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Effects of high-intensity interval training after stroke (the HIIT-stroke study): a multicenter randomized controlled trial
Gjellesvik TI, Becker F, Tjonna AE, Indredavik B, Nilsen H, Brurok B, Torhaug T, Busuladzic M, Lydersen S, Askim T
Archives of Physical Medicine and Rehabilitation 2020 Jun;101(6):939-947
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To examine if 8 weeks of high-intensity interval training (HIIT) in addition to standard care would increase and maintain peak oxygen uptake (VO2peak) more than standard care alone in patients with stroke. DESIGN: This was a single-blind, multicenter, parallel group, randomized controlled trial. SETTING: Specialized rehabilitation units at 3 Norwegian hospitals. PARTICIPANTS: Participants (N = 70), 3 months to 5 years after first-ever stroke, were randomly assigned to the intervention group (n = 36) or the control group (n = 34); 42% were women, mean age was 57.6 +/- 9.3 years, mean time post stroke was 26.4 +/- 14.5 months. INTERVENTION: The intervention was 8 weeks: 3 times a week with HIIT treadmill training with work periods of 4x4 minutes at 85% to 95% of peak heart rate interspersed with 3 minutes of active recovery at 50% to 70% of peak heart rate. The control group received standard care according to national guidelines. OUTCOMES: The primary outcome, analyzed by intention-to-treat, was VO2peak measured as liters per minute 12 months after inclusion. Secondary outcome measures were blood pressure and blood profile. RESULTS: Mean baseline VO2peak was 2.63 +/- 1.08 L/min versus 2.87 +/- 0.71 L/min, while at 12 months VO2peak was 2.70 +/- 1.00 L/min versus 2.67 +/- 0.76 L/min (p = 0.068) in the intervention and control groups, respectively. There was a significant and greater improvement in the intervention group compared with the control group at 12 months in 3 of 6 secondary outcomes from the peak test but no significant differences for blood pressure or blood profile. CONCLUSIONS: The HIIT intervention, which was well-tolerated in this sample of well-functioning survivors of stroke, was not superior to standard care in improving and maintaining VO2peak at the 12-month follow-up. However, secondary results from the peak test showed a significant improvement from before to immediately after the intervention.

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