PMID 40722269

Research
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The Effect of Skating Exercises as High-Intensity Interval Training on Elderly Stroke Patients

Kim MS

Question

Can a skating-exercise HIIT protocol safely improve cardiorespiratory fitness, balance function, and muscle mass in elderly minor stroke survivors compared with treadmill-based moderate-intensity continuous training?

Summary

This single-blind randomized controlled trial compared a 3-month skating-exercise HIIT program with treadmill-based moderate-intensity continuous training in 34 adults aged about 71 years with recent minor ischemic stroke. Both groups trained 20 minutes per day, four times per week, with a 15-minute stretching warm-up before exercise. The HIIT skating group alternated 1-minute high-intensity and 1-minute low-intensity skating movements, targeting 80% and 50% heart-rate reserve respectively. Both groups improved aerobic capacity, but the HIIT group improved more on VO2peak, ventilatory threshold, peak MET, Berg Balance Scale, and skeletal muscle mass index. No fall injuries, abnormal exercise symptoms, or cardiovascular or cerebrovascular events were reported during the interventions.

Methodology

  • Elderly adults aged 65 to 75 with first-ever minor ischemic stroke within three months of onset.
  • 34 participants.
  • Bodyweight lateral skating-style exercise.
  • Work intervals: 1 minute high-intensity skating exercise.
  • Recovery: 1 minute low-intensity exercise.
  • Intensity: High intervals targeted 80% HRR and Borg RPE 13-15; low intervals targeted 50% HRR and RPE 9-11.
  • 20 minutes, after 15 minutes of full-body stretching.
  • 4 times per week.
  • 3 months.
  • Single-blind randomized controlled trial with 1:1 allocation to skating-exercise HIIT or treadmill-based MICT.
  • Peak oxygen uptake, Ventilatory threshold, Peak MET, and Berg Balance Scale were tracked.

Outcomes

VO2peak

Both groups improved, with greater improvement in the HIIT group.

HIIT 20.4 to 25.8 mL/kg/min; MICT 20.6 to 23.7 mL/kg/min; between-group p=0.005, Cohen's d=0.20.

Improved

Ventilatory threshold

Both groups improved, with greater improvement in the HIIT group.

HIIT 10.6 to 15.2 mL/kg/min; MICT 10.7 to 13.1 mL/kg/min; between-group p=0.002, Cohen's d=0.22.

Improved

Peak MET

Both groups improved, with greater improvement in the HIIT group.

HIIT 6.3 to 8.5; MICT 6.5 to 7.3; between-group p=0.024, Cohen's d=0.18.

Improved

Balance and skeletal muscle mass index

The HIIT group improved more than MICT on Berg Balance Scale and skeletal muscle mass index.

BBS HIIT 44.9 to 49.4, within-group p=0.004 and between-group p=0.032; SMI HIIT 5.4 to 5.9 kg/m2, within-group p=0.008 and between-group p=0.032.

Improved

Safety

No fall-down injuries, abnormal symptoms, or cardiovascular or cerebrovascular events were reported during HIIT or MICT.

No clear change

Insights

  • A 1-minute hard / 1-minute easy HIIT structure can be adapted to a bodyweight lateral movement pattern in selected supervised older stroke patients.
  • Scaling intensity with both HRR and RPE can support clinical HIIT prescription when all-out efforts are inappropriate.
  • Exercise selection can target cardiorespiratory fitness, balance, agility, and lower-limb muscle demand at the same time.
  • Safety translation depends on screening, therapist supervision, stretching, movement modification, and symptom-stop rules.

Limitations

  • Small sample size.
  • Single-institution study.
  • No no-intervention group.
  • Participants with inability to understand instructions, aphasia, or major cardiovascular, psychiatric, or musculoskeletal disorders were excluded.
  • Bioelectrical impedance analysis may be affected by hydration and recent exercise.
  • Actual session attendance and achieved intensity were not reported.
  • Short duration may explain lack of cardiovascular and ventilatory function improvements.

Safety

  • No fall-down injuries were reported among patients undergoing HIIT or MICT for 3 months.
  • No adverse cardiovascular or cerebrovascular events were reported.
  • No abnormal symptoms including headache, dizziness, dyspnea, or syncope were reported.
  • Exercise was to be stopped immediately if a patient wanted to stop or had symptoms such as dizziness or difficulty breathing.