Tailoring interval training in stroke rehabilitation: The role of peak velocity

Stroke rehabilitation demands innovative approaches to address the diverse physical limitations and functional goals of stroke survivors. Traditional interval training paradigms, such as high-intensity interval training (HIIT) and sprint interval training (SIT), often fall short of meeting the specific needs of this population due to their reliance on sustained or maximal efforts. Peak velocity interval training (PVIT) on the other hand, is an adaptable protocol tailored to optimize gait recovery in stroke survivors. PVIT emphasizes achieving individualized peak walking velocities during short, structured intervals, ensuring safe and effective intensity modulation across a range of functional abilities. This approach incorporates a 2-minute ramp-up phase to facilitate a gradual and safe progression to peak velocity, followed by a brief peak-effort phase and controlled recovery. The protocol is designed to accommodate stroke-specific challenges, including cardiovascular limitations, neuromuscular impairments, and fatigue. PVIT not only prioritizes safety and feasibility but also aligns with the principles of task-specific rehabilitation, focusing on improving walking speed, endurance, and overground functionality. In this manuscript, we present the rationale, structure, and implementation of the PVIT protocol, highlighting its distinctions from HIIT and SIT. We detail how PVIT addresses the physiological and practical limitations of stroke survivors while optimizing training outcomes. This work aims to redefine interval training for stroke gait training, offering practitioners a safe, scalable, and evidence-based strategy to enhance recovery outcomes. Preliminary data supporting the feasibility and efficacy of PVIT are also discussed to contextualize its application in clinical practice.