The combined effect of task-oriented treadmill and high-intensity interval training on balance, gait parameters, and ADL in patients with chronic stroke: A randomized controlled trial with short-term follow-up

Background: This study aimed to determine the effect of task-oriented treadmill training combined with high-intensity interval training (TO-HIIT) on the balance, gait parameters, and ADL in patients with chronic stroke compared to high-intensity interval treadmill training (HIIT). Methods: This parallel-group randomized controlled trial with a 1:1 allocation ratio enrolled 30 chronic stroke patients who were randomly assigned using computer-generated randomization to either an TO- HIIT group (n = 15) or HIIT group (n = 15). Outcome assessors were blinded to group allocation. Both groups trained 30 min per session, three times a week for four weeks. Balance ability was evaluated using the Zebris FDM-T, Gait parameters were measured by the GAITRite, and the activities of daily living (ADL) was assessed using modified barthel index (MBI). Data were analyzed via two-factor repeated measures ANOVA. Findings: Significant interaction effects between time and group were observed for the balance (COP 95% area, COP path length, COP average velocity), gait parameters (step length, stride length, cadence, double limb support, and single limb support), and ADL (p < .05). Post-hoc analysis revealed that the TO-HIIT group showed greater improvements compared to the HIIT group (p < .025); however, no significant between-group differences were observed in cadence and MBI (p > .025). Both groups demonstrated significant improvements over time (p < .017). Interpretation: This study suggests that TO-HIIT is more effective than HIIT alone for chronic stroke patients. High-intensity, repetitive, meaningful task-oriented exercises positively impact balance, gait, and ADL demonstrating notable transfer effects. Therefore, TO-HIIT should be considered in rehabilitation programs.