Fitness

HIIT May Best Moderate Exercise for Poststroke Fitness

Published

2 years ago

August 23, 2024

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.”

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.

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).

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.”

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.

“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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Fitness

Walking May Not Provide Enough Exercise to Maintain Fitness

Published

10 hours ago

April 2, 2026

Press Room

Walking May Not Provide Enough Exercise to Maintain Fitness

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Walking is the most popular physical activity in the U.S., but experts say this might not be enough to maintain fitness levels. Image Credit: Luke Mattson/Stocksy

Researchers report that walking is the most popular leisure activity in the United States.
They note urban dwellers also like to run and lift weights, while rural residents also enjoy gardening and hunting.
Experts say those activities may not be enough for some people to maintain a higher fitness level, so additional exercise may be needed.

Walking is the most popular leisure activity in the United States among both urban and rural residents, according to a new survey.

Researchers reported that urban dwellers also tend to engage in running, weightlifting, and dance, while people in rural areas also enjoy gardening, hunting, and fishing.

The researchers said the differences in leisure activity choices could reflect what people have access to or what is culturally supported in certain areas. They added that urban residents were more likely to meet physical activity guidelines than people living in rural regions.

The researchers, however, noted that even among walkers, only 25% met combined guidelines for aerobic and muscle-strengthening physical activity. About 22% did not meet either guideline.

The researchers reached their conclusions by analyzing telephone survey data collected from a national sample of 396,261 U.S. adults in 2019.

They reported that 44% of respondents listed walking as the activity they spent the most time doing. The data closely matched another U.S. study from 2011.

The new findings were published today in the journal PLOS One.

The researchers said they hoped their study could help boost physical activity by encouraging people, as well as medical and fitness professionals, to tailor workouts to certain regions and demographics.

“We see a need to continue to support our partners in small towns and rural places by creating physical, social, and cultural conditions that support physical activity,” said Christiaan Abildso, PhD, a physical activity specialist at West Virginia University and a lead author of the study, in a statement.

Everyone needs to ask, ‘how does what we’re doing affect physical activity,’ in order to help get people more active, more often, in more places,” he added.

Abildso listed several steps community leaders can take to improve fitness opportunities. Among the suggestions:

Create a wide shoulder on a country road for cycling and running.
Expand the national network of rail trails.
Help a senior center create a chair exercise program.
Create or improve green spaces such as parks.
Keep school facilities open to the public.

“This study aligns with other studies on physical activity in the U.S. population,” said Michael Fredericson, MD, a professor of orthopedic surgery at Stanford Medicine in California. Fredericson wasn’t involved in the study.

“This underscores the continued need to encourage easily accessible forms of exercise, such as walking, or more functional activities around the home, which are more doable for folks,” Fredericson told Healthline.

There are numerous benefits to daily walking, a low-stress activity that can help people exercise with a minimal risk of injury.

A daily walking routine can also improve mood and support long-term weight management.

A 2023 review reported that walking 8,000 to 10,000 steps per day can provide substantial cardiovascular health benefits as well as psychological well-being.

Gardening can also be considered a moderate physical activity that supports weight management and helps build strength. The time outdoors in a garden can also help your body produce vitamin D, which supports bone strength, calcium absorption, and immune function.

Gardening may also support mental well-being by improving mood and reducing stress.

“Walking and gardening can meet exercise recommendations for most people if performed at sufficient intensity and duration,” said Fredericson. “Still, hunting and fishing, unless there is a lot of walking/hiking, typically do not provide adequate moderate-to-vigorous physical activity.”

The Centers for Disease Control and Prevention (CDC) recommends that adults get at least 150 minutes of moderate-intensity aerobic activity per week.

The agency suggests that exercise could come in the form of brisk walking for 30 minutes a day, 5 days a week, or 75 minutes of vigorous-intensity aerobic activity each week, such as swimming laps.

The CDC also states that adults need at least 2 days a week of muscle-strengthening activity.

David Cutler, MD, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California, recommends people try to meet these minimal time standards in their fitness routines.

“There should be greater emphasis for all adults to meet the minimum exercise guideline of 150 minutes per week,” he told Healthline.

“Their exercise routine should include more than just aerobic exercise, like walking, running, biking, swimming, or dancing. There should also be time devoted to muscle-strengthening exercises of both the upper and lower extremities. This could be as simple as using hand weights and squats.”

Agency officials note that the “exact amount of physical activity needed to maintain a healthy weight varies greatly from person to person.”

Fredericson said a comprehensive weekly exercise program should contain four main components. Those are:

He also suggested people can do “exercise snacks,” which consist of physical activity lasting 1 to 5 minutes performed periodically throughout the day. Those quick exercises can include stair climbing, brisk walking, and jumping jacks.

“This approach has demonstrated high compliance rates and can significantly improve cardiorespiratory fitness, particularly in physically inactive adults,” Fredericson said.

Cutler agrees a wide variety of exercise is the best approach.

“Individuals should supplement walking with muscle-strengthening exercises like yoga or resistance bands, and higher-intensity activities such as running, dancing, or cycling,” he said. “Effective ways to increase activity include utilizing community infrastructure like rail-trails, joining senior center programming, and creating local, accessible activity spaces.”

“Core exercises should also be incorporated in a weekly routine,” he added. “These strengthen the muscles in your pelvis, lower back, hips, and abdomen, leading to improved stability, better posture, and reduced back pain.”

“Stretching exercises are also important for health aging, injury prevention, and overall fitness,” Cutler noted. “Evidence supports that consistent stretching increases range of motion, reduces joint stiffness, and enhances vascular health.”

Fitness

Six weeks of exercise in this sport can slash blood pressure more than medicine

Published

22 hours ago

April 1, 2026

Press Room

Six weeks of exercise in this sport can slash blood pressure more than medicine

A first-of-its-kind scientific study found huge benefits to the sport-specific training.

Hanna Geissler and Ewan Mowat Deputy Lifestyle, Trends, & Showbiz Editor

20:00, 01 Apr 2026

Regular exercise is a great way of keeping you fit and healthy. The physical benefits of having improved cardio capacity and better muscle strength can be apparent day to day.

The endorphin rush and sense of achievement that comes with a successful workout can also help your mental health, while there are lots of social benefits if you are exercising with others too. And new research has discovered a huge benefit to training in one specific sport – and it kicks in quickly.

A study on boxing found that within just six weeks of 40-minute workouts, people can see their blood pressure slashed by more than through medication. The exercise regime was seen to reduce the risk of hypertension and improve blood pressure function.

The research, which was published in the peer-reviewed journal Sports earlier this year, involved young adults with stage 1 high blood pressure taking part in three exercise sessions each week. The 24 participants, with an average age of 25, were randomly assigned either boxing training or other workouts in a control group.

As reported by The Express, the boxers completed 10 three-minute rounds of working the heavy bag or mitt work, with a 60 second break in between. The others worked on flexibility and balance exercises on the same three-on-one-off schedule.

The systolic blood pressure of those in the boxing group dropped by an average of 16mmHg, while their diastolic blood pressure dropped by 10mmHg.

Researchers said the reductions were comparable to or greater than those typically achieved through medication. Significant decreases like this “translate to a lower risk of heart attack and stroke”, according to the team.

The study, which is is the first randomised controlled trial to evaluate the effects of boxing training on cardiovascular and vascular health in this population, was co-authored Professor Alvaro Gurovich, of the University of Texas at El Paso in the US.

He said: “What we’re showing is that boxing training is not just a fun workout; it can actually change how your blood vessels work.

“After just six weeks, the blood vessels of our participants were more flexible, more responsive and carrying more blood. That directly translates into a lower risk of heart attack and stroke.”

Prof Gurovich believes that the findings could be a much more positive alternative to “a lifetime of medication” for young adults that are currently heading towards hypertension.

He said: “For young people who are already on a path toward hypertension, this could be a powerful and sustainable alternative to starting a lifetime of medication.”

Each of the 24 participants had stage one hypertension, with readings of 130-139mmHg systolic and 80-89 mmHg diastolic. The findings suggest people with similar blood pressure levels could see a reduction of more than 10 per cent from the boxing regime.

Mild high blood pressure can, if left untreated, progress and cause damage that increases the risk of serious problems such as heart attacks and strokes.

The research team said future studies should examine whether the same benefits can be achieved in older populations.

Prof Gurovich added: “Hypertension is a primary contributor to heart disease, stroke and premature death, and many young adults who are in the early stages of the condition are not aware that they have it.

“These findings could reshape how clinicians approach one of the world’s most prevalent cardiovascular risk factors.”

Fitness

Why movement and engagement are key to cognitive fitness

Published

1 day ago

April 1, 2026

Press Room

Why movement and engagement are key to cognitive fitness

(Aging Untold) — The brain needs regular stimulation to function well, whether through physical exercise, meditation or learning new skills like painting or doing puzzles.

Dr. Rhea Rogers, a board-certified physician, said the brain thrives on neuronal connections and movement. Different activities target different regions and lobes of the brain, each controlling different functions.

“You want mental stimulation if it’s a crossword puzzle, reading,” Rogers said. “But anytime you learn new information, you’re strengthening those neuronal connections, and you want to build a reserve.”

Rogers said other areas of the brain handle sensory input and creativity, while movement promotes blood flow, circulation and oxygen. Social engagement also activates different brain regions.

Movement requires brain planning

Movement is critical because the brain must plan each action, Sam Cradduck, a gerontologist, said. The brain has to anticipate the next step, maintain balance and foresee obstacles like a cat crossing a path or a throw rug.

“As you’re moving along, you’re actually exercising your brain more than you know,” Cradduck said.

For people who cannot move easily, Cradduck suggested organizing family photo albums. The task requires memory, planning and executive function, which can help prevent dementia.

“Memory and mood and all that, that actually is the best resilience against neurodegenerative disorders like Alzheimer’s, Parkinson’s and things like that,” Rogers said.

Find activities you enjoy

Amy O’Rourke, an aging expert, said people should not overthink brain health activities. She compared forcing puzzles or word games on someone to telling people to exercise when they dislike it.

“What do you like to do and build on that?” O’Rourke said. “If you like to walk, go with a friend and walk and talk, like then you get that back-and-forth stimulation with the brain. If you like to cook, then try a new recipe.”

Katherine Ambrose, an aging-well coach, mentioned lifelong learning opportunities and dance lessons as options.

She said her mother loves to dance and has read studies suggesting it could be the best exercise for the brain.

Ambrose also mentioned swimming as another option.

“Just find what really works for you and gets you excited about life,” Ambrose said. “It’s just important to stay engaged with living.”