HIITing the brain with exercise: how staying active could aid stroke recovery

A project led by the University of South Wales (USW) is set to explore whether high-intensity interval training (HITT) could be used to help stroke patients in their recovery.

Funded by the Welsh Government as part of the Québec-Wales collaboration, Professor Damian Bailey, Professor of Physiology & Biochemistry at USW, will work closely with academics at McGill University and Université Laval in Canada, as well as colleagues at Cardiff Metropolitan University, on the project.

As the leading cause of disability in the UK, stroke accounts for the fourth largest cause of death in Wales, and the third largest in Canada. It costs the NHS and other health systems across the world billions of pounds each year, and so finding effective strategies to address this financial burden has become increasingly important.

Accumulative evidence suggests that HIIT can improve cognitive function in older adults who are suffering from stroke, dementia and memory loss, having already been successful in the rehabilitation of patients with chronic conditions such as heart disease, diabetes and chronic obstructive pulmonary disease (COPD).

The benefits of HIIT are linked to the exercise-induced changes which improve blood flow to the brain, making it a time-efficient mode of training that could help boost the cardiopulmonary (heart and lungs) and cerebrovascular (brain) health in patients recovering from stroke – which are critical factors in the prevention of further stroke.

Prof Bailey said: “The increasing number of older adults has seen a corresponding growth in those affected by neurovascular diseases, including stroke and dementia. Since cures are currently unavailable, major efforts in improving brain health need to focus on prevention, with emphasis on modifiable risk factors such as promoting physical activity.

“With overwhelming evidence supporting the musculoskeletal, cardiovascular and cerebrovascular benefits of regular exercise – which are comparable to drug interventions in a number of chronic conditions – now is the time to explore the prescription of HIIT that have arguably more potential to promote healthy ageing by delaying stroke, cognitive decline and dementia, benefiting individuals, their families and society in general.”

As part of the project, Prof Bailey has brought together a group of experts in the prescription of exercise in stroke rehabilitation, neuroplasticity, cardiopulmonary and cerebrovascular health to form a new research network.

The project will explore the scientific evidence of using HIIT and establish how it can be used safely and effectively, particularly under the current restrictions following the Covid-10 pandemic. The research will then design a multisite randomised control trial to determine whether HIIT offers any advantages over conventional moderate intensity continuous training (MICT).

The research team will discuss the characteristics of the patients who could benefit most on HIIT, including the time that has passed since they suffered stroke, the type of stroke and the location of the brain that has been affected. Tailoring the parameters of HIIT to the specific goals of the patients will be a priority to maximise the safety and effectiveness of this intervention.

Minister for Education, Kirsty Williams, said: “Our universities are globally connected institutions, working with partners across the world to change people’s lives and our societies for the better. This project is an excellent example of this work in action, and also highlights the growing links between Wales and Quebec.

“Since establishing a Welsh Government office in Montreal in 2018, we have been working even more closely with our Quebecois counterparts to identify opportunities for collaboration and shared learning, and have provided a number of grants to support cooperation between researchers from both nations. Wales is home to research in Life Sciences of global significance, and this is an area of mutual strength between Wales and Quebec. We hope to see many more long-term exchanges in this field and to support these, we are launching a second Call for Proposals with Quebec this spring with Life Sciences a priority focus.”

The results of the randomised control trial will build on a recently published review in the Journal of Physiology, and will be shared through research networks, charities and local stroke recovery groups.