Short-Term Follow-Up After Early Home-Based High-Intensity Interval Training In Stroke

Background: High-intensity interval training (HIIT) is superior to moderate-intensity continuous training (MICE) in improving aerobic fitness in patients with cardiovascular disease. Few studies have investigated the effect of HIIT in patients with stroke and none specifically in patients with small vessel disease stroke (SVDS). Purpose: We aimed to investigate the short-term effect of 12-weeks home-based HIIT post stroke in addition to usual care, versus usual care only. Methods: We included 71 patients with SVDS in a randomised controlled trial, intervention vs. control 1:1. At baseline and after 3 months we assessed: aerobic fitness (power output from the Graded Cycling Test with Talk Test (GCT-TT)), physical activity, fatigue, depression, well-being, stress, cognition, endothelial function, blood pressure, body mass index, and blood biomarkers. Results: We found that the patients in the intervention group spent more time on vigorous-intensity activity than the usual care group. Home-based HIIT was feasible, with no adverse events reported. No significant difference was detected in GCT-TT power output between groups. Further, we found no significant differences between the groups in general well-being (depression, stress, fatigue, cognition, and quality of life). Insulin levels decreased slightly in the active group (p=0.048). Conclusion: Importantly, this study shows that patients with SVDS can engage in home-based HIIT when encouraged weekly by phone, and provided either a stationary bicycle or choosing a high intensity activity of their own interest. However, increased activity was not reflected in short-term effect on aerobic fitness. This may be due to a lower than requested intensity or duration of activity. We need more investigations on long-term effects, and how to further increase physical activity and aerobic fitness.