{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:29:36Z","timestamp":1792481376279,"version":"4.5.0"},"reference-count":109,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,11,21]]},"abstract":"\n Background<\/jats:title>\n \n The exercise strategy that yields the greatest improvement in both cardiorespiratory fitness (\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mi>\n \n 2<\/mml:mn>\n peak<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}}{\\mathrm{O}}_{2\\mathrm{peak}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n ) and walking capacity poststroke has not been determined. This study aimed to determine whether conventional moderate\u2010intensity continuous training (MICT) or high\u2010intensity interval training (HIIT) have different effects on\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mi>\n \n 2<\/mml:mn>\n peak<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}}{\\mathrm{O}}_{2\\mathrm{peak}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n and 6\u2010minute walk distance (6MWD).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n In this 24\u2010week superiority trial, people with poststroke gait dysfunction were randomized to MICT (5\u2009days\/week) or HIIT (3\u2009days\/week with 2\u2009days\/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\u2010to\u2010recovery protocols: 30:60 and 120:180\u2009seconds. V\u0307O\n 2<\/jats:sub>\n 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\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mi>\n \n 2<\/mml:mn>\n peak<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}}{\\mathrm{O}}_{2\\mathrm{peak}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n and 6MWD. Assessors were blinded to the treatment group for\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mi>\n \n 2<\/mml:mn>\n peak<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}}{\\mathrm{O}}_{2\\mathrm{peak}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n but not 6MWD. Secondary outcomes were change in ventilatory anaerobic threshold, cognition, gait\u2010economy, 10\u2010meter gait\u2010velocity, balance, stair\u2010climb performance, strength, and quality\u2010of\u2010life. Among 47 participants randomized to either MICT (n=23) or HIIT (n=24) (mean age, 62\u00b111\u2009years; 81% men), 96% completed training. In intention\u2010to\u2010treat analysis, change in\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mi>\n \n 2<\/mml:mn>\n peak<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}}{\\mathrm{O}}_{2\\mathrm{peak}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n for MICT versus HIIT was 2.4\u00b12.7 versus 5.7\u00b13.1\u2009mL\u00b7kg\n \u22121<\/jats:sup>\n \u00b7min\n \u22121<\/jats:sup>\n (mean difference, 3.2 [95% CI, 1.5\u20134.8];\n P<\/jats:italic>\n <0.001), and change in 6MWD was 70.9\u00b144.3 versus 83.4\u00b153.6\u2009m (mean difference, 12.5 [95% CI, \u221217 to 42];\n P<\/jats:italic>\n =0.401). HIIT had greater improvement in ventilatory anaerobic threshold (mean difference, 2.07\u2009mL\u00b7kg\n \u22121<\/jats:sup>\n \u00b7min\n \u22121<\/jats:sup>\n [95% CI, 0.59\u20133.6];\n P<\/jats:italic>\n =0.008). No other between\u2010group differences were observed. During V\u0307O\n 2<\/jats:sub>\n monitoring at 8 and 24 weeks, MICT reached 84\u00b114% to 87\u00b118% of\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mi>\n \n 2<\/mml:mn>\n peak<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}}{\\mathrm{O}}_{2\\mathrm{peak}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n while HIIT reached 101\u00b122% to 112\u00b114% of\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mi>\n \n 2<\/mml:mn>\n peak<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}}{\\mathrm{O}}_{2\\mathrm{peak}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n (during peak bouts).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n HIIT resulted in more than a 2\u2010fold greater and clinically important change in\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n \n O<\/mml:mi>\n \n 2<\/mml:mn>\n peak<\/mml:mtext>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}}{\\mathrm{O}}_{2\\mathrm{peak}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n than MICT. Training to target (ventilatory anaerobic threshold) during MICT resulted in ~3 times the minimal clinically important difference in 6MWD, which was similar to HIIT. These findings show proof of concept that HIIT yields greater improvements in cardiorespiratory fitness than conventional MICT in appropriately screened individuals.\n <\/jats:p>\n <\/jats:sec>\n \n Registration<\/jats:title>\n \n URL:\n https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n ; Unique identifier: NCT03006731.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.123.031532","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T05:17:26Z","timestamp":1699593446000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":42,"title":["Effect of High\u2010Intensity Interval Training and Moderate\u2010Intensity Continuous Training in People With Poststroke Gait Dysfunction: A\u00a0Randomized Clinical Trial"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3186-400X","authenticated-orcid":false,"given":"Susan","family":"Marzolini","sequence":"first","affiliation":[{"name":"KITE Research Institute, Toronto Rehabilitation Institute, University Health Network Toronto ON Canada"},{"name":"Rehabilitation Sciences Institute, University of Toronto ON Canada"},{"name":"Faculty of Kinesiology and Physical Education, University of Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9095-9877","authenticated-orcid":false,"given":"Andrew D.","family":"Robertson","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Health Sciences University of Waterloo ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7300-2355","authenticated-orcid":false,"given":"Bradley J.","family":"MacIntosh","sequence":"additional","affiliation":[{"name":"Sandra E Black Centre for Brain Resilience and Repair, Hurvitz Brain Sciences, Physical Sciences Platform, Sunnybrook Research Institute Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0217-4576","authenticated-orcid":false,"given":"Dale","family":"Corbett","sequence":"additional","affiliation":[{"name":"Department of Cellular and Molecular Medicine University of Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5979-2220","authenticated-orcid":false,"given":"Nicole D.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Rotman Research Institute, Baycrest Academy for Research and Education Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6080-5052","authenticated-orcid":false,"given":"Dina","family":"Brooks","sequence":"additional","affiliation":[{"name":"KITE Research Institute, Toronto Rehabilitation Institute, University Health Network Toronto ON Canada"},{"name":"Rehabilitation Sciences Institute, University of Toronto ON Canada"},{"name":"McMaster University, Faculty of Health Sciences Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Koblinsky","sequence":"additional","affiliation":[{"name":"Rotman Research Institute, Baycrest Academy for Research and Education Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0603-6958","authenticated-orcid":false,"given":"Paul","family":"Oh","sequence":"additional","affiliation":[{"name":"KITE Research Institute, Toronto Rehabilitation Institute, University Health Network Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000022"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzz153"},{"key":"e_1_3_2_4_2","volume-title":"American College of Sports Medicine's Guidelines for Exercise Testing and Prescription","author":"ACSM","year":"2020","unstructured":"ACSM . 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