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Yin M, Deng S, Chen Z, Zhang B, Zheng H, Bai M, Li H, Zhang X, Deng J, Liu Q, Little JP, Li Y. Exercise snacks are a time-efficient alternative to moderate-intensity continuous training for improving cardiorespiratory fitness but not maximal fat oxidation in inactive adults: a randomized controlled trial. Appl Physiol Nutr Metab 2024; 49:920-932. [PMID: 38569204 DOI: 10.1139/apnm-2023-0593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
The aims of this study were (1) to determine how stair-climbing-based exercise snacks (ES) compared to moderate-intensity continuous training (MICT) for improving cardiorespiratory fitness (CRF), and (2) to explore whether ES could improve maximal fat oxidation rate (MFO) in inactive adults. Healthy, young, inactive adults (n: 42, age: 21.6 ± 2.3 years, BMI: 22.5 ± 3.6 kg·m-2, peak oxygen uptake (VO2peak): 33.6 ± 6.3 mL·kg-1·min-1) were randomly assigned to ES, MICT, or Control. ES (n = 14) and MICT (n = 13) groups performed three sessions per week over 6 weeks, while the control group (n = 15) maintained their habitual lifestyle. ES involved 3 × 30 s "all-out" stair-climbing (6 flight, 126 steps, and 18.9 m total height) bouts separated by >1 h rest, and MICT involved 40 min × 60%-70% HRmax stationary cycling. A significant group × time interaction was found for relative VO2peak (p < 0.05) with ES significantly increasing by 7% compared to baseline (MD = 2.5 mL·kg-1·min-1 (95% CI = 1.2, 3.7), Cohen's d = 0.44), while MICT had no significant effects (MD = 1.0 mL·kg-1·min-1 (-1.1, 3.2), Cohen's d = 0.17), and Control experienced a significant decrease (MD = -1.7 mL·kg-1·min-1 (-2.9, -0.4), Cohen's d = 0.26). MFO was unchanged among the three groups (group × time interaction, p > 0.05 for all). Stair climbing-based ES are a time-efficient alternative to MICT for improving CRF among inactive adults, but the tested ES intervention appears to have limited potential to increase MFO.
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Affiliation(s)
- Mingyue Yin
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Shengji Deng
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Zhili Chen
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Boyi Zhang
- Department of Physical Education, Exercise and Health Technology Center, Shanghai Jiao Tong University, Shanghai, China
| | - Huakun Zheng
- School of Physical Education, Sichuan Agriculture University, Yaan, China
| | - Mingyang Bai
- School of Physical Education, Sichuan Agriculture University, Yaan, China
| | - Hansen Li
- Department of Physical Education, Southwest University, Chongqing, China
| | - Xing Zhang
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jianfeng Deng
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Qian Liu
- School of Physical Education, Sichuan Agriculture University, Yaan, China
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, Canada
| | - Yongming Li
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
- China Institute of Sport Science, Beijing, China
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Metcalfe RS, Vollaard NBJ. Reduced-exertion high-intensity interval training (REHIT): a feasible approach for improving health and fitness? Appl Physiol Nutr Metab 2024; 49:984-992. [PMID: 38688037 DOI: 10.1139/apnm-2024-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
In recent years, research investigating the dose-response to sprint interval training (SIT) has provided evidence that the number and duration of repetitions in a SIT session can be reduced whilst preserving the beneficial health-related adaptations. Together this research has led to the development of protocols involving minimal doses of SIT: regularly performing just two or three 20-30 s all-out sprints in a 10 min training session has been shown to elicit beneficial metabolic and cardiovascular adaptations. These SIT protocols, which we originally termed "reduced-exertion high-intensity interval training" (or REHIT), have the potential to remove many of the common barriers associated with other SIT protocols, as well as with HIT and aerobic exercise. Here, we critically review the evidence on the efficacy, feasibility and acceptability, and effectiveness of REHIT for improving health and fitness.
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Affiliation(s)
- Richard S Metcalfe
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Faculty of Science and Engineering, Swansea University, Swansea SA1 8EN Wales, UK
| | - Niels B J Vollaard
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK
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Scarà A, Palamà Z, Robles AG, Dei LL, Borrelli A, Zanin F, Pignalosa L, Romano S, Sciarra L. Non-Pharmacological Treatment of Heart Failure-From Physical Activity to Electrical Therapies: A Literature Review. J Cardiovasc Dev Dis 2024; 11:122. [PMID: 38667740 PMCID: PMC11050051 DOI: 10.3390/jcdd11040122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Heart failure (HF) represents a significant global health challenge that is still responsible for increasing morbidity and mortality despite advancements in pharmacological treatments. This review investigates the effectiveness of non-pharmacological interventions in the management of HF, examining lifestyle measures, physical activity, and the role of some electrical therapies such as catheter ablation, cardiac resynchronization therapy (CRT), and cardiac contractility modulation (CCM). Structured exercise training is a cornerstone in this field, demonstrating terrific improvements in functional status, quality of life, and mortality risk reduction, particularly in patients with HF with reduced ejection fraction (HFrEF). Catheter ablation for atrial fibrillation, premature ventricular beats, and ventricular tachycardia aids in improving left ventricular function by reducing arrhythmic burden. CRT remains a key intervention for selected HF patients, helping achieve left ventricular reverse remodeling and improving symptoms. Additionally, the emerging therapy of CCM provides a novel opportunity for patients who do not meet CRT criteria or are non-responders. Integrating non-pharmacological interventions such as digital health alongside specific medications is key for optimizing outcomes in HF management. It is imperative to tailor approaches to individual patients in this diverse patient population to maximize benefits. Further research is warranted to improve treatment strategies and enhance patient outcomes in HF management.
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Affiliation(s)
- Antonio Scarà
- San Carlo di Nancy Hospital—GVM, 00165 Roma, Italy; (A.B.); (F.Z.); (L.P.)
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (Z.P.); (A.G.R.); (L.-L.D.); (S.R.); (L.S.)
| | - Zefferino Palamà
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (Z.P.); (A.G.R.); (L.-L.D.); (S.R.); (L.S.)
- Electrophysiology Unit “Casa di Cura Villa Verde”, 74121 Taranto, Italy
| | - Antonio Gianluca Robles
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (Z.P.); (A.G.R.); (L.-L.D.); (S.R.); (L.S.)
- Electrophysiology Unit “Casa di Cura Villa Verde”, 74121 Taranto, Italy
- Department of Cardiology, “L. Bonomo” Hospital, 76123 Andria, Italy
| | - Lorenzo-Lupo Dei
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (Z.P.); (A.G.R.); (L.-L.D.); (S.R.); (L.S.)
| | - Alessio Borrelli
- San Carlo di Nancy Hospital—GVM, 00165 Roma, Italy; (A.B.); (F.Z.); (L.P.)
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (Z.P.); (A.G.R.); (L.-L.D.); (S.R.); (L.S.)
| | - Federico Zanin
- San Carlo di Nancy Hospital—GVM, 00165 Roma, Italy; (A.B.); (F.Z.); (L.P.)
| | - Leonardo Pignalosa
- San Carlo di Nancy Hospital—GVM, 00165 Roma, Italy; (A.B.); (F.Z.); (L.P.)
| | - Silvio Romano
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (Z.P.); (A.G.R.); (L.-L.D.); (S.R.); (L.S.)
| | - Luigi Sciarra
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (Z.P.); (A.G.R.); (L.-L.D.); (S.R.); (L.S.)
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Ekkekakis P, Hartman ME, Ladwig MA. When Studying Affective Responses to Exercise, the Definition of "Intensity" Must Reference Homeostatic Perturbations: A Retort to Vollaard et al. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2024; 46:66-72. [PMID: 38580300 DOI: 10.1123/jsep.2024-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/18/2024] [Indexed: 04/07/2024]
Abstract
In articles on the methodology of studies investigating affective and enjoyment responses to high-intensity interval training, we noted that, occasionally, exercise conditions described as involving "high" intensity exhibited heart rates that were only as high as, or even lower than, heart rates recorded during comparator conditions described as being of "moderate" intensity. Drs. Vollaard, Metcalfe, Kinghorn, Jung, and Little suggest instead that exercise intensity in high-intensity interval-training studies can be defined in terms of percentages of peak workload. Although we maintain that defining exercise intensity in terms of percentages of maximal heart rate is a suboptimal way to quantify the degree of homeostatic perturbations in response to exercise, we are unconvinced that definitions of intensity relying solely on workload are appropriate for studies investigating affective and enjoyment responses to exercise. The reason is that affect is theorized to have evolved to relay information about homeostatic perturbations to consciousness.
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Affiliation(s)
| | - Mark E Hartman
- Department of Kinesiology, University of Rhode Island, Kingston, RI, USA
| | - Matthew A Ladwig
- Department of Biological Sciences, Purdue University Northwest, Hammond, IN, USA
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Vollaard NBJ, Metcalfe RS, Kinghorn D, Jung ME, Little JP. Percentage of Peak Workload Is Suitable for Quantification of Exercise Intensity During High-Intensity Intervals: A Comment on Ekkekakis, Hartman, and Ladwig. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2024; 46:63-65. [PMID: 38575139 DOI: 10.1123/jsep.2023-0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/16/2023] [Accepted: 10/25/2023] [Indexed: 04/06/2024]
Affiliation(s)
- Niels B J Vollaard
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Richard S Metcalfe
- Applied Sports, Technology, Exercise and Medicine Research Center (A-STEM), Swansea University, Swansea, United Kingdom
| | - Daniel Kinghorn
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Mary E Jung
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
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Yin M, Li H, Bai M, Liu H, Chen Z, Deng J, Deng S, Meng C, Vollaard NBJ, Little JP, Li Y. Is low-volume high-intensity interval training a time-efficient strategy to improve cardiometabolic health and body composition? A meta-analysis. Appl Physiol Nutr Metab 2024; 49:273-292. [PMID: 37939367 DOI: 10.1139/apnm-2023-0329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The present meta-analysis aimed to assess the effects of low-volume high-intensity interval training (LV-HIIT; i.e., ≤5 min high-intensity exercise within a ≤15 min session) on cardiometabolic health and body composition. A systematic search was performed in accordance with PRISMA guidelines to assess the effect of LV-HIIT on cardiometabolic health and body composition. Twenty-one studies (moderate to high quality) with a total of 849 participants were included in this meta-analysis. LV-HIIT increased cardiorespiratory fitness (CRF, SMD = 1.19 [0.87, 1.50]) while lowering systolic blood pressure (SMD = -1.44 [-1.68, -1.20]), diastolic blood pressure (SMD = -1.51 [-1.75, -1.27]), mean arterial pressure (SMD = -1.55 [-1.80, -1.30]), MetS z-score (SMD = -0.76 [-1.02, -0.49]), fat mass (kg) (SMD = -0.22 [-0.44, 0.00]), fat mass (%) (SMD = -0.22 [-0.41, -0.02]), and waist circumference (SMD = -0.53 [-0.75, -0.31]) compared to untrained control (CONTROL). Despite a total time-commitment of LV-HIIT of only 14%-47% and 45%-94% compared to moderate-intensity continuous training and HV-HIIT, respectively, there were no statistically significant differences observed for any outcomes in comparisons between LV-HIIT and moderate-intensity continuous training (MICT) or high-volume HIIT. Significant inverse dose-responses were observed between the change in CRF with LV-HIIT and sprint repetitions (β = -0.52 [-0.76, -0.28]), high-intensity duration (β = -0.21 [-0.39, -0.02]), and total duration (β = -0.19 [-0.36, -0.02]), while higher intensity significantly improved CRF gains. LV-HIIT can improve cardiometabolic health and body composition and represent a time-efficient alternative to MICT and HV-HIIT. Performing LV-HIIT at a higher intensity drives higher CRF gains. More repetitions, longer time at high intensity, and total session duration did not augment gains in CRF.
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Affiliation(s)
- Mingyue Yin
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Hansen Li
- Department of Physical Education, Southwest University, Chongqing, China
| | - Mingyang Bai
- School of Physical Education, Sichuan Agriculture University, Yaan, China
| | - Hengxian Liu
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Zhili Chen
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Jianfeng Deng
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Shengji Deng
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Chuan Meng
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
| | - Niels B J Vollaard
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, Canada
| | - Yongming Li
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China
- China Institute of Sport Science, Beijing, China
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Yao W, Han Y, Yang L, Chen Y, Yan S, Cheng Y. Electronic Interactive Games for Glycemic Control in Individuals With Diabetes: Systematic Review and Meta-Analysis. JMIR Serious Games 2024; 12:e43574. [PMID: 38345856 PMCID: PMC10897792 DOI: 10.2196/43574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 05/05/2023] [Accepted: 10/24/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Several electronic interventions have been used to improve glycemic control in patients with diabetes. Electronic interactive games specific to physical activity are available, but it is unclear if these are effective at improving glycemic control in patients with diabetes. OBJECTIVE This study aimed to determine the effects of electronic game-based interventions on glycemic control in patients with diabetes. METHODS Relevant studies that were published before April 1, 2023, were searched from 5 databases: PubMed, Embase, Web of Science, Scopus, and Cochrane Library. Eligibility criteria included prospective studies examining the relationship between electronic games with physical activities or diet education and glycemic control as the outcome. The risk of bias was assessed using the Cochrane risk-of-bias tool. All analyses were conducted using RevMan5.4.1. Depending on the heterogeneity across studies, the pooled effects were calculated using fixed-effects or random-effects models. RESULTS Participants from 9 studies were included and assessed. Glycated hemoglobin (HbA1c) and fasting blood glucose improved in the intervention group, although the analysis revealed no significant reduction in HbA1c (-0.09%, 95% CI -0.29% to 0.10%) or fasting blood glucose (-0.94 mg/dL, 95% CI -9.34 to 7.46 mg/dL). However, the physical activity of individuals in the intervention group was significantly higher than that of those in the control group (standardized mean difference=0.84, 95% CI 0.30 to 1.38; P=.002). Other outcomes, such as weight and blood lipids, exhibited no significant improvement (all P>.05). CONCLUSIONS Electronic games had a good impact on participants' physical activity and offered an advantage in glycemic control without reaching statistical significance. Electronic games are convenient for reminders and education. Low-intensity exercise games may not be considered a better adjuvant intervention to improve diabetes self-management care.
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Affiliation(s)
- WenQi Yao
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - YiBing Han
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Li Yang
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
- Department of Nutrition, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Ying Chen
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - ShengZhe Yan
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - YanZhen Cheng
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
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Navarro-Ledesma S, Hamed-Hamed D, González-Muñoz A, Pruimboom L. Physical Activity, Insulin Resistance and Cancer: A Systematic Review. Cancers (Basel) 2024; 16:656. [PMID: 38339407 PMCID: PMC10854631 DOI: 10.3390/cancers16030656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Insulin resistance (IR), a key aspect of type 2 diabetes and a defining characteristic of obesity and its associated conditions, emerges as a mechanistic pathway potentially implicated in cancer pathophysiology. This presents an appealing intervention target for cancer patients. The objective of this study is to conduct a systematic review, examining the scientific evidence regarding the impact of physical activity on modifying insulin resistance in individuals with cancer. METHODS The selection criteria were specific: only randomized controlled clinical trials published in the last 13 years and written in English or Spanish were included. The databases utilized for the search included PubMed, Scopus, Cochrane Library, EBSCO, and WEB OF SCIENCE. The protocol for this review was duly registered in the International Register of Systematic Reviews (CRD42023435002). The final search was conducted on 14 May 2023. RESULTS The outcomes were assessed using the tool proposed by the Cochrane Handbook to evaluate the risk of bias in the included studies. Among the 12 studies incorporated, 8 demonstrated a low risk of bias, two had an unclear risk of bias, and the remaining two showed a high risk of bias. The variety of exercise types used across all studies was extensive, making definitive conclusions challenging. Physical activity was linked to enhanced insulin sensitivity in seven studies, while five studies showed no significant changes in insulin resistance between the intervention and control groups. Importantly, none of the interventions employed in the included studies exhibited adverse effects on the study participants. CONCLUSIONS The role of exercise as a medicine against insulin resistance has been evidenced in many different studies, mostly related to obesity and cardiovascular diseases. Engaging in physical activity could be a healthy option to combat the effects of insulin resistance in cancer patients, although evidence is weak and limited, according to the results of our systemic review. We further found that literature is lacking at the level of optimal doses, timing, and type of exercise. More studies are needed with more defined PA programs in type and length.
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Affiliation(s)
- Santiago Navarro-Ledesma
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Campus of Melilla Querol Streel 5, 52004 Melilla, Spain
- University Chair in Clinical Psychoneuroimmunology, University of Granada and PNI Europe, 52004 Melilla, Spain;
| | - Dina Hamed-Hamed
- Clinical Medicine and Public Health PhD Program, Faculty of Health Sciences, University of Granada, Av. de la I, 18071 Granada, Spain; (D.H.-H.); (A.G.-M.)
| | - Ana González-Muñoz
- Clinical Medicine and Public Health PhD Program, Faculty of Health Sciences, University of Granada, Av. de la I, 18071 Granada, Spain; (D.H.-H.); (A.G.-M.)
- Clinic Ana González, Avenida Hernan Nuñez de Toledo 6, 29018 Malaga, Spain
| | - Leo Pruimboom
- University Chair in Clinical Psychoneuroimmunology, University of Granada and PNI Europe, 52004 Melilla, Spain;
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Cavalli NP, de Mello MB, Righi NC, Schuch FB, Signori LU, da Silva AMV. Effects of high-intensity interval training and its different protocols on lipid profile and glycaemic control in type 2 diabetes: A meta-analysis. J Sports Sci 2024; 42:333-349. [PMID: 38531052 DOI: 10.1080/02640414.2024.2330232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 03/07/2024] [Indexed: 03/28/2024]
Abstract
This meta-analysis of randomised clinical trials aimed to compare the effects of high-intensity interval training (HIIT) and its different protocols versus moderate-intensity continuous training (MICT) and/or control on total cholesterol, HDL, LDL, triglycerides, HbA1c levels, and fasting glucose in individuals with type 2 diabetes mellitus (T2DM). The search strategy was performed in PubMed/MEDLINE, Cochrane CENTRAL, EMBASE, Web of Science, Sport DISCUS, and PEDro, until January 2023. A total of 31 studies (1092 individuals) were included. When compared to control, HIIT decreased total cholesterol by -0.31 mmol/L (95% CI -0.49; -0.12), LDL by -0.31 mmol/L (95% CI -0.49; -0.12), triglycerides by -0.27 mmol/L (95% CI -0.33; -0.2), HbA1c by -0.75% (95% CI -0.97; -0.53), fasting glucose by -1.15 mmol/L (95% CI -1.44; -0.86), and increased HDL by 0.24 mmol/L (95% CI 0.06; 0.42). No difference was found in the comparison between HIIT versus MICT for any of the outcomes analysed, however subgroup analysis showed that a moderate-interval (>30s to < 2 min) and moderate-term (>4 to < 12 weeks) HIIT protocol reduced total cholesterol, when compared to MICT. HIIT is able to improve lipid profile and glycaemic control in T2DM individuals, and specific protocols can be recommended for improving total cholesterol levels.
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Affiliation(s)
- Nandiny Paula Cavalli
- Postgraduate Program in Movement Sciences and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Mariana Brondani de Mello
- Postgraduate Program in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Natiele Camponogara Righi
- Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Felipe Barreto Schuch
- Department of Sport Methods and Techniques, Postgraduate Program in Movement Sciences and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Luis Ulisses Signori
- Department of Physiotherapy and Rehabilitation, Postgraduate Program in Movement Sciences and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Antônio Marcos Vargas da Silva
- Department of Physiotherapy and Rehabilitation, Postgraduate Program in Movement Sciences and Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
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Santos A, Braaten K, MacPherson M, Vasconcellos D, Vis-Dunbar M, Lonsdale C, Lubans D, Jung ME. Rates of compliance and adherence to high-intensity interval training: a systematic review and Meta-analyses. Int J Behav Nutr Phys Act 2023; 20:134. [PMID: 37990239 PMCID: PMC10664287 DOI: 10.1186/s12966-023-01535-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND To determine rates of compliance (i.e., supervised intervention attendance) and adherence (i.e., unsupervised physical activity completion) to high-intensity interval training (HIIT) among insufficiently active adults and adults with a medical condition, and determine whether compliance and adherence rates were different between HIIT and moderate-intensity continuous training (MICT). METHODS Articles on adults in a HIIT intervention and who were either insufficiently active or had a medical condition were included. MEDLINE, EMBASE, PsychINFO, SPORTDiscus, CINAHL, and Web of Science were searched. Article screening and data extraction were completed by two independent reviewers. Risk of bias was assessed using RoB 2.0 or ROBINS-I. Meta-analyses were conducted to discern differences in compliance and adherence between HIIT vs. MICT. Sensitivity analyses, publication bias, sub-group analyses, and quality appraisal were conducted for each meta-analysis. RESULTS One hundred eighty-eight unique studies were included (n = 8928 participants). Compliance to HIIT interventions averaged 89.4% (SD:11.8%), while adherence to HIIT averaged 63% (SD: 21.1%). Compliance and adherence to MICT averaged 92.5% (SD:10.6%) and 68.2% (SD:16.2%), respectively. Based on 65 studies included in the meta-analysis, compliance rates were not different between supervised HIIT and MICT interventions [Hedge's g = 0.015 (95%CI: - 0.088-0.118), p = .78]. Results were robust and low risk of publication bias was detected. No differences were detected based on sub-group analyses comparing medical conditions or risk of bias of studies. Quality of the evidence was rated as moderate over concerns in the directness of the evidence. Based on 10 studies, adherence rates were not different between unsupervised HIIT and MICT interventions [Hedge's g = - 0.313 (95%CI: - 0.681-0.056), p = .096]. Sub-group analysis points to differences in adherence rates dependent on the method of outcome measurement. Adherence results should be interpreted with caution due to very low quality of evidence. CONCLUSIONS Compliance to HIIT and MICT was high among insufficiently active adults and adults with a medical condition. Adherence to HIIT and MICT was relatively moderate, although there was high heterogeneity and very low quality of evidence. Further research should take into consideration exercise protocols employed, methods of outcome measurement, and measurement timepoints. REGISTRATION This review was registered in the PROSPERO database and given the identifier CRD42019103313.
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Affiliation(s)
- Alexandre Santos
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Kyra Braaten
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Megan MacPherson
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Diego Vasconcellos
- Institute for Positive Psychology & Education, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mathew Vis-Dunbar
- Library, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Chris Lonsdale
- Institute for Positive Psychology & Education, Australian Catholic University, Melbourne, Victoria, Australia
| | - David Lubans
- School of Education, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Mary E Jung
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada.
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Parada Flores B, Luna-Villouta P, Martínez Salazar C, Flández Valderrama J, Valenzuela Contreras L, Flores-Rivera C, Vargas-Vitoria R. Physical Exercise Methods and Their Effects on Glycemic Control and Body Composition in Adults with Type 2 Diabetes Mellitus (T2DM): A Systematic Review. Eur J Investig Health Psychol Educ 2023; 13:2529-2545. [PMID: 37998066 PMCID: PMC10670304 DOI: 10.3390/ejihpe13110176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/25/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
The prevalence of T2DM represents a challenge for health agencies due to its high risk of morbidity and mortality. Physical Activity (PA) is one of the fundamental pillars for the treatment of T2DM, so Physical Exercise (PE) programs have been applied to research their effectiveness. The objective of the study was to analyze the effects of PE methods on glycemic control and body composition of adults with T2DM. A systematic review without meta-analysis was performed, using the PubMed database. Quasi-experimental and pure experimental clinical trials were included, which were available free of charge and were published during 2010-2020. In the results, 589 articles were found and 25 passed the inclusion criteria. These were classified and analyzed according to the methods identified (AE, IE, RE, COM, and others), duration and variable(s) studied. It is concluded that PE is effective for glycemic control and body composition in adults with T2DM using different methods (AE, IE, RE, COM, and others), both in the short and long term. Adequate organization of PE components such as frequency, duration, volume, and intensity, is essential.
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Affiliation(s)
- Bastián Parada Flores
- Facultad de Educación, Magíster en Ciencias de la Actividad Física, Universidad Católica del Maule, Talca 3460000, Chile;
| | - Pablo Luna-Villouta
- Facultad de Educación, Departamento de Educación Física, Universidad de Concepción, Concepción 4030000, Chile;
| | - Cristian Martínez Salazar
- Departamento de Educación Física, Deportes y Recreación, Universidad de La Frontera, Temuco 4780000, Chile;
| | - Jorge Flández Valderrama
- Facultad Filosofía y Humanidades, Instituto de Ciencias de la Educación, Escuela de Educación Física, Universidad Austral de Chile, Valdivia 5090000, Chile;
| | - Luis Valenzuela Contreras
- Facultad de Educación, Pedagogía en Educación Física, Universidad Católica Silva Henríquez, Santiago 8330226, Chile;
| | - Carol Flores-Rivera
- Facultad de Educación y Ciencias Sociales, Universidad Andres Bello, Concepción 4030000, Chile;
| | - Rodrigo Vargas-Vitoria
- Facultad de Educación, Pedagogía en Educación Física, Universidad Católica del Maule, Talca 3460000, Chile
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12
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Findikoglu G, Altinkapak A, Yaylali GF. Is isoenergetic high-intensity interval exercise superior to moderate-intensity continuous exercise for cardiometabolic risk factors in individuals with type 2 diabetes mellitus? A single-blinded randomized controlled study. Eur J Sport Sci 2023; 23:2086-2097. [PMID: 36622777 DOI: 10.1080/17461391.2023.2167238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The aim of this study was to compare the effect of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) with equal energy expenditure on glycaemic and cardiometabolic risk factors in people with Type 2 Diabetes Mellitus (T2DM) when compared to the control. Sixty-three people with T2DM were randomly assigned to HIIT, MICT, or non-exercising controls. Individuals were trained with HIIT at 90 and 30% of their VO2peak (1:2 min ratio) starting from 8 up to 16 intervals and MICT at 50% of VO2peak, on a cycle ergometer, 3 times/week for 12 weeks under supervision. The primary outcome measure was the change in HbA1c. Aerobic capacity, cardiovascular responses, anthropometric measures, body composition, glycaemic, and cardiometabolic risk factors were measured at the beginning and the end of the 12-week training period. There was no significant difference between HIIT and MICT or when compared to the control for HbA1c, glucose, insulin resistance, blood lipids, cardiovascular responses, anthropometric measures, body composition, and abdominal and visceral fat (padj > 0.05). HIIT and MICT increased VO2peak significantly compared to controls (p < 0.05) but not to each other (p > 0.05). Both HIIT and MICT improved VO2peak and HbA1c after 12 weeks of training compared to their baseline, furthermore, only MICT caused additional improvements in cardiovascular responses, anthropometric measures, and abdominal fat compared to baseline (p < 0.05). As a conclusion, isoenergetic HIIT or MICT did not improve HbA1c. The two protocols were equally efficient for improvement in aerobic capacity but had little effect on other cardiometabolic factors.Trial registration: ClinicalTrials.gov identifier: NCT03682445.HighlightsHIIT and MICT with equal energy expenditure were equally efficient for aerobic capacity compared to controls.Isoenergetic HIIT or MICT were not superior for improving HbA1c.Isoenergetic HIIT and MICT were not superior to each other for anthropometric measures, body composition, and cardiometabolic risk factors.
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Affiliation(s)
- Gulin Findikoglu
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Pamukkale, Denizli, Turkey
| | - Abdurrahim Altinkapak
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Pamukkale, Denizli, Turkey
| | - Guzin Fidan Yaylali
- Faculty of Medicine, Department of Endocrinology and Metabolism Diseases, University of Pamukkale, Denizli, Turkey
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Hsu CH, Yang CB, Chen MH, Tsao TH. Accumulated Short Bouts of Walking in Older Adults With Type 2 Diabetes: Effects on Glycosylated Hemoglobin (HbA1c) and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Res Gerontol Nurs 2023; 16:250-258. [PMID: 37159390 DOI: 10.3928/19404921-20230503-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The current study examined the effects of accumulated short bouts of walking on glycosylated hemoglobin (HbA1c) and homeostasis model assessment of insulin resistance (HOMA-IR) of older adults with type 2 diabetes. Differences in variables between models of accumulated bouts of walking and 10,000 steps were also investigated. Sedentary participants (N = 38) were randomized into one of three groups: accumulated 10-minute bouts of walking at 100 steps/min (10/100MW), accumulated 10,000 steps (10KS), or control. HbA1c, HOMA-IR, blood lipids, and cardiorespiratory fitness (VO2max) were assessed before and after the intervention. VO2max, HbA1c, and HOMA-IR in the 10/100MW and 10KS groups showed significant and comparable improvements postintervention compared to preintervention (p < 0.05). Furthermore, the change in average daily step count was significantly associated with the change in HbA1c of the two walking groups (r = -0.61 for 10KS and r = -0.63 for 10/100MW; p < 0.05). Accumulated short bouts of walking at 100 steps/min and 10,000 steps daily improved HbA1c and HOMA-IR of older adults with type 2 diabetes. [Research in Gerontological Nursing, 16(5), 250-258.].
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Abdeen HA, Helmy ZM, Elnaggar MI, Aldhahi MI, Taha MM, Marques-Sule E, Amin DI, Ibrahim BS, Abdel Aziz A, Castiglione V, Atef H. Different Continuous Training Intensities Improve Echocardiographic Parameters, Quality of Life, and Functional Capacity in Heart Failure Patients with Reduced Ejection Fraction. Int J Gen Med 2023; 16:3933-3945. [PMID: 37670928 PMCID: PMC10475351 DOI: 10.2147/ijgm.s420933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/10/2023] [Indexed: 09/07/2023] Open
Abstract
Background Multiple comorbidities and physiological changes play a role in a range of heart failure conditions and influence the most effective approach to exercise-based rehabilitation. This research aimed to examine and compare the outcomes of continuous training at three different intensities, focusing on left ventricular (LV) remodeling, functional capacity, and quality of life among patients with heart failure with reduced ejection fraction (HFrEF). Methods In this randomized control trial, a total of 60 male patients (average age: 54.33 ±2.35 years) with HFrEF were randomly allocated into three groups: 1) High-intensity continuous training group (HICT), 2) Moderate-intensity continuous training group (MICT), and 3) Low-intensity continuous training group (LICT). All the training was performed on a bicycle ergometer 3 times/week for 12 weeks. Echocardiographic parameters (left ventricular ejection fraction, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, N-terminal pro-B-type natriuretic peptide (NT-proBNP), quality of life (Minnesota Living with Heart Failure Questionnaire), and functional capacity (6-minute walking test) were assessed before and the end of the study. Results The HICT group demonstrated the greatest improvements in all measured variables when compared to the other two groups (P < 0.05). These findings were consistent across all measured outcomes. Conclusion It was determined that HICT appears to yield the most favorable outcomes in enhancing echocardiographic measures, NT-proBNP levels, quality of life, and functional capacity among HFrEF patients.
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Affiliation(s)
- Heba A Abdeen
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, 11432, Egypt
| | - Zeinab M Helmy
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, 11432, Egypt
| | - Moustafa I Elnaggar
- Faculty of Physical Therapy, Heliopolis University for Sustainable Development, Giza, Egypt
| | - Monira I Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Mona Mohamed Taha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Doaa I Amin
- Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | | | | | - Vincenzo Castiglione
- Fondazione Toscana Gabriele Monasterio; “Health Science” Interdisciplinary Research Center, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Hady Atef
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, 11432, Egypt
- School of Allied Health Professions (SAHP), Keele University, Staffordshire, UK
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15
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Bourne JE, Leary S, Page A, Searle A, England C, Thompson D, Andrews RC, Foster C, Cooper AR. Electrically assisted cycling for individuals with type 2 diabetes mellitus: a pilot randomized controlled trial. Pilot Feasibility Stud 2023; 9:60. [PMID: 37072802 PMCID: PMC10111297 DOI: 10.1186/s40814-023-01283-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/28/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and its associated complications puts considerable strain on healthcare systems. With the global incidence of T2DM increasing, effective disease management is essential. Physical activity (PA) is a key component of T2DM management; however, rates of PA engagement are low in this population. Developing effective and sustainable interventions that encourage PA is a high priority. Electrically assisted bicycles are becoming increasingly popular and may increase PA in healthy adults. This study aimed to provide evidence of the feasibility of conducting a randomized controlled trial to evaluate the efficacy of an e-cycling intervention to increase PA and improve health in individuals with T2DM. METHODS A parallel-group two-arm randomized, waitlist-controlled pilot study was conducted. Individuals were randomized to either an e-bike intervention or standard care. The intervention incorporated two one-to-one e-bike skills training and behavioural counselling sessions delivered by a community-based cycling charity, followed by a 12-week e-bike loan with two further sessions with the instructors. Feasibility was assessed via measures related to recruitment, retention and intervention implementation. Post-intervention interviews with instructors and participants explored the acceptability of the study procedures and intervention. Clinical, physiological and behavioural outcomes were collected at baseline and post-intervention to evaluate the intervention's potential. RESULTS Forty participants (Mage = 57) were randomized, of which 34 were recruited from primary care practices. Thirty-five participants were retained in the trial. The intervention was conducted with high fidelity (> 80% content delivered). E-bike training provided participants with the skills, knowledge and confidence needed to e-bike independently. Instructors reported being more confident delivering the skills training than behavioural counselling, despite acknowledging its importance. The study procedures were found to be acceptable to participants. Between-group differences in change during the intervention were indicative of the interventions potential for improving glucose control, health-related quality of life and cardiorespiratory fitness. Increases in overall device measured moderate-to-vigorous PA behaviour following the intervention were found, and there was evidence that this population self-selected to e-cycle at a moderate intensity. CONCLUSIONS The study's recruitment, retention, acceptability and potential efficacy support the development of a definitive trial subject to identified refinements. TRIAL REGISTRATION ISRCTN, ISRCTN67421464 . Registered 17/12/2018.
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Affiliation(s)
- Jessica E Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.
| | - Sam Leary
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Angie Page
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Aidan Searle
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Clare England
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, BA2 7PB, UK
| | - Robert C Andrews
- Institute of Biomedical and Clinical Sciences, Medical Research, University of Exeter Medical School, RILD Level 3, Barrack Road, Exeter, EX2 5DW, Devon, UK
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
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16
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Kirchner H, Weisner L, Wilms B. When should I run-the role of exercise timing in metabolic health. Acta Physiol (Oxf) 2023; 237:e13953. [PMID: 36815281 DOI: 10.1111/apha.13953] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
The prevalence of type 2 diabetes is reaching epidemic proportions. First line therapy approaches are lifestyle interventions including exercise. Although a vast amount of studies reports on beneficial effects of exercise on metabolism in humans per se, overall data are contradictory which makes it difficult to optimize interventions. Innovative exercise strategies and its underlying mechanism are needed to elucidate in order to close this therapeutic gap. The skeletal muscle produces and secretes myokines and microRNAs in response to exercise and both are discussed as mechanisms linking exercise and metabolic adaptation. Aspects of chronophysiology such as diurnal variation in insulin sensitivity or exercise as a signal to reset dysregulated peripheral clocks are of growing interest in the context of impaired metabolism. Deep insight of how exercise timing determines metabolic adaptations is required to optimize exercise interventions. This review aims to summarize the current state of research on the interaction between timing of exercise and metabolism in humans, providing insights into proposed mechanistic concepts focusing on myokines and microRNAs. First evidence points to an impact of timing of exercise on health outcome, although data are inconclusive. Underlying mechanisms remain elusive. It is currently unknown if the timed release of mykokines depends on time of day when exercise is performed. microRNAs have been found as an important mediator of processes associated with exercise adaptation. Further research is needed to evaluate their full relevance. In conclusion, it seems to be too early to provide concrete recommendations on timing of exercise to maximize beneficial effects.
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Affiliation(s)
- Henriette Kirchner
- Institute for Human Genetics, Epigenetics and Metabolism Lab, University of Lübeck, Lübeck, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Leon Weisner
- Institute of Endocrinology and Diabetes, University of Luebeck, Luebeck, Germany
| | - Britta Wilms
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Endocrinology and Diabetes, University of Luebeck, Luebeck, Germany
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Gentil P, Silva LRBE, Antunes DE, Carneiro LB, de Lira CAB, Batista G, de Oliveira JCM, Cardoso JS, Souza DC, Rebelo ACS. The effects of three different low-volume aerobic training protocols on cardiometabolic parameters of type 2 diabetes patients: A randomized clinical trial. Front Endocrinol (Lausanne) 2023; 14:985404. [PMID: 36755928 PMCID: PMC9900112 DOI: 10.3389/fendo.2023.985404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
Objective To compare the effects of different aerobic training protocols on cardiometabolic variables in patients with type 2 diabetes mellitus (T2DM). Methods This study was a parallel clinical trial. Fifty-two men and women with T2DM (>40 years) were randomly allocated into three groups, and 44 (22 males/22 females) were included in the final analysis. Exercise intensity was based on the speed corresponding to the maximum oxygen consumption (v V ˙ O2max). Moderate intensity continuous training (MICT) involved 14 minutes at 70% of v V ˙ O2max; short interval high-intensity interval training (S-HIIT) consisted of 20 bouts of 30 seconds at 100% of V˙O2max with 30 seconds passive recovery; long interval high-intensity training (L-HIIT) consisted of 5 bouts of 2 minutes at 100% of v V ˙ O2max with 2 minutes passive recovery. Training protocols were performed on a motorized treadmill two times per week for eight weeks. Glycated hemoglobin (Hb1Ac), total cholesterol, triglycerides, resting systolic blood pressure (SBP), resting diastolic blood pressure (DBP), resting heart rate (resting HR) and maximum oxygen consumption (V˙O2max) were measured before and after the exercise intervention. The study was registered on the Brazilian clinical trial records (ID: RBR45 4RJGC3). Results There was a significant difference between groups for changes on V ˙ O2max. Greater increases on V ˙ O2max were achieved for L-HIIT (p = 0.04) and S-HIIT (p = 0.01) in comparison to MICT group, with no significant difference between L-HIIT and S-HIIT (p = 0.9). Regarding comparison within groups, there were significant reductions on HbA1c and triglycerides levels only for L-HIIT (p< 0.05). V ˙ O2max significantly increased for both L-HIIT (MD = 3.2 ± 1.7 ml/kg/min, p< 0.001) and S-HIIT (MD = 3.4 ± 1.7, p< 0.001). There was a significant reduction on resting SBP for L-HIIT group (MD = -12.07 ± 15.3 mmHg, p< 0.01), but not for S-HIIT and MICT. There were no significant changes from pre- to post-training on fasting glycemia, total cholesterol, HDL, LDL, resting HR and resting DBP for any group (p > 0.05). Conclusion Low-volume HIIT promoted greater improvements in cardiorespiratory capacity in comparison with low-volume MICT, independent of the protocols used. There were no other differences between groups. All protocols improved at least one of the variables analyzed; however, the most evident benefits were after the high-intensity protocols, especially L-HIIT.
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Affiliation(s)
- Paulo Gentil
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
- Hypertension League, Federal University of Goiás, Goiânia, Brazil
- Instituto VIDA, Brasilia, Brazil
| | - Lucas Raphael Bento e Silva
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
- Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil
- Hospital das Clínicas, Federal University of Goiás, Goiânia, Brazil
| | | | | | - Claudio Andre Barbosa de Lira
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
- Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil
| | - Gislene Batista
- Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | | | | | | | - Ana Cristina Silva Rebelo
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
- Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil
- Hospital das Clínicas, Federal University of Goiás, Goiânia, Brazil
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18
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Hamasaki H. High-intensity Interval Training in Patients with Type 2 Diabetes: A Perspective from Previous Systematic Reviews. Endocr Metab Immune Disord Drug Targets 2023; 23:1248-1253. [PMID: 37005528 DOI: 10.2174/1871530323666230330124105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/11/2023] [Accepted: 02/16/2023] [Indexed: 04/04/2023]
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Islam H, Gillen JB. Skeletal muscle mechanisms contributing to improved glycemic control following intense interval exercise and training. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:20-28. [PMID: 36994179 PMCID: PMC10040385 DOI: 10.1016/j.smhs.2023.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
High-intensity and sprint interval training (HIIT and SIT, respectively) enhance insulin sensitivity and glycemic control in both healthy adults and those with cardiometabolic diseases. The beneficial effects of intense interval training on glycemic control include both improvements seen in the hours to days following a single session of HIIT/SIT and those which accrue with chronic training. Skeletal muscle is the largest site of insulin-stimulated glucose uptake and plays an integral role in the beneficial effects of exercise on glycemic control. Here we summarize the skeletal muscle responses that contribute to improved glycemic control during and following a single session of interval exercise and evaluate the relationship between skeletal muscle remodelling and improved insulin sensitivity following HIIT/SIT training interventions. Recent evidence suggests that targeting skeletal muscle mechanisms via nutritional interventions around exercise, particularly with carbohydrate manipulation, can enhance the acute glycemic benefits of HIIT. There is also some evidence of sex-based differences in the glycemic benefits of intense interval exercise, with blunted responses observed after training in females relative to males. Differences in skeletal muscle metabolism between males and females may contribute to sex differences in insulin sensitivity following HIIT/SIT, but well-controlled studies evaluating purported muscle mechanisms alongside measurement of insulin sensitivity are needed. Given the greater representation of males in muscle physiology literature, there is also a need for more research involving female-only cohorts to enhance our basic understanding of how intense interval training influences muscle insulin sensitivity in females across the lifespan.
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Stern G. Equalization of exercise protocols: not if, but how. Trends Endocrinol Metab 2022; 33:799-800. [PMID: 36384862 DOI: 10.1016/j.tem.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/13/2022] [Indexed: 11/15/2022]
Abstract
Comparative analysis of high-intensity interval training (HIIT) suffers from a lack of standardized metrics for intervention programming. Given the huge amount of research and general public attention to exercise as medicine, understanding how to compare exercise intervention protocols is both prescient and essential to interpreting the findings of studies of exercise therapy.
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Affiliation(s)
- Guy Stern
- University of Edinburgh, Moray House School of Education and Sport, Holyrood Road, Edinburgh, UK.
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21
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Gonçalves GCV, Santos ATS, Calixto Júnior R, Dias MPF, Iunes DH, Chaves EDCL, Marino LDS, Borges JBC, Silva Vilela Terra AM. Aquatic Exercise on Brain Activity in Type 2 Diabetic: Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14759. [PMID: 36429477 PMCID: PMC9690811 DOI: 10.3390/ijerph192214759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND A water-based physical exercise program is extremely important for the rehabilitation of type 2 diabetes. Little is known about its action on cerebral electrical activity. OBJECTIVE To evaluate the effect of a water-based physical exercise protocol on electroencephalographic activity, blood glucose levels, and functional capacity, as well as their correlation, in type 2 diabetics. METHODS Study design: Randomized Clinical Trial. Forty volunteers were randomized into two groups: control (n = 20) and study (n = 20). A water-based physical exercise program comprising 50 min sessions was conducted three times a week for five weeks. Assessments were performed at the pre- and post-intervention and follow-up phases. The qualitative data were compared using the Mann-Whitney test and Chi-Square. Quantitative data were compared using the Kruskal-Wallis, Independent t, and ANOVA mixed tests. The Spearman correlation coefficient was used to correlate the data. RESULTS The data were similar when comparing the groups. Six-minute walk test data increased in the comparison between times (p = 0.01-PrexPos). EEG data decreased in comparison between times (prexfollow-up-p < 0.05), except AF3. EEG data decreased in the timexgroup comparison (prexfollow-up and postxfollow-up-p < 0.05). CONCLUSIONS The water-based exercise protocol maintained electroencephalographic activity, glucose levels, and functional capacity in people with type 2 diabetes, and there was no relationship between brain electrical activity and capillary blood glucose.
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Affiliation(s)
- Guilherme Cândido Viana Gonçalves
- Pos-Graduation in Rehabilitation Sciencies, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
- Human Performance Research Laboratory, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
| | - Adriana Teresa Silva Santos
- Pos-Graduation in Rehabilitation Sciencies, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
- Human Performance Research Laboratory, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
| | - Ruanito Calixto Júnior
- Pos-Graduation in Rehabilitation Sciencies, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
- Human Performance Research Laboratory, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
| | - Miqueline Pivoto Faria Dias
- Pos-Graduation in Rehabilitation Sciencies, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
- Human Performance Research Laboratory, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
| | - Denise Hollanda Iunes
- Pos-Graduation in Rehabilitation Sciencies, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
| | | | - Ligia de Sousa Marino
- Pos-Graduation in Rehabilitation Sciencies, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
| | - Juliana Bassalobre Carvalho Borges
- Pos-Graduation in Rehabilitation Sciencies, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
| | - Andréia Maria Silva Vilela Terra
- Pos-Graduation in Rehabilitation Sciencies, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
- Human Performance Research Laboratory, Institute of Motor Science, Federal University of Alfenas, Santa Clara Campus, Alfenas 37133-840, MG, Brazil
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Cardiometabolic and perceptual responses to different forms of interval training in patients with type 2 diabetes. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [DOI: 10.1007/s12662-022-00841-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Leahy DJ, Dalleck LC, Ramos JS. Changes in the Fitness Fatness Index following reduced exertion high-intensity interval training versus moderate-intensity continuous training in physically inactive adults. Front Sports Act Living 2022; 4:961957. [PMID: 35992158 PMCID: PMC9388827 DOI: 10.3389/fspor.2022.961957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMany adults do not reach the recommended exercise participation guidelines, often citing lack of time as a barrier. Reduced exertion high-intensity training (REHIT) is a mode of exercise that takes as few as 10 min and has been shown to be as effective as other modalities. The Fitness Fatness Index (FFI) is a recently developed index that is used to predict cardiovascular disease (CVD) risk. The aim of this study was to determine the efficacy of a REHIT vs. a traditional moderate-intensity continuous training (MICT) on FFI in physically inactive adults.MethodsThirty-two participants were randomized into one of two 8-week exercise intervention groups: (i) REHIT (n = 16); (ii) MICT (n = 16). The REHIT group performed 10 min of individualized cycling intervals on 2–4 days of the week. The MICT group were prescribed aerobic exercise at 50–65% of their heart rate reserve (HRR) on 3–5 days of the week. FFI was recorded at baseline and post 8-weeks, with FFI being calculated as cardiorespiratory fitness (CRF) (expressed as metabolic equivalents) divided by waist to height ratio (WtHR). A 1-unit increase in FFI was recognized as a clinically significant change in FFI.ResultsThe REHIT group showed significantly greater (+1.95, ±0.63) improvements in FFI compared to those in the MICT (+0.99, ±0.47) group (between group difference, p < 0.001). Furthermore, there was a greater proportion of participants who achieved a clinically significant change in FFI in the REHIT group (12/12, 100%) than in the MICT group (8/15, 53%) (between group difference, p = 0.01).ConclusionThis study suggests that REHIT may be a more efficacious exercise modality to increase FFI than MICT. This outcome is beneficial as the clinician can prescribe REHIT to physically inactive adults who cite lack of time as a barrier to physical activity participation and achieve significant reductions in CVD risk.
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Affiliation(s)
- Daniel J. Leahy
- Caring Futures Institute, SHAPE Research Centre, Clinical Exercise Physiology, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Lance C. Dalleck
- Caring Futures Institute, SHAPE Research Centre, Clinical Exercise Physiology, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Recreation, Exercise and Sport, Western Colorado University, Gunnison, CO, United States
| | - Joyce S. Ramos
- Caring Futures Institute, SHAPE Research Centre, Clinical Exercise Physiology, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- *Correspondence: Joyce S. Ramos
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Mateo-Gallego R, Madinaveitia-Nisarre L, Giné-Gonzalez J, María Bea A, Guerra-Torrecilla L, Baila-Rueda L, Perez-Calahorra S, Civeira F, Lamiquiz-Moneo I. The effects of high-intensity interval training on glucose metabolism, cardiorespiratory fitness and weight control in subjects with diabetes: Systematic review a meta-analysis. Diabetes Res Clin Pract 2022; 190:109979. [PMID: 35780905 DOI: 10.1016/j.diabres.2022.109979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 06/27/2022] [Indexed: 11/27/2022]
Abstract
AIM The objective of this meta-analysis was to explore the effects of high-intensity interval training (HIIT) compared with control conditions (CON) or moderate intensity continuous training (MICT) on glycemic parameters in diabetes subjects. METHODS Pubmed, Embase and Google Scholar databases were searched for HIIT interventions that were carried out in diabetic subjects and exploring fasting glucose, glycated haemoglobin (HbA1c), fasting insulin and/or HOMA-IR. RESULTS This systematic review retrieved a total of 1741 studies of which 32 articles fulfilled the eligibility criteria. Nineteen trials were included in the meta-analysis since they compared HIIT intervention with CON or MICT group. There was a significantly reduction of fasting glucose of 13.3 mg/dL (p < 0.001), Hb1Ac -0.34% (p < 0.001), insulin -2.27 UI/L (p = 0.003), HOMA-IR -0.88 (p = 0.005) in the HIIT-group compared with CON-group. Nevertheless, this reduction was not significantly different when comparing HIIT with MICT (p = 0.140, p = 0.315, p = 0.520 and p = 0.389). Besides, there was a significant increase of absolute VO2max of 0.21 L/min (p < 0.001) and relative VO2max of 2.94 ml/kg/min (p < 0.001) in the HIIT-group compared with the CON-group and the MICT-group (0.22 L/min, p = 0.025) and (0.97 ml/kg/min, p = 0.045). CONCLUSIONS These findings revealed that HIIT intervention led to significant improvement in glycemic control and insulin resistance in subjects with diabetes compared with CON-group.
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Affiliation(s)
- Rocío Mateo-Gallego
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Universidad de Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing. Facultad de Ciencias de la Salud y del Deporte, Universidad de Za-ragoza, 22002 Huesca, Spain
| | - Loreto Madinaveitia-Nisarre
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Jaume Giné-Gonzalez
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Ana María Bea
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Lydia Guerra-Torrecilla
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Lucía Baila-Rueda
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Universidad de Zaragoza, Zaragoza, Spain
| | - Sofia Perez-Calahorra
- Department of Physiatry and Nursing. Facultad de Ciencias de la Salud y del Deporte, Universidad de Za-ragoza, 22002 Huesca, Spain
| | - Fernando Civeira
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Universidad de Zaragoza, Zaragoza, Spain; Department of Medicine, Psychiatry and Dermatology. Facultad de Medicina, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Itziar Lamiquiz-Moneo
- Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), CIBERCV, Universidad de Zaragoza, Zaragoza, Spain; Department of Human Anatomy and Histology. Facultad de Medicina, Universidad de Zaragoza, 50009 Zaragoza, Spain.
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25
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Khalafi M, Ravasi AA, Malandish A, Rosenkranz SK. The impact of high-intensity interval training on postprandial glucose and insulin: A systematic review and meta-analysis. Diabetes Res Clin Pract 2022; 186:109815. [PMID: 35271876 DOI: 10.1016/j.diabres.2022.109815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/10/2022] [Accepted: 02/28/2022] [Indexed: 12/14/2022]
Abstract
AIMS We performed a systematic review and meta-analysis to investigate the effects of high-intensity interval training (HIIT) on postprandial glucose (PPG) and insulin (PPI) versus non-exercise control and moderate-intensity continuous training (MICT) in participants with both normal and impaired glucose. METHODS The PubMed, Scopus, and Web of Science electronic databases were searched up to October 2021 for randomized trials evaluating HIIT versus control and/or versus MICT on glucose and insulin AUC using oral glucose tolerance testing. Subgroup analyses based on intervention duration (short-duration < 8 weeks, moderate-duration ≥ 8 weeks), baseline glucose levels (normal glucose and impaired glucose) and type of HIIT (L-HIIT and SIT) were also conducted across included studies. RESULTS A total of 25 studies involving 870 participants were included in the current meta-analysis. HIIT effectively reduced glucose [-0.37 (95% CI -0.60 to -0.13), p = 0.002] and insulin [-0.36 (95% CI -0.68 to -0.04), p = 0.02] AUC when compared with a CON group. Reductions in glucose AUC were significant for those with impaired glucose at baseline (p = 0.03), but not for those with normal glucose levels (p = 0.11) and following moderate-duration (p = 0.01), but not short-duration interventions (p = 0.18). However, there were no differences in glucose (p = 0.76) or insulin (p = 0.43) AUC between HIIT and MICT intervention arms. CONCLUSIONS Our results demonstrated that both HIIT and MICT are effective for reducing postprandial glycemia and insulinemia, particularly by moderate-duration interventions, and in those with impaired glucose.
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Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Ali A Ravasi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Abbas Malandish
- Department of Exercise Physiology, Faculty of Sport Sciences, Urmia University, Urmia, Iran
| | - Sara K Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, USA
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Metcalfe RS, Williams S, Fernandes GS, Astorino TA, Stork MJ, Phillips SM, Niven A, Vollaard NBJ. Affecting Effects on Affect: The Impact of Protocol Permutations on Affective Responses to Sprint Interval Exercise; A Systematic Review and Meta-Analysis of Pooled Individual Participant Data. Front Sports Act Living 2022; 4:815555. [PMID: 35252858 PMCID: PMC8891702 DOI: 10.3389/fspor.2022.815555] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/13/2022] [Indexed: 01/08/2023] Open
Abstract
Responses to sprint interval exercise (SIE) are hypothesized to be perceived as unpleasant, but SIE protocols are diverse, and moderating effects of various SIE protocol parameters on affective responses are unknown. We performed a systematic search to identify studies (up to 01/05/2021) measuring affective valence using the Feeling Scale during acute SIE in healthy adults. Thirteen studies involving 18 unique trials and 316 unique participant (142 women and 174 men) affective responses to SIE were eligible for inclusion. We received individual participant data for all participants from all studies. All available end-of-sprint affect scores from each trial were combined in a linear mixed model with sprint duration, mode, intensity, recovery duration, familiarization and baseline affect included as covariates. Affective valence decreased significantly and proportionally with each additional sprint repetition, but this effect was modified by sprint duration: affect decreased more during 30 s (0.84 units/sprint; 95% CI: 0.74–0.93) and 15–20 s sprints (1.02 units/sprint; 95% CI: 0.93–1.10) compared with 5–6 s sprints (0.20 units/sprint; 95% CI: 0.18–0.22) (both p < 0.0001). Although the difference between 15–20 s and 30 s sprints was also significant (p = 0.02), the effect size was trivial (d = −0.12). We observed significant but trivial effects of mode, sprint intensity and pre-trial familiarization, whilst there was no significant effect of recovery duration. We conclude that affective valence declines during SIE, but the magnitude of the decrease for an overall SIE session strongly depends on the number and duration of sprints. This information can be applied by researchers to design SIE protocols that are less likely to be perceived as unpleasant in studies of real-world effectiveness.
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Affiliation(s)
- Richard S. Metcalfe
- Applied Sports Science, Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University, Swansea, United Kingdom
| | - Sean Williams
- Department for Health, University of Bath, Bath, United Kingdom
| | - Gwen S. Fernandes
- Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - Todd A. Astorino
- Department of Kinesiology, California State University San Marcos, San Marcos, CA, United States
| | - Matthew J. Stork
- School of Health and Exercise Sciences, The University of British Columbia, Kelowna, BC, Canada
| | - Shaun M. Phillips
- Human Performance Science Research Group, University of Edinburgh, Edinburgh, United Kingdom
| | - Ailsa Niven
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Niels B. J. Vollaard
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
- *Correspondence: Niels B. J. Vollaard
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Li J, Cheng W, Ma H. A Comparative Study of Health Efficacy Indicators in Subjects with T2DM Applying Power Cycling to 12 Weeks of Low-Volume High-Intensity Interval Training and Moderate-Intensity Continuous Training. J Diabetes Res 2022; 2022:9273830. [PMID: 35071605 PMCID: PMC8776485 DOI: 10.1155/2022/9273830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/22/2021] [Indexed: 11/17/2022] Open
Abstract
This study is aimed at comparing the effects of different exercise intensities, namely, high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), on body composition, heart and lung fitness, and blood glucose, and blood pressure indices in patients with type 2 diabetes mellitus (T2DM), using power cycling. A total of 96 T2DM volunteers who met the inclusion criteria were recruited from a hospital in Yangpu, Shanghai. Based on the blood index data of their medical examination results which comprised blood pressure, fasting blood glucose, hemoglobin A1c (HbA1c), and insulin, 37 volunteers were included in the study. Exercise prescription was determined based on T2DM exercise guidelines combined with medical diagnosis and exercise test results, and the patients were randomly assigned to three groups: HIIT group, MICT group, and control (CON) group. HIIT involved one-minute power cycling (80%-95% maximal oxygen uptake (VO2max)), one-minute passive or active rest (25%-30% VO2max), and two-minute rounds of eight groups. MICT required the use of a power bike for 30 minutes of continuous training (50%-70% VO2max) five times a week. The CON group was introduced to relevant medicine, exercise, and nutrition knowledge. The exercise interventions were completed under the supervision of an exercise instructor and hospital doctors. The same indicators were measured after 12 weeks of intervention, and the results of the two tests within and between groups were analyzed for comparison. The weight index of the MICT intervention showed statistically significant within-group differences (difference = 3.52, 95% CI = 2.11-4.92, p = 0.001 < 0.01); group differences for the MICT and CON groups were also statistically significant (difference = 3.52 ± 2.09, Cd1 = -0.39 ± 1.25, p = 0.004 < 0.01). Body mass index (BMI) analysis revealed that the overall means of BMI indicators were not statistically different between groups (F = 0.369, p = 0.694 > 0.05) and the before and after values of the MICT and CON (difference = -1.30 ± 0.79, Cd1 = -0.18 ± 0.45, p = 0.001 < 0.01). No statistically significant difference was observed in the overall mean VO2max index between the groups after the 12-week intervention (F = 2.51, p = 0.100 > 0.05). A statistically significant difference was found in the overall means of the data between the two groups (difference = 0.32, 95% CI = 0.23-0.40, p = 0.001 < 0.01). Analysis of fasting blood glucose (FBG) indicators revealed statistically significant differences between the MICT and control groups (p = 0.028 < 0.05). Analysis of HbA1c and fasting insulin (FI) indicators revealed no statistically significant difference in the overall HbA1c index after the 12-week exercise intervention (F = 0.523, p = 0.598 > 0.05), and the overall difference before and after the experiment between the groups was statistically significant (F = 6.13, p = 0.006 < 0.01). No statistically significant difference was found in the FI index overall after the 12-week exercise intervention (F = 2.50, p = 0.1 > 0.05). Analysis of systolic blood pressure (SBP) revealed statistically significant difference before and after the HIIT and CON interventions (Hd7 = -1.10 ± 1.79, Cd7 = 1.2 ± 1.31, p = 0.018 < 0.05) and statistically significant difference before and after the MICT and CON interventions (Md7 = -0.99 ± 0.91, Cd7 = 1.40 ± 1.78, p = 0.02 < 0.05). The diastolic blood pressure (DBP) revealed no statistically significant within-group differences before and after. Exercise interventions applying both low-volume HIIT and MICT, with both intensity exercises designed for power cycling, improved health-related indicators in the participants; low-volume HIIT had more time advantage. The current experiment compared HIIT with MICT in a safe manner: 50% of the exercise time produced similar benefits and advantages in the two indicators of VO2max and FI. However, MICT was superior to HIIT in the two indicators of body weight (weight) and BMI. The effect of power cycling on FI has the advantages of both aerobic and resistance exercise, which may optimize the type, intensity, and time of exercise prescription according to the individual or the type of exercise program. Our results provide a reference for the personalization of exercise prescription for patients with T2DM.
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Affiliation(s)
- Jun Li
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
| | - Wei Cheng
- Department of Endocrinology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China
| | - Haifeng Ma
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
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Li J, Jiang R, Cheng W, Ma H. A Study Using Power Cycling on the Affective Responses of a Low-Volume High-Intensity Interval Training to Male Subjects with Type 2 Diabetes in Different Physical Activity Status. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1255943. [PMID: 34876964 PMCID: PMC8645398 DOI: 10.1155/2021/1255943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/02/2021] [Accepted: 11/06/2021] [Indexed: 11/18/2022]
Abstract
High-intensity interval training (HIIT) has been shown in studies to enhance glucose management and cardiovascular well-being in patients with type 2 diabetes. In this study, we used power cycling to assess the physical activity levels of men with type 2 diabetes during a single low-volume HIIT session. First, fifty-six men with type 2 diabetes volunteered to take part in the study, and they were split into two groups based on the International Physical Activity Scale Short Form (IPA). To the first 1-4 labor bouts, both the sufficiently physically active and insufficiently physically active groups exhibited equal positive emotional reactions (p > 0.05). However, over time (about 5-10 times), both of them showed reduced emotional reactions, with a significant difference (p < 0.01). The insufficiently physically active group had lower mean emotional response, lowest effective response, and maximum effective response values than the sufficiently physically active group (p < 0.001), while the difference in RPE between the two groups was not statistically significant (p > 0.05). From the standpoint of emotional response, the proposed model shows that HIIT or reduced volume HIIT exercise prescriptions should be utilized with caution in physical activity programs for novices and less active and chronically sick persons. The frequency, intensity, and effects of low-volume HIIT on individuals' emotional reactions and health conditions in the T2DM group are also investigated. Furthermore, this low-volume HIIT program can be successfully applied in the real-world setting of people who are not physically active enough or who are chronically unwell.
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Affiliation(s)
- Jun Li
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
| | - Ruichen Jiang
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
| | - Wei Cheng
- Department of Endocrinology, Yangpu Hospital, Tongji University, Shanghai 200090, China
| | - Haifeng Ma
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai 200438, China
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de Mello MB, Righi NC, Schuch FB, Signori LU, da Silva AMV. Effect of high-intensity interval training protocols on VO 2max and HbA1c level in people with type 2 diabetes: A systematic review and meta-analysis. Ann Phys Rehabil Med 2021; 65:101586. [PMID: 34648979 DOI: 10.1016/j.rehab.2021.101586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/19/2021] [Accepted: 08/10/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The effect of high-intensity interval training (HIIT) protocols according to different work intervals, session volumes and training periods has not been evaluated in patients with type 2 diabetes mellitus (T2DM). OBJECTIVE This was a systematic review and meta-analysis of the effect of HIIT and its different protocols compared to moderate-intensity continuous training (MICT) and the control group on VO2max and glycated hemoglobin (HbA1c) level in patients with T2DM. METHODS The search strategy considered studies published up to September 2020 in the databases MEDLINE (PubMed), EMBASE, Cochrane CENTRAL, Web of Science and SPORTDiscus. Two authors independently searched the selected databases for randomized clinical trials that compared HIIT to MICT or the control in adults with T2DM. A random-effects meta-analysis was performed and the data are presented as the mean difference (95% confidence intervals [95% CIs]) between HIIT, MICT and control groups. RESULTS A total of 20 studies (738 participants) were included. Overall, HIIT increased VO2max by 5.09 mL/kg/min (95% CI 2.99; 7.19, I² = 80.89) versus the control and by 1.9 mL/kg/min (95% CI 0.81; 2.98, I² = 25.62) versus MICT. HIIT promoted a significant reduction in HbA1c level of -0.8% (95% CI -1.06; -0.49, I² = 77.31) versus the control but with no difference versus MICT. Moderate-interval, high-volume and long-term training promoted a greater increase in VO2max. A long interval and moderate volume and period conferred a greater increase in VO2max versus MICT. A short interval and moderate volume and period conferred a greater reduction in HbA1c level versus the control. No publication bias was detected, as evaluated by a funnel chart and Egger's test (p > 0.05). CONCLUSIONS As compared with MICT, HIIT had better effect on VO2max and a similar effect on HbA1C level. Interval protocols, moderate to long training period and moderate to high volume may maximize the HIIT effect in patients with T2DM.
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Affiliation(s)
- Mariana Brondani de Mello
- Postgraduate Program in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Natiele Camponogara Righi
- Postgraduate Program in Rehabilitation Sciences at the Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil; Department of Physiotherapy and Rehabilitation, Post-Graduate Programme in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Luis Ulisses Signori
- Department of Physiotherapy and Rehabilitation, Post-Graduate Programme in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil
| | - Antônio Marcos Vargas da Silva
- Department of Physiotherapy and Rehabilitation, Post-Graduate Programme in Functional Rehabilitation, Federal University of Santa Maria, Santa Maria, Brazil.
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Vollaard NBJ, Metcalfe RS. Those Apples Don't Taste Like Oranges! Why 'Equalising' HIIT and MICT Protocols Does Not Make Sense. Trends Endocrinol Metab 2021; 32:131-132. [PMID: 33419707 DOI: 10.1016/j.tem.2020.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/13/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Niels B J Vollaard
- Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK.
| | - Richard S Metcalfe
- Applied Sports, Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University, Swansea SA1 8EN, UK
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Atef H, Muka T. Reduced-Exertion High-Intensity Interval Training as a Novel Therapeutic Approach for Insomnia. Front Psychiatry 2021; 12:754171. [PMID: 34795600 PMCID: PMC8593976 DOI: 10.3389/fpsyt.2021.754171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hady Atef
- Faculty of Physical Therapy, Cairo University, Giza, Egypt.,Department of Preclinical Medicine, Medical School, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Taulant Muka
- Department of Preclinical Medicine, Medical School, Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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Haines M, Broom D, Stephenson J, Gillibrand W. Influence of Sprint Duration during Minimal Volume Exercise on Aerobic Capacity and Affect. Int J Sports Med 2020; 42:357-364. [PMID: 33022736 DOI: 10.1055/a-1255-3161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aims of this study were to investigate the influence of reduced-exertion, high-intensity interval training (REHIT), comparing a novel shortened-sprint protocol (SSREHIT) against a traditional protocol (TREHIT), on perceptual responses and to determine if changes in peak oxygen uptake (V˙O2peak) are attenuated with shorter sprints. Twenty-four healthy men undertook 15 sessions of SSREHIT or TREHIT. V˙O2peak was determined at baseline and after completion of each exercise condition. Affective (pleasure-displeasure) responses and perceived exertion were assessed during exercise to capture peak responses. Enjoyment was recorded 5-min after cessation of exercise. Compared to baseline, V˙O2peak increased in both groups (6% for SSREHIT [d=- 0.36] and 9% for TREHIT [d=- 0.53], p=0.01). Affective responses were more favourable for SSREHIT (p=0.001, d=1.62), but both protocols avoided large negative peaks of displeasure. Peak ratings of perceived exertion were lower for SSREHIT (p=0.001, d=- 1.71), although there were no differences in enjoyment (d=0.25). The results demonstrate both exercise conditions can increase V˙O2peak without overly compromising perceptual responses. Decreased sprint duration might further circumvent negative perceptual responses but might also attenuate physiological adaptations.
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Affiliation(s)
- Matthew Haines
- Department of Allied Health Professions, Sport and Exercise, University of Huddersfield, Huddersfield
| | - David Broom
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry
| | - John Stephenson
- Department of Allied Health Professions, Sport and Exercise, University of Huddersfield, Huddersfield
| | - Warren Gillibrand
- Department of Nursing and Midwifery, University of Huddersfield, Huddersfield
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The Effect of Low-Volume High-Intensity Interval Training on Body Composition and Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis. Sports Med 2020; 49:1687-1721. [PMID: 31401727 DOI: 10.1007/s40279-019-01167-w] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Evidence for the efficacy of low-volume high-intensity interval training (HIIT) for the modulation of body composition is unclear. OBJECTIVES We examined the effect of low-volume HIIT versus a non-exercising control and moderate-intensity continuous training (MICT) on body composition and cardiorespiratory fitness in normal weight, overweight and obese adults. We evaluated the impact of low-volume HIIT (HIIT interventions where the total amount of exercise performed during training was ≤ 500 metabolic equivalent minutes per week [MET-min/week]) compared to a non-exercising control and MICT. METHODS A database search was conducted in PubMed (MEDLINE), EMBASE, CINAHL, Web of Science, SPORTDiscus and Scopus from the earliest record to June 2019 for studies (randomised controlled trials and non-randomised controlled trials) with exercise training interventions with a minimum 4-week duration. Meta-analyses were conducted for between-group (low-volume HIIT vs. non-exercising control and low-volume HIIT vs. MICT) comparisons for change in total body fat mass (kg), body fat percentage (%), lean body mass (kg) and cardiorespiratory fitness. RESULTS From 11,485 relevant records, 47 studies were included. No difference was found between low-volume HIIT and a non-exercising control on total body fat mass (kg) (effect size [ES]: - 0.129, 95% confidence interval [CI] - 0.468 to 0.210; p = 0.455), body fat (%) (ES: - 0.063, 95% CI - 0.383 to 0.257; p = 0.700) and lean body mass (kg) (ES: 0.050, 95% CI - 0.250 to 0.351; p = 0.744), or between low-volume HIIT and MICT on total body fat mass (kg) (ES: - 0.021, 95% CI - 0.272 to 0.231; p = 0.872), body fat (%) (ES: 0.005, 95% CI - 0.294 to 0.304; p = 0.974) and lean body mass (kg) (ES: 0.030, 95% CI - 0.167 to 0.266; p = 0.768). However, low-volume HIIT significantly improved cardiorespiratory fitness compared with a non-exercising control (p < 0.001) and MICT (p = 0.017). CONCLUSION These data suggest that low-volume HIIT is inefficient for the modulation of total body fat mass or total body fat percentage in comparison with a non-exercise control and MICT. A novel finding of our meta-analysis was that there appears to be no significant effect of low-volume HIIT on lean body mass when compared with a non-exercising control, and while most studies tended to favour improvement in lean body mass with low-volume HIIT versus MICT, this was not significant. However, despite its lower training volume, low-volume HIIT induces greater improvements in cardiorespiratory fitness than a non-exercising control and MICT in normal weight, overweight and obese adults. Low-volume HIIT, therefore, appears to be a time-efficient treatment for increasing fitness, but not for the improvement of body composition.
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Baasch-Skytte T, Lemgart CT, Oehlenschläger MH, Petersen PE, Hostrup M, Bangsbo J, Gunnarsson TP. Efficacy of 10-20-30 training versus moderate-intensity continuous training on HbA1c, body composition and maximum oxygen uptake in male patients with type 2 diabetes: A randomized controlled trial. Diabetes Obes Metab 2020; 22:767-778. [PMID: 31903682 DOI: 10.1111/dom.13953] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/17/2019] [Accepted: 12/28/2019] [Indexed: 01/31/2023]
Abstract
AIM To compare the efficacy of 10-20-30 training versus moderate-intensity continuous training (MICT) on HbA1c, body composition and maximum oxygen uptake (V˙O2 max) in male patients with type 2 diabetes (T2D). MATERIALS AND METHODS Fifty-one male participants with T2D were randomly assigned (1:1) to a 10-20-30 (N = 26) and a MICT (N = 25) training group. Interventions consisted of supervised cycling three times weekly for 10 weeks, lasting 29 minutes (10-20-30) and 50 minutes (MICT) in a local non-clinical setting. The primary outcome was change in HbA1c from baseline to 10-week follow-up. RESULTS Of 51 participants enrolled, 44 (mean age 61.0 ± 6.8 [mean ± SD] years, diagnosed 7.5 ± 5.8 years, baseline HbA1c 7.4% ± 1.3%) were included in the analysis. Training compliance was 84% and 86% in 10-20-30 and MICT, respectively. No adverse events occurred during the intervention. HbA1c decreased (P <0.001) by 0.5 (95% CI -0.72 to -0.21) percentage points with training in 10-20-30, with no change in MICT. The change in 10-20-30 was greater (P <0.05) than in MICT. Visceral fat mass decreased (P <0.05) only with 10-20-30 training, whereas total fat mass decreased (P <0.01) and V˙O2 max increased (P <0.01) with training in both groups. CONCLUSIONS Ten weeks of 10-20-30 training was superior to MICT in lowering HbA1c, and only 10-20-30 training decreased visceral fat mass in patients with T2D. Furthermore, 10-20-30 training was as effective as MICT in reducing total fat mass and increasing V˙O2 max, despite a 42% lower training time commitment.
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Affiliation(s)
- Thomas Baasch-Skytte
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte T Lemgart
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Mads H Oehlenschläger
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Morten Hostrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Thomas P Gunnarsson
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Metcalfe RS, Atef H, Mackintosh K, McNarry M, Ryde G, Hill DM, Vollaard NBJ. Time-efficient and computer-guided sprint interval exercise training for improving health in the workplace: a randomised mixed-methods feasibility study in office-based employees. BMC Public Health 2020; 20:313. [PMID: 32164631 PMCID: PMC7068982 DOI: 10.1186/s12889-020-8444-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/02/2020] [Indexed: 12/13/2022] Open
Abstract
Background The efficacy of high-intensity interval training (HIT) as a time-efficient exercise strategy for beneficially modifying risk factors for cardiovascular disease has repeatedly been demonstrated in controlled laboratory settings. However, the effectiveness of HIT in an unsupervised workplace setting has not been investigated. The objective of this study was to use mixed methods to investigate the feasibility, acceptability and effectiveness of a short-duration, high-intensity exercise intervention (REHIT) when applied unsupervised in a workplace setting. Methods Twenty-five office-workers (mean ± SD age: 47 ± 9 y, BMI: 27.5 ± 4.4 kg·m− 2, V̇O2max: 28 ± 7 mL·kg− 1·min− 1) completed a 6-week REHIT intervention unsupervised in their workplace (n = 13, 6 men), or acted as a no-intervention control (n = 12, 6 men). The intervention consisted of 2 sessions/week of low-intensity (~ 25 W) cycling interspersed with 2 ‘all-out’ sprints, increasing in duration from 10 to 20 s per sprint over the 6 weeks (total time-commitment: 8:40 min per session). V̇O2max was assessed pre- and post-training, whilst questionnaire-based measures of exercise enjoyment, self-efficacy, and acceptability were completed post-training. Eight participants also completed post-intervention semi-structured interviews. Results V̇O2max significantly improved in the exercise group (2.25 ± 0.75 L·min− 1 vs. 2.42 ± 0.82 L·min− 1; + 7.4%) compared to the control group (2.22 ± 0.72 L·min− 1 vs. 2.17 ± 0.74 L·min− 1; − 2.3%; time*intervention interaction effect: p < 0.01). Participants considered the REHIT intervention acceptable and enjoyable (PACES: 89 ± 17 out of 119) and were confident in their ability to continue to perform REHIT (7.8 ± 1.2 out of 9). Qualitative data revealed that REHIT offered a time-efficient opportunity to exercise, that was perceived as achievable, and which encouraged highly valued post-exercise outcomes (e.g. progress towards health/fitness benefits). Conclusions REHIT could be implemented as a feasible, effective and acceptable exercise intervention in a workplace setting, with a total time-commitment of < 20 min/week. Consideration of certain psycho-social factors and behaviour-change techniques may ensure adherence to the REHIT programme in the long term. Trial registration The study was registered on ClinicalTrials.gov on 07/05/2019 (registration: NCT03941145).
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Affiliation(s)
- Richard S Metcalfe
- Applied Sports Science, Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University, Swansea, SA1 8EN, UK
| | - Hady Atef
- Department of Physical Therapy for Internal Medicine, Faculty of Physical Therapy, Cairo University, Giza, Egypt.,Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Kelly Mackintosh
- Applied Sports Science, Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University, Swansea, SA1 8EN, UK
| | - Melitta McNarry
- Applied Sports Science, Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University, Swansea, SA1 8EN, UK
| | - Gemma Ryde
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Denise M Hill
- Applied Sports Science, Technology, Exercise and Medicine Research Centre (A-STEM), Swansea University, Swansea, SA1 8EN, UK
| | - Niels B J Vollaard
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK.
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Haines M. Feasibility of procedures for a randomised pilot study of reduced exertion, high-intensity interval training (REHIT) with non-diabetic hyperglycaemia patients. Pilot Feasibility Stud 2020; 6:28. [PMID: 32099663 PMCID: PMC7031996 DOI: 10.1186/s40814-020-00571-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 02/10/2020] [Indexed: 12/28/2022] Open
Abstract
Background Physical activity and exercise interventions to improve health frequently bring about intended effects under ideal circumstances but often fail to demonstrate benefits in real-world contexts. The aim of this study was to describe the feasibility of an exercise intervention (reduced-exertion, high-intensity interval training) in non-diabetic hyperglycaemia patients delivered in a National Health Service setting to assess whether it would be appropriate to progress to a future large-scale study. Methods The intention was to recruit 40 participants from a single centre (specialist diabesity centre). Patients were eligible to take part if they were diagnostically defined as non-diabetic hyperglycaemic based on a glycated haemoglobin (HbA1c) value of 42–46 mmol mol. Study procedures including recruitment, occurrence of adverse events, intervention acceptability, and intervention adherence were used to assess feasibility. Results Key criteria for progression to a larger study were not met. The study revealed several issues including patient eligibility, challenges to recruitment, patient consent, and poor clinician engagement. Furthermore, despite the simplicity and convenience of using HbA1c to screen for diabetes risk, the process of accurately screening and case finding eligible patients was problematic. The small sample recruited for this trial (n = 6) also limits the interpretation of data, thus it is not possible to estimate the variability of intended outcomes to use in a formal sample size calculation for a full-scale trial. Some aspects of the intervention worked well. The acceptability of the exercise intervention and outcome measures met progression criteria thresholds and adherence was very high, with 97% of exercise sessions completed for participants that finished the study. Conclusions Given the issues, the trial is not feasible in its current form. Yet, this preparatory stage of trial design pre-empted problems with the intervention that could be changed to optimise the design and conduct of future studies. Solutions to the issues identified in this study revolve around using a dedicated local recruiter with a strong relationship among the healthcare team and patients, using participant incentives to take part, and allowing for a longer recruitment period. Trial registration ClinicalTrials.gov, NCT04011397. Registered 07 July 2019—retrospectively registered.
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Affiliation(s)
- Matthew Haines
- Department of Allied Health Professions, Sport and Exercise, University of Huddersfield, Huddersfield, HD1 3DH UK
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Thomas G, Songsorn P, Gorman A, Brackenridge B, Cullen T, Fitzpatrick B, Metcalfe RS, Vollaard NBJ. Reducing training frequency from 3 or 4 sessions/week to 2 sessions/week does not attenuate improvements in maximal aerobic capacity with reduced-exertion high-intensity interval training (REHIT). Appl Physiol Nutr Metab 2020; 45:683-685. [PMID: 32078337 DOI: 10.1139/apnm-2019-0750] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the present randomised-controlled trial we investigated the effect of reduced-exertion high-intensity interval training (REHIT) training frequency (2, 3, or 4 sessions/week for 6 weeks) on maximal aerobic capacity in 42 inactive individuals (13 women; mean ± SD age: 25 ± 5 years, maximal aerobic capacity: 35 ± 5 mL·kg-1·min-1). Changes in maximal aerobic capacity were not significantly different between the 3 groups (2 sessions/week: +10.2%; 3 sessions/week: +8.1%; 4 sessions per week: +7.3%). In conclusion, a training frequency of 2 sessions/week is sufficient for REHIT to improve maximal aerobic capacity. Novelty We demonstrate that reducing REHIT training frequency from 3 or 4 to 2 sessions/week does not attenuate improvements in the key health marker of maximal aerobic capacity.
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Affiliation(s)
- Gavin Thomas
- School of Sport & Exercise Science, University of Worcester, Worcester, WR2 6AJ, UK
| | - Preeyaphorn Songsorn
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Aimee Gorman
- Sport and Exercise Sciences Research Institute, Ulster University, BT37 0QB, UK
| | - Ben Brackenridge
- Sport and Exercise Sciences Research Institute, Ulster University, BT37 0QB, UK
| | - Tom Cullen
- School of Sport & Exercise Science, University of Worcester, Worcester, WR2 6AJ, UK
| | - Ben Fitzpatrick
- Sport and Exercise Sciences Research Institute, Ulster University, BT37 0QB, UK
| | - Richard S Metcalfe
- Applied Sports Science Technology and Medicine Research Centre (A-STEM), Swansea University, Swansea, SA1 8EN, UK
| | - Niels B J Vollaard
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
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Munan M, Oliveira CLP, Marcotte-Chénard A, Rees JL, Prado CM, Riesco E, Boulé NG. Acute and Chronic Effects of Exercise on Continuous Glucose Monitoring Outcomes in Type 2 Diabetes: A Meta-Analysis. Front Endocrinol (Lausanne) 2020; 11:495. [PMID: 32849285 PMCID: PMC7417355 DOI: 10.3389/fendo.2020.00495] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/22/2020] [Indexed: 12/16/2022] Open
Abstract
Objective: To examine the acute and chronic effects of structured exercise on glucose outcomes assessed by continuous glucose monitors in adults with type 2 diabetes. Methods: PubMed, Medline, EMBASE were searched up to January 2020 to identify studies prescribing structured exercise interventions with continuous glucose monitoring outcomes in adults with type 2 diabetes. Randomized controlled trials, crossover trials, and studies with pre- and post-designs were eligible. Short-term studies were defined as having exercise interventions lasting ≤2 weeks. Longer-term studies were defined as >2 weeks. Results: A total of 28 studies were included. Of these, 23 studies were short-term exercise interventions. For all short-term studies, the same participants completed a control condition as well as at least one exercise condition. Compared to the control condition, exercise decreased the primary outcome of mean 24-h glucose concentrations in short-term studies (-0.5 mmol/L, [-0.7, -0.3]; p < 0.001). In longer-term studies, mean 24-h glucose was not significantly reduced compared to control (-0.9 mmol/L [-2.2, 0.3], p = 0.14) but was reduced compared to pre-exercise values (-0.5 mmol/L, [-0.7 to -0.2] p < 0.001). The amount of time spent in hyperglycemia and indices of glycemic variability, but not fasting glucose, also improved following short-term exercise. Among the shorter-term studies, subgroup, and regression analyses suggested that the timing of exercise and sex of participants explained some of the heterogeneity among trials. Conclusion: Both acute and chronic exercise can improve 24-h glucose profiles in adults with type 2 diabetes. The timing of exercise and sex of participants are among the factors that may explain part of the heterogeneity in acute glycemic improvements following exercise.
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Affiliation(s)
- Matthew Munan
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
- Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada
| | - Camila L. P. Oliveira
- Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada
- Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, AB, Canada
| | - Alexis Marcotte-Chénard
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
- Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, QC, Canada
| | - Jordan L. Rees
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
- Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada
| | - Carla M. Prado
- Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada
- Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, AB, Canada
| | - Eléonor Riesco
- Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
- Research Center on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, QC, Canada
| | - Normand G. Boulé
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
- Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada
- *Correspondence: Normand G. Boulé
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Gibala MJ, Little JP. Physiological basis of brief vigorous exercise to improve health. J Physiol 2019; 598:61-69. [PMID: 31691289 DOI: 10.1113/jp276849] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/15/2019] [Indexed: 12/21/2022] Open
Abstract
This review considers the physiological basis of brief vigorous exercise to improve health, with a focus on cardiorespiratory fitness (CRF) and glycaemic control, and the potential underlying mechanisms involved. We defined 'brief' as a protocol lasting ≤15 min including warm-up, cool-down and recovery, and involving a total of ≤5 min of 'vigorous' exercise, which was classified as meeting or exceeding the lower end of the range for this relative intensity as per the criteria from the American College of Sports Medicine. The physiological mechanisms responsible for the increase in CRF, as measured by maximal oxygen update ( V ̇ O 2 max ), after brief vigorous exercise are unclear and likely depend on various factors including the specific nature of the intervention as well as the time course of the response. Limited available evidence suggests the potential for an increased oxygen extraction by active muscle (i.e. greater arterio-venous oxygen difference), since an increase in V ̇ O 2 max has been reported after several weeks of brief vigorous exercise despite no measurable change in cardiac output. Emerging evidence indicates that brief vigorous exercise can improve glycaemic control, suggesting that this type of exercise could potentially play a role in the prevention and management of type 2 diabetes. The acute response is not well characterized but several studies have shown that several weeks of vigorous exercise improves estimates of insulin sensitivity as determined by various methods including by hyperinsulinaemic-euglycaemic clamp. The physiological mechanisms underlying improved CRF and glycaemic control after brief vigorous exercise, and the broader impact on health, remain fruitful areas of investigation.
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Affiliation(s)
- Martin J Gibala
- Department of Kinesiology, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4K1, Canada
| | - Jonathan P Little
- School of Health and Exercise Science, University of British Columbia, Okanagan Campus, Kelowna, BC, V1V 1V7, Canada
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Wood G, Murrell A, van der Touw T, Smart N. HIIT is not superior to MICT in altering blood lipids: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2019; 5:e000647. [PMID: 31921439 PMCID: PMC6937112 DOI: 10.1136/bmjsem-2019-000647] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2019] [Indexed: 01/07/2023] Open
Abstract
Objective To compare the effects of moderate intensity continuous training (MICT) and high intensity interval training (HIIT) on adult lipid profiles; to identify training or participant characteristics that may determine exercise-induced change in total cholesterol (TC), triglycerides (TRG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Design Systematic review and meta-analysis. Data sources English language searches of several databases were conducted from inception until September 2019. Eligibility criteria for excluding studies Inclusion: (1) published randomised controlled human trials with group population n≥5; (2) intervention duration ≥4 weeks; (3) comparing HIIT with MICT; and (4) reporting pre–post intervention lipid measurements. Exclusion: subjects with chronic disease, <18 years, pregnant/lactating, in elite athletic training; and studies with a dietary or pharmaceutical intervention component. Results Twenty-nine data sets (mmol/L) of 823 participants were pooled and analysed. Neither HIIT nor MICT was better in decreasing TC (0.10 (−0.06 to 0.19), p=0.12, I2=0%), TRG (−0.05 (−0.11 to 0.01), p=0.10, I2=0%), LDL-C (0.05 (−0.06 to 0.17), p=0.37, I2=0%), or TC/HDL-C (−0.03 (−0.36 to 0.29), p=0.85, I2=0%). HIIT significantly raised HDL-C (0.07 (0.04 to 0.11), p<0.0001, I2=0%) compared with MICT. Conclusion Neither HIIT nor MICT is superior for altering TC, TRG, or LDL-C, or TC-HDL-C ratio. Compared with MICT, HIIT appeared to significantly improve HDL-C. Clinicians may prescribe either protocol to encourage participation in exercise and reduce cardiovascular risk. To raise HDL-C, HIIT may result in a larger effect size compared with MICT. PROSPERO registration number CRD42019136722.
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Affiliation(s)
- Gina Wood
- School of Science and Technology, University of New England, Armidale, New South Wales, Australia
| | - Anna Murrell
- School of Rural Medicine, University of New England, Armidale, New South Wales, Australia
| | - Tom van der Touw
- School of Science and Technology, University of New England, Armidale, New South Wales, Australia
| | - Neil Smart
- School of Science and Technology, University of New England, Armidale, New South Wales, Australia
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Lora-Pozo I, Lucena-Anton D, Salazar A, Galán-Mercant A, Moral-Munoz JA. Anthropometric, Cardiopulmonary and Metabolic Benefits of the High-Intensity Interval Training Versus Moderate, Low-Intensity or Control for Type 2 Diabetes: Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4524. [PMID: 31731764 PMCID: PMC6887993 DOI: 10.3390/ijerph16224524] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 12/18/2022]
Abstract
Abstract: This study aims to evaluate the effectiveness of high-intensity interval training compared with no intervention and other types of training interventions for people with Type 2 Diabetes. A systematic review and meta-analysis of randomized controlled trials that used high-interval intensity training to improve anthropometric, cardiopulmonary and metabolic conditions were conducted. The search was performed during October-December 2017 using the databases PubMed, Web of Science and Physiotherapy Evidence Database (PEDro). The methodological quality of the studies was evaluated using the PEDro scale. A total of 10 articles were included in this meta-analysis. After statistical analysis, favorable results were obtained for high-Intensity Interval Training compared with control (non-intervention): [Weight: Standardized mean difference (SMD) = -2.09; confidence interval (CI) 95%: (-3.41; -0.78); body-mass index: SMD = -3.73; CI 95%: (-5.53; -1.93); systolic blood pressure: SMD = -4.55; CI 95%: (-8.44; -0.65); VO2max: SMD = 12.20; CI 95%: (0.26; 24.14); HbA1c: SMD = -3.72; CI 95%: (-7.34; -0.10)], moderate intensity continuous training: [body-mass index: SMD = -0.41; CI 95%: (-0.80; -0.03); VO2max: SMD = 1.91; CI 95%: (0.18; 3.64)], and low intensity training: [Weight: SMD = -2.06; CI 95%: (-2.80; -1.31); body-mass index: SMD = -3.04; CI 95%: (-5.16; -0.92); systolic blood pressure: SMD = -2.17; CI 95%: (-3.93; -0.41); HbA1c: SMD = -1.58; CI 95%: (-1.84; -1.33)]. The results show that high-intensity interval training can be a useful strategy in order to improve anthropometric, cardiopulmonary and metabolic parameters in people with Type 2 diabetes. Despite this, it could be essential to clarify and unify criteria in the intervention protocols, being necessary new lines of research.
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Affiliation(s)
- Ivan Lora-Pozo
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain; (I.L.-P.); (A.G.-M.); (J.A.M.-M.)
| | - David Lucena-Anton
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain; (I.L.-P.); (A.G.-M.); (J.A.M.-M.)
| | - Alejandro Salazar
- Department of Statistics and Operational Research, University of Cadiz, 11009 Cadiz, Spain;
- Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), University of Cadiz, 11009 Cadiz, Spain
- Observatory of Pain, Grünenthal Foundation-University of Cadiz, 11009 Cadiz, Spain
| | - Alejandro Galán-Mercant
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain; (I.L.-P.); (A.G.-M.); (J.A.M.-M.)
- Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), University of Cadiz, 11009 Cadiz, Spain
| | - Jose A. Moral-Munoz
- Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain; (I.L.-P.); (A.G.-M.); (J.A.M.-M.)
- Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), University of Cadiz, 11009 Cadiz, Spain
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Haines M, Broom D, Gillibrand W, Stephenson J. Effects of three low-volume, high-intensity exercise conditions on affective valence. J Sports Sci 2019; 38:121-129. [PMID: 31661663 DOI: 10.1080/02640414.2019.1684779] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A common barrier to exercise is "lack of time". Accordingly, interest in low-volume, high-intensity training has grown exponentially since this activity is considered time-efficient. However, the high-intensity nature of this exercise may frequently result in feelings of displeasure creating another barrier for many people. The purpose of this study was to compare affective (pleasure-displeasure) responses to three low-volume, high-intensity exercise conditions, including a novel shortened-sprint protocol. Using a within-subjects, randomised crossover experiment, healthy participants (N = 36) undertook a single bout of: 1) traditional reduced-exertion, high-intensity interval training (TREHIT), 2) a novel, shortened-sprint REHIT (SSREHIT) protocol, and 3) sprint continuous training (SCT). Affect and perceived efforts were recorded throughout exercise using the Feeling Scale (FS) and the 15-point Borg Rating of Perceived Exertion (RPE) scale, respectively. Enjoyment was recorded 5 min post-exercise using the Exercise Enjoyment Scale (EES). Differences were found for FS (condition by time interaction: P = 0.01GG, η2 = 0.26), RPE (P = 0.01GG, η2 = 0.23), and enjoyment (P < 0.01) with all outcomes favouring SSREHIT. Shortened-sprint protocols may diminish feelings of displeasure and might be a time-efficient yet tolerable exercise choice to help motivate some people to increase their physical activity and fitness.
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Affiliation(s)
- Matthew Haines
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - David Broom
- Academy for Sport and Physical Activity, Sheffield Hallam University, Sheffield, UK
| | - Warren Gillibrand
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - John Stephenson
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
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Moxley E, Bugaieski T. Exercise Intensities as Factors of Metabolic Outcomes in Type 2 Diabetes: A Systematic Review. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2019. [DOI: 10.1177/1084822318815446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Exercise is effective to prevent and treat type 2 diabetes, although currently underutilized. This review analyzes the metabolic response to exercise performance at various intensities in individuals with type 2 diabetes. These findings provide insight into the development of safe and efficacious exercise prescriptions and education. We conducted a systemic review of the literature to examine the association of various exercise protocols with metabolic outcomes in type 2 diabetes. Between 1984 and 2018, 29 studies were categorized per exercise mode and intensity levels according to the American College of Sports Medicine standards. The most consistent improvement was found in HbA1c following moderate- to high-intensity exercise—post-exercise fasting glucose improved to a lesser extent. Low-intensity exercise improved HOMA-IR (homeostasis model assessment for insulin resistance) levels. Glucose and HbA1c improved most following interval compared with continuous exercise, irrespective of intensity. A comparison of high-intensity exercise with moderate-intensity exercise demonstrated few differences in HbA1c, fasting glucose, fasting insulin, and HOMA-IR. Irrespective of exercise intensity, HbA1c improvements were observed, suggesting a delayed progression to diabetes-related complications. Initial low-intensity exercise, with increased quantities when feasible, will contribute to metabolic improvements. The variability in methodology and measurement contributed to inconsistent outcomes; additional research with larger samples sizes is warranted.
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Ito S. High-intensity interval training for health benefits and care of cardiac diseases - The key to an efficient exercise protocol. World J Cardiol 2019; 11:171-188. [PMID: 31565193 PMCID: PMC6763680 DOI: 10.4330/wjc.v11.i7.171] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 06/28/2019] [Accepted: 07/16/2019] [Indexed: 02/06/2023] Open
Abstract
Aerobic capacity, which is expressed as peak oxygen consumption (VO2peak), is well-known to be an independent predictor of all-cause mortality and cardiovascular prognosis. This is true even for people with various coronary risk factors and cardiovascular diseases. Although exercise training is the best method to improve VO2peak, the guidelines of most academic societies recommend 150 or 75 min of moderate- or vigorous- intensity physical activities, respectively, every week to gain health benefits. For general health and primary and secondary cardiovascular prevention, high-intensity interval training (HIIT) has been recognized as an efficient exercise protocol with short exercise sessions. Given the availability of the numerous HIIT protocols, which can be classified into aerobic HIIT and anaerobic HIIT [usually called sprint interval training (SIT)], professionals in health-related fields, including primary physicians and cardiologists, may find it confusing when trying to select an appropriate protocol for their patients. This review describes the classifications of aerobic HIIT and SIT, and their differences in terms of effects, target subjects, adaptability, working mechanisms, and safety. Understanding the HIIT protocols and adopting the correct type for each subject would lead to better improvements in VO2peak with higher adherence and less risk.
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Affiliation(s)
- Shigenori Ito
- Division of Cardiology, Sankuro Hospital, Aichi-ken, Toyota 4710035, Japan
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Marin DP, Astorino TA, Martinatto F, Ragazzini FT, Bispo RE, Foschini D, Otton R. Comparison of perceptual responses between different upper-body sprint interval exercise protocols. Physiol Behav 2019; 210:112626. [PMID: 31344392 DOI: 10.1016/j.physbeh.2019.112626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 10/26/2022]
Abstract
This study examined the perceptual responses to various upper-body sprint interval exercise (SIE) protocols matched for total work and work/rest ratio. Fourteen active men (24 ± 4 years, BMI = 26.2 ± 2.7 kg/m2, body fat = 11.5 ± 4.4%) participated in 3 all-out SIE protocols consisting of battling rope exercise: P10:30 (12 × 10-s bouts with 30-s recovery); P15:45 (8 × 15-s bouts with 45 s recovery); and P30:90 (4 × 30-s bouts with 90-s recovery). During exercise, affective valence (FS +5 to -5), arousal (FAS 1-6), rating of perceived exertion (RPE 6-20), and heart rate (HR) were assessed. Post-exercise, enjoyment, self-efficacy, and intentions were measured. Results revealed a significant decline in FS (p = .02; partial eta squared [η2p] = 0.27) and a progressive increase in FAS (p = .001; η2p = 0.86), RPE (p = .001; η2p = 0.88), and HR (p = .001; η2p = 0.94), but no protocol X time interaction. Affective valence reached a nadir at values equal to -0.36 ± 3.41 (Cohen's d = -0.49), -0.43 ± 3.75 (Cohen's d = -0.44), and - 0.93 ± 3.49 (Cohen's d = -0.56) in response to P10:30, P15:45, and P30:90, respectively. There were no differences between protocols for enjoyment, intention, or self-efficacy. A negative relationship exhibited between FS and RPE was moderated by participants' tolerance of exercise intensity (β = 1.84, p < .05). Further, the association between FS and future intention was mediated by self-efficacy. Overall, upper-body SIE protocols exhibit similar perceptual responses when volume and work to rest ratio (1:3) are matched. Tolerance of exercise intensity may be used to predict changes in FS during SIE.
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Affiliation(s)
- Douglas Popp Marin
- Interdisciplinary Post-graduate Program in Health Science, CBS, Cruzeiro do Sul University, São Paulo, Brazil; Graduation Program in Physical Education, Methodist University of São Paulo, São Bernardo do Campo, SP, Brazil.
| | | | - Felipe Martinatto
- Graduation Program in Physical Education, Methodist University of São Paulo, São Bernardo do Campo, SP, Brazil
| | - Filipe Teixeira Ragazzini
- Graduation Program in Physical Education, Methodist University of São Paulo, São Bernardo do Campo, SP, Brazil
| | - Rafael Eduardo Bispo
- Graduation Program in Physical Education, Methodist University of São Paulo, São Bernardo do Campo, SP, Brazil
| | - Denis Foschini
- Post-graduate program in Food, Nutrition and Health, Federal University of São Paulo, Santos, SP, Brazil
| | - Rosemari Otton
- Interdisciplinary Post-graduate Program in Health Science, CBS, Cruzeiro do Sul University, São Paulo, Brazil.
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Hedlund M, Lindelöf N, Johansson B, Boraxbekk CJ, Rosendahl E. Development and Feasibility of a Regulated, Supramaximal High-Intensity Training Program Adapted for Older Individuals. Front Physiol 2019; 10:590. [PMID: 31164835 PMCID: PMC6536694 DOI: 10.3389/fphys.2019.00590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/26/2019] [Indexed: 12/14/2022] Open
Abstract
Background: High-intensity training (HIT) with extremely short intervals (designated here as supramaximal HIT) is a time-efficient training method for health and performance. However, a protocol for regulation and control of intensity is missing, impeding implementation in various groups, such as older individuals. Methods: This study presents the development and characteristics of a novel training protocol with regulated and controlled supramaximal intervals adapted for older people. Using both quantitative and qualitative analyses, we explored the feasibility of the program, performed in a group training setting, with physically active older individuals (aged 65-75, n = 7; five women). The developed supramaximal HIT program consisted of 10 × 6 s cycle sprint intervals with ∼1 min of active recovery with the following key characteristics: (1) an individual target power output was reached and maintained during all intervals and regulated and expressed as the percentage of the estimated maximum mean power output for the duration of the interval (i.e., 6 s); (2) pedaling cadence was standardized for all participants, while resistance was individualized; and (3) the protocol enabled controlled and systematic adjustments of training intensity following standardized escalation criteria. Aim: Our aim was to test the feasibility of a novel training regimen with regulated and controlled supramaximal HIT, adapted for older people. The feasibility criteria for the program were to support participants in reaching a supramaximal intensity (i.e., power output > 100% of estimated VO2 max), avoid inducing a negative affective response, and have participants perceive it as feasible and acceptable. Results: All feasibility criteria were met. The standardized escalation procedure provided safe escalation of training load up to a supramaximal intensity (around three times the power output at estimated VO2 max). The participants never reported negative affective responses, and they perceived the program as fun and feasible. Conclusion: This novel program offers a usable methodology for further studies on supramaximal HIT among older individuals with different levels of physical capacity. Future research should explore the effects of the program in various populations of older people and their experiences and long-term adherence compared with other forms of training.
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Affiliation(s)
- Mattias Hedlund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Nina Lindelöf
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Bengt Johansson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Carl-Johan Boraxbekk
- Centre for Demographic and Aging Research (CEDAR), Umeå University, Umeå, Sweden
- Danish Research Center for Magnetic Resonance, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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Rayes ABR, de Lira CAB, Viana RB, Benedito-Silva AA, Vancini RL, Mascarin N, Andrade MS. The effects of Pilates vs. aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional tasks outcomes for individuals who are overweight/obese: a clinical trial. PeerJ 2019; 7:e6022. [PMID: 30842893 PMCID: PMC6397755 DOI: 10.7717/peerj.6022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/29/2018] [Indexed: 11/20/2022] Open
Abstract
Background Some studies have been conducted to verify the effects of Pilates for individuals who are obese, but conclusive results are not yet available due to methodological concerns. The present study aims to verify and compare the effects of Pilates and aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional task outcomes for individuals who are overweight/obese. Methods Of the sixty participants, seventeen were allocated to the control group, since the intervention protocol (Pilates or walking sessions) was during their working hours. The remaining 44 participants were randomly allocated to one of two experimental groups (Pilates (n = 22)) or aerobic groups (n = 21).The Pilates and aerobic groups attended 60-min exercise sessions, three times per week for 8 weeks. The aerobic group performed walking training at a heart rate corresponding to the ventilatory threshold. The Pilates group performed exercises on the floor, resistance apparatus, and 1-kg dumbbells. The control group received no intervention. All volunteers were evaluated at the beginning and end of the intervention. The following assessments were conducted: food intake, cardiorespiratory maximal treadmill test, isokinetic strength testing, body composition and anthropometry, abdominal endurance test, trunk extensor endurance test, flexibility test and functional (stair and chair) tests. Results There was no significant difference pre- and post-intervention in calorie intake [F(2, 57) = 0.02744, p = 0.97)]. A significant improvement in oxygen uptake at ventilatory threshold (p = 0.001; d = 0.60), respiratory compensation point (p = 0.01; d = 0.48), and maximum effort (p = 0.01; d = 0.33) was observed only in the Pilates group. Isokinetic peak torque for knee flexor and extensor muscles did not change for any groups. Lean mass (p = 0.0005; d = 0.19) and fat mass (p = 0.0001; d = 0.19) improved only in the Pilates group. Waist and hip circumference measurements decreased similarly in both experimental groups. Abdominal test performance improved more in the Pilates group (p = 0.0001; d = 1.69) than in the aerobic group (p = 0.003; d = 0.95). Trunk extensor endurance and flexibility improved only in the Pilates group (p = 0.0003; d = 0.80 and p = 0.0001; d = 0.41, respectively). The Pilates group showed greater improvement on the chair and stair tests (p = 0.0001; d = 1.48 and p = 0.003; d = 0.78, respectively) than the aerobic group (p = 0.005; d = 0.75 and p = 0.05; d = 0.41, respectively). Conclusion Pilates can be used as an alternative physical training method for individuals who are overweight or obese since it promotes significant effects in cardiorespiratory fitness, body composition, and performance on functional tests.
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Affiliation(s)
| | | | - Ricardo B Viana
- Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Ana A Benedito-Silva
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, Brazil
| | - Rodrigo L Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Naryana Mascarin
- Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Marilia S Andrade
- Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
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Viana RB, Naves JPA, Coswig VS, de Lira CAB, Steele J, Fisher JP, Gentil P. Is interval training the magic bullet for fat loss? A systematic review and meta-analysis comparing moderate-intensity continuous training with high-intensity interval training (HIIT). Br J Sports Med 2019; 53:655-664. [PMID: 30765340 DOI: 10.1136/bjsports-2018-099928] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To compare the effects of interval training and moderate-intensity continuous training (MOD) on body adiposity in humans, and to perform subgroup analyses that consider the type and duration of interval training in different groups. DESIGN Systematic review and meta-analysis. DATA SOURCES English-language, Spanish-language and Portuguese-language searches of the electronic databases PubMed and Scopus were conducted from inception to 11 December 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies that met the following criteria were included: (1) original articles, (2) human trials, (3) minimum exercise training duration of 4 weeks, and (4) directly or indirectly compared interval training with MOD as the primary or secondary aim. RESULTS Of the 786 studies found, 41 and 36 were included in the qualitative analysis and meta-analysis, respectively. Within-group analyses showed significant reductions in total body fat percentage (%) (interval training: -1.50 [95% CI -2.14 to -0.86, p<0.00001] and MOD: -1.44 [95% CI -2.00 to -0.89, p<0.00001]) and in total absolute fat mass (kg) (interval training: -1.58 [95% CI -2.74 to -0.43, p=0.007] and MOD: -1.13 [95% CI -2.18 to -0.08, p=0.04]), with no significant differences between interval training and MOD for total body fat percentage reduction (-0.23 [95% CI -1.43 to 0.97], p=0.705). However, there was a significant difference between the groups in total absolute fat mass (kg) reduction (-2.28 [95% CI -4.00 to -0.56], p=0.0094). Subgroup analyses comparing sprint interval training (SIT) with MOD protocols favour SIT for loss of total absolute fat mass (kg) (-3.22 [95% CI -5.71 to -0.73], p=0.01). Supervised training, walking/running/jogging, age (<30 years), study quality and intervention duration (<12 weeks) favourably influence the decreases in total absolute fat mass (kg) observed from interval training programmes; however, no significant effect was found on total body fat percentage (%). No effect of sex or body mass index was observed on total absolute fat mass (kg) or total body fat percentage (%). CONCLUSION Interval training and MOD both reduce body fat percentage (%). Interval training provided 28.5% greater reductions in total absolute fat mass (kg) than MOD. TRIAL REGISTRATION NUMBER CRD42018089427.
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Affiliation(s)
- Ricardo Borges Viana
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - João Pedro Araújo Naves
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | | | - James Steele
- Centre for Health, Exercise, and Sport Science, School of Sport, Health and Social Sciences, Southampton, Hampshire, UK
| | - James Peter Fisher
- Centre for Health, Exercise, and Sport Science, School of Sport, Health and Social Sciences, Southampton, Hampshire, UK
| | - Paulo Gentil
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Goiás, Brazil
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Reduced Exertion High-Intensity Interval Training is More Effective at Improving Cardiorespiratory Fitness and Cardiometabolic Health than Traditional Moderate-Intensity Continuous Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030483. [PMID: 30736402 PMCID: PMC6388288 DOI: 10.3390/ijerph16030483] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/02/2019] [Accepted: 02/03/2019] [Indexed: 02/06/2023]
Abstract
This study sought to determine the effectiveness of an 8 wk reduced-exertion high-intensity interval training (REHIT) at improving cardiorespiratory fitness (CRF) and positively modifying cardiometabolic health in the workplace environment. Participants (n = 32) were randomized to two groups: (1) One group (n = 16) was prescribed an 8 wk REHIT program, and (2) one group (n = 16) was prescribed moderate-intensity continuous training (MICT). Cardiometabolic risk factors and CRF were measured at baseline and 8 wks. After 8 wks, changes in CRF (REHIT, 12%; MICT, 7%), systolic blood pressure (REHIT, −5%; MICT, −2%), waist circumference (REHIT, −1.4%; MICT, −0.3%), and metabolic syndrome (MetS) severity (MetS z-score: REHIT, −62%; MICT, 27%) were more favorable (p < 0.05) in the REHIT group relative to the MICT group. Interestingly, there was a significantly greater proportion of participants in the REHIT group (75%, 9/12) who had a favorable change in the MetS z-score (Δ > −0.60) relative to the MICT group (47%, 7/15). The main finding of the present study is that 8 wks REHIT elicited more potent and time-efficient improvements in CRF and cardiometabolic health when compared to traditional MICT. This study provides critical evidence for implementation of the sprint interval training (SIT) paradigm from the scientific literature into a real-world workplace setting.
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Both aging and exercise training alter the rate of recovery of neuromuscular performance of male soleus muscles. Biogerontology 2018; 20:213-223. [DOI: 10.1007/s10522-018-9788-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/26/2018] [Indexed: 01/06/2023]
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