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HIIT May Best Moderate Exercise for Poststroke Fitness

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HIIT May Best Moderate Exercise for Poststroke Fitness

Repeated 1-minute bursts of high-intensity interval training (HIIT) are more effective than conventional moderate, continuous exercise for improving aerobic fitness after stroke, according to a multicenter randomized controlled trial.

“We hoped that we would see improvements in cardiovascular fitness after HIIT and anticipated that these improvements would be greater than in the moderate-intensity group, but we were pleasantly surprised by the degree of improvement we observed,” Ada Tang, PT, PhD, associate professor of health sciences at McMaster University in Hamilton, Ontario, Canada, told Medscape Medical News. “The improvements seen in the HIIT group were twofold higher than in the other group.”

Ada Tang, PT, PhD

The results were published on August 7 in Stroke.

Clinically Meaningful

Researchers compared the effects of 12 weeks of short-interval HIIT with those of moderate-intensity continuous training (MICT) on peak oxygen uptake (V̇O2peak), cardiovascular risk factors, and mobility outcomes after stroke.

They randomly assigned participants to receive 3 days per week of HIIT or traditional moderate exercise sessions for 12 weeks. Participants’ mean age was 65 years, and 39% were women. They enrolled at a mean age of 1.8 years after sustaining a mild stroke.

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A total of 42 participants were randomized to HIIT and 40 to MICT. There were no significant differences between the groups at baseline, and both groups exercised on adaptive recumbent steppers, which are suitable for stroke survivors with varying abilities.

The short-interval HIIT protocol involved 10 1-minute intervals of high-intensity exercise, interspersed with nine 1-minute low-intensity intervals, for a total of 19 minutes. HIIT intervals targeted 80% heart rate reserve (HRR) and progressed by 10% every 4 weeks up to 100% HRR. The low-intensity intervals targeted 30% HRR.

The traditional MICT protocol for stroke rehabilitation targeted 40% HRR for 20 minutes and progressed by 10% HRR and 5 minutes every 4 weeks, up to 60% HRR for 30 minutes.

The HIIT group’s cardiorespiratory fitness levels (V̇O2peak) improved twice as much as those of the MICT group: 3.5 mL of oxygen consumed in 1 minute per kg of body weight (mL/kg/min) compared with 1.8 mL/kg/min.

Of note, changes in V̇O2peak from baseline remained above the clinically important threshold of 1.0 mL/kg/min at 8-week follow-up in the HIIT group (1.71 mL/kg/min) but not in the MICT group (0.67 mL/kg/min).

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Both groups increased their 6-minute walk test distances by 8.8 m at 12 weeks and by 18.5 m at 20 weeks. No between-group differences were found for cardiovascular risk or mobility outcomes, and no adverse events occurred in either group.

On average, the HIIT group spent 36% of total training time exercising at intensities > 80% HRR throughout the intervention, while the MICT group spent 42% of time at intensities of 40%-59% HRR.

The study was limited by a small sample size of high-functioning individuals who sustained a mild stroke. Enrollment was halted for 2 years due to the COVID-19 lockdowns, limiting the study’s statistical power.

Nevertheless, the authors concluded, “Given that a lack of time is a significant barrier to the implementation of aerobic exercise in stroke clinical practice, our findings suggest that short-interval HIIT may be an effective alternative to traditional MICT for improving V̇O2peak after stroke, with potential clinically meaningful benefits sustained in the short-term.”

“Our findings show that a short HIIT protocol is possible in people with stroke, which is exciting to see,” said Tang. “But there are different factors that clinicians should consider before recommending this training for their patients, such as their health status and their physical status. Stroke rehabilitation specialists, including stroke physical therapists, can advise on how to proceed to ensure the safety and effectiveness of HIIT.”

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Selected Patients May Benefit

“Broad implementation of this intervention may be premature without further research,” Ryan Glatt, CPT, senior brain health coach and director of the FitBrain Program at Pacific Neuroscience Institute in Santa Monica, California, told Medscape Medical News. “The study focused on relatively high-functioning stroke survivors, which raises questions about the applicability of the results to those with more severe impairments.” Glatt did not participate in the research.

photo of Ryan Glatt
Ryan Glatt, CPT

“Additional studies are needed to confirm whether these findings are applicable to more diverse and severely affected populations and to assess the long-term sustainability of the benefits observed,” he said. “Also, the lack of significant improvements in other critical outcomes, such as mobility, suggests limitations in the broader application of HIIT for stroke rehabilitation.”

“While HIIT shows potential, it should be approached with caution,” Glatt continued. “It may benefit select patients, but replacing traditional exercise protocols with HIIT should not be done in all cases. More robust evidence and careful consideration of individual patient needs are essential.”

This study was funded by an operating grant from the Canadian Institutes of Health Research. Tang reported grants from the Canadian Institutes of Health Research, the Physiotherapy Foundation of Canada, and the Heart and Stroke Foundation of Canada. Glatt declared no relevant financial relationships.

Marilynn Larkin, MA, is an award-winning medical writer and editor whose work has appeared in numerous publications, including Medscape Medical News and its sister publication MDedge, The Lancet (where she was a contributing editor), and Reuters Health.

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60 Sweat-Worthy Gifts for Seriously Active People

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60 Sweat-Worthy Gifts for Seriously Active People

Tom Price is a reviews editor for Popular Mechanics while also contributing to Runner’s World, Best Products, and Bicycling. Here at Popular Mechanics, Tom loves testing out home appliances, smart tech, gear for city life and outdoor adventures, small gadgets like watches and multitools, and anything else you can find piled up at his hoarder’s nest of a desk.

Prior to working here, Tom attended NYU, graduating with a degree in English and a minor in creative writing. He also wrote for Best Reviews, The Daily Beast, and other publications covering tech, fitness gear, gadgets, and lifestyle products. Furthermore, he covered startup news, pop culture, and even professional wrestling. To follow more of his work, check back here for new stories.

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5 more minutes of exercise can help you live longer | CNN

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5 more minutes of exercise can help you live longer | CNN

Daily step counts and reaching at least 150 minutes a week of exercise — lots of exercise guidance focuses on hitting specific step, mile or time targets. But for many people, especially those who are least active, these goals can feel daunting and out of reach.

Can you commit to walk for five minutes daily? Instead of asking what happens when people meet ideal exercise benchmarks, researchers examined what might change if people made small, realistic shifts in how they move and how much time they spend sitting.

The findings, published recently in The Lancet journal, suggest that even modest changes could have meaningful implications for your health and longevity.

I spoke with CNN wellness expert Dr. Leana Wen about what the study found and how it influences what we think about movement in daily life. Wen is an emergency physician and clinical associate professor at George Washington University. She previously was Baltimore’s health commissioner.

CNN: What’s unusual about this new study of exercise?

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Dr. Leana Wen: This study set out to answer a deceptively simple question: What might happen if people moved just a little more each day or sat a little less? Rather than focusing on whether people met established exercise targets, the researchers examined the potential population-wide impact of very small increases in physical activity and small reductions in sedentary time.

To investigate this question, they conducted an individual participant data meta-analysis, which means they combined and reanalyzed data from multiple other studies. The analysis included data from seven groups in the United States, Norway and Sweden, comprising more than 40,000 participants, along with a separate analysis of nearly 95,000 participants from the United Kingdom.

The researchers focused on moderate-to-vigorous physical activity, which includes activities that raise the heart rate and make people breathe harder, as well as total sedentary time. They then estimated how many deaths might be prevented if people increased their activity by just five or 10 minutes a day or reduced their sitting time by 30 or 60 minutes a day.

CNN: What did they learn about the potential impact of small changes?

Wen: The key finding was that even very small changes in daily movement could be associated with meaningful reductions in deaths when applied across large populations.

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The researchers modeled two different scenarios. One focused on people who were least active — roughly the bottom 20% of participants — and asked what might happen if this high-risk group slightly increased their activity. The second took a broader, population-based approach, looking at what might happen if nearly everyone except the most active 20% of individuals made small changes.

In the high-risk scenario, a five-minute-per-day increase in moderate-to-vigorous physical activity among the least active participants was estimated to prevent about 6% of all deaths. When that same five-minute increase was applied across the broader population — excluding only the most active individuals — the potential reduction rose to about 10% of all deaths. These estimates suggest that modest increases in movement, when adopted widely, could translate into substantial population-level benefits.

The researchers also examined reductions in sedentary time. Cutting daily sitting time by 30 minutes was associated with smaller but still meaningful reductions in deaths. Among the least active participants, a 30-minute reduction in sedentary time was estimated to prevent about 3% of deaths, while applying that same reduction across the broader population could prevent about 7% of deaths.

CNN: Do these results support what we already know about exercise, sitting and longevity?

Wen: These findings are consistent with decades of research showing that physical activity is strongly associated with longer life and lower risk of chronic disease, while prolonged sedentary time is linked to higher risk of cardiovascular disease, diabetes and premature death.

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What this study adds is nuance. Traditional exercise research and guidelines often emphasize thresholds; for example, the US Centers for Disease Control and Prevention recommends at least 150 minutes a week of moderate-intensity physical activity such as brisk walking, dancing or gardening. These thresholds are based on levels of activity associated with maximal or near-maximal health benefits. While those targets are evidence-based, they could unintentionally reinforce the idea that anything less does not matter.

This analysis reinforces the concept that the relationship between activity and health is not all or nothing. Benefits begin at very low levels of activity, particularly for people who are starting from a sedentary baseline. Even incremental increases below guideline thresholds can contribute to better health outcomes.

The study also aligns with growing recognition that sitting time itself is an independent health risk. Even people who exercise regularly can spend large portions of the day sitting, and reducing sedentary time appears to confer benefits beyond structured exercise alone.

CNN: Does this study change existing exercise guidelines?

Wen: It does not change existing exercise guidelines, and it does not suggest that recommended activity levels should be lowered. The current guidelines remain grounded in extensive evidence and are designed to optimize health outcomes across many dimensions, including cardiovascular fitness, muscle strength and metabolic health.

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What this research does change is how people might think about those guidelines. Instead of viewing them as a rigid standard that must be met to see any benefit, people can think of them as an aspirational goal along a continuum. Movement exists on a spectrum, and every step along that spectrum matters.

This framing can be particularly helpful for people who feel discouraged or defeated by traditional exercise advice. Rather than feeling that anything short of a full workout is pointless, people can recognize that small increases in daily movement are worthwhile and meaningful.

CNN: Who may benefit most from focusing on small, incremental changes?

Wen: As seen across numerous studies, the largest potential gains appear to be among people who are least active to begin with. For individuals who spend most of the day sitting and engage in very little moderate or vigorous activity, adding even a few minutes of movement represents a substantial relative increase.

This group includes many older adults, people with chronic medical conditions, individuals with physically demanding caregiving roles, and those whose jobs involve prolonged sitting. It also encompasses people who may feel intimidated by exercise culture or who have limited access to safe spaces for physical activity.

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From a public health perspective, helping these groups move just a little more could have an outsize impact. Small, realistic changes are more likely to be adopted and sustained, and when spread across large populations, they can translate into meaningful reductions in disease and premature death.

CNN: For someone who feels overwhelmed by exercise advice, what is a realistic first step they could take today?

Wen: A helpful first step may be to shift the mindset from “exercise” to “movement.” Physical activity does not have to mean a gym membership or an intense, structured workout. It can be as simple as taking a brisk walk, taking the stairs instead of the elevator, and standing up and doing chores like vacuuming during the day.

The goal is not perfection or intensity but consistency. Adding a few minutes of movement to the day, or finding opportunities to sit less, can be a manageable place to start. Over time, those small changes can build confidence and momentum.

The central message of this new study is actually reassuring: Progress does not have to be dramatic to matter a lot. Small, realistic changes, repeated day after day, can add up in ways that benefit both you and your community as a whole.

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Get inspired by a weekly roundup on living well, made simple. Sign up for CNN’s Life, But Better newsletter for information and tools designed to improve your well-being.

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Plymouth Twp. official criticized for saying female employees need to exercise

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Plymouth Twp. official criticized for saying female employees need to exercise

PLYMOUTH TWP. — A township trustee is drawing criticism and demands for an apology after he implied that women who work in the township hall need to exercise.

At a public meeting of the Plymouth Township Board of Trustees on Feb. 10, Trustee John Stewart said he supported a $29,200 purchase for exercise equipment for the township exercise room and wanted to encourage better mental and physical health among staff.

“Psychologists say you do things that make you feel good, so let’s create a new atmosphere,” said Stewart, 75. “I don’t know why the women employees on the first floor of township hall aren’t asked to pack a brown bag lunch and transport it down to the Lake Pointe Soccer Park and you walk them around that beautiful park.”

Stewart also suggested a lunchtime yoga class for female employees.

“You would make my month if you would call me and say, ‘You know what? (A township employee) has begun to organize yoga for women, and they’re meeting at 12:00 to 12:30 in the new workout room,’ ” Stewart said. “That would be a significant improvement and something that the supervisor can take credit for and the board of trustees can all take credit for.

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“I was very surprised when the supervisor called me two weeks ago and said, ‘We’re going to buy $20,000 worth of equipment,’ ” Stewart said. “I said, ‘Eureka, it’s about time.’ ”

Calls for apologies

Township Treasurer Bob Doroshewitz was not at the meeting but said he watched online and arrived at work the following day to find female employees discussing Stewart’s comments. 

Some, he noted, were “livid.” 

“The implication was that they need exercise,” Doroshewitz said. “It was horrible, particularly if you have somebody who is maybe self-conscious about their weight. You’re basically saying the women in township hall are too fat.” 

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Doroshewitz estimated about 18 to 20 women and eight men work on the first floor of township hall between the various departments.  

“You don’t tell somebody they need to go on an exercise program, particularly ‘you women,’ ” he said. “It’s just not cool.” 

Doroshewitz said he sent an email to Stewart, which he later shared with Hometown Life.

“I am requesting that you issue a formal apology to the Township’s female employees, particularly those working on the first floor, for the comments you made last night,” the email said, in part, also noting the remarks were “offensive, unprofessional, and unacceptable in the workplace.”

Doroshewitz said Stewart came into the township office shortly after receiving the email, confronted him about it and said he would not apologize. Doroshewitz also said he has concerns about Stewart’s behavior, citing recent outbursts, saying “it’s getting worse.”

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Supervisor Chuck Curmi declined to comment on Stewart’s remarks at the meeting, except to say the issue was Stewart’s to address. He added he had “nothing to say” about whether a complaint was filed with his office about Stewart’s remarks.

“My judgment is that a simple apology would work, but that’s for his judgment,” Curmi said. “I can’t make him do that. He’s got to handle that himself.” 

Stewart stands by statements

Stewart said his comments were meant only to promote employee wellness and ensure the township’s updated workout space would be open to women as well as men. 

“If we’re going to spend money on a weight room, it should be available to women to exercise if they wish,” he said in a Feb. 12 interview, pointing to his own family of “strong women.” 

Stewart called himself a “health fanatic” and said his suggestion that female staffers take a lunchtime walk or consider yoga was motivated by concerns for the health and well-being of township employees. 

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When asked about his comment suggesting the township’s female employees pack lunches and take a walk at the park, Stewart replied, “I live by that statement. Mental health, a break. Get out of that office because there’s toxic communications going on in that office.” 

“We want to encourage good health,” he added. “Sometimes I come on way too strong. But I am all about health and fitness. This was a purely motivated thing.” 

Trustee Sandy Groth said she did not view Stewart’s remarks as sexist and interpreted them as an effort to ensure female employees were included in workplace wellness opportunities. 

“I did not take offense to anything he said, and I’m a woman,” Groth said. “I really took it that he was trying to make sure that they also had opportunities.” 

While acknowledging that others interpreted the comments differently, Groth said her reaction was “very different.” 

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“I think you interpret things how you want to interpret them,” she said, noting she would have preferred a conversation seeking clarification rather than calls for an apology.”

Exercise room will open to all employees

Stewart was reelected to a second consecutive term in 2024, but also sat on the board from 1988-92. He also served three terms as state representative for the 20th District from 2000 to 2006.

Before Stewart’s comments, the board heard a presentation from Plymouth Township Police Sgt. Mike Hinkle, who said that while proposed upgrades to the dated fitness room would be led by the police department, the new equipment would be suitable for all fitness levels and available to all employees, not just police. 

“This is a police department project that we hope benefits every employee in the (township),” Hinkle said. “Every employee is going to be able to go up there and utilize this facility.” 

Hinkle noted the room is open 24/7 and has historically been open to all township staff.

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Contact reporter Laura Colvin: lcolvin@hometownlife.com.

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