Feasibility Of High-intensity Interval Training Research Articles

Feasibility Of High-intensity Interval Training For Non-muscle Invasive Bladder Cancer During Or After Intravesical Therapy

Feasibility Of High-intensity Interval Training For Non-muscle Invasive Bladder Cancer During Or After Intravesical Therapy

Feasibility and acceptability of high-intensity interval training and moderate-intensity continuous training in kidney transplant recipients: the PACE-KD study

BackgroundKidney transplant recipients (KTRs) exhibit unique elevated inflammation, impaired immune function, and increased cardiovascular risk. Although exercise reduces cardiovascular risk, there is limited research on this population, particularly surrounding novel high-intensity interval training (HIIT). The purpose of this pilot study was to determine the feasibility and acceptability of HIIT in KTRs.MethodsTwenty KTRs (male 14; eGFR 58±19 mL/min/1.73 m2; age 49±11 years) were randomised and completed one of three trials: HIIT A (4-, 2-, and 1-min intervals; 80–90% watts at V̇O2peak), HIITB (4×4 min intervals; 80–90% V̇O2peak) or MICT (~40 min; 50–60% V̇O2peak) for 24 supervised sessions on a stationary bike (approx. 3x/week over 8 weeks) and followed up for 3 months. Feasibility was assessed by recruitment, retention, and intervention acceptability and adherence.ResultsTwenty participants completed the intervention, and 8 of whom achieved the required intensity based on power output (HIIT A, 0/6 [0%]; HIITB, 3/8 [38%]; MICT, 5/6 [83%]). Participants completed 92% of the 24 sessions with 105 cancelled and rescheduled sessions and an average of 10 weeks to complete the intervention. Pre-intervention versus post-intervention V̇O2peak (mL/kg-1/min-1) was 24.28±4.91 versus 27.06±4.82 in HIITA, 24.65±7.67 versus 27.48±8.23 in HIIT B, and 29.33±9.04 versus 33.05±9.90 in MICT. No adverse events were reported.ConclusionsThis is the first study to report the feasibility of HIIT in KTRs. Although participants struggled to achieve the required intensity (power), this study highlights the potential that exercise has to reduce cardiovascular risk in KTRs. HIIT and MICT performed on a cycle, with some modification, could be considered safe and feasible in KTRs. Larger scale trials are required to assess the efficacy of HIIT in KTRs and in particular identify the most appropriate intensities, recovery periods, and session duration. Some flexibility in delivery, such as incorporating home-based sessions, may need to be considered to improve recruitment and retention.Trial registrationISRCTN, ISRCTN17122775. Registered on 30 January 2017.

Reducing fatigue following acquired brain injury: A feasibility study of high intensity interval training for young adults

ABSTRACT The aim was to evaluate feasibility of high-intensity interval training (HIIT) in fatigued adults (20–40 years old) with acquired brain injury (ABI). A prospective pre-post single-arm intervention trial was conducted, including 6–8 months follow-up assessment and interview. Intervention was 18 sessions of intermittent exercise on a cycle ergometer over six weeks. Six out of ten participants without motor impairments completed the intervention (all females, mean age = 30.2 years, months post-injury = 22). On average, participants attended 88% of sessions and achieved high intensity (93% of max heart rate). VO2max improved by 0.53 l/min (SD = 0.29), and participants continued exercising post-intervention. All participants were satisfied with HIIT, were more inclined to exercise, and reported positive effects of exercising for self-management of fatigue. Three sessions a week were demanding to some participants. Findings support feasibility of HIIT as a promising intervention for young adults with post-ABI fatigue.

Effect of high-intensity exercise on cardiorespiratory fitness, cardiovascular disease risk and disease activity in patients with inflammatory joint disease: protocol for the ExeHeart randomised controlled trial

IntroductionInflammatory joint disease (IJD) is associated with increased risk of cardiovascular disease (CVD) fostered by systemic inflammation and a high prevalence of CVD risk factors. Cardiorespiratory fitness (CRF) is an...

Adherence to High-Intensity Interval Training in Cardiac Rehabilitation: A REVIEW AND RECOMMENDATIONS.

High-intensity interval training (HIIT) is gaining popularity as a training approach for patients attending cardiac rehabilitation (CR). While the literature has focused on the efficacy of HIIT for improving cardiorespiratory fitness (CRF), particularly when compared with moderate intensity exercise, less emphasis has been placed on adherence to HIIT. The aim of this review was to summarize the current literature regarding adherence to HIIT in CR patients with coronary artery disease. A review identified 36 studies investigating HIIT in CR patients with coronary artery disease. Methods and data were extracted for exercise or training adherence (to attendance, intensity, and duration), feasibility of protocols, and CRF. The review summarizes reporting of adherence; adherence to HIIT and comparator/s; the influence of adherence on changes in CRF; and feasibility of HIIT. Adherence to the attendance of HIIT sessions was high and comparable with moderate-intensity exercise. However, adherence to the intensity and duration of HIIT was variable and underreported, which has implications for determining the treatment effect of the exercise interventions being compared. Furthermore, additional research is needed to investigate the utility of home-based HIIT and long-term adherence to HIIT following supervised programs. This review provides recommendations for researchers in the measurement and reporting of adherence to HIIT and other exercise interventions to facilitate a sufficient and consistent approach for future studies. This article also highlights strategies for clinicians to improve adherence, feasibility, and enjoyment of HIIT for their patients.

The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation

BackgroundIntensive care unit-acquired weakness syndrome (ICUAWS) can be a consequence of long-term mechanical ventilation. Despite recommendations of early patient mobilisation, little is known about the feasibility, safety and benefit of interval training in early rehabilitation facilities (ERF) after long-term invasive ventilation.Methods and ResultsWe retrospectively analysed two established training protocols of bicycle ergometry in ERF patients after long-term (> 7 days) invasive ventilation (n = 46). Patients conducted moderate continuous (MCT, n = 24, mean age 70.3 ± 10.1 years) or high-intensity interval training (HIIT, n = 22, mean age 63.6 ± 12.6 years). The intensity of training was monitored with the BORG CR10 scale (intense phases ≥ 7/10 and moderate phases ≤ 4/10 points). The primary outcome was improvement (∆-values) of six-minute-walk-test (6 MWT), while the secondary outcomes were improvement of vital capacity (VCmax), forced expiratory volume in 1 s (FEV1), maximal inspiratory pressure (PImax) and functional capabilities (functional independence assessment measure, FIM/FAM and Barthel scores) after 3 weeks of training. No adverse events were observed. There was a trend towards a greater improvement of 6 MWT in HIIT than MCT (159.5 ± 64.9 m vs. 120.4 ± 60.4 m; p = .057), despite more days of invasive ventilation (39.6 ± 16.8 days vs. 26.8 ± 16.2 days; p = .009). VCmax (∆0.5l ± 0.6 vs. ∆0.5l ± 0.3; p = .462), FEV1 (∆0.2l ± 0.3 vs. ∆0.3l ± 0.2; p = .218) PImax (∆0.8 ± 1.1 kPa vs. ∆0.7 ± 1.3pts; p = .918) and functional status (FIM/FAM: ∆29.0 ± 14.8pts vs. ∆30.9 ± 16.0pts; p = .707; Barthel: ∆28.9 ± 16.0 pts vs. ∆25.0 ± 10.5pts; p = .341) improved in HIIT and MCT.ConclusionsWe demonstrate the feasibility and safety of HIIT in the early rehabilitation of ICUAWS patients. Larger trials are necessary to find adequate dosage of HIIT in ICUAWS patients.

CARDIAC REHABILITATION IN THE PEDIATRIC FONTAN POPULATION: DEVELOPMENT OF A HOME-BASED HIGH-INTENSITY INTERVAL TRAINING PROGRAM

Youth with Fontan physiology have reduced exercise capacity compared with those with biventricular circulations, due in part to key anatomic and physiologic limitations and suboptimal physical activity levels. Traditional exercise programs involving moderate-intensity continuous exercise have not consistently demonstrated clinically meaningful improvements in exercise capacity in the Fontan population. We thus, evaluated the safety and feasibility of high-intensity interval training (HIIT) via a novel telemedicine ergometer (MedBIKE™) in children with Fontan physiology.

Cardiac rehabilitation in the paediatric Fontan population: development of a home-based high-intensity interval training programme.

We evaluated the safety and feasibility of high-intensity interval training via a novel telemedicine ergometer (MedBIKE™) in children with Fontan physiology. The MedBIKE™ is a custom telemedicine ergometer, incorporating a video game platform and live feed of patient video/audio, electrocardiography, pulse oximetry, and power output, for remote medical supervision and modulation of work. There were three study phases: (I) exercise workload comparison between the MedBIKE™ and a standard cardiopulmonary exercise ergometer in 10 healthy adults. (II) In-hospital safety, feasibility, and user experience (via questionnaire) assessment of a MedBIKE™ high-intensity interval training protocol in children with Fontan physiology. (III) Eight-week home-based high-intensity interval trial programme in two participants with Fontan physiology. There was good agreement in oxygen consumption during graded exercise at matched work rates between the cardiopulmonary exercise ergometer and MedBIKE™ (1.1 ± 0.5 L/minute versus 1.1 ± 0.5 L/minute, p = 0.44). Ten youth with Fontan physiology (11.5 ± 1.8 years old) completed a MedBIKE™ high-intensity interval training session with no adverse events. The participants found the MedBIKE™ to be enjoyable and easy to navigate. In two participants, the 8-week home-based protocol was tolerated well with completion of 23/24 (96%) and 24/24 (100%) of sessions, respectively, and no adverse events across the 47 sessions in total. The MedBIKE™ resulted in similar physiological responses as compared to a cardiopulmonary exercise test ergometer and the high-intensity interval training protocol was safe, feasible, and enjoyable in youth with Fontan physiology. A randomised-controlled trial of a home-based high-intensity interval training exercise intervention using the MedBIKE™ will next be undertaken.

Feasibility Of High-intensity Interval Training In Men With Prostate Cancer Undergoing Active Surveillance: Erase Trial

PURPOSE: To examine the feasibility of high-intensity interval training (HIIT) in prostate cancer patients on active surveillance from the Exercise duRing Active Surveillance for prostatE cancer (ERASE) trial. METHODS: ERASE is a two-armed, single centre, randomized controlled trial in Edmonton, Alberta, Canada. Men diagnosed with very low- to favorable intermediate-risk prostate cancer undergoing active surveillance are approached via clinic visit or telephone call. Participants are randomized to either the HIIT group or usual care group. The HIIT group performs a 12-week, thrice-weekly, supervised, aerobic HIIT protocol on a treadmill for 28-40 min/session. Work and recovery intervals alternated every 2 minutes with workloads corresponding to 85-95% and 40% VO2peak, respectively. The target sample size is 66 to detect a significant between-group difference in VO2peak of 3.5 ml/kg/min with a two-tailed alpha level of less than 0.05, 80% power, and a 10% drop-out rate. RESULTS: To date, we have recruited from July 2019 to October 2020 with a planned additional 2 months of recruitment. Of 283 patients screened so far, 131 (46%) were eligible, and 43 (33%; mean age 67±7 years) were randomized (22 in the HIIT group; 21 in the usual care group). Ineligible patients were mostly living too far away (47%), too active (22%), or having medical issues (19%). Reasons for eligible patients declining were mostly lack of time (35%), not interested (34%), or lost contact (14%). Of 43 patients randomized so far, 33/35 (94%) have completed postintervention assessments. The reasons for dropout were unwilling to continue in the study and lost contact. Total number of attended sessions is 593/612 (96.9%) with 100% compliance to the HIIT protocol. Reasons for missed sessions were dropout (16 sessions), knee pain (2 sessions), and traveling (1 session). 6 participants in the HIIT group reported aggravation of a previous joint issue, 1 chest discomfort, and 1 light-headedness, all explainable by previous medical history. CONCLUSION: Prostate cancer patients undergoing active surveillance are interested in HIIT and are able to achieve high adherence. Future analyses of ERASE will report the preliminary efficacy of HIIT for improving fitness outcomes, patient-report outcomes, and biomarkers related to cancer progression and survival.

Rates of compliance and adherence to high-intensity interval training in insufficiently active adults: a systematic review and meta-analysis protocol

BackgroundBoth high-intensity interval training and moderate-intensity continuous training demonstrate beneficial physiological outcomes for active and insufficiently active populations. However, it remains unclear whether compliance to exercise in supervised settings translates to long-term adherence to physical activity in real-world, unstructured environments. To our knowledge, no comprehensive review is available on compliance and/or adherence rates to either modes of exercise for insufficiently active individuals. Furthermore, it is unclear which training modality insufficiently active individuals comply and/or adhere more readily to. Based on these gaps, the following two questions will be addressed: (1) What are compliance and adherence rates to high-intensity interval training for insufficiently active adults aged 18–65 years and (2) How do compliance and adherence rates differ between high-intensity interval training and moderate-intensity continuous training?MethodsBoth observational and experimental studies that report on compliance and/or adherence rates to high-intensity interval training will be included. Relevant studies will be retrieved from Medline, EMBASE, PsychINFO, SPORTDiscus, CINAHL, and Web of Science using a pre-specified search strategy. Pre-defined inclusion and exclusion criteria will be used by two independent researchers to determine eligible studies. Of those meeting the inclusion criteria, data extraction and narrative synthesis will be completed, and where applicable, random-effects meta-analyses will be computed to compare compliance and adherence rates between high-intensity interval training and moderate-intensity continuous training. Meta-regressions and sensitivity analyses will be used to further explore factors that could influence aggregate effect sizes. Risk of bias will be assessed using established tools by the Cochrane association, and quality assessment of the cumulative evidence will be assessed using the GRADE approach.DiscussionResults from this study may have the potential to inform future physical activity recommendations and guidelines on the ideal mode of exercise for the general population. This review will add to the body of literature on the feasibility of high-intensity interval training for an insufficiently active population, conclusively addressing the ongoing debate of whether it is an appropriate exercise choice for this demographic. With this new information, individuals working towards a healthier lifestyle through physical activity engagement may be better equipped to make an evidence-based decision.Systematic review registrationThis review has been registered in the PROSPERO database and assigned the identifier CRD42019103313.

HIITing it from all angles: assessing the feasibility of high-intensity interval training in schools, workplaces, and the community

The efficacy of high-intensity interval training (HIIT) under optimal controlled conditions is now well established, but can HIIT successfully transition from the laboratory into the wider public health domain? New studies are needed to assess the viability of HIIT for priority groups in real world conditions. The session aims to: 1) address feasibility of delivering HIIT outside of laboratory settings, 2) understand barriers and facilitators to implementing HIIT in school, workplace and community settings, and 3) provide information about a novel HIIT approach. Jeff Coombes will introduce HIIT and provide a summary of the evidence on the benefits of this training approach. David Lubans will present findings from his studies using HIIT in school settings. Nicholas Gilson will discuss the feasibility of HIIT with truck drivers. Mary Jung will provide data and learnings from a community-based HIIT diabetes prevention project, and Jonathan Little will discuss a new, low-volume HIIT approach; sprint snacking. Following the presentations, a discussion about translating and applying HIIT in real-world settings will be led by the chair.

Feasibility of Two High-Intensity Interval Training Protocols in Cancer Survivors.

High-intensity interval training (HIIT) is a time-efficient and promising tool for enhancing physical fitness. However, there is lack of research concerning safety and feasibility of HIIT in cancer survivors. Therefore, two different HIIT protocols were investigated in terms of safety, feasibility, and acute exercise responses. Forty cancer survivors (20 breast and 20 prostate cancer survivors, 62.9 ± 9.2 yr, BMI 27.4 ± 3.9 kg·m, 6 to 52 wk after the end of primary therapy) completed a maximal cardiopulmonary exercise test and two HIIT protocols on a cycle ergometer: 10 × 1 min at peak power output (10 × 1) and 4 × 4 min at 85%-95% peak HR (4 × 4). Safety (adverse events), acute physiological responses (HR, blood lactate concentration) and acute psychological responses (RPE, enjoyment) were recorded. No major but three minor adverse events occurred. Ninety-five percent of participants were able to complete each HIIT protocol. Estimated energy expenditure (159 ± 15 vs 223 ± 45 kcal, P < 0.001), HR (128 ± 20 vs 139 ± 18 bpm; P < 0.001), blood lactate concentration (5.4 ± 1.0 vs 5.9 ± 1.9 mmol·L; P = 0.035), and RPE legs/breathing (13.8 ± 2.0/13.1 ± 2.0 vs 14.6 ± 2.1/14.3 ± 2.0; P = 0.038/0.003) were significantly higher in the 4 × 4. Enjoyment did not differ between protocols (P = 0.301). The two HIIT protocols as single sessions appear safe and in the vast majority of breast and prostate cancer survivors after the end of primary therapy also feasible and enjoyable. The 4 × 4 elicited higher energy expenditure and higher cardio-circulatory and metabolic strain and might therefore be preferred if a high training stimulus is intended.

High-Intensity Interval Training Is Feasible in Women at High Risk for Breast Cancer.

ABSTRACTPurposeThis trial aimed to demonstrate the feasibility of high-intensity interval training (HIIT) in postmenopausal, overweight/obese women at high risk of invasive breast cancer and to explore HIIT on changes in cardiorespiratory fitness (CRF), body weight, and body mass index (BMI) compared with moderate-intensity continuous training (MICT) and usual care (UC).MethodsForty-four women were randomized to HIIT, MICT, or UC for a 12-wk, thrice weekly, supervised exercise intervention. HIIT included a 5-min warm-up at 50%–70% HRpeak, four cycles of 4 min at 90%–100% HRpeak, followed by 3 min at 50%–70% HRpeak. MICT consisted of 41 min at 60%–70% HRpeak. Feasibility was assessed by consent, adherence, compliance, and retention rates. CRF, body weight, and BMI were measured at baseline and end of study. Repeated-measures linear mixed models were used to assess within- and between-group differences.ResultsAverage age was 63.9 ± 8.8 yr. BMI was 30.9 ± 5.7 kg·m−2. Participants completed 90% and 89% of HIIT and MICT workouts, respectively, with 100% compliance to the exercise prescriptions. No serious adverse events were reported. Compared with MICT and UC, HIIT exhibited improvements in change in treadmill time (101 s greater than MICT, and 125 s greater than UC, respectively, P < 0.001). Compared with UC, HIIT exhibited improvement in changes in absolute and relative V˙O2peak (a 0.15-L·min−1 increase, P = 0.005, and a 2.3-mL·kg−1⋅min−1 increase, P = 0.004). There were no significant differences between groups for body weight or BMI (P > 0.05).ConclusionsHIIT is feasible, safe, and seems to promote greater improvements in CRF compared with MICT and UC in women at high risk for breast cancer.

Short-term pre-operative high-intensity interval training does not improve fitness of colorectal cancer patients.

BackgroundPre‐operative cardiorespiratory fitness (CRF) in colorectal cancer (CRC) patients has been shown to affect post‐operative outcomes. The aim of this study was to test the feasibility of high‐intensity interval training (HIIT) for improving fitness in pre‐operative CRC patients within the 31‐day cancer waiting‐time targets imposed in the UK.MethodsEighteen CRC patients (13 males, mean age: 67 years (range: 52‐77 years) participated in supervised HIIT on cycle ergometers 3 or 4 times each week prior to surgery. Exercise intensity during 5 × 1‐minute HIIT intervals (interspersed with 90‐second recovery) was 100%‐120% maximum wattage achieved at a baseline cardiopulmonary exercise test (CPET). CPET before and after HIIT was used to assess CRF.ResultsPatients completed a mean of eight HIIT sessions (range 6‐14) over 19 days (SD 7). There was no significant increase in VO2 peak (23.9 ± 7.0 vs 24.2 ± 7.8 mL/kg/min (mean ± SD), P = 0.58) or anaerobic threshold (AT: 14.0 ± 3.4 vs 14.5 ± 4.5 mL/kg/min, P = 0.50) after HIIT. There was a significant reduction in resting systolic blood pressure (152 ± 19 vs 142 ± 19 mm Hg, P = 0.0005) and heart rate at submaximal exercise intensities after HIIT.ConclusionsOur pragmatic HIIT exercise protocol did not improve the pre‐operative fitness of CRC patients within the 31‐day window available in the UK to meet cancer surgical waiting‐time targets.

Effects of high-intensity interval training on vascular function in breast cancer survivors undergoing anthracycline chemotherapy: design of a pilot study

IntroductionCardiovascular disease (CVD) mortality is higher among breast cancer survivors (BCS) who receive chemotherapy compared with those not receiving chemotherapy. Anthracycline chemotherapy is of particular concern due to anthracycline-related impairment...

Feasibility of high-intensity interval training with hyperoxia vs. intermittent hyperoxia and hypoxia in cancer patients undergoing chemotherapy - Study protocol of a randomized controlled trial.

Exercise has been well demonstrated to potentially reduce chemotherapy-induced side effects and possibly aid slowing down tumor growth in cancer patients but exercise training adherence is typically low. Thus, training regimens which are perceived less strenuous but do not compromise the training-induced beneficial adaptations will help to increase adherence to exercise and reduce attrition.This 4-armed study aims to investigate the effects of high intensity interval training (HIIT) in hyperoxia versus intermittent hyperoxia and hypoxia in cancer patients undergoing chemotherapy. Forty-eight cancer patients will be randomized into either of three intervention groups or a no-training control group. Patients in the intervention groups will perform twice weekly HIIT on a cycle ergometer in hyperoxia, intermittent hyperoxia and hypoxia or normoxia. Study outcomes will be assessed before and after 4 weeks of training, while selected measures will also be performed pre- and post the first and last training session. The primary aim of this study is to investigate the feasibility, compliance, tolerance and safety of the training. Secondary endpoints will include measures of quality of life, aerobic capacity, transcutaneous oxygen saturation, red blood cell deformability, as well as the assessment of anabolic and catabolic hormone concentrations, reactive oxygen species, cytokine profiles and NK-cell cytotoxicity.To the best of our knowledge, this is the first study investigating the combined effects of exercise with modified fraction of inspired O2 in cancer patients. As such, we provide a novel approach for exercise as an adjuvant therapy in cancer patients undergoing chemotherapy.

Within-Session Responses to High Intensity Interval Training in Spinal Cord Injury

High intensity interval training (HIIT) has shown to be a robust alternative to traditional aerobic training (Gillen et al. 2014, 2016; Astorino et al. 2011). In most individuals, incorporation of HIIT elicits increases in maximum oxygen uptake and overall health status, yet its feasibility in persons with spinal cord injury (SCI) is unknown. PURPOSE: The aim of this study was to compare acute changes in cardiorespiratory and metabolic variables during different HIIT regimens versus moderate intensity continuous exercise training (MICT). METHODS: Nine habitually active men and women (injury duration = 6.8 ± 6.2 yr) with SCI initially underwent determination of peak oxygen uptake (VO2peak) on an arm ergometer. During subsequent sessions, they completed MICT, HIIT, or sprint interval training (SIT). MICT consisted of 25 min of arm cycling at 45 %Wpeak. HIIT consisted of eight 60 s bouts at 70 %Wpeak separated by 90 s of active recovery at 10 %Wpeak, while SIT required eight 30 s bouts at 105 %Wpeak separated by 120 s of active recovery at 10 %Wpeak. Gas exchange data, heart rate (HR), and blood lactate concentration were measured. Each session was broken up into 16 phases (eight exercise and eight recovery data points for HIIT/SIT) for which mean oxygen uptake and HR were determined. RESULTS: Peak VO2 was higher (p = 0.03) in response to HIIT (1.13 ± 0.44 L/min at bout 8) and SIT (1.02 ± 0.37 L/min at bout 8) compared to MICT (0.90 ± 0.29 L/min), but mean VO2 was similar (p > 0.05) between MICT (0.86 ± 0.17 L/min), HIIT (0.89 ± 0.20 L/min), and SIT (0.82 ± 0.19 L/min). Peak HR was higher (p < 0.05) with HIIT (90 %VO2peak and 99 % HRpeak) and SIT (80 %VO2peak and 96 %HRpeak) versus MICT. There was no difference in mean HR across bouts (p = 0.16) which was equal to 130.7 ± 19.3, 129.3 ± 18.6, and 126.9 ± 14.9 b/min for HIIT, SIT, and MICT, equivalent to 79 - 82 %HRpeak. CONCLUSION: Despite a higher intensity, all participants preferred HIIT or SIT versus MICT. Compared to MICT, submaximal or supramaximal interval training elicits higher peak oxygen uptake and heart rate. The long-term efficacy and feasibility of HIIT in this population should be explored, considering that exercise intensity seems to be the most important variable manipulated in exercise programming to optimize maximal oxygen uptake. This study was partially funded by a University GPSM grant.

Feasibility of high-intensity interval training and moderate-intensity continuous training in adults with inactive or mildly active Crohn\u2019s disease: study protocol for a randomised controlled trial

BackgroundStructured exercise training has been proposed as a useful adjunctive therapy for Crohn’s disease by improving immune function and psychological health, reducing fatigue and promoting gains in muscle and bone strength. However, the evidence for exercise in Crohn’s disease is sparse, with only a handful of small prospective trials [1, 2], with methodological limitations, including the use of non-randomised and non-controlled study designs and small sample sizes. Here, we describe the protocol for a study that aims to assess the feasibility and acceptability of two common types of exercise training—high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT)—in adults with inactive or mildly active Crohn’s disease (CD).MethodsThis is a randomised, controlled, assessor-blinded, feasibility trial with three parallel groups. Forty-five adults with inactive or mildly active Crohn’s disease will be randomly assigned 1:1:1 to HIIT, MICT or usual care control. Participants in the HIIT and MICT groups will be invited to undertake three sessions of supervised exercise each week for 12 consecutive weeks. HIIT sessions will consist of ten 1-min intervals of cycling exercise at 90% of peak power output separated by 1 min of active recovery. MICT sessions will involve 30 min of continuous cycling at 35% of peak power output. Participants will be assessed before randomisation and 13 and 26 weeks after randomisation. Feasibility outcomes include rates of recruitment, retention and adherence. Interviews with participants will explore the acceptability of the exercise programmes and study procedures. Clinical/health outcomes include cardiorespiratory fitness, body mass index, resting blood pressure, markers of disease activity (faecal calprotectin and Crohn’s Disease Activity Index) and activated T cell cytokine profiles. Study questionnaires include the Inflammatory Bowel Disease Quality of Life Questionnaire, EQ-5D-5L, IBD Fatigue Scale, Hospital and Anxiety Depression Scale, and International Physical Activity Questionnaire.DiscussionThis study will provide useful information on the feasibility and acceptability of supervised exercise training in adults with inactive and mildly active Crohn’s disease and will inform the design of a subsequent, adequately powered, multi-centre trial.Trial RegistrationThe trial is registered with the International Standard Randomised Controlled Trial Register (ISRCTN13021107). Date registration assigned was 02/12/2015.

Interval training elicits higher enjoyment versus moderate exercise in persons with spinal cord injury

Background: High intensity interval training (HIIT) is a robust and time-efficient approach to improve multiple health indices including maximal oxygen uptake (VO2max). Despite the intense nature of HIIT, data in untrained adults report greater enjoyment of HIIT versus continuous exercise (CEX). However, this has yet to be investigated in persons with spinal cord injury (SCI).Objective: To examine differences in enjoyment in response to CEX and HIIT in persons with SCI.Design: Repeated measures, within-subjects design.Setting: University laboratory in San Diego, CA.Participants: Nine habitually active men and women (age = 33.3 ± 10.5 years) with chronic SCI.Intervention: Participants performed progressive arm ergometry to volitional exhaustion to determine VO2peak. During subsequent sessions, they completed CEX, sprint interval training (SIT), or HIIT in randomized order.Outcome Measures: Physical activity enjoyment (PACES), affect, rating of perceived exertion (RPE), VO2, and blood lactate concentration (BLa) were measured.Results: Despite a higher VO2, RPE, and BLa consequent with HIIT and SIT (P < 0.05), PACES was significantly higher (P = 0.03) in response to HIIT (107.4 ± 13.4) and SIT (103.7 ± 12.5) compared to CEX (81.6 ± 25.4). Fifty-five percent of participants preferred HIIT and 45% preferred SIT, with none identifying CEX as their preferred exercise mode.Conclusion: Compared to CEX, brief sessions of submaximal or supramaximal interval training elicit higher enjoyment despite higher metabolic strain. The long-term efficacy and feasibility of HIIT in this population should be explored considering that it is not viewed as more aversive than CEX.