Safety Of High-intensity Interval Training Research Articles

High-intensity interval training and thromboembolic events during chemotherapy for testicular cancer: a retrospective analysis from the Body & Cancer cohort

Background: Men with testicular cancer receiving platinum-based chemotherapy have an increased risk of thromboembolic events, with incidence rates between 8–24%. A recent trial evaluating the effect of high-intensity interval training (HIIT) prematurely closed as three out of nine participants (33%) in the intervention group developed a thromboembolic event. The purpose of this retrospective cohort study was: 1) (primary) to evaluate the incidence of thromboembolic events in men receiving chemotherapy for testicular cancer who had participated in HIIT during a 6-week exercise program (Body & Cancer) 2) to describe the feasibility of this program. Material and methods: Forty men who had participated in at least one HIIT session from February 2007 to February 2020 were included. Electronic medical records were searched for incident thromboembolic events (arterial and venous) during Body & Cancer and up to one-year post-chemotherapy. Attendance, cardiorespiratory fitness (VO2-peak), and upper and lower extremity muscular strength (1 repetition maximum (RM)) were obtained from the Body & Cancer database. Results: One participant developed a thromboembolic event during Body & Cancer. No participants developed a thromboembolic event in the follow-up period. In all, data represent 160 HIIT sessions with a median attendance of eight sessions [range 1–19]. Statistically significant increases in upper and lower extremity strength were observed (8.6 (4.2 to 13.0) and 26.0 (14.9 to 37.0) kg, respectively). No significant increase in cardiorespiratory fitness was found (0.14 (−0.03 to 0.31) l/min). Conclusion: While conclusions on the safety of HIIT cannot be drawn, data from the present study do not support previous findings cautioning avoidance of HIIT due to a possible added risk of thromboembolic events in men receiving platinum-based chemotherapy for testicular cancer. Considering the potential for positive effects on cardiovascular outcomes associated with HIIT, future studies with robust design should be performed in this population to confirm these observations.

Effects of high-intensity interval training on physical morphology, cardiorespiratoryfitness and metabolic risk factors of cardiovascular disease in children and adolescents: A systematic review and meta-analysis.

To systematically evaluate the safety and efficacy of high-intensity interval training in children and adolescents. Eight databases were searched. Descriptive analysis of the efficacy and safety of high-intensity interval training on body shape, cardiorespiratory fitness, and metabolic risk markers of cardiovascular disease in children and adolescents. Subgroup analysis was performed using age, participants, intervention time, and exercise frequency as covariates. 47 studies included 2995 children and adolescents. The results of the meta-analysis showed that high-intensity interval training significantly improved cardiorespiratory fitness indicators (VO2max, SBP, DBP and HRmax) and cardiovascular disease biomarkers (TC and HDL-C). HIIT had no significant effect on body shape indicators (BMI, BF% and WC) or cardiovascular disease biomarkers (TG and LDL-C). Currently, there is insufficient evidence that HIIT with interval running as the predominant form improves physical indicators in children and adolescents. However, HIIT can be promoted in children and adolescents to improve cardiorespiratory fitness and reduce some metabolic risk of cardiovascular disease.

High-intensity interval training improves the outcomes of patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials

BackgroundPulmonary exercise is an important part in the treatment of chronic obstructive pulmonary disease (COPD). We aimed to evaluate the effects and safety of high-intensity interval training (HIIT) in patients with COPD, to provide insights to the COPD treatment and care. MethodsTwo investigators searched PubMed, Medline, Embase, web of Science, Cochrane library, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases up to Sept 15, 2022 for randomized controlled trials (RCTs) on the effects and safety of HIIT for COPD patients. RevMan5.3 software was used for statistical analysis. ResultsA total of 20 RCTs involving 962 COPD patients were finally included. 514 patients underwent HIIT interventions. Meta-analysis showed that HIIT increased the peak oxygen consumption (SMD = 0.30, 95%CI:0.14–0.46), peak minute ventilation (SMD = 0.26, 95%CI: 0.05–0.47), peak work rate (SMD = 0.34, 95%CI: 0.17–0.51), 6-min walking distance (SMD = 0.39, 95%CI: 0.23–0.55) in COPD patients (all P < 0.05). HIIT improved the quality of life (SMD = 0.30, 95%CI: 0.06–0.54) and reduced the dyspnea (SMD = −0.27, 95%CI: −0.51∼-0.03) in COPD patients (all P < 0.05). There were no significant differences in the forced expiratory volume in 1 s/forced vital capacity (SMD = 0.28, 95%CI: −0.01–0.56) and St. George's Respiratory Questionnaire score (SMD = −0.35, 95%CI: −0.73–0.03) between HIIT and control group (all P > 0.05). There was no publication bias analyzed by the Egger test and funnel plots (all P > 0.05). ConclusionsHIIT may be beneficial to improve the pulmonary function, exercise capacity and quality of life of patients with COPD, which is worthy of clinical promotion for COPD treatment and care.

Effect of High-Intensity Interval Training Combined with Fasting in the Treatment of Overweight and Obese Adults: A Systematic Review and Meta-Analysis.

Objectives: A systematic review and meta-analysis is conducted to compare the effects of high-intensity interval training (HIIT) combined with fasting (HIIT + fasting) and other interventions (HIIT alone, fasting alone, or normal intervention) in adults with overweight and obesity on body composition (body mass, body mass index (BMI), waist circumference (WC), percent fat mass (PFM), fat mass (FM), fat-free mass (FFM)), maximal oxygen uptake (VO2peak), and glucose metabolism (fasting plasma glucose (FPG)), fasting plasma insulin (FPI)). Methods: The databases of PubMed, the Cochrane Library, Embace, Web of Science, CNKI, Wangfang Data, and CBM were searched from their inception to February 2022. Randomized controlled trials comparing the effects of HIIT + fasting and other interventions on adults with overweight and obesity were included in this meta-analysis. The risk of bias was assessed by the Cochrane risk of bias tool. The effect size was completed by using mean difference (MD) and standard deviation. If there were varying units or large differences among the included studies, the standardized mean difference (SMD) would be used. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Nine randomized controlled trials with 230 overweight and obese adults were conducted in accordance with our inclusion criteria. The results of the meta-analysis revealed that compared to the control group HIIT + fasting had better effects on the body mass, WC, FM, and VO2peak, while there were no significant differences in PFM, FFM, FPG, and FPI. Conclusions: Despite the number of included trials being small and the GRADE of all outcomes being very low, HIIT + fasting has a positive effect on the body composition of overweight and obese adults, and significantly improves VO2peak. For adults with overweight and obesity who have long-term comorbidity, HIIT + fasting was a better way to improve FPG than HIIT alone or fasting alone. More studies are required to investigate different combinations of HIIT + fasting; and the safety of HIIT + fasting intervention on overweight and obese adults.

High-intensity Interval Training for Older Adults: Safety Issues

High-intensity interval training (HIIT) has been reported to become an alternative of moderate-intensity continuous training and adapted even in older adults. However, to implement the use of HIIT for older adults, who are very often associated with life-style related and chronic diseases, safety issues should be considered in the first place. However, at present, the evaluation of the safety of HIIT among older adults is compromised by the limited availability of relevant data due to the low proportion of studies reporting adverse events. In this review, update data regarding safety and check-up methods for older adults are described in submaximal HIIT and spring interval training.

The effect and safety of high-intensity interval training in the treatment of adolescent obesity: a meta-analysis.

It's necessary to conduct meta-analysis to quantitatively evaluate the effect and safety of high-intensity interval training (HIIT) on obese adolescents, to provide a basis for the management of obesity in adolescents. Randomized controlled trials (RCTs) on the role of HIIT in the obese adolescents were searched from PubMed databases and so on up to Jan 15, 2021. Two researchers independently performed literature screening, literature quality evaluation and data extraction according to the inclusion and exclusion criteria. Revman 5.3 Software and Stata 12.2 Software were used for data analysis. A total of 11 RCTs with 488 obese adolescents were included. Meta-analysis indicated that HIIT can effectively reduce the body weight (MD =-1.73 kg, 95% CI: -3.25 to -0.21, P=0.02), BMI (MD =-1.42 kg/m2, 95% CI: -1.97 to -0.87, P<0.001), body fat percentage (MD =-1.70%, 95% CI: -2.94 to -0.45, P=0.007) and waist circumference (MD =-1.80 cm, 95% CI: -3.5 to -0.10, P=0.04). The "high-intensity short-interval" HIIT program can significantly reduce waist circumference (MD =-2.31 cm, 95% CI: -4.20 to -0.42, P=0.022), the "high-intensity long-interval" HIIT program is more beneficial to reduce the BMI (MD =-1.44 kg/m2, 95% CI: -2.03 to -0.84, P=0.001) and body fat percentage (MD =-0.56, 95% CI: -1.08 to -0.05, P=0.009). HIIT can effectively improve the body composition of obese adolescents and produce an effective fat-reducing effect, which should be promoted for the clinical treatment of adolescent obesity.

High-Intensity Interval Training in Patients with Pulmonary Embolism: A Randomized Controlled Trial.

High-intensity interval training (HIIT) appears to be safe and effective in cardiovascular diseases. However, there is a paucity of data on the effect of HIIT for patients with acute pulmonary embolism (PE). The present randomized controlled trial (RCT) therefore examined the efficiency and safety of HIIT in patients with acute PE. In single-center parallel open-label RCT, 24 patients (5 women) discharged recently with a diagnosis of intermediate-high-risk acute PE were randomized (1:1) to supervised HIIT (n = 12) or control (n = 12) group. The primary outcomes were exercise capacity evaluated in terms of the estimated maximal oxygen uptake (eV˙O2max), lung function (forced expiratory volume in 1 s [FEV1]), right ventricular (RV) function (RV/left ventricular diameter [LV] ratio), and health-related quality of life (HRQoL). Safety was the secondary outcome. Eight weeks of HIIT improved eV˙O2max (+65%, P < 0.001), FEV1 (%) (+17%, P = 0.031), and RV/LV ratio diameter (-27%, P = 0.005), as well as HRQoL. All patients in the HIIT group tolerated exercise training without serious adverse events. The control group did not improve (P > 0.05) eV˙O2max, RV/LV ratio diameter, or HRQoL; however, FEV1 (%) was slightly reduced (-6%, P = 0.030). The present RCT of a tailored center-based HIIT intervention provides preliminary evidence that this intervention could improve exercise capacity, lung function, RV function, and HRQoL without serious adverse events, which could provide marked clinical benefits after PE. Further larger multicenter randomized controlled studies are needed to confirm these promising findings.

Considering the Feasibility, Tolerability, and Safety of High-Intensity Interval Training as a Novel Treatment for Patients With Intermittent Claudication.

This study assessed the feasibility, tolerability, safety, and potential efficacy of a novel, 6-wk, high-intensity interval training (HIIT) program for patients with intermittent claudication (IC). Patients referred to a usual-care supervised exercise program were invited to undertake a HIIT program. All recruited patients performed a baseline cardiopulmonary exercise test (CPX) to inform their exercise prescription. HIIT involved 10, 1-min high-intensity cycling intervals interspersed with 1-min recovery intervals, performed 3 d/wk for 6 wk. Outcomes included feasibility, tolerability, safety, walking distance, and quality of life. A total of 144 patients with IC were referred, 95 met initial eligibility criteria (66%) and 30 (32%) were recruited for HIIT, of which 15 (50%) completed. Of the recruited patients, 90% were on optimal medical therapy and 40% had concomitant cardiac, cerebrovascular, and/or respiratory disease. Patients who completed the program attended 100% of the sessions and one serious adverse event was recorded. Improvements in walking distances and quality of life were observed. Following recruitment of the first 20 patients, the inclusion criteria were refined on the basis of CPX, leading to improved completion rates. This study provides preliminary findings indicating that patients with IC can complete a short-term HIIT program. We provide very early evidence that HIIT may be safe and well-tolerated. In addition, walking distances seem to improve following HIIT. After a small change in the exclusion criteria, the intervention and inclusion/exclusion criteria now seem appropriate for this population, meaning further research to evaluate HIIT in patients with IC is warranted.

Feasibility and safety of high-intensity interval training for the rehabilitation of geriatric inpatients (HIITERGY) a pilot randomized study

BackgroundHigh-intensity interval training (HIIT) has been shown to be more effective than moderate-intensity continuous training (MICT) for the physical rehabilitation. However, data on its suitability for older hospitalized patients is scarce.MethodsRandomized controlled trial in a hospital setting. Inclusion of 100 patients, ≥65 years old, hospitalized for rehabilitation after an acute medical condition, in a two-week rehabilitation program of either four HIIT or three MICT sessions per week. Completion was defined as participation in all but two planned sessions accomplishing ≥50% of each session. We assessed: upper-limb muscle strength (handgrip isometric strength test), lower-limb muscle strength (quadriceps and ankle flexion and extension tests); gait speed and spatio-temporal parameters (instrumented walkway), and exercise capacity (6-min walk test). All adverse events were recorded as safety endpoints.ResultsAn intention-to-treat analysis showed a 44% completion rate for the HIIT group (95% CI, 30–59) and 77% for MICT (95% CI, 55–82). A modified intention-to-treat analysis restricted to patients who participated in ≥1 session showed an 88% completion rate in the HIIT group (95%CI, 69–97) and an 80% completion rate in MICT (95%CI, 65–90). The exercises most frequently undertaken were the pedal exerciser (54%) and the NuStep (32%). There were no significant differences in the various measures. No serious adverse events occurred.ConclusionA HIIT rehabilitation program for this population was feasible, safe and had a high adherence rate.Trial registration numberClinicatrials.gov ID: NCT02318459.Trial registration date: November 7th, 2014. Retrospectively registered.This study adheres to the CONSORT guidelines.

Physical Activity and Diabetes.

Physical Activity and Diabetes.

Study protocol for the FITR Heart Study: Feasibility, safety, adherence, and efficacy of high intensity interval training in a hospital-initiated rehabilitation program for coronary heart disease.

BackgroundFor decades, moderate intensity continuous training (MICT) has been the cornerstone of exercise prescription for cardiac rehabilitation (CR). High intensity interval training (HIIT) is now recognized in CR exercise guidelines as an appropriate and efficient modality for improving cardiorespiratory fitness, a strong predictor of mortality. However, the clinical application of HIIT in a real world CR setting, in terms of feasibility, safety, and long-term adherence, needs further investigation to address ongoing reservations. Furthermore, studies using objective measures of exercise intensity (such as heart rate; HR) have produced variable outcomes. Therefore we propose investigating the use of subjective measures (such as rating of perceived exertion (RPE)) for prescribing exercise intensity.MethodsOne hundred adults with coronary artery disease (CAD) attending a hospital-initiated CR program will be randomized to 1) HIIT: 4 × 4 min high intensity intervals at 15–18 RPE interspersed with 3-min active recovery periods or 2) MICT: usual care exercise including 40 min continuous exercise at a moderate intensity corresponding to 11–13 RPE. Primary outcome is change in exercise capacity (peak VO2) following 4 weeks of exercise training. Secondary outcome measures are: feasibility, safety, exercise adherence, body composition, vascular function, inflammatory markers, intrahepatic lipid, energy intake, and dietary behavior over 12-months; and visceral adipose tissue (VAT) following 12 weeks of exercise training.ConclusionsThis study aims to address the ongoing concerns regarding the practicality and safety of HIIT in CR programs. We anticipate study findings will lead to the development of a standardized protocol to facilitate CR programs to incorporate HIIT as a standard exercise option for appropriate patients.

Exercise Guidelines to Promote Cardiometabolic Health in Spinal Cord Injured Humans: Time to Raise the Intensity?

Spinal cord injury (SCI) is a life-changing event that, as a result of paralysis, negatively influences habitual levels of physical activity and hence cardiometabolic health. Performing regular structured exercise therefore appears extremely important in persons with SCI. However, exercise options are mainly limited to the upper body, which involves a smaller activated muscle mass compared with the mainly leg-based activities commonly performed by nondisabled individuals. Current exercise guidelines for SCI focus predominantly on relative short durations of moderate-intensity aerobic upper-body exercise, yet contemporary evidence suggests this is not sufficient to induce meaningful improvements in risk factors for the prevention of cardiometabolic disease in this population. As such, these guidelines and their physiological basis require reappraisal. In this special communication, we propose that high-intensity interval training (HIIT) may be a viable alternative exercise strategy to promote vigorous-intensity exercise and prevent cardiometabolic disease in persons with SCI. Supplementing the limited data from SCI cohorts with consistent findings from studies in nondisabled populations, we present strong evidence to suggest that HIIT is superior to moderate-intensity aerobic exercise for improving cardiorespiratory fitness, insulin sensitivity, and vascular function. The potential application and safety of HIIT in this population is also discussed. We conclude that increasing exercise intensity could offer a simple, readily available, time-efficient solution to improve cardiometabolic health in persons with SCI. We call for high-quality randomized controlled trials to examine the efficacy and safety of HIIT in this population.

Effectiveness and safety of high-intensity interval training in patients with type 2 diabetes.

IN BRIEF Recent research has shown that high-intensity interval training (HIIT) can promote improvements in glucose control and cardiovascular health in individuals with type 2 diabetes. This article summarizes the evidence and highlights the ways in which HIIT might be safely implemented as an adjunct to more traditional exercise approaches.