Effects of a low-volume aerobic-type interval exercise on VO2max and cardiac mass

Different High-Intensity Interval Training Programs versus Moderate Intensity Continuous Training for Heart Failure Patients: a systematic review and meta-analysis

OBJECTIVE

To explore the effect sizes of different HIIT protocols on cardiorespiratory parameters when compared with the MICT in different HF subtypes.

DATA SOURCES

Electronic databases were searched from their inception date until January 23rd, 2023.

STUDY SELECTION

Randomized controlled trials (RCTs) were included if they compared HIIT to MICT in HF patients. The primary outcomes was peak oxygen consumption (VO2peak). Two reviewers independently evaluated 99 initially identified studies, resulting in the selection of 15 RCTs that met the eligibility criteria.

DATA EXTRACTION

Data was extracted independently by two observers using data extraction form drafted based on the CONSORT statement and the TIDieR; and the The methodological quality of the studies was analyzed individually based on the TESTEX scale.

DATA SYNTHESIS

Fifteen RCTs with 553 HF patients were included in the systematic review. The studies included had moderate to good overall methodological quality. The results showed that HIIT was generally more effective than MICT at improving VO2peak in HF patients (n=541, 15 RCT; MD: 1.49 mL/kg/min, I2=66%, p<0.001). However, the effect size varied depending on the HF subtype and HIIT protocol used. For HFrEF patients, the long-interval (high-intensity interval lasting≥ 4 min) and high-volume HIIT (high-intensity efforts in total ≥ 15 min) showed the largest benefits over the MICT (n=261, 6 RCT; MD: 2.11 mL/kg/min, p<0.001); followed by the short-interval (≤ 1 min) and high-volume HIIT (≥ 15 min; n=71, 3 RCT; MD: 0.91 mL/kg/min, p=0.12); and the short-interval and low-volume HIIT showed the least superiority over MICT (n=68, 3 RCT; MD: 0.54 mL/kg/min; p=0.05). For HFpEF patients, there was a modest beneficial effect from HIIT over MICT (n=141, 3 RCT; MD: 0.55 mL/kg/min; p=0.32).

CONCLUSIONS

The long-interval and high-volume HIIT protocol may produce greater benefits than MICT for improving cardiopulmonary fitness in HFrEF patients. Further research is needed to determine the optimal HIIT protocol for different HF subtypes and to provide definitive recommendations for clinical practice.

High-intensity interval training improves respiratory and cardiovascular adjustments before and after initiation of exercise

Purpose: High-intensity interval training (HIIT) may induce training-specific physiological adaptations such as improved respiratory and cardiovascular adjustments before and after the onset of high-intensity exercise, leading to improved exercise performance during high-intensity exercise. The present study investigated the effects of HIIT on time-dependent cardiorespiratory adjustment during maximal exercise and before and after initiation of high-intensity exercise, as well as on maximal exercise performance. Methods: 21 healthy male college students were randomly assigned to HIIT group (n = 11) or control group (n = 10). HIIT group performed training on a cycle ergometer once a week for 8 weeks. The training consisted of three bouts of exercise at 95% maximal work rate (WRmax) until exhaustion. Before and after the HIIT program, dynamic cardiorespiratory function was investigated by ramp and step exercise tests, and HIIT-induced cardiac morphological changes were assessed using echocardiography. Results: HIIT significantly improved not only maximal oxygen uptake and minute ventilation, but also maximal heart rate (HR), systolic blood pressure (SBP), and time to exhaustion in both exercise tests (p < 0.05). Time-dependent increases in minute ventilation (VE) and HR before and at the start of exercise were significantly enhanced after HIIT. During high-intensity exercise, there was a strong correlation between percent change (from before to after HIIT program) in time to exhaustion and percent change in HRmax (r = 0.932, p < 0.001). Furthermore, HIIT-induced cardiac morphological changes such as ventricular wall hypertrophy was observed (p < 0.001). Conclusion: We have demonstrated that HIIT at 95% WRmax induces training-specific adaptations such as improved cardiorespiratory adjustments, not only during maximal exercise but also before and after the onset of high-intensity exercise, improvement of exercise performance mainly associated with circulatory systems.

Is low-volume high-intensity interval training a time-efficient strategy to improve cardiometabolic health and body composition? A meta-analysis

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.

The Additional Effect of Training Above the Maximal Metabolic Steady State on VO2peak, Wpeak and Time-Trial Performance in Endurance-Trained Athletes: A Systematic Review, Meta-analysis, and Reality Check

BACKGROUND

To improve sport performance, athletes use training regimens that include exercise below and above the maximal metabolic steady state (MMSS).

OBJECTIVE

The objective of this review was to determine the additional effect of training above MMSS on VO2peak, Wpeak and time-trial (TT) performance in endurance-trained athletes.

METHODS

Studies were included in the review if they (i) were published in academic journals, (ii) were in English, (iii) were prospective, (iv) included trained participants, (v) had an intervention group that contained training above and below MMSS, (vi) had a comparator group that only performed training below MMSS, and (vii) reported results for VO2peak, Wpeak, or TT performance. Medline and SPORTDiscus were searched from inception until February 23, 2023.

RESULTS

Fourteen studies that ranged from 2 to 12 weeks were included in the review. There were 171 recreational and 128 competitive endurance athletes. The mean age and VO2peak of participants ranged from 15 to 43 years and 38 to 68 mL·kg-1·min-1, respectively. The inclusion of training above MMSS led to a 2.5 mL·kg-1·min-1 (95% CI 1.4-3.6; p < 0.01; I2 = 0%) greater improvement in VO2peak. A minimum of 81 participants per group would be required to obtain sufficient power to determine a significant effect (SMD 0.44) for VO2peak. No intensity-specific effect was observed for Wpeak or TT performance, in part due to a smaller sample size.

CONCLUSION

A single training meso-cycle that includes training above MMSS can improve VO2peak in endurance-trained athletes more than training only below MMSS. However, we do not have sufficient evidence to conclude that concurrent adaptation occurs for Wpeak or TT performance.

Rates of compliance and adherence to high-intensity interval training: a systematic review and Meta-analyses

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.

Extraordinary Claims in the Literature on High-Intensity Interval Training (HIIT): I. Bonafide Scientific Revolution or a Looming Crisis of Replication and Credibility?

The literature on high-intensity interval training (HIIT) contains claims that, if true, could revolutionize the science and practice of exercise. This critical analysis examines two varieties of claims: (i) HIIT is effective in improving various indices of fitness and health, and (ii) HIIT is as effective as more time-consuming moderate-intensity continuous exercise. Using data from two recent systematic reviews as working examples, we show that studies in both categories exhibit considerable weaknesses when judged through the prism of fundamental statistical principles. Predominantly, small-to-medium effects are investigated in severely underpowered studies, thus greatly increasing the risk of both type I and type II errors of statistical inference. Studies in the first category combine the volatility of estimates associated with small samples with numerous dependent variables analyzed without consideration of the inflation of the type I error rate. Studies in the second category inappropriately use the p > 0.05 criterion from small studies to support claims of 'similar' or 'comparable' effects. It is concluded that the situation in the HIIT literature is reminiscent of the research climate that led to the replication crisis in psychology. As in psychology, this could be an opportunity to reform statistical practices in exercise science.

Estimation methods to detect changes in cardiorespiratory fitness due to exercise training and subsequent detraining

PURPOSE

To determine whether estimated maximal oxygen consumption ([Formula: see text]) can detect cardiorespiratory fitness (CRF) changes by behavioral modifications. This study compared changes in measured [Formula: see text]O_2max (m[Formula: see text]O_2max) through exercise intervention with e[Formula: see text]O_2max using a multiple regression model (MRM) and linear extrapolation method (LEM).

METHODS

A cross-sectional analysis involving 173 adults was conducted to establish an MRM by including age, sex, body mass index, questionnaire score, heart rate (HR) from step test, and m[Formula: see text]O_2max. Subsequently, 15 men participated in an intervention experiment comprising an 8-week, high-intensity interval training, followed by 8-week detraining, and completed anthropometric measurements, questionnaires, step tests, and m[Formula: see text]O_2max tests. m[Formula: see text]O_2max changes throughout the intervention were compared to e[Formula: see text]O_2max changes calculated using the MRM and LEM. The LEM used the HR during the step test with constant values (predetermined [Formula: see text]O₂), such as the Chester step test.

RESULTS

Inclusion of the step test HR in a questionnaire-based MRM improved the estimation power, although the MRM underestimated higher m[Formula: see text]O_2max values. In the intervention, m[Formula: see text]O_2max increased by 20.0 ± 14.1% (P < 0.01) and subsequently decreased by 9.5 ± 6.6% (P < 0.01) after exercise training and detraining, respectively. Significant method × time interactions were observed between m[Formula: see text]O_2max and e[Formula: see text]O_2max in the MRM but not in the LEM, i.e., an apparent systematic error (underestimation of high values) of the MRM was absent in the LEM, although the correlation between m[Formula: see text]O_2max and e[Formula: see text]O_2max using the LEM was moderate.

CONCLUSION

e[Formula: see text]O_2max, particularly using the MRM with HR as an explanatory factor, is not an appropriate method for detecting CRF changes along with behavioral modifications.

CLINICAL TRIAL REGISTRATION

Registered number, UMIN000041031; Registered date, 2020/07/08; URL, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046855.

Exercise and Airway Clearance Techniques in Cystic Fibrosis

Exercise and airway clearance techniques (ACTs) have been a cornerstone of treatment for people with cystic fibrosis (pwCF) for many decades. Exercise may confer both respiratory and nonrespiratory benefits for pwCF, with greater exercise capacity associated with improved survival. A wide variety of exercise interventions for pwCF have been investigated. ACTs may assist in reducing respiratory symptoms for pwCF and are currently recommended to be performed daily, with the types of ACTs used varying globally. While recommended components of care, both exercise and ACTs are time-intensive and maintaining adherence to the recommendations over the longer term can be challenging. It has been proposed that with advances in the therapeutic options for pwCF, a rationalization of the therapeutic regimen may be possible. We summarize the current evidence for the use of exercise and ACTs by pwCF, discuss the implications of the introduction of cystic fibrosis transmembrane conductance regulator modulators on both exercise and ACTs, and highlight areas for further research.

Change in Central Cardiovascular Function in Response to Intense Interval Training: A Systematic Review and Meta-analysis

INTRODUCTION

High-intensity interval training and sprint interval training significantly increase maximal oxygen uptake (V̇O 2max ), which enhances endurance performance and health status. Whether this response is due to increases in central cardiovascular function (cardiac output (CO) and blood volume) or peripheral factors is unknown.

PURPOSE

This study aimed to conduct a systematic review and meta-analysis to assess the effects of high-intensity interval training and sprint interval training (referred to as intense interval training) on changes in central cardiovascular function.

METHODS

We performed a systematic search of eight databases for studies denoting increases in V̇O 2max in which CO, stroke volume (SV), blood volume, plasma volume, end-diastolic/systolic volume, or hematocrit were measured.

RESULTS

Forty-five studies were included in this analysis, comprising 946 men and women of various health status (age and V̇O 2max , 20-76 yr and 13-61 mL·kg -1 ·min -1 ) who performed 6-96 sessions of interval training. Results showed an increase in V̇O 2max with intense interval training that was classified as a large effect ( d = 0.83). SV ( d = 0.69), and CO ( d = 0.49) had moderate effect sizes in response to intense interval training. Of 27 studies in which CO was measured, 77% exhibited significant increases in resting CO or that obtained during exercise. Similarly, 93% of studies revealed significant increases in SV in response to intense interval training. Effect sizes for these outcomes were larger for clinical versus healthy populations. Plasma volume, blood volume, and hematocrit had small effect sizes after training ( d = 0.06-0.14).

CONCLUSIONS

Increases in V̇O 2max demonstrated with intense interval training are attendant with increases in central O 2 delivery with little contribution from changes in hematocrit, blood volume, or plasma volume.

Risk of bias and reporting practices in studies comparing VO2max responses to sprint interval vs. continuous training: A systematic review and meta-analysis

BACKGROUND

It remains unclear whether studies comparing maximal oxygen uptake (VO_2max) response to sprint interval training (SIT) vs. moderate-intensity continuous training (MICT) are associated with a high risk of bias and poor reporting quality. The purpose of this study was to evaluate the risk of bias and quality of reporting in studies comparing changes in VO_2max between SIT and MICT.

METHODS

We conducted a comprehensive literature search of 4 major databases: AMED, CINAHL, EMBASE, and MEDLINE. Studies were excluded if participants were not healthy adult humans or if training protocols were unsupervised, lasted less than 2 weeks, or utilized mixed exercise modalities. We used the Cochrane Collaboration tool and the CONSORT checklist for non-pharmacological trials to evaluate the risk of bias and reporting quality, respectively.

RESULTS

Twenty-eight studies with 30 comparisons (3 studies included 2 SIT groups) were included in our meta-analysis (n = 360 SIT participants: body mass index (BMI) = 25.9 ± 3.7 kg/m², baseline VO_2max = 37.9 ± 8.0 mL/kg/min; n = 359 MICT participants: BMI = 25.5 ± 3.8 kg/m², baseline VO_2max = 38.3 ± 8.0 mL/kg/min; all mean ± SD). All studies had an unclear risk of bias and poor reporting quality.

CONCLUSION

Although we observed a lack of superiority between SIT and MICT for improving VO_2max (weighted Hedge's g = -0.004, 95% confidence interval (95%CI): -0.08 to 0.07), the overall unclear risk of bias calls the validity of this conclusion into question. Future studies using robust study designs are needed to interrogate the possibility that SIT and MICT result in similar changes in VO_2max.

Acute Effects of Whole-Body Electromyostimulation on Energy Expenditure at Resting and during Uphill Walking in Healthy Young Men

The effects of the different electrical frequencies of whole-body electrical stimulation (WB-EMS) on energy expenditure (EE) and the respiratory exchange ratio (RER) remain poorly understood. This study aimed to determine the effects of different WB-EMS electrical frequencies on EE and the RER during supine resting and uphill walking. A total of 10 healthy and recreationally active men (21.6 ± 3.3 years old) participated in the present study. Participants completed two testing sessions in a randomized order. In each session, a variety of impulse frequencies (1 hertz (Hz), 2 Hz, 4 Hz, 6 Hz, 8 Hz, and 10 Hz) were applied in a randomized order, allowing a 10 min passive recovery between them. Oxygen consumption and carbon dioxide production were measured to calculate EE and the RER. All frequencies increased EE at rest (all p ≤ 0.001), with 4 Hz being the frequency producing the highest increase (Δ = 8.89 ± 1.49 kcal/min), as did 6 Hz (Δ = 8.05 ± 1.52 kcal/min) and 8 Hz (Δ = 7.04 ± 2.16 kcal/min). An increment in the RER at rest was observed with 4 Hz, 6 Hz, 8 Hz and 10 Hz (all p ≤ 0.016), but not with 1 Hz and 2 Hz (p ≥ 0.923). During uphill walking, the frequency that elicited the highest increase in EE was 6 Hz (Δ = 4.87 ± 0.84 kcal/min) compared to the unstimulated condition. None of the impulse frequencies altered the RER during uphill walking. WB-EMS increases EE in healthy young men both during resting and uphill walking.

Effectiveness of Whole-Body High-Intensity Interval Training on Health-Related Fitness: A Systematic Review and Meta-Analysis

Due to its versatility, whole-body high-intensity interval training (WB-HIIT) can be proposed to the general population and patients to improve health-related fitness. However, its effectiveness compared to traditional aerobic continuous or interval trainings has yet to be determined. A search of four electronic databases was conducted. Studies reporting the effects of WB-HIIT on cardiorespiratory fitness (CRF), fat mass, fat-free mass, musculoskeletal fitness and metabolic risk factors were included. Standardized mean differences (SMD) between WB-HIIT and no exercise or traditional aerobic trainings were calculated. A meta-regression assessed the effect of total training time on the different outcomes. Twenty-two studies were included in the systematic review and nineteen in the meta-analysis. Compared to no exercise, WB-HIIT improves CRF (SMD: 0.75; 95%CI: 0.28, 1.23; p < 0.001), fat-free mass (SMD: 0.38; 95%CI: 0.11, 0.65; p < 0.001), fat mass (SMD: 0.40; 95%CI: 0.09, 0.72; p < 0.001) and musculoskeletal fitness (SMD: 0.84; 95%CI: 0.61, 1.08; p < 0.001). Compared to other aerobic trainings, WB-HIIT has a lower effect on CRF (SMD: −0.40; 95%CI: −0.70, −0.11; p = 0.007), a similar effect on fat-free mass (SMD: −0.04; 95%CI: −0.44, 0.35; p = 0.8) and fat mass (SMD: −0.07; 95%CI: −0.39, 0.25; p = 0.7), and a larger effect on musculoskeletal fitness (SMD: 0.42; 95%CI: 0.14, 0.71; p = 0.003). WB-HIIT overall effect and specific effect on CRF and fat mass were associated with total training time. The systematic review did not provide evidence of metabolic risk improvement. Despite a slightly lower effect on CRF, WB-HIIT is equally effective as traditional aerobic trainings to improve body composition and more effective to enhance musculoskeletal fitness, which is essential for execution of daily tasks.

A Sports Nutrition Perspective on the Impacts of Hypoxic High-Intensity Interval Training (HIIT) on Appetite Regulatory Mechanisms: A Narrative Review of the Current Evidence

High-intensity interval training (HIIT) and low-oxygen exposure may inhibit the secretion of appetite-stimulating hormones, suppress appetite, and inhibit dietary intake. Physiological changes affecting appetite are frequent and include appetite hormone (ghrelin, leptin, PYY, and GLP-1) effects and the subjective loss of appetite, resulting in nutritional deficiencies. This paper is a narrative review of the literature to verify the HIIT effect on appetite regulation mechanisms and discusses the possible relationship between appetite effects and the need for high-intensity exercise training in a hypoxic environment. We searched MEDLINE/PubMed and the Web of Science databases, as well as English articles (gray literature by Google Scholar for English articles) through Google Scholar, and the searched studies primarily focused on the acute effects of exercise and hypoxic environmental factors on appetite, related hormones, and energy intake. In a general normoxic environment, regular exercise habits may have accustomed the athlete to intense training and, therefore, no changes occurred in their subjective appetite, but there is a significant effect on the appetite hormones. The higher the exercise intensity and the longer the duration, the more likely exercise is to cause exercise-induced appetite loss and changes in appetite hormones. It has not been clear whether performing HIIT in a hypoxic environment may interfere with the exerciser’s diet or the nutritional supplement intake as it suppresses appetite, which, in turn, affects and interferes with the recovery efficiency after exercise. Although appetite-regulatory hormones, the subjective appetite, and energy intake may be affected by exercise, such as hypoxia or hypoxic exercise, we believe that energy intake should be the main observable indicator in future studies on environmental and exercise interventions.

Effect of Interval Training on the Factors Influencing Maximal Oxygen Consumption: A Systematic Review and Meta-Analysis

BACKGROUND

The maximal rate of oxygen consumption (VO_2max) is an important measure in exercise science as it is an indicator of cardiorespiratory fitness. Individual studies have identified central and peripheral adaptions to interval training that may underlie improvements in VO_2max, but there is no compilation of results.

OBJECTIVE

We aimed to systematically review the adaptive responses to high-intensity interval training (HIIT) and sprint interval training (SIT) on the central and peripheral factors influencing VO_2max in healthy individuals.

DATA SOURCES

SPORTDiscus and MEDLINE (up to and including 13 June, 2020) were explored to conduct the literature search.

STUDY SELECTION

Reviewed studies met the following criteria: (1) were in the English language; (2) prospective in nature; (3) included at least three interval sessions or were at least 1 week in duration; (4) contained HIIT or SIT; (5) involved participants between the ages of 18 and 65 years; and (6) included at least one of the following central (blood volume, plasma volume, hemoglobin mass, left ventricular mass, maximal stroke volume, maximal cardiac output) or peripheral factors (capillary density, maximal citrate synthase activity, mitochondrial respiration associated with VO_2max).

RESULTS

Thirty-two studies (369 participants, 49 were female) were included in the quantitative analyses, consisting of both HIIT (n = 18) and SIT (n = 17) interventions. There were only statistically significant changes in hematological measures (plasma volume) following HIIT. There was a significant increase in left ventricular mass following HIIT (7.4%, p < 0.001) and SIT (5.3%, p = 0.007) in inactive individuals, though the change following SIT may be misleading. There was only a significant increase in maximal stroke volume (14.1%, p = 0.015) and maximal cardiac output (12.6%, p = 0.002) following HIIT. In addition to central factors, there was a significant increase in capillary density (13.8%, p < 0.001) following SIT in active individuals. With respect to maximal citrate synthase activity, there were improvements following HIIT (20.8%, p < 0.001) and SIT (15.7%, p < 0.001, I² = 97%) in active individuals. The results for mitochondrial respiration suggested that there was no statistically significant improvement following HIIT (5.0%, p = 0.585).

CONCLUSIONS

Improvements in the central and peripheral factors influencing VO_2max were dependent on the interval type. Only HIIT led to a statistically significant improvement in cardiac function. Both HIIT and SIT increased maximal citrate synthase activity, while changes in other peripheral measures (capillary density, mitochondrial respiration) only occurred with SIT.

Effects of Acute Partial Sleep Deprivation and High-Intensity Interval Exercise on Postprandial Network Interactions

Introduction: High-intensity interval exercise (HIIE) is deemed effective for cardiovascular and autonomic nervous system (ANS) health-related benefits, while ANS disturbance increases the risk for cardiovascular disease (CVD). Postprandial lipemia and acute-partial sleep deprivation (APSD) are considered as CVD risk factors due to their respective changes in ANS. Exercising in the morning hours after APSD and have a high-fat breakfast afterwards may alter the interactions of the cardiovascular, autonomic regulation, and postprandial lipemic systems threatening individuals' health. This study examined postprandial network interactions between autonomic regulation through heart rate variability (HRV) and lipemia via low-density lipoprotein (LDL) cholesterol in response to APSD and HIIE. Methods: Fifteen apparently healthy and habitually good sleepers (age 31 ± 5.2 SD yrs) completed an acute bout of an isocaloric HIIE (in form of 3:2 work-to-rest ratio at 90 and 40% of VO₂ reserve) after both a reference sleep (RSX) and 3-3.5 h of acute-partial sleep deprivation (SSX) conditions. HRV time and frequency domains and LDL were evaluated in six and seven time points surrounding sleep and exercise, respectively. To identify postprandial network interactions, we constructed one correlation analysis and one physiological network for each experimental condition. To quantify the interactions within the physiological networks, we also computed the number of links (i.e., number of significant correlations). Results: We observed an irruption of negative links (i.e., negative correlations) between HRV and LDL in the SSX physiological network compared to RSX. Discussion: We recognize that a correlation analysis does not constitute a true network analysis due to the absence of analysis of a time series of the original examined physiological variables. Nonetheless, the presence of negative links in SSX reflected the impact of sleep deprivation on the autonomic regulation and lipemia and, thus, revealed the inability of HIIE to remain cardioprotective under APSD. These findings underlie the need to further investigate the effects of APSD and HIIE on the interactions among physiological systems.

HIIT vs. SIT: What Is the Better to Improve V˙O2max? A Systematic Review and Meta-Analysis

Lack of time is seen as a barrier to maintaining a physically active lifestyle. In this sense, interval training has been suggested as a time-efficient strategy for improving health, mainly due to its potential to increase cardiorespiratory fitness. Currently, the most discussed interval training protocols in the literature are the high-intensity interval training (HIIT) and the sprint interval training (SIT). Objective: We investigated, through a systematic review and meta-analysis, which interval training protocol, HIIT or SIT, promotes greater gain in cardiorespiratory fitness (V˙O2max/peak). The studies were selected from the PubMed (MEDLINE), Scopus and Web of Science databases. From these searches, a screening was carried out, selecting studies that compared the effects of HIIT and SIT protocols on V˙O2max/peak. A total of 19 studies were included in the final analysis. Due to the homogeneity between studies (I2 = 0%), fixed-effects analyses were performed. There was no significant difference in the V˙O2max/peak gains between HIIT and SIT for the standardized mean difference (SMD = 0.150; 95% CI = -0.038 to 0.338; p = 0.119), including studies that presented both measurements in mL·kg-1·min-1 and l·min-1; and raw mean differences (RMD = 0.921 mL·kg-1·min-1; 95% CI = -0.185 to 2.028; p = 0.103) were calculated only with data presented in mL·kg-1·min-1. We conclude that the literature generates very consistent data to confirm that HIIT and SIT protocols promote similar gains in cardiorespiratory fitness. Thus, for this purpose, the choice of the protocol can be made for convenience.

Effects of High-Intensity Interval Exercise and Acute Partial Sleep Deprivation on Cardiac Autonomic Modulation

Sleep deprivation in healthy adults has been associated with disrupted autonomic nervous system function, which in turn has been linked to cardiovascular health. High-intensity interval exercise (HIIE) may affect both sleep and cardiac autonomic modulation. Purpose: To investigate the impact of acute partial sleep deprivation on autonomic cardiac regulation before and after an acute bout of HIIE and the length of time for the autonomic system to return to resting levels. Methods: Fifteen healthy males with body mass index (BMI) of 25.8 ± 2.7 kg·m^-2 and age 31 ± 5 y participated in a reference sleep (~9.5 hr) with no HIIE (RS), a reference sleep with HIIE (RSX), and an acute partial sleep deprivation (~3.5 hr) with HIIE (SDX). HIIE was performed in 3:2 intervals at 90% and 40% of VO₂ reserve. Autonomic regulation through HRV selected time and frequency domain indices were recorded the night before, the morning of the next day, 1 hr-, 2 hr-, 4hr-, and 6-hr post-exercise. Results: HIIE performed in a 3:2 W:R ratio decreased the HRV (p < .05) at 1-hr post exercise and it took up to 4 hr to return to baseline levels. Parasympathetic related HRV indices increased the morning of the next day for SDX (p < .05). Acute partial sleep deprivation and HIIE did not modify the HRV responses compared to reference sleep and HIIE. Conclusion: HRV disturbance typically seen in responses to an acute episode of HIIE is not influenced by acute partial sleep deprivation.

[Physical exercise and loss of weight and body mass index in bariatric surgery: a systematic review]

INTRODUCTION

bariatric surgery is considered successful when the percentage of weight loss is equal to or higher than 25 %, or when the percentage loss of body mass index occurs above 50 % long-term.

OBJECTIVE

to analyze the effect of physical exercise on body weight and body mass index before and/or after bariatric surgery.

METHODOLOGY

articles registered in the PudMed, Scopus and Web of Science databases were searched for original papers with open access in English and Spanish that compared one or more physical exercise programs as treatment before and/or after bariatric surgery, with results on initial and final weight and body mass index, muscle mass, and fat mass from January to April 2021.

RESULTS

a total of 730 articles were obtained in the different databases and only 7 were selected for the analysis. Aerobic exercise combined with resistance training showed a greater decrease in the percentage of weight loss (% PP) and the percentage of loss of body mass index (% PBMI).

CONCLUSIONS

aerobic physical exercise in combination with endurance training is the most applied program in subjects with bariatric surgery, and the most important effects are an increase in percentage of weight loss and a decrease in body mass index.

Optimizing Outcomes in Cardiac Rehabilitation: The Importance of Exercise Intensity

Exercise based cardiac rehabilitation (CR) is recognized internationally as a class 1 clinical practice recommendation for patients with select cardiovascular diseases and heart failure with reduced ejection fraction. Over the past decade, several meta-analyses have generated debate regarding the effectiveness of exercise-based CR for reducing all-cause and cardiovascular mortality. A common theme highlighted in these meta-analyses is the heterogeneity and/or lack of detail regarding exercise prescription methodology within CR programs. Currently there is no international consensus on exercise prescription for CR, and exercise intensity recommendations vary considerably between countries from light-moderate intensity to moderate intensity to moderate-vigorous intensity. As cardiorespiratory fitness [peak oxygen uptake (VO₂peak)] is a strong predictor of mortality in patients with coronary heart disease and heart failure, exercise prescription that optimizes improvement in cardiorespiratory fitness and exercise capacity is a critical consideration for the efficacy of CR programming. This review will examine the evidence for prescribing higher-intensity aerobic exercise in CR, including the role of high-intensity interval training. This discussion will highlight the beneficial physiological adaptations to pulmonary, cardiac, vascular, and skeletal muscle systems associated with moderate-vigorous exercise training in patients with coronary heart disease and heart failure. Moreover, this review will propose how varying interval exercise protocols (such as short-duration or long-duration interval training) and exercise progression models may influence central and peripheral physiological adaptations. Importantly, a key focus of this review is to provide clinically-relevant recommendations and strategies to optimize prescription of exercise intensity while maximizing safety in patients attending CR programs.

Effects and dose-response relationship of high-intensity interval training on cardiorespiratory fitness in overweight and obese adults: a systematic review and meta-analysis

This study aims to quantify the effects of high-intensity interval training (HIIT) on cardiorespiratory fitness (CRF) by considering potential moderators and to characterise dose-response relationships of HIIT variables that could maximise CRF improvements in overweight and obese adults. Following a comprehensive search through four electronic databases, 19 studies met eligibility criteria. Random-effects models were applied to weight all included studies and to compute the weighted mean standardised mean differences (SMD_wm). Meta-analysis showed that HIIT was a highly effective approach for improving CRF in overweight and obese adults (SMD_wm = 1.13). Effects were modified by sex and baseline CRF level. Dose-response relationship analysis provided some preliminary data regarding the training period, training intensity, and session duration. However, it is still not possible to provide accurate recommendations currently. Further studies are still needed to identify the most appropriate training variables to prescribe effective HIIT programmes for improving CRF in overweight and obese adults.

Indicators of response to exercise training: a systematic review and meta-analysis

BACKGROUND

Means-based analysis of maximal rate of oxygen consumption (VO2max) has traditionally been used as the exercise response indicator to assess the efficacy of endurance (END), high intensity interval (HIIT) and resistance exercise training (RET) for improving cardiorespiratory fitness and whole-body health. However, considerable heterogeneity exists in the interindividual variability response to the same or different training modalities.

OBJECTIVES

We performed a systematic review and meta-analysis to investigate exercise response rates in the context of VO2max: (1) in each training modality (END, HIIT and RET) versus controls, (2) in END versus either HIIT or RET and (3) exercise response rates as measured by VO2max versus other indicators of positive exercise response in each exercise modality.

METHODS

Three databases (EMBASE, MEDLINE, CENTRAL) and additional sources were searched. Both individual response rate and population average data were incorporated through continuous data, respectively. Of 3268 identified manuscripts, a total of 29 studies were suitable for qualitative synthesis and a further 22 for quantitative. Stratification based on intervention duration (less than 12 weeks; more than or equal to 12 weeks) was undertaken.

RESULTS

A total of 62 data points were procured. Both END and HIIT training exhibited differential improvements in VO2max based on intervention duration. VO2max did not adequately differentiate between END and HIIT, irrespective of intervention length. Although none of the other exercise response indicators achieved statistical significance, LT and HRrest demonstrated common trajectories in pooled and separate analyses between modalities. RET data were highly limited. Heterogeneity was ubiquitous across all analyses.

CONCLUSIONS

The potential for LT and HRrest as indicators of exercise response requires further elucidation, in addition to the exploration of interventional and intrinsic sources of heterogeneity.

Evidence-Based Effects of High-Intensity Interval Training on Exercise Capacity and Health: A Review with Historical Perspective

Engaging in regular exercise results in a range of physiological adaptations offering benefits for exercise capacity and health, independent of age, gender or the presence of chronic diseases. Accumulating evidence shows that lack of time is a major impediment to exercise, causing physical inactivity worldwide. This issue has resulted in momentum for interval training models known to elicit higher enjoyment and induce adaptations similar to or greater than moderate-intensity continuous training, despite a lower total exercise volume. Although there is no universal definition, high-intensity interval exercise is characterized by repeated short bursts of intense activity, performed with a "near maximal" or "all-out" effort corresponding to ≥90% of maximal oxygen uptake or >75% of maximal power, with periods of rest or low-intensity exercise. Research has indicated that high-intensity interval training induces numerous physiological adaptations that improve exercise capacity (maximal oxygen uptake, aerobic endurance, anaerobic capacity etc.) and metabolic health in both clinical and healthy (athletes, active and inactive individuals without any apparent disease or disorder) populations. In this paper, a brief history of high-intensity interval training is presented, based on the novel findings of some selected studies on exercise capacity and health, starting from the early 1920s to date. Further, an overview of the mechanisms underlying the physiological adaptations in response to high-intensity interval training is provided.

Effect of High-Intensity Interval Training Versus Sprint Interval Training on Time-Trial Performance: A Systematic Review and Meta-analysis

BACKGROUND

Two forms of interval training commonly discussed in the literature are high-intensity interval training (HIIT) and sprint interval training (SIT). HIIT consists of repeated bouts of exercise that occur at a power output or velocity between the second ventilatory threshold and maximal oxygen consumption (VO_2max). SIT is performed at a power output or velocity above those associated with VO_2max.

OBJECTIVE

The primary objective of this study is to systematically review published randomized and pair-matched trials to determine which mode of interval training, HIIT versus SIT, leads to a greater improvement in TT performance in active and trained individuals. The second objective of this review is to perform a subgroup analysis to determine if there is a distinction between HIIT programs that differ in work-bout duration.

DATA SOURCES

SPORTDiscus (1800-present) and Medline with Full Text (1946-present) were used to conduct a systematic literature search.

STUDY SELECTION

Studies were selected for the review if they met the following criteria: (1) individuals (males and females) who were considered at least moderately trained (~ 3-h per week of activity) as specified by the authors of the included studies; (2) between the ages of 18 and 45 years; (3) randomized or pair-matched trials that included a HIIT and a SIT group; (4) provided detailed information about the interval training program; (5) were at least 2 weeks in duration; (6) included a TT test that required participants to complete a set distance.

RESULTS

A total of 6 articles met the inclusion criteria for the subjective and objective analysis. The pooled analysis was based on a random-effects model. There was no difference in the change in TT performance when comparing all HIIT versus SIT (0.9%; 90% CI - 1.2-1.9%, p = 0.18). However, subgroup analysis based on duration of work interval indicated a 2% greater improvement in TT performance following long-HIIT (≥ 4 min) when compared to SIT. There was no difference in change in VO_2max/_peak oxygen consumption (VO_2peak) between groups. There was a moderate effect (ES = 0.70) in favor of HIIT over SIT in maximal aerobic power (MAP) or maximal aerobic velocity (MAV).

CONCLUSION

The results of the meta-analysis indicate that long-HIIT may be the optimal form of interval training to augment TT performance. Additional research that directly compares HIIT exercise differing in work-bout duration would strengthen these results and provide further insight into the mechanisms behind the observed benefits of long-HIIT.

Low-volume high-intensity interval training for cardiometabolic health

High-intensity interval training (HIIT) is characterised by short bouts of high-intensity submaximal exercise interspersed with rest periods. Low-volume HIIT, typically involving less than 15 min of high-intensity exercise per session, is being increasingly investigated in healthy and clinical populations due to its time-efficient nature and purported health benefits. The findings from recent trials suggest that low-volume HIIT can induce similar, and at times greater, improvements in cardiorespiratory fitness, glucose control, blood pressure, and cardiac function when compared to more traditional forms of aerobic exercise training including high-volume HIIT and moderate intensity continuous training, despite requiring less time commitment and lower energy expenditure. Although further studies are required to elucidate the precise mechanisms of action, metabolic improvements appear to be driven, in part, by enhanced mitochondrial function and insulin sensitivity, whereas certain cardiovascular improvements are linked to increased left ventricular function as well as greater central and peripheral arterial compliance. Beyond the purported health benefits, low-volume HIIT appears to be safe and well-tolerated in adults, with high rates of reported exercise adherence and low adverse effects.

Effect of physical exercise in bariatric surgery patients: protocol of a randomized controlled clinical trial

BACKGROUND

Bariatric surgery is an effective approach to weight loss and long-term comorbidity resolution. Although recommended in several guidelines, supervised exercise has not been systematically prescribed after bariatric surgery. The aim of this study is to determine the effects of two types of exercise, moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT), on body composition, cardiopulmonary function, and perceived quality of life in bariatric surgery patients.

METHODS

This randomized controlled exploratory pilot trial will include 75 adults of both sexes scheduled for bariatric surgery. They will be randomly assigned to one of three groups: (1) MICT, (2) HIIT, or (3) a control group. The intervention will occur 2 days a week for 4 months. Outcomes will be assessed at four points: (1) 1 week before surgery, (2) 21 days after surgery (baseline before the exercise program), (3) 8 weeks after beginning the exercise program, and (4) 1 week after the end of intervention. Primary outcomes will include body composition, heart rate variability, and 6-min walk test and quality of life scores. Secondary outcomes will be maximal respiratory pressure, flowmeter, hand dynamometry, and 30-s sit-to-stand test results.

DISCUSSION

Both exercise protocols in this study were developed according to evidence-based practice. It is expected that, after 16 weeks of intervention, body composition (measured by electrical bioimpedance), cardiopulmonary function (measured by heart rate variability, maximal inspiratory pressure, maximal expiratory pressure, peak expiratory flow, handgrip strength, and the 6-min walk test), and perceived quality of life (measured by the Moorehead-Ardelt quality of life questionnaire II and bariatric analysis and reporting outcome system scores) will improve, especially in the HIIT group.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04235842 . Registered on 22 January 2020.

The compensatory effect of exercise on physical activity and energy intake in young men with overweight: The EFECT randomised controlled trial

BACKGROUND

The compensatory effect of exercise on total volume of physical activity and food intake has been described as a possible explanation for the limited body weight loss observed during exercise interventions.

OBJECTIVE

To investigate the effect of different exercise intensities on total volume of physical activity and energy intake amongst active men with overweight.

DESIGN

Young men with overweight from a naval academy (n = 72; mean ± SD, age 21 ± 2 years, BMI 27.9 ± 2.13 kg/m²) were randomised to a control group (CG), moderate-intensity (MEG), or vigorous-intensity exercise group (VEG). MEG and VEG performed exercise sessions three times per week, for 60 min, during a 2-week period. Physical activity was assessed using triaxial accelerometers for 13 days. Energy intake was assessed at four time-points by 24-hour food recall. Intention-to-treat analyses were performed using linear mixed effect models.

RESULTS

MEG and VEG presented a greater compensatory effect in the total volume of physical activity over time compared to CG, with a significant difference in the rate of change between VEG and CG (∆ = -250,503 counts vs. ∆ = -61,306 counts, respectively; p = 0.01), and MEG and CG (∆ = -253,336 counts vs. ∆ = -61,306 counts, respectively; p = 0.01). There was no difference between MEG and VEG (p = 0.97). Changes in energy intake were not different between groups (p = 0.18); however, MEG presented greater energy intake compared to CG (β=491 kcal/day; p = 0.01) and VEG (β=319 kcal/day; p = 0.07). VEG presented a greater reduction in body weight compared to MEG (-1.3 kg vs. -0.4 kg; p = 0.03) and CG (-1.3 kg vs. -0.6 kg; p = 0.07).

CONCLUSIONS

Two weeks of exercise promoted a compensatory effect in total volume of physical activity in active men with overweight, regardless of exercise intensity. The compensatory effect was not observed for energy intake, although there was a trend for higher absolute energy intake in the MEG. Consequently, individuals in the VEG showed greater reduction in body weight over the intervention period.

Influence of Sprint Duration during Minimal Volume Exercise on Aerobic Capacity and Affect

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˙O_2peak) are attenuated with shorter sprints. Twenty-four healthy men undertook 15 sessions of SSREHIT or TREHIT. V˙O_2peak 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˙O_2peak 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˙O_2peak without overly compromising perceptual responses. Decreased sprint duration might further circumvent negative perceptual responses but might also attenuate physiological adaptations.

The Effect of Low-Volume High-Intensity Interval Training on Body Composition and Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis

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.

High Intensity Interval training (HIIT) for people with severe mental illness: A systematic review & meta-analysis of intervention studies- considering diverse approaches for mental and physical recovery

There is a mortality gap of 15 to 20 years for people with severe mental illness (SMI - psychotic spectrum, bipolar, major depressive disorders). Modifiable risk factors include inactivity and low cardiorespiratory fitness (CRF). Exercise can improve mental and physical outcomes; optimal type and intensity of exercise for people with SMI has yet to be determined. High Intensity Interval training (HIIT) is an exercise with distinct cardio-metabolic advantages in other disease populations compared to traditional moderate intensity continuous training (MCT). We investigated the feasibility and efficacy of HIIT for people with SMI. Major electronic databases were searched, identifying HIIT studies for adults experiencing SMI.Data on feasibility, safety, study design, sample characteristics, and physical and psychological outcomes were extracted and systematically reviewed. Meta-analyses were conducted within group, pre and post HIIT interventions, and between group, to compare HIIT with control conditions. Nine articles were identified including three pre/post studies, one non randomised and five randomised trials, (366 participants, 45.1% female). HIIT appears as feasible as MCT, with few safety concerns. Following HIIT, there was a moderate improvement in CRF and depression. There was no difference between HIIT and MCT for adherence or CRF.HIIT improved depression more than MCT.

Effects of three low-volume, high-intensity exercise conditions on affective valence

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 = 0.01_GG, η² = 0.26), RPE (P = 0.01_GG, 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.

Regulation of Skeletal Muscle Glucose Transport and Glucose Metabolism by Exercise Training

Aerobic exercise training and resistance exercise training are both well-known for their ability to improve human health; especially in individuals with type 2 diabetes. However, there are critical differences between these two main forms of exercise training and the adaptations that they induce in the body that may account for their beneficial effects. This article reviews the literature and highlights key gaps in our current understanding of the effects of aerobic and resistance exercise training on the regulation of systemic glucose homeostasis, skeletal muscle glucose transport and skeletal muscle glucose metabolism.

High-intensity interval training for health benefits and care of cardiac diseases - The key to an efficient exercise protocol

Aerobic capacity, which is expressed as peak oxygen consumption (VO_2peak), 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 VO_2peak, 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 VO_2peak with higher adherence and less risk.

High-Intensity Interval Training in Cardiac Rehabilitation

Recently, high-intensity interval training (HIIT) has been recognized as a safe and effective alternative to moderate-intensity continuous training for older patients with cardiovascular disease (CVD) in cardiac rehabilitation settings in an effort to improve health outcomes. This brief review considers general principles and suggestions for prescription of HIIT for older patients with CVD, specific challenges pertaining to older adults, the physiologic mechanisms by which HIIT contributes to improvements in peak Vo₂, and the effects of HIIT on cardiovascular health in older patients with coronary artery disease and heart failure.

Prevalence and predictors of dropout from high-intensity interval training in sedentary individuals: A meta-analysis

Recent evidence suggests that high-intensity interval training (HIIT) is an effective method to improve fitness and various health markers. However, the tolerability and acceptability of HIIT among sedentary individuals is currently controversially discussed. Therefore, our objective was to investigate the prevalence and predictors of dropout among sedentary individuals in HIIT-based exercise interventions. MEDLINE/PubMed, SPORTDiscus, and Web of Science were searched systematically for relevant articles until 06/2018. Studies included were required to (a) be written in English, (b) include sedentary healthy adults, (c) use some form of HIIT without any complementary intervention, (d) last ≥4 weeks, (e) report detailed description of the applied HIIT protocol, and (f) report data that allow calculation of a dropout rate. Fifty-five studies reporting results from 67 HIIT interventions with 1318 participants met the eligibility criteria. The trim and fill adjusted pooled dropout rate across all interventions was 17.6% (95% confidence interval 14.2-21.5%). Dropout rates were significantly lower in cycling-based interventions compared with studies using running/walking as exercise modality (P < 0.001). Longer session time (β = 0.02, P < 0.05), higher time effort/week (β = 0.005, P < 0.05), and overall time effort/intervention (β = 0.0003, P < 0.05) predicted greater dropout. Exercise intensity was not related to dropout. Our data suggest that HIIT-based interventions are tolerable and acceptable for previously sedentary individuals, exhibiting generally lower dropout rates than commonly reported for traditional exercise programs. Given the association between HIIT volume and dropouts, future studies should further focus on identifying the minimally effective dose of practical HIIT for improving health status. Such efforts would be important to increase implementation and public health impact of HIIT.

High-Intensity Interval Training: A Potential Exercise Countermeasure During Human Spaceflight

High-intensity interval training (HIT) is an effective approach for improving a range of physiological markers associated with physical fitness. A considerable body of work has demonstrated substantial improvements in cardiorespiratory fitness following short-term training programmes, while emerging evidence suggests that HIT can positively impact aspects of neuromuscular fitness. Given the detrimental consequences of prolonged exposure to microgravity on both of these physiological systems, and the potential for HIT to impact multiple components of fitness simultaneously, HIT is an appealing exercise countermeasure during human spaceflight. As such, the primary aim of this mini review is to synthesize current terrestrial knowledge relating to the effectiveness of HIT for inducing improvements in cardiorespiratory and neuromuscular fitness. As exercise-induced fitness changes are typically influenced by the specific exercise protocol employed, we will consider the effect of manipulating programming variables, including exercise volume and intensity, when prescribing HIT. In addition, as the maintenance of HIT-induced fitness gains and the choice of exercise mode are important considerations for effective training prescription, these issues are also discussed. We conclude by evaluating the potential integration of HIT into future human spaceflight operations as a strategy to counteract the effects of microgravity.

Combined effects of very short "all out" efforts during sprint and resistance training on physical and physiological adaptations after 2 weeks of training

PURPOSE

The aim of this study was to compare the combined effects of resistance and sprint training, with very short efforts (5 s), on aerobic and anaerobic performances, and cardiometabolic health-related parameters in young healthy adults.

METHODS

Thirty young physically active individuals were randomly allocated into four groups: resistance training (RTG), sprint interval training (SITG), concurrent training (CTG), and control (CONG). Participants trained 3 days/week for 2 weeks in the high-intensity interventions that consisted of 6-12 "all out" efforts of 5 s separated by 24 s of recovery, totalizing ~ 13 min per session, with 48-72 h of recovery between sessions. Body composition, vertical jump, lower body strength, aerobic and anaerobic performances, heart rate variability (HRV), and redox status were evaluated before and after training. Total work (TW), rating of perceived exertion (CR-10 RPE) and mean HR (HR_mean) were monitored during sessions. Incidental physical activity (PA), dietary intake and perceived stress were also controlled.

RESULTS

Maximum oxygen consumption (VO_2max) significantly increased in SITG and CTG (P < 0.05). Lower body strength improved in RTG and CTG (P < 0.05), while countermovement jump (CMJ) was improved in RTG (P = 0.04) only. Redox status improved after all interventions (P < 0.05). No differences were found in TW, PA, dietary intake, and psychological stress between groups (P > 0.05).

CONCLUSIONS

RT and SIT protocols with very short "all out" efforts, either performed in isolation, or combined, demonstrated improvement in several physical fitness- and health-related parameters. However, CT was the most efficient exercise intervention with improvement observed in the majority of the parameters.

A randomized controlled trial on the effectiveness of 8-week high-intensity interval exercise on intrahepatic triglycerides, visceral lipids, and health-related quality of life in diabetic obese patients with nonalcoholic fatty liver disease

BACKGROUND

Medications are limited for patients with nonalcoholic fatty liver disease (NAFLD). It has been reported that aerobic exercise is effective in reducing the characteristics of NAFLD, although unclear data have ascertained the effects of high-intensity interval aerobic exercise on health-related quality of life (HRQoL) in diabetic obese patients with NAFLD.

OBJECTIVES

This a randomized controlled trial aimed to ascertain the effectiveness of 8-week high-intensity interval exercise on intrahepatic triglycerides (IHTG), visceral lipids and HRQoL in diabetic obese patients with NAFLD.

STUDY DESIGN

Between August and December 2017, 32 diabetic obese patients with NAFLD aged 45 to 60 years (21 men and 11 women) were enrolled in this study. They were randomly assigned to 2 groups, 16 patients in each group, high-intensity interval (HII) exercise and control groups. The HII group received a program of HII aerobic exercise for 8 weeks with medications of NAFLD and the control group received only medications without any type of exercise intervention. The test of IHTG, visceral lipids, and HRQoL were recorded at the initial assessment and at the end of the program after 8 weeks.

RESULTS

There were significant differences between the 2 groups at the end of the study. These study findings exhibited significant improvements in IHTG, VO2peak, visceral lipids, glycohemoglobin, plasma glucose, and all dimensions of HRQoL in the HII group (P <.05), But there was non-significant improvement in any measure in the control group (P >.05) after the 8-week intervention.

CONCLUSION

Eight-week high-intensity interval aerobic exercise has a beneficial effect on IHTG, visceral lipids, and HRQoL in diabetic obese patients with NAFLD. Effort and awareness should be dedicated to encouraging the active lifestyle among different population, especially diabetic obese patients with NAFLD.

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)

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.

Reduced Exertion High-Intensity Interval Training is More Effective at Improving Cardiorespiratory Fitness and Cardiometabolic Health than Traditional Moderate-Intensity Continuous Training

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.

Contribution of central and peripheral adaptations to changes in maximal oxygen uptake following 4 weeks of sprint interval training

The current study examined the contribution of central and peripheral adaptations to changes in maximal oxygen uptake (V̇O_2max) following sprint interval training (SIT). Twenty-three males completed 4 weekly SIT sessions (8 × 20-s cycling bouts at ∼170% of work rate at V̇O_2max, 10-s recovery) for 4 weeks. Following completion of training, the relationship between changes in V̇O_2max and changes in central (cardiac output) and peripheral (arterial-mixed venous oxygen difference (a-vO₂diff), muscle capillary density, oxidative capacity, fibre-type distribution) adaptations was determined in all participants using correlation analysis. Participants were then divided into tertiles on the basis of the magnitude of their individual V̇O_2max responses, and differences in central and peripheral adaptations were examined in the top (HI; ∼10 mL·kg^-1·min^-1 increase in V̇O_2max, p < 0.05) and bottom (LO; no change in V̇O_2max, p > 0.05) tertiles (n = 8 each). Training had no impact on maximal cardiac output, and no differences were observed between the LO group and the HI group (p > 0.05). The a-vO₂diff increased in the HI group only (p < 0.05) and correlated significantly (r = 0.71, p < 0.01) with changes in V̇O_2max across all participants. Muscle capillary density (p < 0.02) and β-hydroxyacyl-CoA dehydrogenase maximal activity (p < 0.05) increased in both groups, with no between-group differences (p > 0.05). Citrate synthase maximal activity (p < 0.01) and type IIA fibre composition (p < 0.05) increased in the LO group only. Collectively, although the heterogeneity in the observed V̇O_2max response following 4 weeks of SIT appears to be attributable to individual differences in systemic vascular and/or muscular adaptations, the markers examined in the current study were unable to explain the divergent V̇O_2max responses in the LO and HI groups.

Changes in Echocardiographic Parameters among Beninese Soccer Referees during the Division 1 Championship in 2016

Introduction

The goal of this study was to describe the echocardiographic parameters of soccer referees and to examine the changes in these parameters after a period of intensive physical exercise.

Methods and Patients

We conducted a prospective study that included Beninese soccer referees. The study of the geometry and function of the left ventricle (LV) was made at the beginning and end of the national Division 1 championship, which was held during the course of 10 weeks.

Results

There were 37 referees included in this study; 20 at the national level (G1: 27.8 ± 6.6 years) and 17 at the international level (G2: 32.1 ± 6.4 years). Dimensions of the LV were normal for all the referees. At the beginning of the championship, 51.3% of the referees had a normal LV geometry, 37.8% had concentric remodelling, 2.7% had concentric hypertrophy, and 8.1% had eccentric hypertrophy. In the group of referees with normal LV geometry, a modification in concentric remodelling at the end of the championship was seen in 30% of the referees in G1, 33.3% of the referees in G2, and 31.6% of the whole sample. In the group of subjects who presented concentric LV remodelling, a modification in the normal geometry was observed in 37.5% of those in G1, in 0% of those in G2, and in 21.4% of the whole sample. The cases of LV hypertrophy showed no change regardless of the group considered. An LV ejection fraction of more than 50% and an E/E′ ratio less than 8 were found in all referees.

Conclusion

All the referees studied had normal cardiac morphology and function. The intensity of the physical load was insufficient to impact this morphology.

Ratings of Perceived Exertion Misclassify Intensities for Sedentary Older Adults During Graded Cycling Test: Effect of Supramaximal High-Intensity Interval Training

The present study aims (1) to evaluate ratings of perceived exertion (RPE) and corresponding intensities during a maximal graded cycling test and (2) to determine the effects of 6 weeks of supramaximal cycling exercise (SCE) intervention on RPE and associated physiological factors in young and older sedentary groups. Two healthy groups of 17 young adults [average (SD) age: 26.2 (2.4) year] and 13 older adults [average (SD) age: 54.5 (2.3) year] completed a 6-week SCE intervention on an ergocycle. Physiological values and RPE were collected across stages corresponding to ventilator thresholds 1 (VT1) and 2 (VT2) of the graded cycling test and 10 min following the end of test and during the six bouts of SCE. The relative intensity for both VT1 and VT2 were also objectively calculated based on the percent of maximal heart rate %HRmax and peak oxygen consumption %V˙O₂peak.

Before SCE intervention, RPE values were significantly higher for the older group compared to younger at VT1 [p < 0.01] and VT2 [p < 0.01], although both groups were working at similar relative intensities (%V˙O₂). After 6 weeks of SCE, the older group’s perceived effort values were normalized to the actual estimated ones and were similar to those observed in younger individuals. The intervention elicited physiological changes at rest and submaximal intensities, while no improvements were noted for both groups in aerobic fitness (i.e., V˙O₂peak). For both groups, RPE decreases with SCE at 10 min following graded test correlated significantly to V˙O₂ (r = 0.61, p < 0.01). Our study revealed that the initial over-estimation of the exertion levels found for the older sedentary group at the tested submaximal intensities was no longer present after 6 weeks of SCE training, therefore matching RPE values of the young group and those estimated by %HRmax and %V˙O₂peak methods. Therefore, combining the RPE method with other commonly used methods of estimating exercise intensity is highly recommended for sedentary older adults to suitably monitor the exercise intensity.

Effects of 3-Week Work-Matched High-Intensity Intermittent Cycling Training with Different Cadences on VO2max in University Athletes

The aim of this study is to clarify the effects of 3-week work-matched high-intensity intermittent cycling training (HIICT) with different cadences on the VO_2max of university athletes. Eighteen university athletes performed HIICT with either 60 rpm (n = 9) or 120 rpm (n = 9). The HIICT consisted of eight sets of 20 s exercise with a 10 s passive rest between each set. The initial training intensity was set at 135% of VO_2max and was decreased by 5% every two sets. Athletes in both groups performed nine sessions of HIICT during a 3-week period. The total workload and achievement rate of the workload calculated before experiments in each group were used for analysis. VO_2max was measured pre- and post-training. After 3 weeks of training, no significant differences in the total workload and the achievement rate of the workload were found between the two groups. VO_2max similarly increased in both groups from pre- to post-training (p = 0.016), with no significant differences between the groups (p = 0.680). These results suggest that cadence during HIICT is not a training variable affecting the effect of VO_2max.

Change in VO2max and time trial performance in response to high-intensity interval training prescribed using ventilatory threshold

Completion of high-intensity interval training (HIIT) leads to significant increases in maximal oxygen uptake (VO_2max) and oxidative capacity. However, individual responses to HIIT have been identified as approximately 20-40% of individuals show no change in VO_2max, which may be due to the relatively homogeneous approach to implementing HIIT.

PURPOSE

This study tested the effects of HIIT prescribed using ventilatory threshold (VT) on changes in VO_2max and cycling performance.

METHODS

Fourteen active men and women (age and VO_2max = 27 ± 8 year and 38 ± 4 mL/kg/min) underwent nine sessions of HIIT, and 14 additional men and women (age and VO_2max = 22 ± 3 year and 40 ± 5 mL/kg/min) served as controls. Training was performed on a cycle ergometer at a work rate equal to 130%VT and consisted of eight to ten 1 min bouts interspersed with 75 s of recovery. At baseline and post-testing, they completed progressive cycling to exhaustion to determine VO_2max, and on a separate day, a 5 mile cycling time trial.

RESULTS

Compared to the control group, HIIT led to significant increases in VO_2max (6%, p = 0.007), cycling performance (2.5%, p = 0.003), and absolute VT (9 W, p = 0.005). However, only 57% of participants revealed meaningful increases in VO_2max and cycling performance in response to training, and two showed no change in either outcome.

CONCLUSIONS

A greater volume of HIIT may be needed to maximize the training response for all individuals.

Overnight fasting compromises exercise intensity and volume during sprint interval training but improves high-intensity aerobic endurance

BACKGROUND

The combined effects of sprint interval training (SIT) and exercising in the fasted state are unknown. We compared the effects of SIT with exogenous carbohydrate supplementation (SIT-CHO) and SIT following overnight fast (SIT-Fast) on aerobic capacity (peak oxygen consumption: V̇O2peak) and high-intensity aerobic endurance (time-to-exhaustion at 85% V̇O2peak [T85%]).

METHODS

Twenty male cyclists were randomized to SIT-CHO and SIT-Fast. Both groups performed 30-second all-out cycling followed by 4-minute active recovery 3 times per week for 4 weeks, with the number of sprint bouts progressing from 4 to 7. Peak power output (PPO) and total mechanical work were measured for each sprint interval bout. The SIT-CHO group performed exercise sessions following breakfast and consumed carbohydrate drink during exercise, whereas the SIT-Fast group performed exercise sessions following overnight fast and consumed water during exercise. Before and after training, V̇O2peak and T85% were assessed. Blood glucose, non-esterified fatty acids, insulin and glucagon concentrations were measured during T85%.

RESULTS

Overall PPO and mechanical work were lower in SIT-Fast than SIT-CHO (3664.9 vs. 3871.7 J/kg; P=0.021 and 10.6 vs. 9.9 W/kg; P=0.010, respectively). Post-training V̇O2peak did not differ between groups. Baseline-adjusted post-training T85% was longer in SIT-Fast compared to SIT-CHO (19.7±3.0 vs. 16.6±3.0 minutes, ANCOVA P=0.038) despite no changes in circulating energy substrates or hormones.

CONCLUSIONS

Our results suggest that SIT-Fast compromises exercise intensity and volume but still can have a greater impact on the ability to sustain high-intensity aerobic endurance exercise compared to SIT-CHO.