Moderate-Intensity Exercise Versus High-Intensity Interval Training to Recover Walking Post-Stroke

The objective of the HIT-Stroke Trial was to determine the optimal training intensity and the minimum training duration needed to maximize immediate improvements in walking capacity in chronic stroke. A single-blind, phase II, 3-site randomized controlled trial was conducted. Fifty-five persons >6 months post stroke were randomized to either moderate-intensity aerobic training (MAT) or high-intensity interval training (HIT); each involving 45 minutes of walking exercise, 3x/week for up to 36 total sessions over approximately 12 weeks. Clinical measures of walking function, aerobic fitness, daily walking activity and quality of life were assessed by blinded raters at baseline (PRE) and after 4, 8 and 12 weeks of training. The 6-minute walk test (6MWT) was the primary outcome measure. Groups had similar 6MWT changes after 4 weeks, but HIT elicited greater gains than MAT after 8 weeks and 12 weeks of training. Within the HIT group, 6MWT outcomes continued to improve after each 4 week training block. HIT also showed greater improvements than MAT on some secondary measures of gait speed and fatigue.

HIT-Stroke试验（HIT-Stroke Trial）的研究目标为确定可最大化慢性脑卒中患者步行能力即时改善效果的最优训练强度与最低训练时长。本研究为单盲、Ⅱ期、3中心随机对照试验，共纳入55名卒中发病超过6个月的受试者，随机分配至中等强度有氧训练（Moderate-Intensity Aerobic Training, MAT）组与高强度间歇训练（High-Intensity Interval Training, HIT）组；两组均接受每次45分钟的步行训练，每周3次，总训练周期约12周，累计最多36个训练单元。由盲法评估者在基线（PRE）、训练第4、8、12周时，对受试者的步行功能、有氧耐力、日常步行活动量与生活质量开展临床评估。6分钟步行试验（6-Minute Walk Test, 6MWT）为本次试验的主要结局指标。两组在训练4周后的6MWT改善幅度相近，但训练8周及12周后，HIT组的提升效果显著优于MAT组。在HIT组内部，每完成一轮4周的训练周期后，6MWT的结局指标均持续改善。此外，在步态速度与疲劳感这两项次要结局指标上，HIT组的改善程度同样优于MAT组。