# The Effect of Skating Exercises as High-Intensity Interval Training on Elderly Stroke Patients PMID: 40722269 Journal: Brain sciences Published: 2025-06-24 Authors: 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. ## Population - Elderly adults aged 65 to 75 with first-ever minor ischemic stroke within three months of onset. - Sample size: 34 - Age: Average age 70.7 years; intervention 70.5 +/- 5.5 and control 70.8 +/- 5.7 years. - Sex: 14 male and 20 female overall; 7 male and 10 female in each group. - Fitness level: Low cardiorespiratory fitness after minor stroke; baseline VO2peak about 20 mL/kg/min. - Health status: Recent minor ischemic stroke with NIHSS score 3 or lower; all participants had hypertension, many had diabetes or hyperlipidemia. ## Methodology - Single-blind randomized controlled trial with 1:1 allocation to skating-exercise HIIT or treadmill-based MICT. - 3 months. - Outpatient tertiary hospital rehabilitation setting; exercise conducted by physical therapists experienced in stroke rehabilitation and rehabilitation medicine specialists. - Randomized and controlled study design. ## Protocol - Skating-exercise HIIT. - Modality: Bodyweight lateral skating-style exercise. - Work intervals: 1 minute high-intensity skating exercise. - Recovery: 1 minute low-intensity exercise. - Sets or repetitions: Alternating high- and low-intensity 1-minute intervals for 20 minutes. - Intensity: High intervals targeted 80% HRR and Borg RPE 13-15; low intervals targeted 50% HRR and RPE 9-11. - Session duration: 20 minutes, after 15 minutes of full-body stretching. - Frequency: 4 times per week. - Program length: 3 months. - Progression: No formal progression rule; participants could adjust speed, knee and ankle angles, and quadriceps use by condition and capability. - Treadmill MICT. - Modality: Treadmill-based aerobic exercise. - Work intervals: Continuous exercise. - Sets or repetitions: One continuous 20-minute bout. - Intensity: 40-50% HRR and Borg RPE 9-11. - Session duration: 20 minutes, after 15 minutes of full-body stretching. - Frequency: 4 times per week. - Program length: 3 months. - Progression: Treadmill incline and speed were adjusted to maintain target intensity. ## Outcomes ### VO2peak Status: improved 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. ### Ventilatory threshold Status: improved 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. ### Peak MET Status: improved 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. ### Balance and skeletal muscle mass index Status: improved 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. ### Safety Status: no clear change No fall-down injuries, abnormal symptoms, or cardiovascular or cerebrovascular events were reported during HIIT or MICT. ## Practical 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 And Adherence - 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. ## Original Sources - [PubMed](https://pubmed.ncbi.nlm.nih.gov/40722269/) (pubmed) - [DOI](https://doi.org/10.3390/brainsci15070676) (doi) - [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293109/) (full text) ## Agent Guidance Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.