Advertisement

Randomized Controlled Trial of the Lateral Push-Off Skater Exercise for High-Intensity Interval Training vs Conventional Treadmill Training

  • Soo-Hyun Soh
    Affiliations
    Department of Rehabilitation Medicine, Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, Iksan, Republic of Korea
    Search for articles by this author
  • Min Cheol Joo
    Affiliations
    Department of Rehabilitation Medicine, Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, Iksan, Republic of Korea
    Search for articles by this author
  • Na Ri Yun
    Affiliations
    Department of Rehabilitation Medicine, Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, Iksan, Republic of Korea
    Search for articles by this author
  • Min-Su Kim
    Correspondence
    Corresponding author Min-Su Kim, MD, PhD, Department of Rehabilitation Medicine, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan-si, Jeollabuk-do, 54538, Republic of Korea.
    Affiliations
    Department of Rehabilitation Medicine, Wonkwang University School of Medicine and Institute of Wonkwang Medical Science, Iksan, Republic of Korea
    Search for articles by this author
Published:September 25, 2019DOI:https://doi.org/10.1016/j.apmr.2019.08.480

      Abstract

      Objective

      To examine the therapeutic effects of the lateral push-off skater exercise vs conventional treadmill training on health-related quality of life, cardiorespiratory fitness (CRF), and balance.

      Design

      Single-blinded, randomized controlled trial.

      Setting

      Outpatient clinic at a tertiary hospital.

      Participants

      Patients after minor stroke (N=36) with National Institutes of Health Stroke Scale scores≤3 between 20 and 65 years of age were randomly assigned to the intervention group (n=18) or the control group (n=18).

      Interventions

      Thirty-minute sessions of the skater exercise were performed 3 times weekly for 12 weeks in the intervention group. Conventional treadmill aerobic exercise was conducted in the control group at the same frequency and duration as the experimental group exercise.

      Main Outcome Measures

      The primary outcome was measured using the European Quality of Life–5 Dimension (EQ-5D). Secondary outcomes included CRF and balance indicators. Assessments were performed at baseline (T0), 12 weeks from T0 (T1), and 16 weeks from T0 (T2).

      Results

      Significant improvements in EQ-5D, peak oxygen uptake (VO2peak), peak oxygen pulse, peak minute ventilation (VE), Dynamic Gait Index (DGI), and Berg Balance Scale (BBS) were found in the intervention group after performing the skater exercise (P<.05, all), and these improvements were sustained at T2 (P<.05, all). Between-group comparisons demonstrated greater improvements in EQ-5D, VO2peak, peak oxygen pulse, peak VE, DGI, and BBS in the intervention group than those in the control group at both T1 (P<.05, all) and T2 (P<0.05, all). Correlation analysis showed significant relationships between EQ-5D and VO2peak, peak VE, DGI, and BBS (P<.05, all).

      Conclusions

      The skater exercise improved health-related quality of life, CRF, and balance in patients after minor stroke more effectively than conventional treadmill-based aerobic exercise. We recommend the skater exercise as a high-intensity interval training program for patients after minor stroke.

      Keywords

      List of abbreviations:

      BBS (Berg Balance Scale), CRF (cardiorespiratory fitness), DGI (Dynamic Gait Index), EQ-5D (European Quality of Life–5 Dimension), HR-QOL (health-related quality of life), HIIT (high-intensity interval training), VE (minute ventilation), VO2peak (peak oxygen consumption)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Fischer U.
        • Baumgartner A.
        • Arnold M.
        • et al.
        What is a minor stroke?.
        Stroke. 2010; 41: 661-666
        • Fonarow G.C.
        • Saver J.L.
        • Smith E.E.
        • et al.
        Relationship of national institutes of health stroke scale to 30-day mortality in medicare beneficiaries with acute ischemic stroke.
        J Am Heart Assoc. 2012; 1: 42-50
        • Batchelor F.A.
        • Williams S.B.
        • Wijeratne T.
        • Said C.M.
        • Petty S.
        Balance and gait impairment in transient ischemic attack and minor stroke.
        J Stroke Cerebrovasc Dis. 2015; 24: 2291-2297
        • Li J.
        • You S.J.
        • Xu Y.N.
        • et al.
        Cognitive impairment and sleep disturbances after minor ischemic stroke.
        Sleep Breath. 2019; 23: 455-462
        • Moran G.M.
        • Fletcher B.
        • Feltham M.G.
        • Calvert M.
        • Sackley C.
        • Marshall T.
        Fatigue, psychological and cognitive impairment following transient ischaemic attack and minor stroke: a systematic review.
        Eur J Neurol. 2014; 21: 1258-1267
        • McHutchison C.A.
        • Cvoro V.
        • Makin S.
        • Chappell F.M.
        • Shuler K.
        • Wardlaw J.M.
        Functional, cognitive and physical outcomes 3 years after minor lacunar or cortical ischaemic stroke.
        J Neurol Neurosurg Psychiatry. 2019; 90: 436-443
        • Sangha R.S.
        • Caprio F.Z.
        • Askew R.
        • et al.
        Quality of life in patients with TIA and minor ischemic stroke.
        Neurology. 2015; 85: 1957-1963
        • Heron N.
        • Kee F.
        • Donnelly M.
        • Cupples M.E.
        Systematic review of rehabilitation programmes initiated within 90 days of a transient ischaemic attack or ‘minor' stroke: a protocol.
        BMJ Open. 2015; 5e007849
        • Toledano-Zarhi A.
        • Tanne D.
        • Carmeli E.
        • Katz-Leurer M.
        Feasibility, safety and efficacy of an early aerobic rehabilitation program for patients after minor ischemic stroke: a pilot randomized controlled trial.
        NeuroRehabilitation. 2011; 28: 85-90
        • Heron N.
        • Kee F.
        • Cardwell C.
        • Tully M.A.
        • Donnelly M.
        • Cupples M.E.
        Secondary prevention lifestyle interventions initiated within 90 days after TIA or ‘minor' stroke: a systematic review and meta-analysis of rehabilitation programmes.
        Br J Gen Pract. 2017; 67: e57-e66
        • Faulkner J.
        • Stoner L.
        • Lanford J.
        • Jolliffe E.
        • Mitchelmore A.
        • Lambrick D.
        Long-term effect of participation in an early exercise and education program on clinical outcomes and cost implications, in patients with TIA and minor, non-disabling stroke.
        Transl Stroke Res. 2017; 8: 220-227
        • Boss H.M.
        • Deijle I.A.
        • Van Schaik S.M.
        • et al.
        Cardiorespiratory fitness after transient ischemic attack and minor ischemic stroke: baseline data of the MoveIT study.
        J Stroke Cerebrovasc Dis. 2017; 26: 1114-1120
        • Rosenfeldt A.B.
        • Linder S.M.
        • Davidson S.
        • et al.
        Combined aerobic exercise and task practice improve health-related quality of life after stroke: a preliminary analysis.
        Arch Phys Med Rehabil. 2019; 100: 923-930
        • Boss H.M.
        • Van Schaik S.M.
        • Deijle I.A.
        • et al.
        Safety and feasibility of post-stroke care and exercise after minor ischemic stroke or transient ischemic attack: MotiveS & MoveIT.
        NeuroRehabilitation. 2014; 34: 401-407
        • Saunders D.H.
        • Sanderson M.
        • Hayes S.
        • et al.
        Physical fitness training for stroke patients.
        Cochrane Database Syst Rev. 2016; 3: CD003316
        • Munari D.
        • Pedrinolla A.
        • Smania N.
        • et al.
        High-intensity treadmill training improves gait ability, VO2peak and cost of walking in stroke survivors: preliminary results of a pilot randomized controlled trial.
        Eur J Phys Rehabil Med. 2018; 54: 408-418
        • Romero-Franco N.
        • Jimenez-Reyes P.
        Unipedal postural balance and countermovement jumps after a warm-up and plyometric training session: a randomized controlled trial.
        J Strength Cond Res. 2015; 29: 3216-3222
        • Pellegrino J.
        • Ruby B.C.
        • Dumke C.L.
        Effect of plyometrics on the energy cost of running and MHC and titin isoforms.
        Med Sci Sports Exerc. 2016; 48: 49-56
        • Behrens M.
        • Mau-Moeller A.
        • Mueller K.
        • et al.
        Plyometric training improves voluntary activation and strength during isometric, concentric and eccentric contractions.
        J Sci Med Sport. 2016; 19: 170-176
        • Globas C.
        • Becker C.
        • Cerny J.
        • et al.
        Chronic stroke survivors benefit from high-intensity aerobic treadmill exercise: a randomized control trial.
        Neurorehabil Neural Repair. 2012; 26: 85-95
        • Boyne P.
        • Dunning K.
        • Carl D.
        • Gerson M.
        • Khoury J.
        • Kissela B.
        High-intensity interval training in stroke rehabilitation.
        Top Stroke Rehabil. 2013; 20: 317-330
        • Gama G.L.
        • Celestino M.L.
        • Barela J.A.
        • Forrester L.
        • Whitall J.
        • Barela A.M.
        Effects of gait training with body weight support on a treadmill versus overground in individuals with stroke.
        Arch Phys Med Rehabil. 2017; 98: 738-745
        • Chen P.
        • Lin K.C.
        • Liing R.J.
        • Wu C.Y.
        • Chen C.L.
        • Chang K.C.
        Validity, responsiveness, and minimal clinically important difference of EQ-5D-5L in stroke patients undergoing rehabilitation.
        Qual Life Res. 2016; 25: 1585-1596
        • Hunger M.
        • Sabariego C.
        • Stollenwerk B.
        • Cieza A.
        • Leidl R.
        Validity, reliability and responsiveness of the EQ-5D in German stroke patients undergoing rehabilitation.
        Qual Life Res. 2012; 21: 1205-1216
      1. ATS/ACCP statement on cardiopulmonary exercise testing.
        Am J Respir Crit Care Med. 2003; 167: 211-277
        • Jonsdottir J.
        • Cattaneo D.
        Reliability and validity of the dynamic gait index in persons with chronic stroke.
        Arch Phys Med Rehabil. 2007; 88: 1410-1415
        • Adey-Wakeling Z.
        • Crotty M.
        • Shanahan E.M.
        Suprascapular nerve block for shoulder pain in the first year after stroke: a randomized controlled trial.
        Stroke. 2013; 44: 3136-3141
        • Felser S.
        • Behrens M.
        • Fischer S.
        • et al.
        Relationship between strength qualities and short track speed skating performance in young athletes.
        Scand J Med Sci Sports. 2016; 26: 165-171
        • Fryer C.E.
        • Luker J.A.
        • McDonnell M.N.
        • Hillier S.L.
        Self management programmes for quality of life in people with stroke.
        Cochrane Database Syst Rev. 2016; : CD010442
        • Thilarajah S.
        • Mentiplay B.F.
        • Bower K.J.
        • et al.
        Factors associated with post-stroke physical activity: a systematic review and meta-analysis.
        Arch Phys Med Rehabil. 2018; 99: 1876-1889
        • Chen C.M.
        • Tsai C.C.
        • Chung C.Y.
        • Chen C.L.
        • Wu K.P.
        • Chen H.C.
        Potential predictors for health-related quality of life in stroke patients undergoing inpatient rehabilitation.
        Health Qual Life Outcomes. 2015; 13: 118
        • Cohen J.W.
        • Ivanova T.D.
        • Brouwer B.
        • Miller K.J.
        • Bryant D.
        • Garland S.J.
        Do performance measures of strength, balance, and mobility predict quality of life and community reintegration after stroke?.
        Arch Phys Med Rehabil. 2018; 99: 713-719
        • Schmid A.A.
        • Van Puymbroeck M.
        • Altenburger P.A.
        • Miller K.K.
        • Combs S.A.
        • Page S.J.
        Balance is associated with quality of life in chronic stroke.
        Top Stroke Rehabil. 2013; 20: 340-346
        • Gillen J.B.
        • Gibala M.J.
        Is high-intensity interval training a time-efficient exercise strategy to improve health and fitness?.
        Appl Physiol Nutr Metab. 2014; 39: 409-412
        • Boyne P.
        • Dunning K.
        • Carl D.
        • et al.
        High-intensity interval training and moderate-intensity continuous training in ambulatory chronic stroke: feasibility study.
        Phys Ther. 2016; 96: 1533-1544
        • Carl D.L.
        • Boyne P.
        • Rockwell B.
        • et al.
        Preliminary safety analysis of high-intensity interval training (HIIT) in persons with chronic stroke.
        Appl Physiol Nutr Metab. 2017; 42: 311-318
        • Pang M.Y.
        • Charlesworth S.A.
        • Lau R.W.
        • Chung R.C.
        Using aerobic exercise to improve health outcomes and quality of life in stroke: evidence-based exercise prescription recommendations.
        Cerebrovasc Dis. 2013; 35: 7-22
        • Howe T.E.
        • Rochester L.
        • Neil F.
        • Skelton D.A.
        • Ballinger C.
        Exercise for improving balance in older people.
        Cochrane Database Syst Rev. 2011; : CD004963
        • Schiftan G.S.
        • Ross L.A.
        • Hahne A.J.
        The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: a systematic review and meta-analysis.
        J Sci Med Sport. 2015; 18: 238-244
        • Winter T.
        • Beck H.
        • Walther A.
        • Zwipp H.
        • Rein S.
        Influence of a proprioceptive training on functional ankle stability in young speed skaters - a prospective randomised study.
        J Sports Sci. 2015; 33: 831-840
        • Hall E.A.
        • Docherty C.L.
        • Simon J.
        • Kingma J.J.
        • Klossner J.C.
        Strength-training protocols to improve deficits in participants with chronic ankle instability: a randomized controlled trial.
        J Athl Train. 2015; 50: 36-44