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. 2022 Feb 4:13:812875.
doi: 10.3389/fneur.2022.812875. eCollection 2022.

Preliminary Outcomes of Combined Treadmill and Overground High-Intensity Interval Training in Ambulatory Chronic Stroke

Pierce Boyne  1 , Sarah Doren  1 , Victoria Scholl  1 , Emily Staggs  1 , Dustyn Whitesel  1 , Daniel Carl  1 , Rhonna Shatz  2 , Russell Sawyer  2 , Oluwole O Awosika  2 , Darcy S Reisman  3 , Sandra A Billinger  4 , Brett Kissela  2 , Jennifer Vannest  5 , Kari Dunning  1
Affiliations

Preliminary Outcomes of Combined Treadmill and Overground High-Intensity Interval Training in Ambulatory Chronic Stroke

Pierce Boyne et al. Front Neurol. .

Abstract

Purpose: Locomotor high-intensity interval training (HIIT) is a promising intervention for stroke rehabilitation. However, overground translation of treadmill speed gains has been somewhat limited, some important outcomes have not been tested and baseline response predictors are poorly understood. This pilot study aimed to guide future research by assessing preliminary outcomes of combined overground and treadmill HIIT.

Materials and methods: Ten participants >6 months post-stroke were assessed before and after a 4-week no-intervention control phase and a 4-week treatment phase involving 12 sessions of overground and treadmill HIIT.

Results: Overground and treadmill gait function both improved during the treatment phase relative to the control phase, with overground speed changes averaging 61% of treadmill speed changes (95% CI: 33-89%). Moderate or larger effect sizes were observed for measures of gait performance, balance, fitness, cognition, fatigue, perceived change and brain volume. Participants with baseline comfortable gait speed <0.4 m/s had less absolute improvement in walking capacity but similar proportional and perceived changes.

Conclusions: These findings reinforce the potential of locomotor HIIT research for stroke rehabilitation and provide guidance for more definitive studies. Based on the current results, future locomotor HIIT studies should consider including: (1) both overground and treadmill training; (2) measures of cognition, fatigue and brain volume, to complement typical motor and fitness assessment; and (3) baseline gait speed as a covariate.

Keywords: aerobic exercise; brain; gait; locomotion; magnetic resonance imaging.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
Individual changes for selected outcomes. Upper: Solid black lines show individual outcome trajectories across measurement time points. Dashed gray lines show mean estimates. Lower: Black circles show individual changes from previous time point. §Lower score = less fatigue. ∧Adjusted for head size. PROMIS, Patient Reported Outcomes Measurement Information System; FCSRT, free and cued selective reminding test.
See this image and copyright information in PMC

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