High-intensity interval training improves recovery in stroke patients, study finds (Image credit: iStock)
For years, slow and steady exercise has been the primary recommendation for stroke survivors recover safely. However, a new study published in the journal Stroke suggests that high intensity interval training (High intensity training (HIIT)) may offer even greater benefits for some stroke survivors, without increasing the risk of health complications.
The study, led by Dr. Ada Tang, a physical therapist and professor of rehabilitation sciences at McMaster University in Ontario, revealed whether exercise intensity plays a crucial role in recovery after stroke. “There were promising studies that indicated that more intense exercise may be better than low or moderate intensities after stroke,” says Dr. Tang. “But we didn’t know if we could safely force people with stroke to do high-intensity exercise.”
To investigate further, Dr. Tang and her team conducted a study involving 82 stroke survivors. These participants, with an average age of 65, were able to walk and exercise at the start of the study. They were randomly assigned to one of two exercise regimens, both to be followed three days a week for 12 weeks. One group participated in a 19-minute HIIT workout, which included 10 one-minute intervals of high-intensity exercise interspersed with nine one-minute intervals of low-intensity exercise. The other group performed up to 30 minutes of moderate-intensity steady-state exercise.
Throughout the study, researchers assessed participants’ walking ability and cardiovascular risk factors, such as blood pressure and blood vessel stiffness, at three key time points: before the study began, at the end of the 12-week intervention, and again eight weeks later. They also measured cardiorespiratory fitness, specifically VO2 max, which represents the maximum amount of oxygen the body can use in one minute during sustained exercise.
The results revealed that at the end of the 12-week intervention, participants who performed high-intensity training showed a two-fold improvement in oxygen consumption compared to those who performed moderate-intensity training. Even after an additional eight weeks of follow-up, the high-intensity training group continued to show improved cardiorespiratory fitness, although the difference had narrowed to the point where it could potentially be attributed to chance.
Both exercise regimens resulted in improvements in walking speed, but there were no significant differences between the two groups. Similarly, no notable differences were found in cardiovascular risk factors such as blood pressure or blood vessel stiffness.
Importantly, the study also concluded that both exercise regimens were safe for stroke survivors. No participants experienced any adverse effects such as fatigue, shortness of breath, muscle pain, cramps or dizziness during their workouts.
“These findings provide strong evidence that short, high-intensity interval training protocols can be safely and effectively implemented in clinical practice for stroke rehabilitation,” said Dr. Tang. “We showed that HIIT improves physical fitness and walking distance in stroke survivors, which are critical outcomes for their recovery.”
Limitations of the study
Despite the promising results, experts caution that more research is needed before HIIT can be universally recommended for all stroke survivors. “The results of this study are exciting,” said Dr. Sandra Billinger, a professor of neurology at the University of Kansas Medical Center who was not involved in the study. “However, the field still lacks definitive evidence to recommend HIIT for all stroke survivors.”
Dr. Billinger advises stroke survivors to consult with their health care providers, including physical therapists, to determine if HIIT is appropriate for them and to ensure that exercise equipment is tailored to their physical capabilities.
Dr. Joshua Willey, associate professor of neurology at Columbia University, emphasizes that even higher-functioning stroke survivors should not attempt to do HIIT on their own at home without proper guidance and supervision.
While HIIT may have significant potential to improve stroke recovery, survivors should work closely with health experts to tailor their exercise plans to their needs and abilities.
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