Effect of High‐Intensity Interval Training and Moderate‐Intensity Continuous Training in People With Poststroke Gait Dysfunction: A Randomized Clinical Trial
Bibliographic record
Abstract
Background The exercise strategy that yields the greatest improvement in both cardiorespiratory fitness ( <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:semantics> <mml:mrow> <mml:mover accent="true"> <mml:mi mathvariant="normal">V</mml:mi> <mml:mo>̇</mml:mo> </mml:mover> <mml:msub> <mml:mi mathvariant="normal">O</mml:mi> <mml:mrow> <mml:mn>2</mml:mn> <mml:mtext>peak</mml:mtext> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">$$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$</mml:annotation> </mml:semantics> </mml:math> ) and walking capacity poststroke has not been determined. This study aimed to determine whether conventional moderate‐intensity continuous training (MICT) or high‐intensity interval training (HIIT) have different effects on <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:semantics> <mml:mrow> <mml:mover accent="true"> <mml:mi mathvariant="normal">V</mml:mi> <mml:mo>̇</mml:mo> </mml:mover> <mml:msub> <mml:mi mathvariant="normal">O</mml:mi> <mml:mrow> <mml:mn>2</mml:mn> <mml:mtext>peak</mml:mtext> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">$$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$</mml:annotation> </mml:semantics> </mml:math> and 6‐minute walk distance (6MWD). Methods and Results In this 24‐week superiority trial, people with poststroke gait dysfunction were randomized to MICT (5 days/week) or HIIT (3 days/week with 2 days/week of MICT). MICT trained to target intensity at the ventilatory anaerobic threshold. HIIT trained at the maximal tolerable treadmill speed/grade using a novel program of 2 work‐to‐recovery protocols: 30:60 and 120:180 seconds. V̇O 2 and heart rate was measured during performance of the exercise that was prescribed at 8 and 24 weeks for treatment fidelity. Main outcomes were change in <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:semantics> <mml:mrow> <mml:mover accent="true"> <mml:mi mathvariant="normal">V</mml:mi> <mml:mo>̇</mml:mo> </mml:mover> <mml:msub> <mml:mi mathvariant="normal">O</mml:mi> <mml:mrow> <mml:mn>2</mml:mn> <mml:mtext>peak</mml:mtext> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">$$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$</mml:annotation> </mml:semantics> </mml:math> and 6MWD. Assessors were blinded to the treatment group for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:semantics> <mml:mrow> <mml:mover accent="true"> <mml:mi mathvariant="normal">V</mml:mi> <mml:mo>̇</mml:mo> </mml:mover> <mml:msub> <mml:mi mathvariant="normal">O</mml:mi> <mml:mrow> <mml:mn>2</mml:mn> <mml:mtext>peak</mml:mtext> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">$$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$</mml:annotation> </mml:semantics> </mml:math> but not 6MWD. Secondary outcomes were change in ventilatory anaerobic threshold, cognition, gait‐economy, 10‐meter gait‐velocity, balance, stair‐climb performance, strength, and quality‐of‐life. Among 47 participants randomized to either MICT (n=23) or HIIT (n=24) (mean age, 62±11 years; 81% men), 96% completed training. In intention‐to‐treat analysis, change in <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:semantics> <mml:mrow> <mml:mover accent="true"> <mml:mi mathvariant="normal">V</mml:mi> <mml:mo>̇</mml:mo> </mml:mover> <mml:msub> <mml:mi mathvariant="normal">O</mml:mi> <mml:mrow> <mml:mn>2</mml:mn> <mml:mtext>peak</mml:mtext> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">$$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$</mml:annotation> </mml:semantics> </mml:math> for MICT versus HIIT was 2.4±2.7 versus 5.7±3.1 mL·kg −1 ·min −1 (mean difference, 3.2 [95% CI, 1.5–4.8]; P <0.001), and change in 6MWD was 70.9±44.3 versus 83.4±53.6 m (mean difference, 12.5 [95% CI, −17 to 42]; P =0.401). HIIT had greater improvement in ventilatory anaerobic threshold (mean difference, 2.07 mL·kg −1 ·min −1 [95% CI, 0.59–3.6]; P =0.008). No other between‐group differences were observed. During V̇O 2 monitoring at 8 and 24 weeks, MICT reached 84±14% to 87±18% of <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:semantics> <mml:mrow> <mml:mover accent="true"> <mml:mi mathvariant="normal">V</mml:mi> <mml:mo>̇</mml:mo> </mml:mover> <mml:msub> <mml:mi mathvariant="normal">O</mml:mi> <mml:mrow> <mml:mn>2</mml:mn> <mml:mtext>peak</mml:mtext> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">$$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$</mml:annotation> </mml:semantics> </mml:math> while HIIT reached 101±22% to 112±14% of <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:semantics> <mml:mrow> <mml:mover accent="true"> <mml:mi mathvariant="normal">V</mml:mi> <mml:mo>̇</mml:mo> </mml:mover> <mml:msub> <mml:mi mathvariant="normal">O</mml:mi> <mml:mrow> <mml:mn>2</mml:mn> <mml:mtext>peak</mml:mtext> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">$$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$</mml:annotation> </mml:semantics> </mml:math> (during peak bouts). Conclusions HIIT resulted in more than a 2‐fold greater and clinically important change in <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:semantics> <mml:mrow> <mml:mover accent="true"> <mml:mi mathvariant="normal">V</mml:mi> <mml:mo>̇</mml:mo> </mml:mover> <mml:msub> <mml:mi mathvariant="normal">O</mml:mi> <mml:mrow> <mml:mn>2</mml:mn> <mml:mtext>peak</mml:mtext> </mml:mrow> </mml:msub> </mml:mrow> <mml:annotation encoding="application/x-tex">$$ \dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}} $$</mml:annotation> </mml:semantics> </mml:math> than MICT. Training to target (ventilatory anaerobic threshold) during MICT resulted in ~3 times the minimal clini
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".