The aim of this study is to determine comparative effects of High intensity interval training versus Intermittent functional training on cardiovascular fitness, physical function and cognition in stroke.
This randomized clinical trial will be conducted at General Hospital Lahore over the duration of ten months enrolling six months post stroke survivors. The 52 patients will be recruited through non-probability convenience sampling technique and will be randomly assigned to either the HIIT or IFT group through online randomizer tool. Both groups will undergo a 12-week intervention, consisting of three sessions per week with alternate-day training. The HIIT group will perform three sessions per week 30 minutes in total with each session consisting of 5 min intervals at 85-95% of their maximum heart rate, with 3-minute active recovery periods, while IFT group will perform three sessions per week 30 minutes in total with each session consisting of 6-9 circuits of task-oriented exercises both including a 5-min warm-up and cool down period. Data will be collected through different assessment tools including NIHSS (The National Institutes of Health Stroke Scale) to assess the severity of stroke, 6-minute walk test (6MWT) for cardiovascular fitness, MoCA (Montreal Cognitive Assessment or The MoCA Test) for cognition and Berg-balance scale (BBS) and TUG (Time Up and Go Test) for mobility and physical function
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
52
The intervention consists of HIIT protocol performed 3-5 days per week for a period of 12 weeks, focusing on either the fastest safe walking speed for mobility gains or maintaining 85%-95% of heart rate reserve or power output at 90%-100% VO2 peak. Each session should last 25-30 minutes, utilizing a burst-to-recovery ratio of 30 seconds of intense activity followed by 30-60 seconds to 3 minutes of recovery. Treadmills or recumbent steppers will be used, with careful monitoring of intensity to prevent potential hypotensive responses.
IFT exercises will be performed for 3-5 days per week sessions involve 6-9 circuits of task-oriented exercises lasting about 3 minutes each, designed to enhance functional ability. Each circuit combines more demanding tasks with less intense ones to maintain heart rates 30-50 beats per minute above resting levels, achieving moderate aerobic intensity for chronic stroke survivors. Exercises are tailored to individual needs and progressively increased in difficulty, including movements like rolling, transitioning between positions, and practicing stepping and transferring
Riphah International University
Daska Kalan, Punjab Province, Pakistan
NOT_YET_RECRUITINGRiphah International University
Daska Kalan, Punjab Province, Pakistan
RECRUITINGNational Institutes of Health Stroke Scale(NIHSS)
The National Institutes of Health Stroke Scale (NIHSS) is a graded neurological examination that assesses speech, language cognition, inattention, visual field abnormalities, motor and sensory impairments, and ataxia. The scale was developed for use in acute-stroke therapy trials and has since been widely used as a standard part of the assessment in clinical trials. The National Institutes of Health Stroke Scale (NIHSS) demonstrates high reliability and validity in assessing stroke severity. Inter-rater and intra-rater reliability coefficients typically exceed 0.90, indicating consistent scoring among different clinicians and repeated assessments. The scale shows strong construct validity, correlating well with other measures like the modified Rankin Scale and predicting outcomes, as higher NIHSS scores are linked to increased mortality and disability. With a Cronbach's alpha above 0.90, the NIHSS is recognized as an effective tool for guiding treatment decisions and assessing patien
Time frame: 12 weeks
MoCA (Montreal Cognitive Assessment )
The Montreal Cognitive Assessment (MoCA) is a one-page, 30-point cognitive screening measurement scale that takes about 10 minutes to administer. There are 12 subtasks in the MoCA test that include memory, visuospatial orientation, executive functioning, phonemic fluency, and two-item abstract thinking task, attention, concentration, and working memory, language, orientation to time and place. A score of 26 is a cutoff score to differentiate between normal and abnormal. Inter-rater Reliability (0.96) Chronbach's alpha (0.79)
Time frame: 12 week
The 6-minute walk test (6MWT) for cardiorespiratory fitness
The 6-minute walk test (6MWT) is commonly used to measure cardiovascular fitness and overall functional capacity. The 6-Minute Walk Test (6MWT) has shown strong reliability and validity in stroke patients. Specifically, studies report intra-class correlation coefficients (ICCs) ranging from 0.85 to 0.95, indicating excellent intra- and inter-rater reliability. For validity, the 6MWT correlates well with other functional measures, such as the Barthel Index and the Fugl-Meyer Assessment, with correlation coefficients often exceeding 0.70. Additionally, it has been shown to predict outcomes such as mortality and functional independence post-stroke. These statistics underscore the test's utility in assessing exercise capacity and guiding rehabilitation efforts
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: 12 week
The Timed Up and Go (TUG) test for physical function and mobility
The Timed Up and Go (TUG) test is a reliable and valid assessment tool for mobility and fall risk in post-stroke patients, with inter-rater reliability demonstrating Intraclass Correlation Coefficients (ICCs) between 0.95 and 0.98, and intra-rater reliability ranging from 0.91 to 0.95. It shows strong construct validity, correlating well with other functional mobility measures like the Berg Balance Scale, with coefficients often exceeding r = 0.80. Additionally, the TUG effectively predicts fall risk, with sensitivity around 85% and specificity around 90%. Overall, the TUG test is essential for evaluating mobility and guiding rehabilitation in stroke care
Time frame: 12 week