Connect with us

Fitness

HIIT May Best Moderate Exercise for Poststroke Fitness

Published

on

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.

Advertisement

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).

Advertisement

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.”

Advertisement

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.

Advertisement

Fitness

More Muscle, Less Fat—Is This High-Tech Workout A New Fitness Answer?

Published

on

More Muscle, Less Fat—Is This High-Tech Workout A New Fitness Answer?

What if you could put on a suit that did your workout for you, a way to exercise without much time or effort? That’s the premise and promise of a hot and fast growing fitness niche called Electro Muscle Stimulation (EMS) training. Recent years have seen a slew of bestselling books focused on longevity, lifespan and wellspan, and almost universally, the doctors and researchers behind these have identified the extreme importance of growing muscle mass as we age, while singling out a specific health danger, visceral fat. The EMS workouts promise to tackle both of these hot button health issues and help users with more muscle, less fat, and to do it in sessions of 20 minutes or less a couple of times a week.

What Is EMS?

Can It Help You Get More Muscle, Less Fat?

EMS gyms, classes and workouts are relatively new and still largely off the public radar in the United States, but they have been popular in Europe and other parts of the world for decades. The oversimplified explanation of the concept is that an electric impulse causes an involuntary contraction of your muscle similar to but more intense than what you experience while lifting weights or doing other strength training, giving your muscle the exercise without you doing much. In the 1960s sports scientists in the former Soviet Union discovered that EMS could boost muscle strength quickly and used it to train elite athletes for the Olympics, and an article on this history in the Physical Therapy & Rehabilitation Journal reported that one Russian scientist found force gains of 40% in the elite athletes using the technology.

In the 1980s medical devices using EMS for physical therapy and rehabilitation became commonplace, and if you’ve had knee or shoulder surgery you might already be familiar with the technology. In the beginning of this century the first full (mostly) body suits for workouts were introduced in Germany, spawning a massive new fitness trend—today there are thousands of EMS gyms across Europe and other parts of the world.

But as Brendan Kennedy, owner of EMS fitness brand Katalyst told me, in Europe these are sold as consumer electronics, whereas in the U.S. they are FDA-regulated medical devices, which greatly limited access for Americans. Katalyst was the first suit to get FDA clearance for sale to U.S. consumers and the first you could buy, while recent EMS gym chains in this country such as Body20, Manduu and Iron BodyFit provide class participants with suits. Katalyst has a model more similar to Peloton, where they sell the suit for use at home and support it with a robust app full of digitally connected classes, broken into four categories, strength, recovery, cardio and power, with many sub-options in each, such as abs or upper body.

Advertisement

In recent years technology has greatly changed the exercise and fitness industries. As a health minded person who wrote a bestselling book about food and what we eat, and whose life and work has been closely associated with outdoor sports, these are subjects I pay a lot of attention to. I recently wrote here at Forbes about the boom in high-tech exercise recovery, as well as an article about a science-driven fitness and longevity resort retreat in Palm Springs, and an AI enabled all in one home strength training platform. So, the promise of EMS training, supported by many recent scientific and medical studies, and tons of anecdotal evidence, got my attention.

Fast, Low Impact Strength Training For More Muscle, Less Fat

The commonality between the at home approach and the studio classes is that just about all providers target workouts of 25 minutes or less, and as the Body20 website explains, “EMS training activates up to 90% of your muscle fibers in just 20 minutes, offering a fast, efficient way to build strength, improve endurance, and achieve your fitness goals.” Manduu classes are 15-minutes, and the brand claims that “When the brain sends a signal to a muscle, only about 65% of muscle fiber is activated. By contrast, the external EMS stimulus penetrates nearly 100% of muscle tissue. This produces a workout that is simultaneously ultra-low impact and incredibly effective, gentle yet intense.” IronBody Fit comes from Europe (France), has 250 studios worldwide, and claims that 25 minutes of EMS equals a 4-hour conventional strength training session. Most basic Katalyst classes are 20-minutes long, but their extensive library also has lower intensity recovery and cardio add-ons of 5 or 10 minutes and these can be combined to suit users’ goals.

In the U.S., EMS sessions are especially popular with professional athletes and celebrities, and USA Today reported that actor Tom Holland used it to get ripped to play Spider Man and Kendall and Kyle Jenner did an EMS workout on The Kardashians, while supermodel Cindy Crawford was an early investor in Katalyst. Some of the biggest sports stars including Usain Bolt, Rafael Nadal and Christiano Ronaldo have been cited using EMS workouts. George Clooney bought the Katalyst system and told Esquire in 2025 that “My arms are twice the size they’ve ever been. It’s crazy.” There are multiple specialty EMS gyms in New York and Los Angeles, but it is still between hard to impossible to find elsewhere in this country, which is the big appeal of Katalyst, the first at-home product, and one that has been growing for years. In addition, with gym classes often running around $100 a session, the payback on a complete Katalasyt system ($3000) is less than four months.

Katalyst’s Kennedy is a lifetime fitness junkie and self-proclaimed “gym rat” who has done long distance cycling events and Ironman Triathlons. But he told me that since getting hooked on EMS he has not done a conventional weightlifting gym session in four years—and for the first time in his life, in his Fifties, has “six-pack abs.”

Advertisement

It was his wife, a former professional ballet dancer, who discovered the company and EMS workouts. “She was essentially a professional athlete, extremely fit and had just had our first child. She was looking for something to give her that same workout and feeling of a satisfaction and she loved it. I had been going to gyms for 40 years, but during COVID gyms closed, and Katalyst was just getting FDA clearance to sell to consumers so we bought suits in 2021, and took them with us when we traveled around the world, and about a year ago we decided to buy Katalyst.” The portability of the lightweight package combined with the quick time frame of workouts and suitability to just about any hotel room make it extra appealing to frequent travelers.

“Everything we are learning about longevity tells us that strength is essential, at any age, but after we hit 40 or 50 it starts to decline. Same for people on GLP-1 drugs, and we’ve seen doctors telling people they put on those to get a Katalyst suit. It’s a way for people who don’t have time to go to the gym or don’t like going to the gym to get an extremely efficient workout in a short period of time, with a much lower chance of getting hurt.”

Whether at home or in a class setting, EMS workouts typically involve a series of light bodyweight movements, such as bicep curls or overhead presses with no weights, squats and standing “crunches.” The workouts require no weights or other accessories, though Kennedy says he sometimes uses very light dumbbells to help maintain better technical form, and his wife likes to use resistance bands. Workouts can be done entirely while standing in front of the screen, with no laying on the floor. It sounds too good to be true.

Advertisement

“Most fitness innovation is portability, ‘you can do this at home now’ or information, ‘you should do this,’ or motivation, ‘go do this,’ or entertainment that is distracting,” said Kennedy. “Katalyst has elements of that but the main thing that is different is that whether you are using some fancy piece of equipment on the wall or a fancy bike, you’re still doing the thing, you have to exert the effort. Katalyst is doing the thing to you. That’s really the key. I can have a workout on a day when I don’t necessarily want to workout and once I put on the suit I’m working out whether I want to or not, and in 20 minutes I’m getting the equivalent of a three to four hour weight workout. If I’m in the gym and do a curl, I’m using about 50% of my bicep. Even the best, most professional weightlifters might get to 55%. With Katalsyt, no matter how trained I am it’s firing 90% of that muscle. In a 20-minute workout, its four seconds on and four seconds off, so there are 150 impulses, and 26 pads for different muscle groups. That’s 3900 muscle impulses, but for me to do 3900 reps at the gym would take me at least four hours. It’s extremely efficient.”

Recent Studies on EMS Training

Numerous studies have shown the muscle and strength building effects of EMS compare favorably to considerably longer and more arduous traditional strength training sessions, and several also cite fat and visceral fat reductions. One conference paper aimed specifically at this followed a study group that did two 20-minute EMS workouts a week (basically what Katalyst recommends) for 10 weeks who were carefully measured before and after. The conclusion? “After 10 weeks of body weight training with WB-EMS, there is a significant difference in visceral fat between pre-test and post-test (P

A study available at the National Library of Medicine titled “Effects of Whole-Body Electromyostimulation versus High-Intensity Resistance Exercise on Body Composition and Strength: A Randomized Controlled Study,” compared doing a low-impact, low-effort EMS workout with a much more energetic HIT (High Intensity Training) strength workout in the gym. This was chosen because as the study says, HIT is widely considered the most efficient gym workout, “the gold standard reference HIT, for improving body composition and muscle strength.” Both groups exercised for 16 weeks with HIT participants doing workouts “to failure” and the study found nearly identical gains in muscle mass and strength, and concluded that, “In summary, WB-EMS can be considered as a time-efficient but pricy option to HIT-resistance exercise for people aiming at the improvement of general strength and body composition.”

Even most EMS proponents don’t claim that you can’t get as good a workout the old fashioned way, and most of the scientific literature I’ve found supports that, the notion that EMS is on par with longer and more strenuous traditional strength workouts. The advantage is that it’s much faster, much less strenuous, low impact, and if you don’t need to leave home and don’t need to have a room dedicated to machines and weight plates, you are much more likely to actually do it, which is a huge stumbling block in American health and fitness.

Another study, “Muscle Hypertrophy and Architectural Changes in Response to Eight-Week Neuromuscular Electrical Stimulation Training in Healthy Older People,” found EMS to be a “useful mean for combating age-related sarcopenia,” or loss of muscle mass and strength while ageing, and noted that, “Neuromuscular electrical stimulation (NMES), the application of an electric current to muscles in order to trigger muscle contractions, has been long used as an alternative intervention to resistance training in order to improve or attenuate muscle mass and strength losses. NMES has proven to be efficient across different populations, ranging from healthy adults and athletes to people with muscle weakness.”

Advertisement

Finally, a 2023 meta-analysis of 23 studies on EMS in Medicine Journal “concluded that WB-electromyostimulation has significant positive effects on muscle mass, body fat, strength, and power.” Those are all good things to have positive effects on.

I have been doing a lot of different kinds of exercise for decades and have been constantly tweaking and refining my workouts based on the latest research into health, fitness and ageing, and if it works as fans claim, I’m eager to add EMS to my routine. After all, I’m in the demographic that wants more muscle, less fat. Most of the studies I’ve read run from 8-16 weeks, so I’m going to give that a try with the Katalyst workouts, as where I live there is no gym-based class alternative. I’ll do it while using a smart scale with bioelectrical impedance analysis to track my muscle mass, body fat and visceral fat, and we’ll see how it goes.

Continue Reading

Fitness

‘The pants don’t lie’: Lenny Kravitz’s bizarre workout trick

Published

on

‘The pants don’t lie’: Lenny Kravitz’s bizarre workout trick

Lenny Kravitz has shared the secret to his incredible physique, but it’s not what you’d expect. 

Alongside his intensive workout regimen, what the 62-year-old singer wears while working out also plays a huge role in keeping him in check – namely, his famed leather pants. 

Lenny Kravitz works out just as he performs: in leather pants. Adam Berry

The star is known for performing in tight, restrictive outfits like denim and leather, and it makes sense to him to train in the same materials.

“I perform onstage in leather, denim, whatever, so those are the pants I wear to train,” he recently told Men’s Health. 

Advertisement

“It also means I can fit in a workout anytime, anywhere.”

It was words from his good friend Denzel Washington that gave him the idea, sharing that the actor told him, “The pants don’t lie.”

“I can gauge everything by how I’m in my pants,” he said.

“Like, if my pants are a little tight, I know I’m getting outta’ shape.” 

Kravitz is not the only health-conscious celebrity with a wacky approach to fitness.

Advertisement

Mark Wahlberg previously revealed his crazily early wake-up time to squeeze a workout in.

Lenny Kravitz working out in denim

The 62-year-old prefers working out in restrictive materials. Instagram/@lennykravitz

In 2022, the actor shared the details of his workout schedule with a photographer on the streets of New York.

“Tomorrow I’m getting up [at] 2.30, in the gym [by] 3.30, finish about 5.30, go to work 7.30,” he said, as per Fox News. 

He also shared the rest of his bizarre routine to his Instagram stories back in 2018. It read:

Mark Wahlberg

Mark Wahlberg wakes up incredibly early to get to the gym. Instagram

  • 2:30am wake up
  • 2:45am prayer time
  • 3:15am breakfast
  • 3:40 – 5.15am workout
  • 5:30am post-workout meal
  • 6:00am shower
  • 8:00am snack
  • 9:30am cryo chamber recovery
  • 10:30am snack
  • 11:00am family time/meetings/work calls
  • 1:00pm lunch
  • 2:00pm meetings/work calls
  • 3:30pm pick up kids @school
  • 3.30pm snack
  • 4:00pm workout
  • 5:00pm shower
  • 5:30pm dinner/family time
  • 7.30pm bedtime

Fans were shocked by the early bedtime, though it makes sense with his early start time.

Meanwhile, The Hills star Audrina Patridge swears by an unusual hack for a home workout while making the most of her time: vacuuming in heels.

Advertisement
Audrina Patridge

Audrina Patridge swears by vacuuming in heels for an at-home workout. Getty

“When I’m sitting in front of the TV, I lift five-pound weights or do squats,” she said, as per Just Jared.

“And I wear heels when I vacuum because it works my calves and my butt.”

Liam Gallagher is another celebrity with a peculiar workout habit, having been spotted by The Sun running backwards on the streets of north London in 2014.

Liam Gallagher

Liam Gallagher was once spotted running backwards in London Getty

The Oasis star took part in the “retro running” trend, which has been used widely by athletes who play sports where they need to go in multiple directions.

The exercise targets different muscle groups and agility.

Advertisement
Continue Reading

Fitness

“We naturally lose muscle mass, reaction speed and balance as we age,” says this elite Hollywood coach who’s trained everyone from Margot Robbie and Scarlet Johansson to Richard Madden and Pedro Pascal — but recommends doing step-ups to undo the damage of aging in your glutes, quads and calves

Published

on

“We naturally lose muscle mass, reaction speed and balance as we age,” says this elite Hollywood coach who’s trained everyone from Margot Robbie and Scarlet Johansson to Richard Madden and Pedro Pascal — but recommends doing step-ups to undo the damage of aging in your glutes, quads and calves

There’s a reason why some of the most effective exercises tend to mirror movements in real life. It’s not because personal trainers and coaches lack imagination, but because the body doesn’t care how creative your programming is — it cares whether you can climb a flight of stairs without grabbing the banister, for example, or if you can catch yourself from a stumble.

These are just a few of the benchmarks that matter in later life, and for elite performance coach David Higgins — who has trained everyone from Margot Robbie and Scarlett Johansson to Samuel L. Jackson, David Harbour, Game of Thrones’ Richard Madden and the entire cast of The Batman, among many others — one exercise sits at the top of the list for anyone over 50: the step-up. Here’s why.

Lower-body power matters so much after 50

Continue Reading
Advertisement

Trending