- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03006731
High Intensity Interval Training for People With Stroke Deficits (HIIT-Stroke)
May 5, 2023 updated by: Susan Marzolini, University Health Network, Toronto
High Intensity Interval Training for People With Stroke Deficits: Optimizing the Exercise Intervention (The HIIT-Stroke Study)
The purpose of this study is to compare the effects of an exercise training strategy called high-intensity interval training (HIIT) to moderate intensity continuous exercise (MICE), on walking function and cardiovascular fitness in stroke patients.
Hypothesis: HIIT will result in significantly greater benefit to fitness and mobility than MICE.
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Detailed Description
Using a randomized design, the study will evaluate the effects of 3 HIT sessions combined with 2 MICE sessions per week on cardiovascular fitness and mobility compared to MICE training 5 days/week.
Participants post-stroke will be randomly assigned to either MICE (5 days per week (d∙wk-1)) or combined HIIT (3 d∙wk-1) with MICE (2 d∙wk-1).
Both groups will be exercising 5 times per week (walking on a treadmill with harness for fall protection); 3 times at the centre and 2 times at home.
Outcome measures will be conducted before and after 24 weeks of training.
Study Type
Interventional
Enrollment (Actual)
47
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Ontario
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Toronto, Ontario, Canada, M4G 2V6
- Toronto Rehabilitation Institute - Rumsey Centre
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- clinical diagnosis of stroke (hemorrhagic or ischemic),
- ability to walk at least 100 m independently with or without an assistive device with no severe limitations due to pain,
- living in the community at least 10 weeks post stroke (no upper limit) with a stroke-related motor impairment score of <7 on the Chedoke-McMaster Stroke Assessment scale of the leg or foot or with hemiparetic gait pattern,
- no severe communicative aphasia or comprehensive aphasia as noted in in clinical reports or referral form
- no orthopedic issues that may be aggravated by HIT
- ability to provide informed consent
Exclusion Criteria:
- severe uncontrolled hypertension or orthostatic blood pressure decrease of >20 mmHg
- other cardiovascular morbidities which would limit exercise tolerance (e.g. horizontal or downsloping ST-segment depression >2 mm, symptomatic aortic stenosis, complex arrhythmias),
- unstable angina,
- severe proliferative retinopathy or uncontrolled blood glucose,
- hypertrophic cardiomyopathy
- lower extremity claudication
- cognitive and/or behavioral issues limiting participation in exercise testing and training, prior unrelated neurological disorders or psychiatric illness
- abdominal or inguinal hernia causing discomfort with routine activities.
Other issues will be considered case-by-case.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: High Intensity Training
High Intensity Interval Training patients will attend the centre 3 times/week for 24 weeks.
All subjects will participate in MICE aerobic training 5 days/week in the first four weeks of the study to provide a foundation of fitness and endurance for the safe prescription of HIIT.
Subsequently, the HIIT group will replace 3 MICE training days with 3 HIIT.
HIIT sessions will include two 20 minute protocols; 30:60 second work:active rest ratio, and 120:180 second work:active rest ratio on a treadmill with a harness for fall protection.
In addition to supervised exercise training (3 times/week), MICE will be conducted 2 times/week in the home/community, which has been shown to be both safe and effective
|
Supervised HIIT sessions will be conducted on a treadmill at Toronto Rehab's Cardiac Rehabilitation and Secondary Prevention Program.
During each of the three supervised HIIT sessions each week, subjects will be prescribed 2 protocols with a combination of short to moderate duration exercise of near maximal intensity alternating longer periods of active recovery.
The total duration for each HIT session will be approximately 20 minutes with an additional 5 minutes warm-up and cool down period.
Other Names:
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Active Comparator: Moderate Intensity Exercise
Moderate Intensity Continuous Exercise patients will attend the centre 3 times/week for 24 weeks.
Participants will be progressed to 30 to 60 minutes of continuous exercise at the heart rate that occurred at the anaerobic threshold on the exercise test.
Participants will exercise on a treadmill with a harness ofr fall protection.
In addition to supervised exercise training (3 times/week), MICE will be conducted 2 times/week in the home/community by both cohorts.
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MICE sessions represent the standard of care exercise prescription at TRI. Participants will be instructed to complete 20-60 minutes of continuous aerobic exercise at or around the ventilatory anaerobic threshold achieved on the cardiopulmonary exercise test.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Cardiovascular fitness - Peak oxygen uptake (VO2peak)
Time Frame: 0, 24 weeks
|
A symptom-limited exercise test will be performed on a treadmill with a harness for fall protection using a ramp protocol.
Breath-by-breath gas samples will be collected via calibrated metabolic cart to determine peak oxygen uptake.
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0, 24 weeks
|
Change in Six Minute Walk Test
Time Frame: 0, 24 weeks
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This test measures the distance that an individual can quickly walk in a period of 6 minutes on a flat surface.
Participants will complete one trial with the gait aide prescribed to them.
The distance will be recorded.
Participants can stop and rest or discontinue to the test at any time.
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0, 24 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Neuropsychological Test Battery (change over time)
Time Frame: 0, 24 weeks
|
Two executive function measures to measure selective attention and executive inhibition processes as well as a measure to assess speed of processing will be used.
We will also include Trails A and B, DKEFS verbal fluency, the Weschsler digit symbol coding assessment.
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0, 24 weeks
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VO2 during HIT and MICE
Time Frame: 9 weeks and 24 weeks
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To determine the ability of patients to reach critical intensity thresholds during HIT training and MICE and to examine dose-response associations, the acute effects (time spent above the critical intensity levels) will be measured using an ambulatory oxygen monitor.
Ventilatory values will be measured using the CORTEX Biophysik MetaMax®3X portable gas analyzer recorded every 10 seconds for calculation of the time spent above the critical levels.
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9 weeks and 24 weeks
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Change in Dual task gait velocity
Time Frame: 0, 24 weeks
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This assessment will include four 10 metre walking tasks at maximal comfortable speed.
Three minutes after the first two 10 metre trials, participants will be asked to repeat the walk with simultaneous serial 3 subtractions and then naming as many words as possible that begin with a certain letter of the alphabet [FAS].
The number of errors and time to complete the tasks will be recorded.
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0, 24 weeks
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Adherence
Time Frame: 0 to 24 weeks
|
Attendance and completion of home-based sessions measured via exercise diary
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0 to 24 weeks
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Adverse Events
Time Frame: 0 to 24 weeks
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Any adverse event or near miss is required to be reported as standard of care at Toronto Rehab/UHN.
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0 to 24 weeks
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Patient satisfaction
Time Frame: 24 weeks
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questionnaire
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24 weeks
|
Change in Brain Blood Flow response to exercise
Time Frame: 9 weeks and 24 weeks
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Transcarnial Doppler ultrasound of the MCA and simultaneous finger cuff blood pressure monitoring during exercise
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9 weeks and 24 weeks
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Muscle Oxygenation
Time Frame: 0, 8 weeks, 12 weeks, 24 weeks
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Near Infrared Spectroscopy (NIRS) measurement of the vastus lateralis during rest and exercise.
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0, 8 weeks, 12 weeks, 24 weeks
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Susan Marzolini, PhD, Toronto Rehabilitaiton Institute
- Study Director: Paul Oh, MD, Toronto Rehabilitation Institute
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
March 1, 2017
Primary Completion (Actual)
July 31, 2022
Study Completion (Anticipated)
August 31, 2023
Study Registration Dates
First Submitted
December 19, 2016
First Submitted That Met QC Criteria
December 27, 2016
First Posted (Estimate)
December 30, 2016
Study Record Updates
Last Update Posted (Actual)
May 9, 2023
Last Update Submitted That Met QC Criteria
May 5, 2023
Last Verified
May 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 16-5760-DE
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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