{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:39:36Z","timestamp":1792157976884,"version":"4.4.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Studies in individuals with chronic stroke indicate high-intensity training (HIT) focused on walking improves locomotor function, which may be due to repeated activation of locomotor circuits and serotonin-dependent modulation of motor output. Separate studies in animals and individuals with spinal cord injury suggest acute intermittent hypoxia (AIH) can augment the effects of locomotor interventions through similar serotonin-dependent mechanisms, although no studies have coupled AIH with HIT in individuals poststroke. The goal of this study was to evaluate the safety and efficacy of AIH+HIT versus HIT alone in individuals with chronic stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      This phase II double-blind randomized, crossover trial recruited individuals between 18 and 85 years old, &gt;6 months poststroke, and self-selected speeds &lt;1.0 m\/s. Participants received up to 15 sessions of AIH for 30 minutes using 15 cycles of hypoxia (60\u201390 seconds; 8%\u20139% O\n                      <jats:sub>2<\/jats:sub>\n                      ) and normoxia (30\u201360 seconds; 21% O\n                      <jats:sub>2<\/jats:sub>\n                      ), followed by 1 hour of HIT targeting &gt;75% heart rate reserve. The control condition received normoxia for 30 minutes before HIT. Following the first training phase, participants performed the second phase &gt;1 month later. The primary outcomes were self-selected speed and fastest speed, a 6-minute walk test, and peak treadmill speed. A 3-way mixed-model ANOVA assessed the effects of time, training, and order of interventions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Of 55 individuals screened, 35 were randomized to AIH+HIT or normoxia+HIT first, and 28 individuals completed both interventions, revealing greater gains in self-selected speeds (0.14 [0.08\u20130.18] versus 0.05 [0.01\u20130.10] m\/s), fastest speed (0.16 [0.10\u20130.21] versus 0.06 [0.02\u20130.10] m\/s), and peak treadmill speed (0.21 [0.14\u20130.29] versus 0.11 [0.06\u20130.16] m\/s) following AIH+HIT versus normoxia+HIT (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01) with no order effects. Greater gains in spatiotemporal symmetry were observed with AIH+HIT, with worse outcomes for those prescribed serotonin-mediated antidepressant medications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>AIH+HIT resulted in greater gains in locomotor function than normoxia+HIT. Subsequent phase III trials should further evaluate the efficacy of this intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/\">https:\/\/clinicaltrials.gov\/<\/jats:ext-link>\n                      ; Unique identifier: NCT04472442.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.124.047261","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T05:00:42Z","timestamp":1718082042000},"page":"1748-1757","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Acute Intermittent Hypoxia With High-Intensity Gait Training in Chronic Stroke: A Phase II Randomized Crossover Trial"],"prefix":"10.1161","volume":"55","clinical-trial-number":[{"clinical-trial-number":"nct04472442","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3147-3818","authenticated-orcid":true,"given":"T. George","family":"Hornby","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (T.G.H., A.P., E.I., C.E.H.)."},{"name":"Rehabilitation Hospital of Indiana, Indianapolis (T.G.H., A.P., J.K.L., L.H.S., C.J.V., E.I., C.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbey","family":"Plawecki","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (T.G.H., A.P., E.I., C.E.H.)."},{"name":"Rehabilitation Hospital of Indiana, Indianapolis (T.G.H., A.P., J.K.L., L.H.S., C.J.V., E.I., C.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer K.","family":"Lotter","sequence":"additional","affiliation":[{"name":"Rehabilitation Hospital of Indiana, Indianapolis (T.G.H., A.P., J.K.L., L.H.S., C.J.V., E.I., C.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay H.","family":"Shoger","sequence":"additional","affiliation":[{"name":"Rehabilitation Hospital of Indiana, Indianapolis (T.G.H., A.P., J.K.L., L.H.S., C.J.V., E.I., C.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina J.","family":"Voigtmann","sequence":"additional","affiliation":[{"name":"Rehabilitation Hospital of Indiana, Indianapolis (T.G.H., A.P., J.K.L., L.H.S., C.J.V., E.I., C.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Inks","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (T.G.H., A.P., E.I., C.E.H.)."},{"name":"Rehabilitation Hospital of Indiana, Indianapolis (T.G.H., A.P., J.K.L., L.H.S., C.J.V., E.I., 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