondary analysis from a pilot study and subsequent randomized controlled trial.
Setting:
Outpatient laboratory setting.
Participants:
Data were collected from individuals with locomotor impairments 1-6 months poststroke (N=44) who participated in HIT (n=27) or conventional physical therapy (n=17).
Interventions:
Individuals performing HIT practiced walking tasks in variable contexts (stairs, overground, treadmill) while targeting up to 80% maximum heart rate reserve. Individuals performing conventional therapy practiced impairment-based and functional tasks at lower intensities (<40% heart rate reserve).
Main Outcome Measures:
Costs were assessed based on personnel use with availability of similar equipment. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves were calculated for quality-adjusted life years (QALYs) derived from the Medical Outcomes Short Form-36 questionnaire and gains in self-selected speeds (SSSs).
Results:
Personnel costs were higher after HIT (mean, $1420±234) vs conventional therapy (mean, $1111±219), although between-group differences in QALYs (0.05 QALYs; 95% confidence interval [CI], 0.0-0.10 QALYs) and SSS (0.20 m/s; 95% CI, 0.05-0.35 m/s) favored HIT. ICERs were $6180 (95% CI, -$96,364 to $123,211) per QALY and $155 (95% CI, 38-242) for a 0.1 m/s gain in SSS.
Conclusions:
Additional personnel to support HIT are relatively inexpensive but can add substantial effectiveness to subacute rehabilitation. Future research should evaluate patient factors that increase the likelihood of improvement to maximize the cost-effectiveness of treatment post stroke.
More Related Videos
14:56The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb
Published on: September 23, 2018
08:53Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
Published on: June 6, 2025
Related Concept Videos
01:17Exercise and Cardiac Output
Sustained exercise increases the muscles' oxygen demand, which can be...
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...