Effects of task-oriented treadmill training applied high-intensity interval training on walking ability in patients with chronic stroke: A randomized controlled trial with short-term follow-up
Question
Does task-oriented treadmill training combined with high-intensity interval treadmill training improve walking ability more than high-intensity interval treadmill training alone in patients with chronic stroke?
Summary
This randomized controlled trial studied 34 inpatients with chronic stroke who could walk at least 10 meters but had slow walking speed. For 4 weeks, both groups completed supervised high-intensity interval treadmill training for 30 minutes, 3 times per week, and both also received NeuroDevelopment Treatment. The experimental group added task-oriented obstacle crossing on the treadmill, while the control group performed high-intensity interval treadmill training without the task-oriented obstacle component. Both groups improved over time, but the task-oriented HIIT treadmill group improved more on walking speed, walking endurance, and functional gait assessment; timed up and go improved within groups but not significantly more between groups. The protocol is clinically relevant but requires supervision, treadmill hardware, harness safety measures, and stroke-specific screening.
Methodology
- Thirty-four chronic stroke rehabilitation inpatients analyzed after randomization, able to walk at least 10 meters and with walking speed below 0.8 m/s.
- 34 participants.
- Treadmill walking with obstacle-crossing tasks.
- Work intervals: 2 minutes at target high intensity.
- Recovery: 2 minutes active low-intensity treadmill walking.
- Intensity: 70-80% exercise intensity using Karvonen target heart rate for high intervals; 30-40% for low-intensity periods.
- 30 minutes: 5-minute warm-up, 20-minute main exercise, 5-minute cool-down.
- 3 times per week.
- 4 weeks.
- Randomized controlled trial with pretest, post-test after 4 weeks, and 2-week follow-up.
- Timed up and go, Functional gait assessment, 10-meter walk test, and 6-minute walk test were tracked.
Outcomes
TUG
Both groups improved over time, but between-group differences were not significant.
Experimental group 14.76 +/- 2.75 s pre, 11.83 +/- 2.50 post, 10.99 +/- 2.53 follow-up; control 15.27 +/- 4.14, 13.14 +/- 3.51, 12.62 +/- 3.47. Time-by-group interaction P = .001; between-group P values .671, .219, .124.
FGA
Experimental group improved more than control at post-test and follow-up.
Experimental 23.65 +/- 2.71 pre, 26.41 +/- 1.73 post, 26.71 +/- 1.86 follow-up; control 22.88 +/- 3.22, 24.18 +/- 2.92, 24.24 +/- 3.03. Time-by-group interaction P < .001; between-group post P = .011 and follow-up P = .007.
10MWT
Experimental walking speed increased more than control and exceeded the cited 0.8 m/s community walking threshold after training.
Experimental 0.72 +/- 0.06 m/s pre, 0.91 +/- 0.09 post, 0.87 +/- 0.08 follow-up; control 0.71 +/- 0.11, 0.80 +/- 0.11, 0.78 +/- 0.12. Time-by-group interaction P < .001; between-group post P = .002 and follow-up P = .011.
6MWT
Experimental walking endurance increased more than control.
Experimental 276.71 +/- 25.86 m pre, 349.71 +/- 38.83 post, 352.94 +/- 40.39 follow-up; control 268.24 +/- 34.00, 317.94 +/- 39.17, 312.94 +/- 41.04. Time-by-group interaction P < .001; between-group post P = .024 and follow-up P = .007.
Insights
- For clinical rehabilitation, HIIT can be implemented as prescribed heart-rate intervals rather than all-out work.
- Task specificity matters: adding obstacle-crossing tasks to treadmill intervals improved gait measures more than treadmill intervals alone in this chronic stroke sample.
- Clinical HIIT protocols need fall prevention, symptom stop rules, vital-sign monitoring pathways, and professional supervision.
Limitations
- Short intervention period.
- Small sample size.
- Actual community walking transfer was not closely evaluated.
- Spatiotemporal gait variables were not measured.
- Both groups also received NDT, so the isolated contribution of HIIT versus broader rehabilitation is limited.
- Adverse-event outcomes were not explicitly reported.
Safety
- Harness/suspension device, protective vest, safety bars, automatic treadmill stop, physical therapist supervision, and heart-rate monitoring were used.
- Training was to be stopped immediately for breathing symptoms, chest pain, reported difficulty, pain elsewhere, or participant request.
- Blood pressure, heart rate, respiration rate, and oxygen saturation were monitored when training stopped.
- The article did not report actual adverse events or injuries.