Feasibility of single session high-intensity interval training utilizing speed and active recovery to push beyond standard practice post-stroke

ABSTRACT

Background: Improvement in overground walking speed reduces dependency and is a central focus in post-stroke rehabilitation. Previous studies have shown that high-intensity interval training (HIT) can significantly improve functional and health-related outcomes in neurologically health individuals more so than traditional approaches. Emerging evidence suggests the same may be true post-stroke.

Objective: The purpose of this study was to assess the feasibility of a single session, novel HIT design.

Methods: Participants walked on a treadmill, alternating between one minute at high-intensity and one minute at low-intensity for 20 minutes, adjusting the speed of the treadmill to dictate intensity. Treadmill speeds were determined from overground self-selected walking speed (SSWS).

Results: No adverse events occurred during the training sessions. High-intensity treadmill speeds were significantly faster than treadmill SSWS (standard practice; +227%; p < 0.0001) and overground SSWS (+142%; p = 0.003). 15 of the 21 subjects were able to walk on the treadmill at 150% of overground SSWS; with the remaining individuals (n = 6) walking at 123% of overground SSWS. Average peak heart rate during HIT was 90% of age-predicted max.

Conclusions: These results demonstrate the feasibility of this single session HIT design and suggest that individuals following stroke are capable of prolonged training at speeds significantly faster than standard practice. Additionally, this training intensity elicited heart rate responses in the upper range of vigorous exercise. Future studies are needed to investigate a progressive HIT intervention applying this design and its effects on functional outcomes as well as cardiovascular fitness.

KEYWORDS:

• Chronic stroke
• exercise
• high-intensity interval training
• walking speed

Disclosure statement

The authors report no conflicts of interest.

OBE statement—checklist of items that should be included in reports of observational studies.

Additional information

Funding

This work was supported by the Institutional Development Award from the National Institute of General Medical Sciences of the NIH [Grant number P20-GM109040].