EFFECTIVENESS OF HIGH-INTENSITY INTERVAL TRAINING ON WALKING CAPACITY IN ADULTS AFTER STROKE: A SYSTEMATIC REVIEW

Abstract

DOI: https://doi.org/10.46296/gt.v9i18edespsep.0448

Abstract

Background: Stroke is one of the leading causes of acquired disability in adults, and gait impairment is among its most relevant functional sequelae. High-intensity interval training (HIIT) has been proposed as a strategy to increase locomotor practice dose and cardiorespiratory stimulus during rehabilitation. Objective: To analyze the effectiveness of HIIT with a locomotor component, compared with moderate-intensity aerobic training or conventional rehabilitation, on walking endurance, speed, and mobility in adults after stroke. Methods: A systematic review was structured according to PRISMA 2020, with PICOS eligibility criteria defined a priori. Randomized clinical trials published from January 1, 2020, to August 31, 2026, involving adults after stroke and applying clearly identifiable HIIT with at least one objective walking outcome were considered. Findings were grouped by walking endurance (6MWT/2MWT), speed (10MWT or gait speed), functional mobility, and safety. A narrative synthesis was performed because of clinical heterogeneity among interventions and comparators. Results: Seven randomized clinical trials met the eligibility criteria and were included in the qualitative synthesis. Evidence was favorable but heterogeneous. HIIT with a locomotor component produced greater improvements in walking endurance when accumulated training dose was sufficient, particularly in programs lasting 8 to 12 weeks. However, some trials showed superior cardiorespiratory adaptations without between-group differences in the 6MWT or gait speed. Studies integrating HIIT with conventional or robot-assisted locomotor training reported benefits in the 10MWT, 2MWT, 6MWT, and other functional measures. No consistent signal of serious intervention-related adverse events was identified in trials reporting safety. Conclusion: HIIT is a promising strategy to improve post-stroke walking capacity, particularly endurance, although its superiority over moderate-intensity training is not uniform across all outcomes. Response appears to depend on accumulated dose, locomotor modality, baseline functional level, and task specificity. Current evidence supports its clinical use in appropriately selected and monitored patients, while methodological heterogeneity and certainty limitations remain.

Keywords: stroke; high-intensity interval training; HIIT; gait; rehabilitation; physical therapy.