Abstract
Background: High-intensity interval training (HIIT) is superior to moderate-intensity continuous training in improving cardiorespiratory fitness in patients with cardiovascular disease, but is it safe, feasible and effective in patients with stroke? We investigated feasibility and effect of early, home-based HIIT in patients with lacunar stroke combined with usual care vs. usual care, only.Methods: Patients with minor stroke (severity: 55/58 point on the Scandinavian Stroke Scale) were randomized to HIIT or usual care in a randomized, controlled trial. We measured the following outcomes at baseline and post-intervention: cardiorespiratory fitness monitored as power output from the Graded Cycling Test with Talk Test (GCT-TT; primary outcome), physical activity, fatigue, depression, well-being, stress, cognition, endothelial function, blood pressure, body mass index, and biomarkers.Results: We included 71 patients (mean age 63.7 ± 9.2), 49 men, 31 in intervention group. Home-based HIIT was feasible with no reported adverse events in relation to the intervention. No significant change between the groups in GCT-TT power output was detected (p = 0.90). The change in time spent on vigorous-intensity activity was 2 h/week and 0.6 h/week, intervention and usual care, respectively (p = 0.045). There were no significant differences between groups in the remaining secondary outcomes.Conclusion: HIIT was feasible and safe in patients with lacunar stroke. Patients can engage early in home-based HIIT when involved in choosing exercise modality and guided by weekly motivational phone calls. Within 3 months, HIIT did, however, not yield effect on cardiorespiratory fitness. We await further evaluation of long-term effects of this intervention on continued regular physical exercise and cardiovascular event.Clinical Trial Registration: https://clinicaltrials.gov, identifier NCT02731235
Highlights
Stroke is one of the leading causes of mortality and disability [1]
No significant differences were found between the groups in terms of demographics or baseline characteristics (Table 1), and no adverse events related to the intervention were recorded during the study
We screened records on all patients admitted to the stroke unit (n = 3,098) daily and excluded 2,969 patients who did not have a diagnosis of lacunar stroke
Summary
Stroke is one of the leading causes of mortality and disability [1]. Approximately 90% of strokes are attributed to modifiable risk factors, and 75% of the global stroke burden may be avoided by control of behavioral and metabolic risk factors [2]. The international multicentre study INTERSTROKE [5] highlighted ten common modifiable risk factors associated with ischemic stroke and identified physical inactivity as one of the most important. Physical activity and stroke risk factors can evoke changes in inflammatory, endothelial and cardiovascular biomarkers, which may be used to monitor risk factor load, disease progression, or effect of specific interventions [10]. High-intensity interval training (HIIT) is superior to moderate-intensity continuous training in improving cardiorespiratory fitness in patients with cardiovascular disease, but is it safe, feasible and effective in patients with stroke? We investigated feasibility and effect of early, home-based HIIT in patients with lacunar stroke combined with usual care vs usual care, only High-intensity interval training (HIIT) is superior to moderate-intensity continuous training in improving cardiorespiratory fitness in patients with cardiovascular disease, but is it safe, feasible and effective in patients with stroke? We investigated feasibility and effect of early, home-based HIIT in patients with lacunar stroke combined with usual care vs. usual care, only
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