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.