EFFECTS OF HIGH-INTENSITY INTERVAL TRAINING ON MUSCLE STRENGTH, ATROPHY AND AEROBIC CAPACITY IN STROKE PATIENTS
Main Article Content
Keywords
Aerobic capacity, High-Intensity Interval Training, Muscle atrophy, Muscle Strength, stroke
Abstract
Introduction :Stroke is a major cause of long-term disability and reduced physical functioning. It often leads to muscle weakness, muscle wasting, and decreased cardiovascular fitness, which can affect daily activities. The aim of this study was to determine the effects of high-intensity interval training (HIIT) on muscle strength, atrophy, and aerobic capacity in stroke patients.
Method : It was a single-blinded, randomized controlled trial, including 34 stroke patients. Patients were randomly allocated into two groups. One group received HIIT along with conventional treatment, and the other received conventional treatment alone. To measure muscle strength, calf circumference, and aerobic capacity in stroke patients, MMT, Measuring Tape, 6MWT, and Harvard step test were used, respectively.
Results :Results showed a significant difference between group analysis, as the p-value was less than 0.05, and within the group, both therapies showed effectiveness, but paired differences of group A were more than those of group B.
Conclusion: Both therapies yielded significant outcomes. However, when combined with conventional therapy, the HIIT program improved strength in the muscles and aerobic capacity and reduced atrophy in stroke patients.
References
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20. Doren S, Boyne P. Short Versus Long Intervals for High-Intensity Interval Training (HIT) in Chronic Stroke: Within-Session Exercise Responses. Undergraduate Scholarly Showcase. 2019.
21. Boyne P, Scholl V, Doren S, Carl D, Billinger SA, Reisman DS, et al. Locomotor training intensity after stroke: Effects of interval type and mode. Topics in stroke rehabilitation. 2020;27(7):483-93.
22. Sivaramakrishnan A, Subramanian SK. A Systematic Review on the Effects of Acute Aerobic Exercise on Neurophysiological, Molecular, and Behavioral Measures in Chronic Stroke. Neurorehabilitation and Neural Repair. 2023;37(2-3):151-64.
23. Caparrós-Manosalva C, Garrido-Muñoz N, Alvear-Constanzo B, Sanzana-Laurié S, Artigas-Arias M, Alegría-Molina A, et al. Effects of high-intensity interval training on lean mass, strength, and power of the lower limbs in healthy old and young people. Frontiers in Physiology. 2023;14.
24. Fajrin F, Kusnanik N, editors. Effects of high intensity interval training on increasing explosive power, speed, and agility. Journal of Physics: conference series; 2018: IOP Publishing.
25. Luo L, Meng H, Wang Z, Zhu S, Yuan S, Wang Y, et al. Effect of high-intensity exercise on cardiorespiratory fitness in stroke survivors: a systematic review and meta-analysis. Annals of physical and rehabilitation medicine. 2020;63(1):59-68.
26. Alatawi SF. A Comparison of Three Common Rehabilitation Interventions Used to Improve Cardiovascular Fitness after Stroke: An Overview of the Literature. BioMed Research International. 2023;2023.
27. Blue MN, Smith-Ryan AE, Trexler ET, Hirsch KR. The effects of high intensity interval training on muscle size and quality in overweight and obese adults. Journal of science and medicine in sport. 2018;21(2):207-12.
28. Stoller O, de Bruin ED, Knols RH, Hunt KJ. Effects of cardiovascular exercise early after stroke: systematic review and meta-analysis. BMC neurology. 2012;12(1):1-16.
29. Pang MY, Eng JJ, Dawson AS, Gylfadóttir S. The use of aerobic exercise training in improving aerobic capacity in individuals with stroke: a meta-analysis. Clinical rehabilitation. 2006;20(2):97-111.
30. Chang Y-H, Chou Y-C, Chang Y-C, Tan K-H, Wu M-H. The Effects of High-Intensity Power Training versus Traditional Resistance Training on Exercise Performance. International Journal of Environmental Research and Public Health. 2022;19(15):9400.
31. Neuendorf T, Haase R, Schroeder S, Schumann M, Nitzsche N. Effects of high-intensity interval training on functional performance and maximal oxygen uptake in comparison with moderate intensity continuous training in cancer patients: a systematic review and meta-analysis. Supportive Care in Cancer. 2023;31(12):643.
32. Josyula S, Alagesan J. Comparative analysis of high-intensity interval training and traditional rehabilitation programs for accelerated recovery from musculoskeletal injuries. Journal of Back and Musculoskeletal Rehabilitation. 2023(Preprint):1-7.
33. Nunes PR, Martins FM, Souza AP, Carneiro MA, Nomelini RS, Michelin MA, et al. Comparative effects of high-intensity interval training with combined training on physical function markers in obese postmenopausal women: a randomized controlled trial. Menopause. 2019;26(11):1242-9.
34. Stankovic M, Djordjevic D, Trajkovic N, Milanovic Z. Effects of High-Intensity Interval Training (HIIT) on Physical Performance in Female Team Sports: A Systematic Review. Sports Medicine-Open. 2023;9(1):78.
35. Linder SM, Davidson S, Rosenfeldt A, Penko A, Lee J, Koop MM, et al. Predictors of improved aerobic capacity in individuals with chronic stroke participating in cycling interventions. Archives of physical medicine and rehabilitation. 2020;101(4):717-21.
36. Rhibi F, Abderrahman AB, Prioux J, Clark CC, Bideau B, Besbes S, et al. Effects of different training intensities in high-intensity interval training (HIIT) on maximal aerobic velocity, hematological and muscle-damage markers in healthy young adults. BMC Sports Science, Medicine and Rehabilitation. 2022;14(1):1-12.
2. Bernhardt J, Urimubenshi G, Gandhi DB, Eng JJ. Stroke rehabilitation in low-income and middle-income countries: a call to action. The Lancet. 2020;396(10260):1452-62.
3. Azzollini V, Dalise S, Chisari CJFiN. How does stroke affect skeletal muscle? State of the art and rehabilitation perspective. 2021;12:797559.
4. Kumar A, Adhikari D, Karmarkar A, Freburger J, Gozalo P, Mor V, et al. Variation in Hospital-Based Rehabilitation Services Among Patients With Ischemic Stroke in the United States. Physical Therapy. 2019;99(5):494-506. doi: 10.1093/ptj/pzz014.
5. Bosch PR, Holzapfel SD, Nordin K, Ojameruaye O, Zubriski M, Angadi SS. High-Intensity Interval Training for Adults With Chronic Stroke: A Pilot Feasibility Study. Cardiopulmonary Physical Therapy Journal. 2021;32(1):20-9. doi: 10.1097/cpt.0000000000000152. PubMed PMID: 01823246-202101000-00005.
6. Ito S. High-intensity interval training for health benefits and care of cardiac diseases - The key to an efficient exercise protocol. World journal of cardiology. 2019;11(7):171-88. Epub 2019/10/01. doi: 10.4330/wjc.v11.i7.171. PubMed PMID: 31565193; PubMed Central PMCID: PMC6763680.
7. Alzar-Teruel M, Aibar-Almazán A, Hita-Contreras F, Carcelén-Fraile MdC, Martínez-Amat A, Jiménez-García JD, et al. High-intensity interval training among middle-aged and older adults for body composition and muscle strength: A systematic review. 2022;10:992706.
8. Taylor JL, Holland DJ, Spathis JG, Beetham KS, Wisløff U, Keating SE, et al. Guidelines for the delivery and monitoring of high intensity interval training in clinical populations. Progress in cardiovascular diseases. 2019;62(2):140-6.
9. Sabag A, Little JP, Johnson NA. Low-volume high-intensity interval training for cardiometabolic health. The Journal of Physiology. 2022;600(5):1013-26. doi: https://doi.org/10.1113/JP281210.
10. Liu QQ, Xie WQ, Luo YX, Li YD, Huang WH, Wu YX, et al. High Intensity Interval Training: A Potential Method for Treating Sarcopenia. Clin Interv Aging. 2022;17:857-72. Epub 2022/06/04. doi: 10.2147/cia.s366245. PubMed PMID: 35656091; PubMed Central PMCID: PMC9152764.
11. Boyne P, Miller A, Schwab SM, Sucharew H, Carl D, Billinger SA, et al. Training parameters and longitudinal adaptations that most strongly mediate walking capacity gains from high-intensity interval training post-stroke. medRxiv. 2023:2023.02. 20.23286194.
12. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019;50(12):e344-e418.
13. Ivey FM, Hafer-Macko CE, Macko RF. Task-oriented treadmill exercise training in chronic hemiparetic stroke. Journal of rehabilitation research and development. 2008;45(2):249-59. Epub 2008/06/21. doi: 10.1682/jrrd.2007.02.0035. PubMed PMID: 18566943; PubMed Central PMCID: PMC2990953.
14. Gjellesvik TI, Becker F, Tjønna AE, Indredavik B, Lundgaard E, Solbakken H, et al. Effects of high-intensity interval training after stroke (the HIIT stroke study) on physical and cognitive function: a multicenter randomized controlled trial. Archives of physical medicine and rehabilitation. 2021;102(9):1683-91.
15. Borg GA. Psychophysical bases of perceived exertion. Medicine and science in sports and exercise. 1982;14(5):377-81. Epub 1982/01/01. PubMed PMID: 7154893.
16. Boyne P, Billinger SA, Reisman DS, Awosika OO, Buckley S, Burson J, et al. Optimal intensity and duration of walking rehabilitation in patients with chronic stroke: a randomized clinical trial. JAMA neurology. 2023;80(4):342-51.
17. Steen Krawcyk R, Vinther A, Petersen NC, Faber J, Iversen HK, Christensen T, et al. Effect of home-based high-intensity interval training in patients with lacunar stroke: a randomized controlled trial. Frontiers in Neurology. 2019;10:664.
18. Leal JM, Galliano LM, Del Vecchio FB. Effectiveness of high-intensity interval training versus moderate-intensity continuous training in hypertensive patients: a systematic review and meta-analysis. Current hypertension reports. 2020;22:1-13.
19. Boyne P, Doren S, Scholl V, Staggs E, Whitesel D, Carl D, et al. Preliminary outcomes of combined treadmill and overground high-intensity interval training in ambulatory chronic stroke. Frontiers in Neurology. 2022:75.
20. Doren S, Boyne P. Short Versus Long Intervals for High-Intensity Interval Training (HIT) in Chronic Stroke: Within-Session Exercise Responses. Undergraduate Scholarly Showcase. 2019.
21. Boyne P, Scholl V, Doren S, Carl D, Billinger SA, Reisman DS, et al. Locomotor training intensity after stroke: Effects of interval type and mode. Topics in stroke rehabilitation. 2020;27(7):483-93.
22. Sivaramakrishnan A, Subramanian SK. A Systematic Review on the Effects of Acute Aerobic Exercise on Neurophysiological, Molecular, and Behavioral Measures in Chronic Stroke. Neurorehabilitation and Neural Repair. 2023;37(2-3):151-64.
23. Caparrós-Manosalva C, Garrido-Muñoz N, Alvear-Constanzo B, Sanzana-Laurié S, Artigas-Arias M, Alegría-Molina A, et al. Effects of high-intensity interval training on lean mass, strength, and power of the lower limbs in healthy old and young people. Frontiers in Physiology. 2023;14.
24. Fajrin F, Kusnanik N, editors. Effects of high intensity interval training on increasing explosive power, speed, and agility. Journal of Physics: conference series; 2018: IOP Publishing.
25. Luo L, Meng H, Wang Z, Zhu S, Yuan S, Wang Y, et al. Effect of high-intensity exercise on cardiorespiratory fitness in stroke survivors: a systematic review and meta-analysis. Annals of physical and rehabilitation medicine. 2020;63(1):59-68.
26. Alatawi SF. A Comparison of Three Common Rehabilitation Interventions Used to Improve Cardiovascular Fitness after Stroke: An Overview of the Literature. BioMed Research International. 2023;2023.
27. Blue MN, Smith-Ryan AE, Trexler ET, Hirsch KR. The effects of high intensity interval training on muscle size and quality in overweight and obese adults. Journal of science and medicine in sport. 2018;21(2):207-12.
28. Stoller O, de Bruin ED, Knols RH, Hunt KJ. Effects of cardiovascular exercise early after stroke: systematic review and meta-analysis. BMC neurology. 2012;12(1):1-16.
29. Pang MY, Eng JJ, Dawson AS, Gylfadóttir S. The use of aerobic exercise training in improving aerobic capacity in individuals with stroke: a meta-analysis. Clinical rehabilitation. 2006;20(2):97-111.
30. Chang Y-H, Chou Y-C, Chang Y-C, Tan K-H, Wu M-H. The Effects of High-Intensity Power Training versus Traditional Resistance Training on Exercise Performance. International Journal of Environmental Research and Public Health. 2022;19(15):9400.
31. Neuendorf T, Haase R, Schroeder S, Schumann M, Nitzsche N. Effects of high-intensity interval training on functional performance and maximal oxygen uptake in comparison with moderate intensity continuous training in cancer patients: a systematic review and meta-analysis. Supportive Care in Cancer. 2023;31(12):643.
32. Josyula S, Alagesan J. Comparative analysis of high-intensity interval training and traditional rehabilitation programs for accelerated recovery from musculoskeletal injuries. Journal of Back and Musculoskeletal Rehabilitation. 2023(Preprint):1-7.
33. Nunes PR, Martins FM, Souza AP, Carneiro MA, Nomelini RS, Michelin MA, et al. Comparative effects of high-intensity interval training with combined training on physical function markers in obese postmenopausal women: a randomized controlled trial. Menopause. 2019;26(11):1242-9.
34. Stankovic M, Djordjevic D, Trajkovic N, Milanovic Z. Effects of High-Intensity Interval Training (HIIT) on Physical Performance in Female Team Sports: A Systematic Review. Sports Medicine-Open. 2023;9(1):78.
35. Linder SM, Davidson S, Rosenfeldt A, Penko A, Lee J, Koop MM, et al. Predictors of improved aerobic capacity in individuals with chronic stroke participating in cycling interventions. Archives of physical medicine and rehabilitation. 2020;101(4):717-21.
36. Rhibi F, Abderrahman AB, Prioux J, Clark CC, Bideau B, Besbes S, et al. Effects of different training intensities in high-intensity interval training (HIIT) on maximal aerobic velocity, hematological and muscle-damage markers in healthy young adults. BMC Sports Science, Medicine and Rehabilitation. 2022;14(1):1-12.
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Jan 15, 2025
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How to Cite
Tayyaba Zaman, Uzra Batool, Rana Muhammad Hassan, Fazila Bashir, Hafiza Aroofa, Fatima Noor, Faraha Naveed, & Ifrah Anjum. (2025). EFFECTS OF HIGH-INTENSITY INTERVAL TRAINING ON MUSCLE STRENGTH, ATROPHY AND AEROBIC CAPACITY IN STROKE PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 32(1), 156-166. https://doi.org/10.53555/70x65h09
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Author Biographies
Tayyaba Zaman
Physiotherapist, Combined Military Hospital, Lahore, Pakistan
Uzra Batool
Lecturer, University of Lahore, Pakistan
Rana Muhammad Hassan
Physiotherapist, Department of Rehabilitation & Allied Health Sciences/ Riphah International University, Lahore Campus, Pakistan
Fazila Bashir
Senior Lecturer, Independent Medical College, Pakistan
Hafiza Aroofa
Senior Lecturer, Independent Medical College, Pakistan
Fatima Noor
Physiotherapist, MS-NMPT, Department of Rehabilitation & Allied Health Sciences/ Riphah International University, Lahore Campus, Pakistan
Faraha Naveed
Physiotherapist, Master of Science in Neuromuscular Physical Therapy (MS-NMPT), Department of Rehabilitation & Allied Health Sciences/ Riphah International University, Lahore, Pakistan
Ifrah Anjum
Physiotherapist, Gulab Devi Hospital, Lahore
How to Cite
Tayyaba Zaman, Uzra Batool, Rana Muhammad Hassan, Fazila Bashir, Hafiza Aroofa, Fatima Noor, Faraha Naveed, & Ifrah Anjum. (2025). EFFECTS OF HIGH-INTENSITY INTERVAL TRAINING ON MUSCLE STRENGTH, ATROPHY AND AEROBIC CAPACITY IN STROKE PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 32(1), 156-166. https://doi.org/10.53555/70x65h09