Exercise intensity matters in the rehabilitation of stroke in the acute stage: a randomized controlled trial

Elogni Renaud Amanzonwé, Peter Feys, Oyene Kossi
Purpose:

This study aimed to assess the efficacy of adding HIIT vs combining unloaded cycling to conventional physiotherapy on exercise capacity, functional ability, disability level, and health-related quality of life (HRQoL) in the early post-stroke stageThis study aimed to assess the efficacy of adding HIIT vs combining unloaded cycling to conventional physiotherapy on exercise capacity, functional ability, disability level, and health-related quality of life (HRQoL) in the early post-stroke stage

Methods:

A double-blind randomized controlled trial was conducted. All participants received 30-minute of conventional physiotherapy. Furthermore, the control (SHAM) group (n=22) received volume-matched unloaded cycling, while the intervention group (n= 22) performed HIIT for 20 to 30 minutes, 3 times a week for 6-week, with 3- and 6-months follow-up. The primary outcome was exercise capacity measured by a maximal exercise test. Secondary outcomes included balance: Berg Balance Scale [BBS], walking ability: 6-minute and 10-meter walk tests [6MWT and 10mWT], lower extremity muscle strength: 5-Repetition Sit-To-Stand test [5R-STS], disability level: modified Rankin Scale [mRS] and HRQoL by EuroQOL five-dimension questionnaire [EQ-5D]. 

Results:

At 6-week, change in exercise capacity for HIIT versus SHAM was 28.1±12.8 versus 10.4±11.5 watts (mean, +17.7 [95% CI, 10.2 to 25.1]), change in 6MWT was 220.7±82 versus 93.8±78.7 m (mean, +126.8 [95% CI, 77.9 to 175.7]), change in 10mWT was 0.8±0.3 versus 0.2±0.2 m/s (mean, +0.5 [95% CI, 0.3 to 0.7]), and change in mRS was -2.1±0.8 versus -1.4±0.7 point (mean, -0.7 [95% CI, -1.2 to -0.2]). These changes are also significantly greater compared to SHAM at 3- and 6-months (p0.001) follow-up.

Conclusion(s):

Combining HIIT with conventional physiotherapy offers the potential for a significantly greater recovery of exercise capacity, walking ability and lower the overall disability early post-stroke than SHAM. Furthermore, changes in exercise capacity are moderately correlated with changes in walking ability and disability level. 

Implications:

An early HIIT program can be safely implemented in people with mild to moderately severe disability within the first-month post-stroke, with certain precautionsan.

Funding acknowledgements:
This study was supported by the Special Research Fund (BOF20BL15) from Hasselt University.
Keywords:
Acute stroke
High-intensity interval training
Functional recovery
Primary topic:
Neurology: stroke
Second topic:
Disability and rehabilitation
Third topic:
Cardiorespiratory
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The biomedical ethics committee of the University of Parakou in Benin
Provide the ethics approval number:
CLERB-UP023/2023
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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