HIT-Stroke Trial 2 (HST2)
Moderate-Intensity Exercise Versus High-Intensity Interval Training to Recover Walking Post-Stroke: HIT-Stroke Trial 2
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Audrey Nicoloff
- Phone Number: 513-558-7487
- Email: strokerecovery@uc.edu
Study Locations
-
-
Delaware
-
Newark, Delaware, United States, 19713
- Recruiting
- University of Delaware
-
Contact:
- Jane Diehl
- Email: strokestudies@udel.edu
-
Principal Investigator:
- Darcy Reisman, PT, PhD
-
-
Kansas
-
Kansas City, Kansas, United States, 66160
- Recruiting
- University of Kansas Medical Center
-
Contact:
- Sasha Moores
- Phone Number: 913-588-2697
- Email: reachlab@kumc.edu
-
Principal Investigator:
- Sandra Billinger, PT, PhD
-
-
Ohio
-
Cincinnati, Ohio, United States, 45267
- Recruiting
- University of Cincinnati
-
Contact:
- Audrey Nicoloff
- Phone Number: 513-558-7487
- Email: strokerecovery@uc.udu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 30-85 years at time of consenting
- Hemiparesis from ischemic and/or hemorrhagic strokes
- Most recent stroke for which participant sought treatment, at least 6 months prior to study consent
- Walking speed <1.0 m/s on the 10-meter walk test
- Able to walk 10m over ground with assistive devices as needed and no continuous physical assistance from another person (guarding and intermittent assistance for loss of balance allowed)
- Able to walk at least 3 minutes on the treadmill at ≥0.13m/s (0.3 mph)
- Stable cardiovascular condition (AHA class B, allowing for aerobic capacity <6 metabolic equivalents)
- Able to communicate with investigators, follow a 2-step command and correctly answer consent comprehension questions
Exclusion Criteria:
- Exercise testing uninterpretable for ischemia or arrhythmia (e.g. resting ECG abnormality that makes exercise ECG uninterpretable for ischemia and no other clinical testing from the past year available to rule out these conditions)
- Evidence of significant arrhythmia or myocardial ischemia on treadmill ECG graded exercise test in the absence of recent (past year) more definitive clinical testing (e.g. stress nuclear imaging) with negative result
- Hospitalization for cardiac or pulmonary disease within past 3 months
- Implanted pacemaker or defibrillator with an upper heart rate limit that would interfere with exercise testing or prescription, or with unknown limit
- Significant ataxia or neglect (score of 2 on NIH stroke scale item 7 or 11)
- Severe lower limb spasticity (Ashworth >2)
- Known recent history (<3 months) of unstable substance abuse or unstable mental illness
- Major post-stroke depression (Patient Health Questionnaire [PHQ-9] ≥ 10) in the absence of depression management by a health care provider
- Currently participating in physical therapy or another interventional study targeting walking function
- Recent (<2 weeks) or planned changes in lower limb orthotic or spasticity management
- Foot drop or lower limb joint instability without adequate stabilizing device, as assessed by a physical therapist
- Clinically significant neurologic disorder other than stroke or unable to walk outside the home prior to stroke
- Unable to walk outside the home prior to stroke
- Other significant medical condition likely to limit improvement or jeopardize safety as assessed by a physical therapist (e.g. joint contracture, gait limited by pain)
- Pregnancy
- Previous exposure to fast treadmill walking (>3 cumulative hours) in the past year
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Moderate-Intensity Aerobic Training
|
Overground and treadmill walking with speed continuously adjusted to maintain a target heart rate of 40 +/- 5% heart rate reserve, progressing up to 55 +/- 5% heart rate reserve.
|
|
Experimental: High-Intensity Interval Training
|
Overground and treadmill walking with 30 second bursts at maximum speed alternated with 30-60 second passive recovery periods.
Intended to achieve a target average heart rate above 60% heart rate reserve.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
6-Minute Walk Test Distance
Time Frame: Change from Baseline to 12 weeks
|
Total distance walked in 6 minutes in meters
|
Change from Baseline to 12 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
6-Minute Walk Test Distance
Time Frame: Change from Baseline to 3 month follow up
|
Total distance walked in 6 minutes in meters
|
Change from Baseline to 3 month follow up
|
|
Self-Selected Gait Speed
Time Frame: Change from Baseline to 12 weeks
|
From 10-meter walk test at self-selected speed, in meters per second
|
Change from Baseline to 12 weeks
|
|
Fastest Gait Speed
Time Frame: Change from Baseline to 12 weeks
|
From 10-meter walk test at fastest speed, in meters per second
|
Change from Baseline to 12 weeks
|
|
PROMIS-Fatigue Scale version 8a
Time Frame: Change from Baseline to 3 month follow up
|
An 8-item self-report questionnaire about symptoms of fatigue.
Each item is rated from 1-5.
Items are combined to obtain a total T score, where higher scores indicate greater fatigue.
|
Change from Baseline to 3 month follow up
|
|
Aerobic Capacity
Time Frame: Change from Baseline to 12 weeks
|
Oxygen consumption rate at ventilatory threshold during treadmill graded exercise test, in milliliters per kilogram body mass per minute
|
Change from Baseline to 12 weeks
|
|
EuroQol-5D-5L
Time Frame: Change from Baseline to 3 month follow up
|
A 6-item questionnaire about quality of life, including: mobility, self-care, usual activities, pain/discomfort, anxiety/depression and overall health.
Each item is scored from 1 to 5, where lower scores indicate greater quality of life.
A total 'misery score' will be calculated by averaging the scores for each item.
|
Change from Baseline to 3 month follow up
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Pierce Boyne, PT, DPT, PhD, University of Cincinnati
Publications and helpful links
General Publications
- Garrity C, Reisman DS, Billinger SA, Pressler D, Wagner E, Awosika O, Bartsch BL, Briton-Carpenter A, Carl D, Engler A, Foster J, Kim J, McCartney K, Moores A, Sucharew H, Thompson E, Walters K, Wasik E, Wright H, Yeazell M, Boyne P. Protocol for the HIT-Stroke Trial 2 randomized controlled trial: Moderate-intensity exercise versus high-intensity interval training to determine the optimal training intensity for walking rehabilitation in chronic stroke. medRxiv [Preprint]. 2025 Jul 31:2025.07.30.25332470. doi: 10.1101/2025.07.30.25332470.
- Pressler D, Schwab-Farrell SM, Awosika OO, Reisman DS, Billinger SA, Riley MA, Boyne P. Predicting Musculoskeletal Adverse Events During Moderate- to High-Intensity Walking Training in Chronic Stroke. medRxiv [Preprint]. 2026 Apr 18:2026.04.16.26351040. doi: 10.64898/2026.04.16.26351040.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Vascular Diseases
- Cardiovascular Diseases
- Stroke
- Motor Activity
- Movement
- Musculoskeletal Physiological Phenomena
- Musculoskeletal and Neural Physiological Phenomena
- Physical Conditioning, Human
- Exercise
- High-Intensity Interval Training
Other Study ID Numbers
Other Study ID Numbers
- 427659
- R01HD093694 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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