Effectiveness of High‐Intensity Interval Training for Fitness and Mobility Post Stroke: A Systematic Review

Abstract

Objective To evaluate the evidence on the effectiveness of high‐intensity interval training (HIIT) in improving fitness and mobility post stroke. Type Systematic review. Literature Survey Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for articles published in English up to January 2018. Methodology Studies were included if the sample was adult human participants with stroke, the sample size was ≥3, and participants received >1 session of HIIT. Study and participant characteristics, treatment protocols, and results were extracted. Synthesis Six studies with a total of 140 participants met inclusion criteria: three randomized controlled trials and three pre‐post studies. HIIT protocols ranged 20 to 30 minutes per session, 2 to 5 times per week, and 2 to 8 weeks in total. HIIT was delivered on a treadmill in five studies and a stationary bicycle in one study. Regarding fitness measures, HIIT produced significant improvements in peak oxygen consumption compared to baseline, but the effect was not significant compared to moderate intensity continuous exercise (MICE). Regarding mobility measures, HIIT produced significant improvements on the 10‐Meter Walk Test (10MWT), 6‐Minute Walk Test (6MWT), Berg Balance Scale (BBS), Functional Ambulation Categories (FAC), Timed Up and Go Test, and Rivermead Motor Assessment compared to baseline. The effect of HIIT was significant compared to MICE on the 10MWT and FAC but not on the 6MWT or BBS. Conclusions There is preliminary evidence that HIIT may be an effective rehabilitation intervention for improving some aspects of cardiorespiratory fitness and mobility post stroke. Level of Evidence I.

Intensity of daily physical activity – a key component for improving physical capacity after minor stroke?

“…Further, more prolonged PA bouts (e.g., >10 min) have a more positive effect on PC compared to shorter bouts [23]. In the present study, in accordance with Wiener et al [22], we considered PC to be a comprehensive term represented by independent validated tests so as to obtain insight into several PC components [4]. Unraveling the complex interactions between PA and PC outcomes will aid in improving the effectiveness of interventions and guidelines [24].…”

“…However, given this multidimensionality, it is expected that not all PA dimensions will be similarly related to PC outcomes. For example, the review by Wiener et al [22] indicates that being physically active at a high intensity has a more substantial effect on diverse capacity measures (for example, the 10MWT, Berg Balance Scale, Timed Up & GO) compared to moderate intensity. Further, more prolonged PA bouts (e.g., >10 min) have a more positive effect on PC compared to shorter bouts [23].…”

High‐intensity exercise to improve cardiorespiratory fitness in cancer patients and survivors: A systematic review and meta‐analysis

“…30,31 High-intensity training (HIT) can induce greater improvements in CRFit than moderate continuous aerobic exercise in patients with heart failure 32 or stroke. 33 In cancer patients, different RTC of HIT have demonstrated improved CRFit in comparison with controls 34,35 or moderate-intensity exercise. 36 The optimal characteristics of high-intensity exercise are still unknown, and some examples of non-successful (in terms of CRFit) interventions can be read.…”

Effects of High-Intensity Interval Training After Stroke (The HIIT Stroke Study) on Physical and Cognitive Function: A Multicenter Randomized Controlled Trial

“…High-intensity interval training (HIIT) has emerged as a popular and potent exercise modality (7,8). This intervention has been shown to be safe and feasible for use in the stroke population with promising findings on both VO 2peak and mobility (7,(9)(10)(11)(12)(13). To better understand the effectiveness of HIIT in stroke rehabilitation, high-quality RCTs assessing the impact of HIIT on important clinical outcomes including physical, mental, and cognitive functions are warranted (12,13).…”