PMID- 37947080
OWN - NLM
STAT- Publisher
LR  - 20231220
IS  - 2047-9980 (Electronic)
IS  - 2047-9980 (Linking)
VI  - 12
IP  - 22
DP  - 2023 Nov 10
TI  - Effect of High-Intensity Interval Training and Moderate-Intensity Continuous 
      Training in People With Poststroke Gait Dysfunction: A Randomized Clinical Trial.
PG  - e031532
LID - 10.1161/JAHA.123.031532 [doi]
LID - e031532
AB  - Background The exercise strategy that yields the greatest improvement in both 
      cardiorespiratory fitness (V̇O2peak) and walking capacity poststroke has not been 
      determined. This study aimed to determine whether conventional moderate-intensity 
      continuous training (MICT) or high-intensity interval training (HIIT) have 
      different effects on V̇O2peak and 6-minute walk distance (6MWD). Methods and 
      Results In this 24-week superiority trial, people with poststroke gait 
      dysfunction were randomized to MICT (5 days/week) or HIIT (3 days/week with 
      2 days/week of MICT). MICT trained to target intensity at the ventilatory 
      anaerobic threshold. HIIT trained at the maximal tolerable treadmill speed/grade 
      using a novel program of 2 work-to-recovery protocols: 30:60 and 120:180 seconds. 
      V̇O(2) and heart rate was measured during performance of the exercise that was 
      prescribed at 8 and 24 weeks for treatment fidelity. Main outcomes were change in 
      V̇O2peak and 6MWD. Assessors were blinded to the treatment group for V̇O2peak but 
      not 6MWD. Secondary outcomes were change in ventilatory anaerobic threshold, 
      cognition, gait-economy, 10-meter gait-velocity, balance, stair-climb 
      performance, strength, and quality-of-life. Among 47 participants randomized to 
      either MICT (n=23) or HIIT (n=24) (mean age, 62+/-11 years; 81% men), 96% completed 
      training. In intention-to-treat analysis, change in V̇O2peak for MICT versus HIIT 
      was 2.4+/-2.7 versus 5.7+/-3.1 mL.kg(-1).min(-1) (mean difference, 3.2 [95% CI, 
      1.5-4.8]; P<0.001), and change in 6MWD was 70.9+/-44.3 versus 83.4+/-53.6 m (mean 
      difference, 12.5 [95% CI, -17 to 42]; P=0.401). HIIT had greater improvement in 
      ventilatory anaerobic threshold (mean difference, 2.07 mL.kg(-1).min(-1) [95% CI, 
      0.59-3.6]; P=0.008). No other between-group differences were observed. During 
      V̇O(2) monitoring at 8 and 24 weeks, MICT reached 84+/-14% to 87+/-18% of V̇O2peak 
      while HIIT reached 101+/-22% to 112+/-14% of V̇O2peak (during peak bouts). 
      Conclusions HIIT resulted in more than a 2-fold greater and clinically important 
      change in V̇O2peak than MICT. Training to target (ventilatory anaerobic 
      threshold) during MICT resulted in ~3 times the minimal clinically important 
      difference in 6MWD, which was similar to HIIT. These findings show proof of 
      concept that HIIT yields greater improvements in cardiorespiratory fitness than 
      conventional MICT in appropriately screened individuals. Registration URL: 
      https://www.clinicaltrials.gov; Unique identifier: NCT03006731.
FAU - Marzolini, Susan
AU  - Marzolini S
AUID- ORCID: 0000-0002-3186-400X
AD  - KITE Research Institute, Toronto Rehabilitation Institute, University Health 
      Network Toronto ON Canada.
AD  - Rehabilitation Sciences Institute, University of Toronto ON Canada.
AD  - Faculty of Kinesiology and Physical Education, University of Toronto ON Canada.
FAU - Robertson, Andrew D
AU  - Robertson AD
AUID- ORCID: 0000-0002-9095-9877
AD  - Department of Kinesiology and Health Sciences University of Waterloo ON Canada.
FAU - MacIntosh, Bradley J
AU  - MacIntosh BJ
AUID- ORCID: 0000-0001-7300-2355
AD  - Sandra E Black Centre for Brain Resilience and Repair, Hurvitz Brain Sciences, 
      Physical Sciences Platform, Sunnybrook Research Institute Toronto ON Canada.
FAU - Corbett, Dale
AU  - Corbett D
AUID- ORCID: 0000-0003-0217-4576
AD  - Department of Cellular and Molecular Medicine University of Ottawa ON Canada.
FAU - Anderson, Nicole D
AU  - Anderson ND
AUID- ORCID: 0000-0002-5979-2220
AD  - Rotman Research Institute, Baycrest Academy for Research and Education Toronto ON 
      Canada.
FAU - Brooks, Dina
AU  - Brooks D
AUID- ORCID: 0000-0001-6080-5052
AD  - KITE Research Institute, Toronto Rehabilitation Institute, University Health 
      Network Toronto ON Canada.
AD  - Rehabilitation Sciences Institute, University of Toronto ON Canada.
AD  - McMaster University, Faculty of Health Sciences Hamilton ON Canada.
FAU - Koblinsky, Noah
AU  - Koblinsky N
AD  - Rotman Research Institute, Baycrest Academy for Research and Education Toronto ON 
      Canada.
FAU - Oh, Paul
AU  - Oh P
AUID- ORCID: 0000-0002-0603-6958
AD  - KITE Research Institute, Toronto Rehabilitation Institute, University Health 
      Network Toronto ON Canada.
LA  - eng
SI  - ClinicalTrials.gov/NCT03006731
PT  - Journal Article
DEP - 20231110
PL  - England
TA  - J Am Heart Assoc
JT  - Journal of the American Heart Association
JID - 101580524
SB  - IM
PMC - PMC10727274
OTO - NOTNLM
OT  - HIIT
OT  - aerobic exercise
OT  - cardiorespiratory fitness
OT  - hemiplegia
OT  - locomotion
OT  - stroke
EDAT- 2023/11/10 06:45
MHDA- 2023/11/10 06:45
PMCR- 2023/11/21
CRDT- 2023/11/10 05:27
PHST- 2023/11/10 06:45 [medline]
PHST- 2023/11/10 06:45 [pubmed]
PHST- 2023/11/10 05:27 [entrez]
PHST- 2023/11/21 00:00 [pmc-release]
AID - JAH38953 [pii]
AID - 10.1161/JAHA.123.031532 [doi]
PST - aheadofprint
SO  - J Am Heart Assoc. 2023 Nov 10;12(22):e031532. doi: 10.1161/JAHA.123.031532.