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

Tor Ivar Gjellesvik; Frank Becker; Arnt Erik Tjønna; Bent Indredavik; Eivind Lundgaard; Hedvig Solbakken; Berit Brurok; Tom Tørhaug; Stian Lydersen; Torunn Askim

doi:10.1016/j.apmr.2021.05.008

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

Arch Phys Med Rehabil. 2021 Sep;102(9):1683-1691. doi: 10.1016/j.apmr.2021.05.008. Epub 2021 Jun 6.

Authors

Affiliations

¹ Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim; Department of Physical Medicine and Rehabilitation, St Olav's Hospital, The University Hospital in Trondheim, Trondheim. Electronic address: tor.i.gjellesvik@ntnu.no.
² Department of Research, Sunnaas Rehabilitation Hospital, Oslo; Institute of Clinical Medicine, University of Oslo, Faculty of Medicine, Oslo.
³ Department of Circulation and Medical Imaging, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim; Central Administration, St Olav's Hospital, The University Hospital in Trondheim, Trondheim.
⁴ Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim; Stroke Unit, Department of Internal Medicine, St Olav's Hospital, The University Hospital in Trondheim, Trondheim.
⁵ Department of Research, Sunnaas Rehabilitation Hospital, Oslo.
⁶ Department of Physical Medicine and Rehabilitation, Ålesund Hospital, Ålesund.
⁷ Department of Physical Medicine and Rehabilitation, St Olav's Hospital, The University Hospital in Trondheim, Trondheim.
⁸ Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim; Department of Physical Medicine and Rehabilitation, St Olav's Hospital, The University Hospital in Trondheim, Trondheim.
⁹ Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.

PMID: 34102144
DOI: 10.1016/j.apmr.2021.05.008

Abstract

Objective: To assess the effects of high-intensity interval training (HIIT) on physical, mental, and cognitive functioning after stroke.

Design: The HIIT Stroke Study was a single-blind, multicenter, parallel-group randomized controlled trial.

Setting: Specialized rehabilitation units at 3 Norwegian hospitals.

Participants: Adult stroke survivors (N=70) 3 months to 5 years after a first-ever stroke. Mean age was 57.6±9.2 years and 58.7±9.2 years in the intervention and control groups, respectively.

Interventions: Participants were randomized to standard care in combination with 4×4 minutes of treadmill HIIT at 85%-95% of peak heart rate or standard care only.

Outcomes: Outcomes were measured using physical, mental, and cognitive tests and the FIM and Stroke Impact Scale. Linear mixed models were used to analyze differences between groups at posttest and 12-month follow-up.

Results: The intervention group showed a significant treatment effect (95% confidence interval [CI]) from baseline to posttest on a 6-minute walk test of 28.3 (CI, 2.80-53.77) meters (P=.030); Berg Balance Scale 1.27 (CI, 0.17-2.28) points (P=.025); and Trail Making Test Part B (TMT-B; -24.16 [CI, -46.35 to -1.98] s, P=.033). The intervention group showed significantly greater improvement on TMT-B at the 12-month follow-up (25.44 [CI, -49.01 to -1.87] s, P=.035). The control group showed significantly greater improvement in total Functional Independence Measure score with a treatment effect of -2.37 (CI, -4.30 to -0.44) points (P=.016) at 12-month follow-up. No significant differences were identified between groups on other outcomes at any time point.

Conclusions: HIIT combined with standard care improved walking distance, balance, and executive function immediately after the intervention compared with standard care only. However, only TMT-B remained significant at the 12-month follow-up.

Keywords: Cognition; Function; High-intensity interval training; RCT; Rehabilitation; Stroke.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cognition / physiology*
Female
High-Intensity Interval Training / methods*
Humans
Male
Middle Aged
Postural Balance / physiology*
Quality of Life
Single-Blind Method
Stroke Rehabilitation / methods*
Surveys and Questionnaires
Walk Test
Walking / physiology*