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Effects of High-Intensity Interval Training After Stroke (the HIIT-Stroke Study): A Multicenter Randomized Controlled Trial

  • Tor Ivar Gjellesvik
    Correspondence
    Corresponding author Tor Ivar Gjellesvik, MSc, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, 7491 Trondheim, Norway.
    Affiliations
    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway

    Department of Physical Medicine and Rehabilitation, St Olav’s University Hospital, Trondheim, Norway
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  • Frank Becker
    Affiliations
    Department of Research, Sunnaas Rehabilitation Hospital, Oslo, Norway

    Institute of Clinical Medicine, University of Oslo, Faculty of Medicine, Oslo, Norway
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  • Arnt Erik Tjønna
    Affiliations
    Department of Circulation and Medical Imaging, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway

    NeXt Move, NTNU, Trondheim, Norway
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  • Bent Indredavik
    Affiliations
    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway

    Stroke Unit, Department of Internal Medicine, St Olav’s University Hospital, Trondheim, Norway
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  • Halvard Nilsen
    Affiliations
    Department of Physical Medicine and Rehabilitation, Ålesund Hospital, Ålesund, Norway
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  • Berit Brurok
    Affiliations
    Department of Physical Medicine and Rehabilitation, St Olav’s University Hospital, Trondheim, Norway

    Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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  • Tom Tørhaug
    Affiliations
    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway

    Department of Physical Medicine and Rehabilitation, St Olav’s University Hospital, Trondheim, Norway
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  • Maja Busuladzic
    Affiliations
    Department of Research, Sunnaas Rehabilitation Hospital, Oslo, Norway
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  • Stian Lydersen
    Affiliations
    Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
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  • Torunn Askim
    Affiliations
    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway

    Stroke Unit, Department of Internal Medicine, St Olav’s University Hospital, Trondheim, Norway
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Published:March 04, 2020DOI:https://doi.org/10.1016/j.apmr.2020.02.006

      Abstract

      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 4 × 4 minutes at 85%-95% of peak heart rate interspersed with 3 minutes of active recovery at 50%-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−1 vs 2.87±0.71 L·min−1, while at 12 months Vo2peak was 2.70±1.00 L·min−1 vs 2.67±0.76 L·min−1 (P=.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.

      Keywords

      List of abbreviations:

      HIIT (high-intensity interval training), PT (physical therapist), Vo2peak (peak oxygen uptake)
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