Abstract Body:
Introduction: Cardiovascular comorbidities are highly prevalent in patients who suffer from cerebrovascular disease. Peak oxygen uptake (VO₂ peak) is a well-established, independent predictor of cardiovascular health and premature mortality. Dyslipidemia also contributes significantly to cardiovascular disease risk. Although previous studies have demonstrated improvements in these parameters with any exercise, the evidence remains inconclusive regarding which exercise intensity offers the greatest benefit. This systematic review and meta-analysis aims to compare the effects of high-intensity training (HIT) with other exercise intensities, including moderate intensity (MIT) and usual activity (UA).
Methods: We systematically searched the PubMed, Cochrane, Embase, and Scopus databases for studies comparing HIT with MIT or UA in stroke patients. We evaluated changes from baseline in VO₂ peak, serum LDL, and HDL levels. Additionally, a separate analysis comparing HIT with MIT and UA was conducted for VO₂ peak.
Results: A total of eight studies, involving 338 patients, were included in our analysis, with 163 (48%) of these patients undergoing HIT. The pooled analysis revealed that VO₂ peak was significantly higher in the control group compared to the HIT group, with a mean difference (MD) of 2.01 ml/kg/min (95% CI: 0.85-3.18, p < 0.01). Further analysis of four studies comparing HIT with MIT and three studies comparing HIT with UA showed that VO₂ peak was significantly higher following MIT (MD 2.03; 95% CI: 0.70-3.35; p < 0.01) and UA (MD 3.73; 95% CI: 0.87-6.59; p = 0.01). A separate analysis of three studies involving 148 patients showed no significant difference in serum LDL levels (MD 0.51; 95% CI: -0.46-1.49; p = 0.30) or serum HDL levels (MD -0.02; 95% CI: -0.16-0.13; p = 0.83).
Conclusion: High-intensity training, based on a moderate sized pooled sample, does not offer superior advantages in changes from baseline in cardiopulmonary parameters compared to different exercise intensities. Future well-structured randomized controlled trials are needed to evaluate different exercise intensities and durations for more definitive conclusions. Nevertheless, the early data seems to indicate that there are no differences between exercise modalities.