高强度间歇训练对中风后心肺功能益处的随机对照试验。
Cardiorespiratory Fitness Benefits of High-Intensity Interval Training After Stroke: A Randomized Controlled Trial.
机构信息
School of Rehabilitation Sciences (K.M., K.S.N., E.W., P.S., J.A.R., A. Tang), Faculty of Science, McMaster University, Hamilton, Canada.
School of Physical and Occupational Therapy, Faculty of Medicine (L.R., B.D.L.H., J.F., M.R.), McGill University, Montreal, Canada.
出版信息
Stroke. 2024 Sep;55(9):2202-2211. doi: 10.1161/STROKEAHA.124.046564. Epub 2024 Aug 7.
BACKGROUND
Limited evidence supports the effects of short-interval high-intensity interval training (HIIT) for improving cardiorespiratory fitness (V̇Opeak) after stroke. We aimed to compare the effects of 12 weeks of short-interval HIIT versus moderate-intensity continuous training (MICT) on V̇Opeak, cardiovascular risk factors, and mobility outcomes among individuals ≥6 months poststroke.
METHODS
This study was a multi-site, 12-week randomized controlled trial (NCT03614585) with an 8-week follow-up. Participants were randomized into 3 d/wk of HIIT (10×1 minute 80%-100% heart rate reserve interspersed with 1 minute 30% heart rate reserve [19 minutes]) or MICT (20-30 minutes 40%-60% heart rate reserve). Secondary outcomes of the trial, including V̇Opeak, cardiovascular risk factors (carotid-femoral pulse wave velocity, blood pressure, and waist-hip ratio), and mobility (6-minute walk test, 10 m gait speed), were reported. Linear mixed model analyses with a group×study time point interaction evaluated between-group differences.
RESULTS
Of the 305 potential participants, 82 consented (mean [SD] age 64.9 [9.3] years, 32 females [39%], 1.8 [1.2] years poststroke) and were randomized to HIIT (n=42, mean [SD] baseline V̇Opeak 17.3 [5.9] mL/kg·min) or MICT (n=40, mean [SD] baseline V̇Opeak 17.2 [6.0] mL/kg·min). Participants attended 82% of visits (n=2417/2952). No adverse events occurred during the study period. A significant group×study time point interaction was found (χ=8.46; =0.015) for V̇Opeak at 12 weeks (mean difference, 1.81 [95% CI, 0.58-3.04]; =0.004) whereby the HIIT group had greater gains in V̇Opeak (∆3.52 mL/kg·min [95% CI, 2.47-4.57]; <0.001) compared with the MICT group (∆1.71 mL/kg·min [95% CI, 0.55-2.86]; =0.001). There was no between-group difference in V̇Opeak (mean difference, 1.08 [95% CI, -0.26 to 2.42]; =0.11) at 8-week follow-up. No group×study time point interactions were found for cardiovascular risk factors or mobility outcomes.
CONCLUSIONS
Short-interval HIIT may be an effective alternative to MICT for improving V̇Opeak at 12 weeks postintervention.
REGISTRATION
URL: https://clinicaltrials.gov; Unique identifier: NCT03614585.
背景
有限的证据支持短时间间隔高强度间歇训练（HIIT）在改善中风后心肺功能（V̇Opeak）方面的作用。我们旨在比较 12 周的短时间间隔 HIIT 与中等强度持续训练（MICT）对 V̇Opeak、心血管危险因素和中风后 6 个月以上个体的移动能力结局的影响。
方法
这是一项多中心、12 周的随机对照试验（NCT03614585），随访 8 周。参与者被随机分为 3 组/周，进行 HIIT（10×1 分钟 80%-100%心率储备间隔 1 分钟 30%心率储备[19 分钟]）或 MICT（20-30 分钟 40%-60%心率储备）。试验的次要结局包括 V̇Opeak、心血管危险因素（颈动脉-股动脉脉搏波速度、血压和腰臀比）和移动能力（6 分钟步行测试、10 m 步行速度）。采用线性混合模型分析评估组间差异与研究时间点的交互作用。
结果
在 305 名潜在参与者中，有 82 人同意（平均[标准差]年龄 64.9[9.3]岁，32 名女性[39%]，中风后 1.8[1.2]年）并随机分为 HIIT（n=42，平均[标准差]基线 V̇Opeak 17.3[5.9]mL/kg·min）或 MICT（n=40，平均[标准差]基线 V̇Opeak 17.2[6.0]mL/kg·min）。参与者出席率为 82%（n=2417/2952）。研究期间未发生不良事件。在 12 周时，发现 V̇Opeak 存在显著的组间时间点交互作用（χ=8.46；=0.015）（平均差异，1.81[95%CI，0.58-3.04]；=0.004），HIIT 组 V̇Opeak 增加幅度更大（∆3.52 mL/kg·min[95%CI，2.47-4.57]；<0.001），而 MICT 组则较小（∆1.71 mL/kg·min[95%CI，0.55-2.86]；=0.001）。在 8 周随访时，两组之间的 V̇Opeak 无差异（平均差异，1.08[95%CI，-0.26 至 2.42]；=0.11）。在心血管危险因素或移动能力结局方面，未发现组间时间点的交互作用。
结论
短时间间隔 HIIT 可能是改善中风后 12 周 V̇Opeak 的有效替代方案。
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