HIIT and Neuroplasticity in Post-stroke Patients: A Review

Hugaris Kwasnica^*
*Correspondence: Hugaris Kwasnica, Department of Physiotherapy, Medical University of Gdańsk, 80-208 Gdańsk, Poland, Email:

Keywords

High-intensity interval training • Neuroplasticity • Stroke rehabilitation • Exercise therapy

Introduction

Stroke is a leading cause of long-term disability worldwide, with survivors often experiencing significant impairments in motor function, mobility and quality of life. Conventional rehabilitation interventions, while beneficial, may not fully address the complex neuroplastic changes that occur following stroke, leading to suboptimal recovery outcomes. In recent years, there has been growing interest in the potential of High-Intensity Interval Training (HIIT) to promote neuroplasticity and enhance functional recovery in post-stroke patients. HIIT involves short bursts of intense exercise followed by periods of rest or low-intensity activity, repeated over a session. This form of exercise has gained popularity due to its efficiency in improving cardiovascular fitness, metabolic function and muscular endurance. Moreover, emerging evidence suggests that HIIT may induce neuroplastic changes in the brain, including increased synaptic connectivity, neurogenesis and cortical reorganization, which are essential for motor learning and recovery following stroke. This review aims to explore the mechanisms underlying the beneficial effects of HIIT on neuroplasticity in post-stroke patients and its potential as a complementary approach to conventional rehabilitation strategies. By examining current literature and clinical studies, we seek to elucidate the physiological and molecular pathways through which HIIT may exert its effects on brain plasticity and motor recovery post-stroke. Additionally, we will discuss the practical considerations, safety concerns and future directions for integrating HIIT into stroke rehabilitation programs, with the goal of optimizing functional outcomes and improving quality of life for individuals affected by stroke [1,2].

Literature Review

Numerous studies have investigated the effects of High-Intensity Interval Training (HIIT) on neuroplasticity and motor recovery in post-stroke patients. Evidence suggests that HIIT may induce beneficial changes in brain structure and function, leading to improvements in motor function, gait performance and activities of daily living. For example, a study demonstrated that HIIT led to significant improvements in walking speed, endurance and balance in chronic stroke survivors compared to traditional aerobic training. Similarly, a meta-analysis found that HIIT was associated with greater gains in aerobic capacity and walking ability in individuals with stroke compared to moderate-intensity continuous training. The mechanisms underlying the beneficial effects of HIIT on neuroplasticity post-stroke are multifaceted [3]. HIIT promotes cardiovascular fitness and increases cerebral blood flow, which may enhance oxygen and nutrient delivery to the brain, facilitating neurorepair and synaptic plasticity. Additionally, HIIT activates molecular signaling pathways involved in neurogenesis, synaptogenesis and myelination, leading to structural and functional improvements in brain regions affected by stroke. Moreover, HIIT may exert neuroprotective effects by reducing inflammation, oxidative stress and apoptosis in the brain, thereby mitigating secondary injury cascades and promoting neuronal survival and regeneration. Animal studies have shown that HIIT enhances the expression of growth factors, such as Brain-Derived Neurotrophic Factor (BDNF) and Vascular Endothelial Growth Factor (VEGF), which play key roles in neuroplasticity and neuroprotection post-stroke. Despite the promising evidence supporting the benefits of HIIT in post-stroke rehabilitation, several factors must be considered when implementing HIIT programs in clinical practice. These include patient characteristics (e.g., age, comorbidities, functional status), exercise intensity and duration, supervision and monitoring and adherence to safety guidelines. Furthermore, individualized exercise prescriptions and progression protocols are essential to ensure optimal outcomes and minimize the risk of adverse events [4].

Discussion

The findings from the literature review suggest that HIIT holds promise as a valuable adjunctive therapy for promoting neuroplasticity and functional recovery in post-stroke patients. By targeting multiple aspects of brain function and motor performance, HIIT may offer a more comprehensive and effective approach to stroke rehabilitation compared to traditional interventions. Moreover, HIIT has the potential to improve cardiovascular health, metabolic function and overall quality of life in stroke survivors, thereby addressing multiple domains of disability and enhancing long-term outcomes. However, challenges remain in translating the evidence from research settings into clinical practice. Implementation barriers, such as limited access to specialized exercise facilities, lack of trained personnel and reimbursement issues, may hinder the widespread adoption of HIIT programs in stroke rehabilitation settings. Additionally, concerns regarding patient safety, adherence and feasibility must be addressed to ensure the successful implementation of HIIT interventions in diverse patient populations [5,6].

Conclusion

In conclusion, the evidence suggests that HIIT has the potential to induce neuroplastic changes in the brain and promote motor recovery in post-stroke patients. By targeting cardiovascular fitness, metabolic function and neuroplasticity simultaneously, HIIT offers a promising approach to stroke rehabilitation that may enhance functional outcomes and improve quality of life for individuals affected by stroke. However, further research is needed to elucidate the optimal parameters and protocols for HIIT in stroke rehabilitation, as well as to address implementation barriers and ensure the safe and effective delivery of HIIT interventions in clinical practice.

Acknowledgement

None.

Conflict of Interest

There are no conflicts of interest by author.

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