Fitness
HIIT May Best Moderate Exercise for Poststroke Fitness
![HIIT May Best Moderate Exercise for Poststroke Fitness HIIT May Best Moderate Exercise for Poststroke Fitness](https://img.medscapestatic.com/vim/live/professional_assets/medscape/images/thumbnail_library/dt_240822_senior_exercise_recumbent_stepper_800x450.jpg)
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
Smartwatches and Fitness Trackers May Be Unreliable in Tracking
![Smartwatches and Fitness Trackers May Be Unreliable in Tracking Smartwatches and Fitness Trackers May Be Unreliable in Tracking](https://fs.npstatic.com/userfiles/7687254/image/OnePlus_Watch_2R/nextpit_OnePlus_Watch_2R_Fit.jpg)
Smartwatches and fitness trackers have come a long way, offering more comprehensive health and fitness tracking capabilities than ever. As these devices continue to improve, has recorded data using these devices become more reliable? A new study suggests you shouldn’t trust all the metrics your smartwatch or fitness tracker records.
Published in Sports Medicine, a recent system review revealed the state of smartwatches and fitness trackers today regarding their reliability and potential limitations in terms of tracking vital metrics, ranging from heart rate and SpO2 to aerobic capacity and sleep.
Researchers conducted an umbrella review, which compiled several findings into a single study that involved over 430,465 participants. The gathered data yielded surprising findings that support how key tracking features in wearables have improved over the years, while some tools could still be far from being truly reliable.
Which aspects of health metrics from smartwatches are reliable?
One of the key findings showed how the heart rate measurement in today’s smartwatches and fitness trackers has an accuracy of +/- 3 percent with the possibility of a slight deviation. This means the heart rate data from these wearables are highly accurate.
The same case is touted for arrhythmia detection including Afib, with the sensitivity and specificity of the feature touted to be 100 percent and 95 percent accurate, respectively. Moreover, blood oxygen level saturation or SpO2 monitoring has also shown a 2 percent mean difference, indicating a high level of reliability.
Smartwatches might not be reliable enough to monitor your sleep and fitness activities
It is on the wellness and fitness fronts that smartwatches and fitness trackers seem to exhibit a notable degree of inaccuracy. For instance, VO2 max, or a measurement of the amount of oxygen your body can absorb and use during workouts, has been highlighted to produce about +/- 15 percent difference during rests and +/- 9 percent during exercises. On the other hand, a bigger mean error is observed when tracking physical activity intensity.
Even so, the findings mentioned that wearables also fail to deliver dependable step counts despite being one of the most basic features. It listed mean errors as falling between -9 to +12 percent. Meanwhile, calorie expenditure measurement, or the amount of calories burned during a workout, has an even worse accuracy rate with a -21 percent to +15 percent difference.
Regarding sleep, data from smartwatches and fitness trackers might not be relied upon as well. The study revealed these devices overestimate sleep time by as much as 10 percent when compared to results from polysomnography.
What can we build from this? Are wearables only useful to capture valuable health and fitness insights? Users should be aware that accuracy in other metrics does vary significantly and they should be cautious when interpreting such data.
What is your opinion on this study? How do you manage your health from your smartwatch or fitness tracker? We want to hear your thoughts on this.
Fitness
Golf fitness: One exercise that checks all the boxes
Everyone loves a golf-specific exercise that checks all the boxes.
This week, Golfweek’s fitness guru and long driver Averee Dovsek and her trainer Jon Freed, demonstrate the quadruped plank kettlebell pull-through as an excellent workout for golfers due to several reasons.
Golfers require strong and stable core muscles to maintain balance and control during the swing. This exercise targets the core, particularly the transverse abdomens and obliques, which are essential for rotational stability and power.
The movement mimics the rotational aspects of a golf swing. As you pull the kettlebell across your body, you engage the muscles that are crucial for generating rotational force, helping to improve the power and accuracy of your swing.
The exercise emphasizes resisting rotation, which is vital for maintaining proper form and preventing injury during the dynamic motions of golf.
The quadruped position also challenges your balance and coordination.
If you’re interested in any of Averee’s fitness content, click here.
If you’re looking for more instruction, click here.
This article originally appeared on Golfweek: Golf fitness: One exercise that checks all the boxes
Fitness
Fit balance exercises into a busy day – Harvard Health
![Fit balance exercises into a busy day – Harvard Health Fit balance exercises into a busy day – Harvard Health](https://domf5oio6qrcr.cloudfront.net/medialibrary/15579/conversions/p5-balanceexercise-standtandem-hl0924-mc-4117-thumb.jpg)
Adding balance exercises to a hectic schedule might seem like one chore too many. How are you supposed to squeeze in another 30-minute regimen when you’re already exercising daily, working, and running errands? The answer is by doing a little balance training at a time. “Just a minute of balance exercise here or there has a cumulative effect. As your balance improves, it gets easier to carry out daily functions,” says Kristina Dunlea, a physical therapist at Harvard-affiliated Brigham and Women’s Hospital.
We need good balance to safely perform upright activities, such as walking, getting up and down from a chair or bed, climbing stairs, or reaching up for a dish in a cupboard. Unfortunately, balance declines over time, increasing the risk of falls — a leading cause of injury and disability past age 65.
Finding the time
Since you need only a minute for a balance exercise, Dunlea recommends integrating it into a free moment that’s already built into your day.
“For many people, it’s when they’re standing and waiting for coffee to brew or brushing their teeth. Or it might be during TV time: think of commercials as your cue to get up and do a balance exercise,” she suggests.
Those opportunities also come with equipment to keep you safe if you become unstable during a balance exercise, such as a counter or desk to hold on to or a chair to fall back on.
Balance exercise ideas
A counter or sturdy chair works well for several effective balance exercises.
For example, a sturdy chair is a good spot for a sit-to-stand exercise — going from a sitting to a standing position, arms crossed, then returning to a sitting position and repeating the process. Dunlea recommends doing this exercise five to 10 times in a row. “It strengthens your leg and abdominal muscles and trains you to shift the main weight of your body up over your feet — your base of support,” she explains.
A counter works well for doing one minute of heel raises, tandem standing or walking, or standing on one leg (see “3 balance exercises to try at home”). “Standing on one leg is especially helpful for tasks requiring you to shift your weight and balance on one leg for a moment, such as climbing stairs or stepping up onto a curb,” Dunlea says.
But don’t continue a balance exercise if it’s so challenging that you’re at risk of falling. And if you currently have balance problems, it’s best to work with a physical therapist before trying these moves on your own. For more information, check out the Harvard Special Health Report Better Balance.
3 balance exercises to try at home
Tandem standing
Stand with your arms at your sides. Place your left foot directly in front of your right foot, heel to toe, and squeeze your inner thighs together. Lift your arms out to your sides to help you balance. Hold the position up to 30 seconds. Return to the starting position, then repeat with your right foot in front.
Heel raises
Stand with your arms at your sides. Lift your heels, shifting your weight to the balls of your feet. Try to balance evenly without allowing your ankles to roll inward or outward. Hold. Lower your heels to the floor, maintaining good posture as you do. Repeat 10 times.
Single leg stance
Stand with your arms at your sides. Bend your right knee, lifting that foot several inches off the floor, and balance on your left leg. Hold the position up to 30 seconds. Return to the starting position, then repeat the process while balancing on your right leg.
Exercise photos by Michael Carroll
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