1
|
Grannell A, Hallson H, Gunlaugsson B, Jonsson H. Exercise therapy as a digital therapeutic for chronic disease management: consideration for clinical product development. Front Digit Health 2023; 5:1250979. [PMID: 38173910 PMCID: PMC10761443 DOI: 10.3389/fdgth.2023.1250979] [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: 06/30/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Digital exercise therapies (DET) have the potential to bridge existing care gaps for people living with chronic conditions. Acting as either a standalone, embedded within multi-modal lifestyle therapy, or adjunct to pharmacotherapy or surgery, evidence-based DETs can favorably impact the health of a rapidly growing population. Given the nascent nature of digital therapeutics, the regulatory landscape has yet to mature. As such, in the absence of clear guidelines clinical digital product developers are responsible for ensuring the DET adheres to fundamental principles such as patient risk management and clinical effectiveness. The purpose of this narrative review paper is to discuss key considerations for clinical digital product developers who are striving to build novel digital therapeutic (DTx) solutions and thus contribute towards standardization of product development. We herein draw upon DET as an example, highlighting the need for adherence to existing clinical guidelines, human-centered design and an intervention approach that leverages the Chronic Care Model. Specific topics and recommendations related to the development of innovative and scalable products are discussed which ultimately allow for differentiation from a basic wellness tool and integration to clinical workflows. By embodying a code of ethics, clinical digital product developers can adequately address patients' needs and optimize their own future digital health technology assessments including appropriate evidence of safety and efficacy.
Collapse
Affiliation(s)
- Andrew Grannell
- Sidekick Health, Research & Development Unit, Kópavogur, Iceland
| | | | | | | |
Collapse
|
2
|
Nikoletou D, Chis Ster I, Lech CY, MacNaughton IS, Chua F, Aul R, Jones PW. Comparison of high-intensity interval training versus moderate-intensity continuous training in pulmonary rehabilitation for interstitial lung disease: a randomised controlled pilot feasibility trial. BMJ Open 2023; 13:e066609. [PMID: 37607782 PMCID: PMC10445364 DOI: 10.1136/bmjopen-2022-066609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/27/2023] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the feasibility and efficacy of high-intensity interval training (HIIT) compared with moderate-intensity continuous training (MICT) in pulmonary rehabilitation (PR) for people with interstitial lung disease (ILD). DESIGN Single-centre, randomised controlled feasibility, pilot trial. SETTING Patients were recruited from the chest clinic of a tertiary ILD centre and attended circuit-based PR in the hospital's gym, followed by a personalised 6-month community programme. PARTICIPANTS 58 patients, stratified per ILD type, were randomised into two groups: 33 to HIIT (18 males:15 females) (mean age (SD): 70.2 (11.4) years) and 25 to the MICT exercise mode (14 males:11 females) (mean age (SD): 69.8 (10.8) years). INTERVENTIONS 8-week, twice weekly, circuit-based PR programme of exercise and education, followed by a personalised 6-month community exercise programme. OUTCOME MEASURES Feasibility outcomes included staff-to-patient ratio and dropout rates per group. Primary outcome was the 6 min walk distance (6MWD). Secondary outcomes included the sniff nasal pressure, mouth inspiratory and expiratory pressures, handgrip and quadriceps strength and health status. Random-effects models were used to evaluate average variation in outcomes through time across the two groups. RESULTS The 6MWD peaked earlier with HIIT compared with MICT (at 4 months vs 5 months) but values were lower at peak (mean (95% CI): 26.3 m (3.5 to 49.1) vs 51.6 m (29.2 to 73.9)) and declined faster at 6 months post-PR. Secondary outcomes showed similar faster but smaller improvements with HIIT over MICT and more consistent maintenance 6 months post-PR with MICT than HIIT. CONCLUSIONS HIIT is feasible in circuit-based ILD PR programmes and provides quick improvements but requires closer supervision of training and resources than MICT and benefits may be less well sustained. This would make it a less attractive option for clinical PR programmes. A definitive, multicentre randomised controlled trial is required to address the role of HIIT in ILD. TRIAL REGISTRATION NUMBER ISRCTN55846300.
Collapse
Affiliation(s)
- Dimitra Nikoletou
- Centre for Allied Health, Institute of Medical and Biomedical Education, St George's University of London, London, UK
- Faculty of Health, Science, Social Care and Education, Kingston University, Kingston-Upon-Thames, London, UK
| | - Irina Chis Ster
- Infection and Immunity Research Institute, St George's University of London, London, UK
| | - Carmen Y Lech
- Infection and Immunity Research Institute, St George's University of London, London, UK
| | - Iain S MacNaughton
- Infection and Immunity Research Institute, St George's University of London, London, UK
| | - Felix Chua
- Interstitial Lung Disease Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Raminder Aul
- Respiratory Medicine, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Paul W Jones
- Infection and Immunity Research Institute, St George's University of London, London, UK
| |
Collapse
|
3
|
Bo B, Guo A, Kaila SJ, Hao Z, Zhang H, Wei J, Yao Y. Elucidating the primary mechanisms of high-intensity interval training for improved cardiac fitness in obesity. Front Physiol 2023; 14:1170324. [PMID: 37608837 PMCID: PMC10441243 DOI: 10.3389/fphys.2023.1170324] [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: 02/20/2023] [Accepted: 07/31/2023] [Indexed: 08/24/2023] Open
Abstract
Obesity is a global and rising multifactorial pandemic associated with the emergence of several comorbidities that are risk factors for malignant cardiac remodeling and disease. High-intensity interval training (HIIT) has gained considerable attention due to its favorable outcomes of cardiometabolic health in individuals with overweight or obese. The primary aim of this review is to discuss the fundamental processes through which HIIT improves cardiac impairment in individuals with obesity to develop viable treatments for obesity management. In this review, a multiple database search and collection were conducted from the earliest record to January 2013 for studies included the qualitative component of HIIT intervention in humans and animals with overweight/obesity related to cardiac remodeling and fitness. We attempt to integrate the main mechanisms of HIIT in cardiac remolding improvement in obesity into an overall sequential hypothesis. This work focus on the ameliorative effects of HIIT on obesity-induced cardiac remodeling with respect to potential and pleiotropic mechanisms, including adipose distribution, energy metabolism, inflammatory response, insulin resistance, and related risk profiles in obesity. In conclusion, HIIT has been shown to reduce obesity-induced risks of cardiac remodeling, but the long-term effects of HIIT on obesity-induced cardiac injury and disease are presently unknown. Collective understanding highlights numerous specific research that are needed before the safety and effectiveness of HIIT can be confirmed and widely adopted in patient with obesity.
Collapse
Affiliation(s)
- Bing Bo
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng, China
- Sports Reform and Development Research Center, School of Physical Education, Henan University, Kaifeng, China
| | - Aijing Guo
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng, China
| | - Severa Jafeth Kaila
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng, China
| | - Zhe Hao
- Department of Kinesiology, School of Physical Education, Henan University, Kaifeng, China
| | - Huiqing Zhang
- Sports Reform and Development Research Center, School of Physical Education, Henan University, Kaifeng, China
| | - Jianshe Wei
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng, China
| | - Yuan Yao
- Sports Reform and Development Research Center, School of Physical Education, Henan University, Kaifeng, China
| |
Collapse
|
4
|
Jaguri A, Al Thani AA, Elrayess MA. Exercise Metabolome: Insights for Health and Performance. Metabolites 2023; 13:694. [PMID: 37367852 DOI: 10.3390/metabo13060694] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/14/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Exercise has many benefits for physical and mental well-being. Metabolomics research has allowed scientists to study the impact of exercise on the body by analyzing metabolites released by tissues such as skeletal muscle, bone, and the liver. Endurance training increases mitochondrial content and oxidative enzymes, while resistance training increases muscle fiber and glycolytic enzymes. Acute endurance exercise affects amino acid metabolism, fat metabolism, cellular energy metabolism, and cofactor and vitamin metabolism. Subacute endurance exercise alters amino acid metabolism, lipid metabolism, and nucleotide metabolism. Chronic endurance exercise improves lipid metabolism and changes amino acid metabolism. Acute resistance exercise changes several metabolic pathways, including anaerobic processes and muscular strength. Chronic resistance exercise affects metabolic pathways, resulting in skeletal muscle adaptations. Combined endurance-resistance exercise alters lipid metabolism, carbohydrate metabolism, and amino acid metabolism, increasing anaerobic metabolic capacity and fatigue resistance. Studying exercise-induced metabolites is a growing field, and further research can uncover the underlying metabolic mechanisms and help tailor exercise programs for optimal health and performance.
Collapse
Affiliation(s)
- Aayami Jaguri
- Weill Cornell Medicine-Qatar, Doha P.O. Box 24811, Qatar
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
| | - Asmaa A Al Thani
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
- QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Mohamed A Elrayess
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
- QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| |
Collapse
|
5
|
High-Intensity Interval Training is Safe, Feasible and Efficacious in Nonalcoholic Steatohepatitis: A Randomized Controlled Trial. Dig Dis Sci 2022; 68:2123-2139. [PMID: 36538276 PMCID: PMC9763796 DOI: 10.1007/s10620-022-07779-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND High-Intensity Interval Training (HIIT) involves bursts of high-intensity exercise interspersed with lower-intensity exercise recovery. HIIT may benefit cardiometabolic health in people with nonalcoholic steatohepatitis (NASH). AIMS We aimed to examine the safety, feasibility, and efficacy of 12-weeks of supervised HIIT compared with a sham-exercise control (CON) for improving aerobic fitness and peripheral insulin sensitivity in biopsy-proven NASH. METHODS Participants based in the community [(n = 14, 56 ± 10 years, BMI 39.2 ± 6.7 kg/m2, 64% male), NAFLD Activity Score 5 (range 3-7)] were randomized to 12-weeks of supervised HIIT (n = 8, 4 × 4 min at 85-95% maximal heart rate, interspersed with 3 min active recovery; 3 days/week) or CON (n = 6, stretching; 3 days/week). Safety (adverse events) and feasibility determined as ≥ 70% program completion and ≥ 70% global adherence (including session attendance, interval intensity adherence, and duration adherence) were assessed. Changes in cardiorespiratory fitness (V̇O2peak), exercise capacity (time-on-test) and peripheral insulin sensitivity (euglycemic hyperinsulinemic clamp) were assessed. Data were analysed using ANCOVA with baseline value as the covariate. RESULTS There were no HIIT-related adverse events and HIIT was globally feasible [program completion 75%, global adherence 100% (including adherence to session 95.4 ± 7.3%, interval intensity 95.3 ± 6.0% and duration 96.8 ± 2.4%)]. A large between-group effect was observed for exercise capacity [mean difference 134.2 s (95% CI 19.8, 248.6 s), ƞ2 0.44, p = 0.03], improving in HIIT (106.2 ± 97.5 s) but not CON (- 33.4 ± 43.3 s), and for peripheral insulin sensitivity [mean difference 3.4 mg/KgLegFFM/min (95% CI 0.9,6.8 mg/KgLegFFM/min), ƞ2 0.32, p = 0.046], improving in HIIT (1.0 ± 0.8 mg/KgLegFFM/min) but not CON (- 3.1 ± 1.2 mg/KgLegFFM/min). CONCLUSIONS HIIT is safe, feasible and efficacious for improving exercise capacity and peripheral insulin sensitivity in people with NASH. CLINICAL TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trial Registry (anzctr.org.au) identifier ACTRN12616000305426 (09/03/2016).
Collapse
|
6
|
Liu H, Liu F, Ji H, Dai Z, Han W. A Bibliometric Analysis of High-Intensity Interval Training in Cardiac Rehabilitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113745. [PMID: 36360625 PMCID: PMC9658065 DOI: 10.3390/ijerph192113745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 05/31/2023]
Abstract
As global quality of life has improved, the risk factors for cardiovascular diseases have gradually increased in prevalence. People have consequently sought to improve their health through physical exercise. High-intensity interval training (HIIT) is a cardiac rehabilitation (CR) tool that has been of great interest for several years. However, its feasibility and safety remain controversial. This study aimed to explore hot research topics and new directions regarding the role of HIIT in CR and to describe the dynamic development of the field. We used the Web of Science Core Collection database to develop visualizations using CiteSpace software (v.6.1.R2). The number of articles published, institutional collaboration networks, author partnerships, and keyword co-occurrence and clustering were used to analyze the impact of HIIT on CR. Our results showed that Norway, Canada, and the United States were the most prominent contributors to this field. Articles by Nigam, A and Juneau, M had the highest number of citations. The Norwegian University of Science and Technology had performed the most in-depth research in this area. The European Journal of Preventive Cardiology had published the most articles. The United States had the highest number of publishing journals. Relevant issues focused on coronary artery disease, exercise capacity, heart failure, cardiorespiratory fitness, and physical activity. HIIT in heart transplantation may be at the forefront of research in this field and future studies should focus on this topic. HIIT-based CR can therefore improve the exercise capacity and quality of life of cardiovascular patients and improve patient compliance in a safe manner.
Collapse
Affiliation(s)
- Haitao Liu
- College of Physical Education, Henan University, Kaifeng 475001, China
- Research Center of Sports Reform and Development, Henan University, Kaifeng 475001, China
- Institute of Physical Fitness and Health, Henan University, Kaifeng 475001, China
| | - Feiyue Liu
- College of Physical Education, Henan University, Kaifeng 475001, China
| | - Haoyuan Ji
- College of Physical Education, Henan University, Kaifeng 475001, China
| | - Zuanqin Dai
- College of Physical Education, Henan University, Kaifeng 475001, China
| | - Wenxiu Han
- College of Physical Education, Henan University, Kaifeng 475001, China
| |
Collapse
|
7
|
Ketelhut S, Ketelhut RG, Weisser B, Nigg CR. Interval Training in Sports Medicine: Current Thoughts on an Old Idea. J Clin Med 2022; 11:jcm11185468. [PMID: 36143115 PMCID: PMC9501174 DOI: 10.3390/jcm11185468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sascha Ketelhut
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland
- Correspondence:
| | - Reinhard G. Ketelhut
- Cardiology and Sports Medicine, Medical Center Berlin (MCB), 10559 Berlin, Germany
| | - Burkhard Weisser
- Institute of Sports Science, Christian-Albrechts-University of Kiel, 24118 Kiel, Germany
| | - Claudio R. Nigg
- Institute of Sport Science, University of Bern, 3012 Bern, Switzerland
| |
Collapse
|
8
|
Effect of acute high-intensity exercise on myocardium metabolic profiles in rat and human study via metabolomics approach. Sci Rep 2022; 12:6791. [PMID: 35473956 PMCID: PMC9042871 DOI: 10.1038/s41598-022-10976-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/14/2022] [Indexed: 12/16/2022] Open
Abstract
Acute high-intensity exercise can affect cardiac health by altering substance metabolism. However, few metabolomics-based studies provide data on the effect of exercise along with myocardial metabolism. Our study aimed to identify metabolic signatures in rat myocardium during acute high-intensity exercise and evaluate their diagnostic potential for sports injuries. We collected rat myocardium samples and subjects’ serum samples before and after acute high-intensity exercise for metabolite profiling to explore metabolic alterations of exercise response in the myocardium. Multivariate analysis revealed myocardium metabolism differed before and after acute high-intensity exercise. Furthermore, 6 target metabolic pathways and 12 potential metabolic markers for acute high-intensity exercise were identified. Our findings provided an insight that myocardium metabolism during acute high-intensity exercise had distinct disorders in complex lipids and fatty acids. Moreover, an increase of purine degradation products, as well as signs of impaired glucose metabolism, were observed. Besides, amino acids were enhanced with a certain protective effect on the myocardium. In this study, we discovered how acute high-intensity exercise affected myocardial metabolism and exercise-related heart injury risks, which can provide references for pre-competition screening, risk prevention, and disease prognosis in competitive sports and effective formulation of exercise prescriptions for different people.
Collapse
|
9
|
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
|
12
|
Serrablo-Torrejon I, Lopez-Valenciano A, Ayuso M, Horton E, Mayo X, Medina-Gomez G, Liguori G, Jimenez A. High intensity interval training exercise-induced physiological changes and their potential influence on metabolic syndrome clinical biomarkers: a meta-analysis. BMC Endocr Disord 2020; 20:167. [PMID: 33172413 PMCID: PMC7653723 DOI: 10.1186/s12902-020-00640-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/20/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite the current debate about the effects of high intensity interval training (HIIT), HIIT elicits big morpho-physiological benefit on Metabolic Syndrome (MetS) treatment. However, no review or meta-analysis has compared the effects of HIIT to non-exercising controls in MetS variables. The aim of this study was to determine through a systematic review, the effectiveness of HIIT on MetS clinical variables in adults. METHODS Studies had to be randomised controlled trials, lasting at least 3 weeks, and compare the effects of HIIT on at least one of the MetS clinical variables [fasting blood glucose (BG), high-density lipoprotein (HDL-C) triglyceride (TG), systolic (SBP) or diastolic blood pressure (DBP) and waist circumference (WC)] compared to a control group. The methodological quality of the studies selected was evaluated using the PEDro scale. RESULTS Ten articles fulfilled the selection criteria, with a mean quality score on the PEDro scale of 6.7. Compared with controls, HIIT groups showed significant and relevant reductions in BG (- 0.11 mmol/L), SBP (- 4.44 mmHg), DBP (- 3.60 mmHg), and WC (- 2.26 cm). Otherwise, a slight increase was observed in HDL-C (+ 0.02 mmol/L). HIIT did not produce any significant changes in TG (- 1.29 mmol/L). CONCLUSIONS HIIT improves certain clinical aspects in people with MetS (BG, SBP, DBP and WC) compared to people with MetS who do not perform physical exercise. Plausible physiological changes of HIIT interventions might be related with large skeletal muscle mass implication, improvements in the vasomotor control, better baroreflex control, reduction of the total peripheral resistance, increases in excess post-exercise oxygen consumption, and changes in appetite and satiety mechanisms.
Collapse
Affiliation(s)
- I Serrablo-Torrejon
- Faculty Research Centre for Sport, Exercise & Life Sciences, School of Health and Life Sciences, Coventry University, Coventry, UK.
- GO fit LAB, Av. Islas de Filipinas, 7, 28003, Madrid, Spain.
| | - A Lopez-Valenciano
- GO fit LAB, Av. Islas de Filipinas, 7, 28003, Madrid, Spain
- Observatory of Healthy & Active Living, Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
| | - M Ayuso
- GO fit LAB, Av. Islas de Filipinas, 7, 28003, Madrid, Spain
| | - E Horton
- Faculty Research Centre for Sport, Exercise & Life Sciences, School of Health and Life Sciences, Coventry University, Coventry, UK
| | - X Mayo
- GO fit LAB, Av. Islas de Filipinas, 7, 28003, Madrid, Spain
- Observatory of Healthy & Active Living, Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
| | - G Medina-Gomez
- Observatory of Healthy & Active Living, Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
| | - G Liguori
- University of Rhode Island, Kingston, RI, USA
| | - A Jimenez
- GO fit LAB, Av. Islas de Filipinas, 7, 28003, Madrid, Spain
- Observatory of Healthy & Active Living, Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
- Advanced Wellbeing Research Centre, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| |
Collapse
|
13
|
Beneficial Effects of Physical Activity in Diabetic Patients. J Funct Morphol Kinesiol 2020; 5:jfmk5030070. [PMID: 33467285 PMCID: PMC7739324 DOI: 10.3390/jfmk5030070] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/30/2020] [Accepted: 09/01/2020] [Indexed: 12/14/2022] Open
Abstract
One of the main goals of diabetic therapy is to achieve the best metabolic control to prevent the development and progression of potential complications. A multidisciplinary approach characterized by the combination of diet, physical activity (PA) and drug therapy with oral and injectable (non-insulin) pharmacological agents, is desirable to optimize metabolic control. The aim of this review is to explain the contribution of PA and its beneficial effects on patients affected by type 1 (T1D) and type 2 diabetes (T2D). We provide an overview of evidence on the effects of PA for the main two types of diabetes mellitus (DM) to identify the right level of PA to be recommended. We discuss the physiological and clinical role of PA in people with DM. It can be concluded that the objective of antidiabetic therapy should be the achievement and optimization of metabolic control through a multidisciplinary approach involving non-pharmacological therapy such as diet and PA, which has a crucial role.
Collapse
|
14
|
Krusnauskas R, Eimantas N, Baranauskiene N, Venckunas T, Snieckus A, Brazaitis M, Westerblad H, Kamandulis S. Response to Three Weeks of Sprint Interval Training Cannot Be Explained by the Exertional Level. ACTA ACUST UNITED AC 2020; 56:medicina56080395. [PMID: 32784754 PMCID: PMC7466197 DOI: 10.3390/medicina56080395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/04/2020] [Indexed: 01/13/2023]
Abstract
Background and Objectives: The all-out mode of sprint interval training (SIT) has been shown to be an efficient method for improving sports performance, exercise capacity, and aerobic fitness. Although the benefits of SIT are well described, the mechanisms underlying the different degrees of response remain largely unexplored. We aimed to assess the effects of exertion on the responsiveness to SIT. Materials and Methods: The participants were 28 young untrained men (mean ± SD age 25.7 ± 6.03 years) who exhibited either a large or small increase in Wingate test average power in response to nine SIT sessions performed over three weeks. Each training session comprised four-six bouts of 30 s all-out cycling interspaced with 4 min of rest. Individual responses were assessed using heart rate (HR) during exercise for all nine sessions, as well as blood lactate concentration up to 1 h, and the decrement in maximal voluntary knee extension torque (MVC) up to 24 h after the first and last training sessions. Peak oxygen uptake (VO2peak) and maximum HR were measured before and after training during an incremental cycling test to exhaustion. Results: Although all participants showed benefits of SIT such as increased VO2peak, the increase in anaerobic cycling power varied between participants. We identified 17 high responders and nine low responders, whose average power outputs were 0.80 ± 0.22 and 0.22 ± 0.19 W/kg, respectively. The HR achieved during any of the training sessions did not differ between high and low responders. The lactate kinetics did not differ between groups before and after the intervention. Training resulted in a more rapid recovery of MVC without any discernible differences between the high and low responders. Conclusion: The differences in the responses to SIT are not dependent on the exertion level during training.
Collapse
Affiliation(s)
- Raulas Krusnauskas
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
- Correspondence:
| | - Nerijus Eimantas
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| | - Neringa Baranauskiene
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| | - Tomas Venckunas
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| | - Audrius Snieckus
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| | - Marius Brazaitis
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| | - Hakan Westerblad
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
- Department of Physiology and Pharmacology, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Sigitas Kamandulis
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| |
Collapse
|
15
|
Franklin BA, Thompson PD, Al-Zaiti SS, Albert CM, Hivert MF, Levine BD, Lobelo F, Madan K, Sharrief AZ, Eijsvogels TMH. Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update: A Scientific Statement From the American Heart Association. Circulation 2020; 141:e705-e736. [PMID: 32100573 DOI: 10.1161/cir.0000000000000749] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Epidemiological and biological plausibility studies support a cause-and-effect relationship between increased levels of physical activity or cardiorespiratory fitness and reduced coronary heart disease events. These data, plus the well-documented anti-aging effects of exercise, have likely contributed to the escalating numbers of adults who have embraced the notion that "more exercise is better." As a result, worldwide participation in endurance training, competitive long distance endurance events, and high-intensity interval training has increased markedly since the previous American Heart Association statement on exercise risk. On the other hand, vigorous physical activity, particularly when performed by unfit individuals, can acutely increase the risk of sudden cardiac death and acute myocardial infarction in susceptible people. Recent studies have also shown that large exercise volumes and vigorous intensities are both associated with potential cardiac maladaptations, including accelerated coronary artery calcification, exercise-induced cardiac biomarker release, myocardial fibrosis, and atrial fibrillation. The relationship between these maladaptive responses and physical activity often forms a U- or reverse J-shaped dose-response curve. This scientific statement discusses the cardiovascular and health implications for moderate to vigorous physical activity, as well as high-volume, high-intensity exercise regimens, based on current understanding of the associated risks and benefits. The goal is to provide healthcare professionals with updated information to advise patients on appropriate preparticipation screening and the benefits and risks of physical activity or physical exertion in varied environments and during competitive events.
Collapse
|
16
|
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.
Collapse
Affiliation(s)
- Shigenori Ito
- Division of Cardiology, Sankuro Hospital, Aichi-ken, Toyota 4710035, Japan
| |
Collapse
|
17
|
Scott SN, Shepherd SO, Hopkins N, Dawson EA, Strauss JA, Wright DJ, Cooper RG, Kumar P, Wagenmakers AJM, Cocks M. Home‐hit improves muscle capillarisation and eNOS/NAD(P)Hoxidase protein ratio in obese individuals with elevated cardiovascular disease risk. J Physiol 2019; 597:4203-4225. [DOI: 10.1113/jp278062] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/05/2019] [Indexed: 12/17/2022] Open
|
18
|
Kriel Y, Askew CD, Solomon C. Sprint interval exercise versus continuous moderate intensity exercise: acute effects on tissue oxygenation, blood pressure and enjoyment in 18-30 year old inactive men. PeerJ 2019; 7:e7077. [PMID: 31211019 PMCID: PMC6557258 DOI: 10.7717/peerj.7077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/04/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Sprint interval training (SIT) can be as effective, or more effective, than continuous moderate intensity exercise (CMIE) for improving a primary risk factor for cardiometabolic disease, low cardiorespiratory fitness (CRF). However, there has been no direct comparison in inactive individuals, of the acute effects of a session of SIT with a work-matched session of CMIE on local oxygen utilisation, which is a primary stimulus for increasing CRF. Furthermore, post-exercise blood pressure (BP) and enjoyment, if symptomatic and low, respectively, have implications for safety and adherence to exercise and have not been compared between these specific conditions. It was hypothesised that in young inactive men, local oxygen utilisation would be higher, while post-exercise BP and enjoyment would be lower for SIT, when compared to CMIE. METHODS A total of 11 inactive men (mean ± SD; age 23 ± 4 years) completed a maximal ramp-incremental exercise test followed by two experiment conditions: (1) SIT and (2) work-matched CMIE on a cycle ergometer on separate days. Deoxygenated haemoglobin (∆HHb) in the pre-frontal cortex (FH), gastrocnemius (GN), left vastus lateralis (LVL) and the right vastus lateralis (RVL) muscles, systemic oxygen utilisation (VO2), systolic (SBP) and diastolic (DBP) blood pressure and physical activity enjoyment scale (PACES) were measured during the experiment conditions. RESULTS During SIT, compared to CMIE, ∆HHb in FH (p = 0.016) and GN (p = 0.001) was higher, while PACES (p = 0.032) and DBP (p = 0.043) were lower. No differences in SBP and ∆HHb in LVL and RVL were found between conditions. CONCLUSIONS In young inactive men, higher levels of physiological stress occurred during SIT, which potentially contributed to lower levels of post-exercise DBP and enjoyment, when compared to CMIE.
Collapse
Affiliation(s)
- Yuri Kriel
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Christopher D. Askew
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Colin Solomon
- School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| |
Collapse
|
19
|
Dela F, Ingersen A, Andersen NB, Nielsen MB, Petersen HHH, Hansen CN, Larsen S, Wojtaszewski J, Helge JW. Effects of one-legged high-intensity interval training on insulin-mediated skeletal muscle glucose homeostasis in patients with type 2 diabetes. Acta Physiol (Oxf) 2019; 226:e13245. [PMID: 30585698 DOI: 10.1111/apha.13245] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 12/06/2018] [Accepted: 12/17/2018] [Indexed: 12/13/2022]
Abstract
AIM To examine the effect of high-intensity interval training (HIIT) on glucose clearance rates in skeletal muscle and explore the mechanism within the muscle. METHODS Ten males with type 2 diabetes mellitus (T2DM) and ten matched healthy subjects performed 2 weeks of one-legged HIIT (total of eight sessions, each comprised of 10 × 1 minute ergometer bicycle exercise at >80% of maximal heart rate, interspersed with one min of rest). Insulin sensitivity was assessed by an isoglycaemic, hyperinsulinaemic clamp combined with arteriovenous leg balance technique of the trained (T) and the untrained (UT) leg and muscle biopsies of both legs. RESULTS Insulin-stimulated glucose clearance in T legs was ~30% higher compared with UT legs in both groups due to increased blood flow in T vs UT legs and maintained glucose extraction. With each training session, muscle glycogen content decreased only in the training leg, and after the training, glycogen synthase and citrate synthase activities were higher in T vs UT legs. No major changes occurred in the expression of proteins in the insulin signalling cascade. Mitochondrial respiratory capacity was similar in T2DM and healthy subjects, and unchanged by HIIT. CONCLUSION HIIT improves skeletal muscle insulin sensitivity. With HIIT, the skeletal muscle of patients with T2DM becomes just as insulin sensitive as untrained muscle in healthy subjects. The mechanism includes oscillations in muscle glycogen stores and a maintained ability to extract glucose from the blood in the face of increased blood flow in the trained leg.
Collapse
Affiliation(s)
- Flemming Dela
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
- Department of Geriatrics Bispebjerg University Hospital Copenhagen Denmark
| | - Arthur Ingersen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Nynne B. Andersen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Maria B. Nielsen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Helga H. H. Petersen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Christina N. Hansen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Steen Larsen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
- Clinical Research Centre Medical University of Bialystok Bialystok Poland
| | - Jørgen Wojtaszewski
- Department of Nutrition, Exercise and Sports, Faculty of Science University of Copenhagen Copenhagen Denmark
| | - Jørn Wulff Helge
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| |
Collapse
|
20
|
Nie J, Shi Q, Kong Z, Lao CK, Zhang H, Tong TK. QTc interval prolongation during recovery from brief high-intensity intermittent exercise in obese adults. Herz 2019; 45:67-71. [DOI: 10.1007/s00059-019-4808-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/10/2018] [Accepted: 04/05/2019] [Indexed: 10/26/2022]
|
21
|
LeBaron TW, Laher I, Kura B, Slezak J. Hydrogen gas: from clinical medicine to an emerging ergogenic molecule for sports athletes 1. Can J Physiol Pharmacol 2019; 97:797-807. [PMID: 30970215 DOI: 10.1139/cjpp-2019-0067] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
H2 has been clinically demonstrated to provide antioxidant and anti-inflammatory effects, which makes it an attractive agent in exercise medicine. Although exercise provides a multiplicity of benefits including decreased risk of disease, it can also have detrimental effects. For example, chronic high-intensity exercise in elite athletes, or sporadic bouts of exercise (i.e., noxious exercise) in untrained individuals, result in similar pathological factors such as inflammation, oxidation, and cellular damage that arise from and result in disease. Paradoxically, exercise-induced pro-inflammatory cytokines and reactive oxygen species largely mediate the benefits of exercise. Ingestion of conventional antioxidants and anti-inflammatories often impairs exercise-induced training adaptations. Disease and noxious forms of exercise promote redox dysregulation and chronic inflammation, changes that are mitigated by H2 administration. Beneficial exercise and H2 administration promote cytoprotective hormesis, mitochondrial biogenesis, ATP production, increased NAD+/NADH ratio, cytoprotective phase II enzymes, heat-shock proteins, sirtuins, etc. We review the biomedical effects of exercise and those of H2, and we propose that hydrogen may act as an exercise mimetic and redox adaptogen, potentiate the benefits from beneficial exercise, and reduce the harm from noxious exercise. However, more research is warranted to elucidate the potential ergogenic and therapeutic effects of H2 in exercise medicine.
Collapse
Affiliation(s)
- Tyler W LeBaron
- Molecular Hydrogen Institute, Utah, USA.,Centre of Experimental Medicine, Institute for Heart Research, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, The University of British Columbia, 217 - 2176 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
| | - Branislav Kura
- Centre of Experimental Medicine, Institute for Heart Research, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Jan Slezak
- Centre of Experimental Medicine, Institute for Heart Research, Slovak Academy of Sciences, Bratislava, Slovak Republic
| |
Collapse
|
22
|
Maiorana AJ, Williams AD, Askew CD, Levinger I, Coombes J, Vicenzino B, Davison K, Smart NA, Selig SE. Exercise Professionals with Advanced Clinical Training Should be Afforded Greater Responsibility in Pre-Participation Exercise Screening: A New Collaborative Model between Exercise Professionals and Physicians. Sports Med 2018. [PMID: 29524159 PMCID: PMC5948234 DOI: 10.1007/s40279-018-0888-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Regular exercise improves health but can also induce adverse responses. Although such episodes are rare, many guidelines for pre-participation exercise screening have historically had a low threshold for recommending medical clearance prior to the commencement of exercise, placing the responsibility for decision making about exercise participation on physicians. The ‘clearance to exercise’ model still occurs widely in practice, but creates cost burdens and barriers to the uptake of exercise. Moreover, many physicians are not provided the training, nor time in a standard consultation, to be able to effectively perform this role. We present a model for pre-participation exercise screening and the initial assessment of clients wishing to commence an exercise programme. It is designed to guide professional practice for the referral, assessment and prescription of exercise for people across the health spectrum, from individuals who are apparently healthy, through to clients with pre-existing or occult chronic conditions. The model removes the request that physicians provide a ‘clearance’ for patients to engage in exercise programmes. Instead the role of physicians is identified as providing relevant clinical guidance to suitably qualified exercise professionals to allow them to use their knowledge, skills and expertise in exercise prescription to assess and manage any risks related to the prescription and delivery of appropriate exercise programmes. It is anticipated that removing unjustified barriers to exercise participation, such as mandated medical review, will improve the uptake of exercise by the unacceptably high proportion of the population who do not undertake sufficient physical activity for health benefit.
Collapse
Affiliation(s)
- Andrew J Maiorana
- Faculty of Health Sciences, School of Physiotherapy and Exercise Science, Curtin University, Kent St, Bentley, Perth, WA, 6102, Australia. .,Allied Health Department, Fiona Stanley Hospital, Perth, WA, Australia.
| | - Andrew D Williams
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Christopher D Askew
- Faculty of Science, Health, Education and Engineering, School of Health and Sport Sciences, University of Sunshine Coast, Sippy Downs, QLD, Australia
| | - Itamar Levinger
- College of Sport and Exercise Science, Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, VIC, Australia.,Australian Institute for Musculoskeletal Science (AIMSS), Western Health, St Albans, VIC, Australia
| | - Jeff Coombes
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Bill Vicenzino
- Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Kade Davison
- Division of Health Sciences, School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Neil A Smart
- School of Science and Technology, University of New England, Armidale, NSW, Australia
| | - Steve E Selig
- School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC, Australia
| |
Collapse
|
23
|
McCaskey MA, Schättin A, Martin-Niedecken AL, de Bruin ED. Making More of IT: Enabling Intensive Motor Cognitive Rehabilitation Exercises in Geriatrics Using Information Technology Solutions. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4856146. [PMID: 30581853 PMCID: PMC6276519 DOI: 10.1155/2018/4856146] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 10/08/2018] [Indexed: 12/22/2022]
Abstract
Although the health benefits of physical activity and exercise for older people are well established, a largely sedentary lifestyle still prevails in ageing western societies. Finding new ways to make exercise more accessible and acceptable for older adults must be developed to fully unleash its potential in preventing and weakening age-related physical and cognitive decline. Existing barriers to implement effective exercise-based treatment plans include motivational reservations on both the clinician's and patient's side, but also physical limitations caused by disease or deconditioning. Particularly in the more senior population, debilitating conditions do not allow adherence to currently recommended exercise regimes. A major rethinking of age- and user-adapted exercise is overdue. The high intensities required for physical and mental adaptations must be modifiable and personalized according to the functional status of each patient. Emerging information and communication technologies (ICT) have brought forward a plethora of attractive solutions for smart and adapted exercise, but there remains a vast gap between technological advancement and clinical relevance. Where in the beginning ICT for active ageing mainly focussed on aspects of usability and user experience, the current status of IT as applied in ageing populations noticeably shifted toward new services, applications, and devices that can be offered with the aim to prevent, compensate, care, and/or enhance daily life functioning of senior citizens. In this perspective paper, we aim to summarize the current state of the art in ICT-based interventions aimed at improved motor-cognitive control and make suggestions about how these could be combined with high-intensive interval exercise regimes to make rehabilitation for the impaired older adults more effective, and more fun.
Collapse
Affiliation(s)
- M. A. McCaskey
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
- Department of Health Sciences and Technology, The Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - A. Schättin
- Department of Health Sciences and Technology, The Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - A. L. Martin-Niedecken
- Department of Design, Subject Area Game Design, Zurich University of the Arts, Zurich, Switzerland
| | - E. D. de Bruin
- Department of Health Sciences and Technology, The Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
24
|
Bianchi VE, Locatelli V. Testosterone a key factor in gender related metabolic syndrome. Obes Rev 2018; 19:557-575. [PMID: 29356299 DOI: 10.1111/obr.12633] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 09/21/2017] [Indexed: 12/15/2022]
Abstract
Metabolic syndrome (MetS) is highly correlated with cardiovascular diseases. Although an excess of body fat is a determinant factor for MetS development, a reduced level of testosterone plays a fundamental role in its regulation. Low testosterone level is highly related to insulin resistance, visceral obesity and MetS. We have searched in Pubmed clinical trial with the password: testosterone and insulin resistance, and testosterone and MetS. We found 19 studies on the correlation between testosterone level with insulin resistance and 18 on the effect of testosterone therapy on MetS. A high correlation between low testosterone and insulin resistance has been found in men, but not in women. Testosterone administration in hypogonadal men improved MetS and reduced the mortality risk. Androgen and oestrogen receptors are expressed in adipocytes, muscle and liver tissue, and their activation is necessary to improve metabolic control. Normalization of testosterone level should be the primary treatment in men, along with caloric restriction and physical exercise. These findings come mainly from correlative data, and there remains a need for randomized trials to strengthen this evidence. This review will consider the effects of testosterone on the regulation and development of MetS in men and women.
Collapse
Affiliation(s)
- V E Bianchi
- Nutrition and Metabolism, Clinical Center Stella Maris, Falciano, San Marino
| | - V Locatelli
- Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| |
Collapse
|
25
|
Wyckelsma VL, Levinger I, Murphy RM, Petersen AC, Perry BD, Hedges CP, Anderson MJ, McKenna MJ. Intense interval training in healthy older adults increases skeletal muscle [ 3H]ouabain-binding site content and elevates Na +,K +-ATPase α 2 isoform abundance in Type II fibers. Physiol Rep 2017; 5:5/7/e13219. [PMID: 28373411 PMCID: PMC5392511 DOI: 10.14814/phy2.13219] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 02/27/2017] [Indexed: 12/12/2022] Open
Abstract
Young adults typically adapt to intense exercise training with an increased skeletal muscle Na+,K+-ATPase (NKA) content, concomitant with reduced extracellular potassium concentration [K+] during exercise and enhanced exercise performance. Whether these changes with longitudinal training occur in older adults is unknown and was investigated here. Fifteen older adults (69.4 ± 3.5 years, mean ± SD) were randomized to either 12 weeks of intense interval training (4 × 4 min at 90-95% peak heart rate), 3 days/week (IIT, n = 8); or no exercise controls (n = 7). Before and after training, participants completed an incremental cycle ergometer exercise test until a rating of perceived exertion of 17 (very hard) on a 20-point scale was attained, with measures of antecubital venous [K+]v Participants underwent a resting muscle biopsy prior to and at 48-72 h following the final training session. After IIT, the peak exercise work rate (25%), oxygen uptake (16%) and heart rate (6%) were increased (P < 0.05). After IIT, the peak exercise plasma [K+]v tended to rise (P = 0.07), while the rise in plasma [K+]v relative to work performed (nmol.L-1J-1) was unchanged. Muscle NKA content increased by 11% after IIT (P < 0.05). Single fiber measurements, increased in NKA α2 isoform in Type II fibers after IIT (30%, P < 0.05), with no changes to the other isoforms in single fibers or homogenate. Thus, intense exercise training in older adults induced an upregulation of muscle NKA, with a fiber-specific increase in NKA α2 abundance in Type II fibers, coincident with increased muscle NKA content and enhanced exercise performance.
Collapse
Affiliation(s)
- Victoria L Wyckelsma
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria, Australia
| | - Itamar Levinger
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria, Australia
| | - Robyn M Murphy
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Victoria, Australia
| | - Aaron C Petersen
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria, Australia
| | - Ben D Perry
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria, Australia.,Renal Division, Department of Medicine, Emory University, Atlanta, Georgia
| | - Christopher P Hedges
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria, Australia
| | - Mitchell J Anderson
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria, Australia.,Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Michael J McKenna
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living (ISEAL), Victoria, Australia
| |
Collapse
|
26
|
Qiu S, Cai X, Sun Z, Zügel M, Steinacker JM, Schumann U. Aerobic Interval Training and Cardiometabolic Health in Patients with Type 2 Diabetes: A Meta-Analysis. Front Physiol 2017; 8:957. [PMID: 29218018 PMCID: PMC5703832 DOI: 10.3389/fphys.2017.00957] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/10/2017] [Indexed: 12/28/2022] Open
Abstract
Vigorous to maximal aerobic interval training (INT) has received remarkable interest in improving cardiometabolic outcomes for type 2 diabetes patients recently, yet with inconsistent findings. This meta-analysis was aimed to quantify its effectiveness in type 2 diabetes. Randomized controlled trials (RCTs) were identified by searches of 3 databases to October 2017, which evaluated the effects of INT with a minimal training duration of 8 weeks vs. moderate-intensity continuous training (MICT) or non-exercise training (NET) among type 2 diabetes patients on outcomes including cardiorespiratory fitness, glycemic control, body composition, blood pressure, and lipid profiles. Weighted mean differences with 95% confidence intervals (CIs) were calculated with the random-effects model. Nine datasets from 7 RCTs with 189 patients were included. Compared with MICT, INT improved maximal oxygen consumption (VO2max) by 2.60 ml/kg/min (95% CI: 1.32 to 3.88 ml/kg/min, P <0.001) and decreased hemoglobin A1c (HbA1c) by 0.26% (95% CI: −0.46% to −0.07%, P = 0.008). These outcomes for INT were also significant vs. energy expenditure-matched MICT, with VO2max increased by 2.18 ml/kg/min (P = 0.04) and HbA1c decreased by 0.28% (P = 0.01). Yet their magnitudes of changes were larger compared with NET, with VO2max increased by 6.38 ml/kg/min (P <0.001) and HbA1c reduced by 0.83% (P = 0.004). Systolic blood pressure could be lowered by INT compared with energy expenditure-matched MICT or NET (both P <0.05), but other cardiometabolic markers and body composition were not significantly altered in general. In conclusion, despite a limited number of studies, INT improves cardiometabolic health especially for VO2max and HbA1c among patients with type 2 diabetes, and might be considered an alternative to MICT. Yet the optimal training protocols still require to be established.
Collapse
Affiliation(s)
- Shanhu Qiu
- Department of Endocrinology, Institute of Diabetes, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Xue Cai
- Department of Endocrinology, Institute of Diabetes, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Zilin Sun
- Department of Endocrinology, Institute of Diabetes, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Martina Zügel
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
| | - Jürgen M Steinacker
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
| | - Uwe Schumann
- Division of Sports and Rehabilitation Medicine, Ulm University Medical Center, Ulm, Germany
| |
Collapse
|
27
|
Taylor J, Keating SE, Leveritt MD, Holland DJ, Gomersall SR, Coombes JS. Study protocol for the FITR Heart Study: Feasibility, safety, adherence, and efficacy of high intensity interval training in a hospital-initiated rehabilitation program for coronary heart disease. Contemp Clin Trials Commun 2017; 8:181-191. [PMID: 29696208 PMCID: PMC5898506 DOI: 10.1016/j.conctc.2017.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 09/30/2017] [Accepted: 10/04/2017] [Indexed: 12/11/2022] Open
Abstract
Background For decades, moderate intensity continuous training (MICT) has been the cornerstone of exercise prescription for cardiac rehabilitation (CR). High intensity interval training (HIIT) is now recognized in CR exercise guidelines as an appropriate and efficient modality for improving cardiorespiratory fitness, a strong predictor of mortality. However, the clinical application of HIIT in a real world CR setting, in terms of feasibility, safety, and long-term adherence, needs further investigation to address ongoing reservations. Furthermore, studies using objective measures of exercise intensity (such as heart rate; HR) have produced variable outcomes. Therefore we propose investigating the use of subjective measures (such as rating of perceived exertion (RPE)) for prescribing exercise intensity. Methods One hundred adults with coronary artery disease (CAD) attending a hospital-initiated CR program will be randomized to 1) HIIT: 4 × 4 min high intensity intervals at 15–18 RPE interspersed with 3-min active recovery periods or 2) MICT: usual care exercise including 40 min continuous exercise at a moderate intensity corresponding to 11–13 RPE. Primary outcome is change in exercise capacity (peak VO2) following 4 weeks of exercise training. Secondary outcome measures are: feasibility, safety, exercise adherence, body composition, vascular function, inflammatory markers, intrahepatic lipid, energy intake, and dietary behavior over 12-months; and visceral adipose tissue (VAT) following 12 weeks of exercise training. Conclusions This study aims to address the ongoing concerns regarding the practicality and safety of HIIT in CR programs. We anticipate study findings will lead to the development of a standardized protocol to facilitate CR programs to incorporate HIIT as a standard exercise option for appropriate patients.
Collapse
Key Words
- 1H-MRS, Proton magnetic resonance spectroscopy
- API, Application Programming Interface
- CAD, Coronary artery disease
- CR, Cardiac rehabilitation
- Cardiac rehabilitation
- Cardiorespiratory fitness
- DEXA, Dual energy x-ray absorptiometry
- Energy intake
- FIT-TRACK, Fitness Tracking
- FMD, Flow-mediated dilation
- HIIT, High intensity interval training
- HR, Heart rate
- HRpeak, Peak heart rate
- MET, Metabolic equivalent
- MICT, Moderate intensity continuous training
- MRI, Magnetic resonance imaging
- RPE, Rating of perceived exertion
- TFEQ, Three factor eating questionnaire
- VAT, Visceral adipose tissue
- VO2, Oxygen uptake
- Vascular function
- Visceral adipose tissue
Collapse
Affiliation(s)
- Jenna Taylor
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia.,Cardiac Rehabilitation Department, The Wesley Hospital, Chasely St, Auchenflower, QLD, 4066, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Michael D Leveritt
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - David J Holland
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Sjaan R Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| |
Collapse
|
28
|
Cornelissen VA, Buys R, Pattyn N. High intensity interval training in coronary artery disease patients, is it worth the effort? Eur J Prev Cardiol 2017; 24:1692-1695. [DOI: 10.1177/2047487317734051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Veronique A Cornelissen
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Belgium
| | - Roselien Buys
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Belgium
- Department of Cardiovascular Sciences, Faculty of Medicine, Belgium
| | - Nele Pattyn
- Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Belgium
- Department of Cardiovascular Sciences, Faculty of Medicine, Belgium
| |
Collapse
|
29
|
Stork MJ, Banfield LE, Gibala MJ, Martin Ginis KA. A scoping review of the psychological responses to interval exercise: is interval exercise a viable alternative to traditional exercise? Health Psychol Rev 2017; 11:324-344. [PMID: 28460601 DOI: 10.1080/17437199.2017.1326011] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
While considerable evidence suggests that interval exercise confers numerous physiological adaptations linked to improved health, its psychological consequences and behavioural implications are less clear and the subject of intense debate. The purpose of this scoping review was to catalogue studies investigating the psychological responses to interval exercise in order to identify what psychological outcomes have been assessed, the research methods used, and the results. A secondary objective was to identify research issues and gaps. Forty-two published articles met the review inclusion/exclusion criteria. These studies involved 1258 participants drawn from various active/inactive and healthy/unhealthy populations, and 55 interval exercise protocols (69% high-intensity interval training [HIIT], 27% sprint interval training [SIT], and 4% body-weight interval training [BWIT]). Affect and enjoyment were the most frequently studied psychological outcomes. Post-exercise assessments indicate that overall, enjoyment of, and preferences for interval exercise are equal or greater than for continuous exercise, and participants can hold relatively positive social cognitions regarding interval exercise. Although several methodological issues (e.g., inconsistent use of terminology, measures and protocols) and gaps (e.g., data on adherence and real-world protocols) require attention, from a psychological perspective, the emerging data support the viability of interval exercise as an alternative to continuous exercise.
Collapse
Affiliation(s)
- Matthew J Stork
- a School of Health and Exercise Sciences , University of British Columbia , Kelowna , Canada
| | - Laura E Banfield
- b Health Sciences Library , McMaster University , Hamilton , Canada
| | - Martin J Gibala
- c Department of Kinesiology , McMaster University , Hamilton , Canada
| | - Kathleen A Martin Ginis
- a School of Health and Exercise Sciences , University of British Columbia , Kelowna , Canada
| |
Collapse
|
30
|
The impact of acute high-intensity interval exercise on biomarkers of cardiovascular health in type 2 diabetes. Eur J Appl Physiol 2017; 117:1607-1616. [PMID: 28567668 DOI: 10.1007/s00421-017-3649-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 05/20/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE High-intensity interval training (HIIT) interventions improve cardiovascular health, yet the acute effects on circulating and functional biomarkers of cardiovascular function are unclear in individuals with type 2 diabetes (T2D). To explore this, we conducted two investigations to examine the acute response to HIIT in individuals with T2D. METHODS Study 1 measured blood pressure, endothelial-dependent dilation, circulating measures of endothelial activation, and troponin T, 30 min and 2 h after HIIT (7 × 1-min intervals) in T2D (n = 8) and age-matched normoglycemic controls (CTL; n = 8). Study 2 assessed circulating measures of endothelial activation and troponin T, 30 min, and 24 h after HIIT (10 × 1-min intervals) in ten previously trained T2D men. RESULTS In study 1, markers of endothelial function and activation within the first 2 h after HIIT did not differ from baseline between T2D and CTL participants, except at 30 min after HIIT for glucose, which was reduced more in T2D than CTL (by -0.8 ± 1.2 mmol/L, p = 0.04), and VCAM-1, which was reduced more 30 min after HIIT in CTL compared to T2D (by -187 ± 221 ng/mL, p = 0.05). Study 2 saw no significant difference in any circulating markers of endothelial activation and troponin T, 30 min, and 24 h after HIIT in trained T2D males. CONCLUSION Exploratory findings from these two studies suggest that acute HIIT does not substantially alter circulating and functional markers of cardio(vascular) health in individuals with T2D who are unaccustomed (study 1) and accustomed to HIIT (study 2).
Collapse
|
31
|
High Intensity Interval Training for Maximizing Health Outcomes. Prog Cardiovasc Dis 2017; 60:67-77. [PMID: 28385556 DOI: 10.1016/j.pcad.2017.03.006] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 02/08/2023]
Abstract
Regular physical activity and exercise training are important actions to improve cardiorespiratory fitness and maintain health throughout life. There is solid evidence that exercise is an effective preventative strategy against at least 25 medical conditions, including cardiovascular disease, stroke, hypertension, colon and breast cancer, and type 2 diabetes. Traditionally, endurance exercise training (ET) to improve health related outcomes has consisted of low- to moderate ET intensity. However, a growing body of evidence suggests that higher exercise intensities may be superior to moderate intensity for maximizing health outcomes. The primary objective of this review is to discuss how aerobic high-intensity interval training (HIIT) as compared to moderate continuous training may maximize outcomes, and to provide practical advices for successful clinical and home-based HIIT.
Collapse
|
32
|
Colberg SR. Key Points from the Updated Guidelines on Exercise and Diabetes. Front Endocrinol (Lausanne) 2017; 8:33. [PMID: 28265261 PMCID: PMC5317029 DOI: 10.3389/fendo.2017.00033] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 02/07/2017] [Indexed: 12/27/2022] Open
Affiliation(s)
- Sheri R. Colberg
- Human Movement Sciences Department, Old Dominion University, Norfolk, VA, USA
| |
Collapse
|
33
|
Colberg SR, Sigal RJ, Yardley JE, Riddell MC, Dunstan DW, Dempsey PC, Horton ES, Castorino K, Tate DF. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 2016; 39:2065-2079. [PMID: 27926890 PMCID: PMC6908414 DOI: 10.2337/dc16-1728] [Citation(s) in RCA: 1397] [Impact Index Per Article: 174.6] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Sheri R Colberg
- Department of Human Movement Sciences, Old Dominion University, Norfolk, VA
| | - Ronald J Sigal
- Departments of Medicine, Cardiac Sciences, and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jane E Yardley
- Department of Social Sciences, Augustana Campus, University of Alberta, Camrose, Alberta, Canada
| | - Michael C Riddell
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - David W Dunstan
- Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Paddy C Dempsey
- Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Edward S Horton
- Harvard Medical School and Joslin Diabetes Center, Boston, MA
| | | | - Deborah F Tate
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| |
Collapse
|
34
|
Toohey K, Pumpa KL, Arnolda L, Cooke J, Yip D, Craft PS, Semple S. A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors. PeerJ 2016; 4:e2613. [PMID: 27781180 PMCID: PMC5075690 DOI: 10.7717/peerj.2613] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 09/27/2016] [Indexed: 12/14/2022] Open
Abstract
Purpose The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Methods Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group (n = 8) or the continuous low to moderate intensity training group (n = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Results Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05–0.61, p ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43–4.63] ES 0.50, p ≤ 0.01) with the LVHIIT group demonstrating greater improvements. Conclusion These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings.
Collapse
Affiliation(s)
- Kellie Toohey
- Discipline of Sport and Exercise Science/Faculty of Health, University of Canberra, Canberra, ACT, Australia; Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Kate L Pumpa
- Discipline of Sport and Exercise Science/Faculty of Health, University of Canberra, Canberra, ACT, Australia; Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Leonard Arnolda
- ANU Medical School, Australian National University , Canberra , ACT , Australia
| | - Julie Cooke
- Discipline of Sport and Exercise Science/Faculty of Health, University of Canberra, Canberra, ACT, Australia; Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Desmond Yip
- ANU Medical School, Australian National University , Canberra , ACT , Australia
| | - Paul S Craft
- ANU Medical School, Australian National University , Canberra , ACT , Australia
| | - Stuart Semple
- Discipline of Sport and Exercise Science/Faculty of Health, University of Canberra, Canberra, ACT, Australia; Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| |
Collapse
|
35
|
Trevillyan JM, Hoy JF. Managing Cardiovascular Risk in People Living with HIV. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2016. [DOI: 10.1007/s40506-016-0071-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
36
|
Weston M, Weston KL, Prentis JM, Snowden CP. High-intensity interval training (HIT) for effective and time-efficient pre-surgical exercise interventions. Perioper Med (Lond) 2016; 5:2. [PMID: 26770671 PMCID: PMC4712564 DOI: 10.1186/s13741-015-0026-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 12/15/2015] [Indexed: 12/12/2022] Open
Abstract
The advancement of perioperative medicine is leading to greater diversity in development of pre-surgical interventions, implemented to reduce patient surgical risk and enhance post-surgical recovery. Of these interventions, the prescription of pre-operative exercise training is gathering momentum as a realistic means for enhancing patient surgical outcome. Indeed, the general benefits of exercise training have the potential to pre-operatively optimise several pre-surgical risks factors, including cardiorespiratory function, frailty and cognitive function. Any exercise programme incorporated into the pre-operative pathway of care needs to be effective and time efficient in that any fitness gains are achievable in the limited period between the decision for surgery and operation (e.g. 4 weeks). Fortunately, there is a large volume of research describing effective and time-efficient exercise training programmes within the discipline of sports science. Accordingly, the objective of our commentary is to synthesise contemporary exercise training research, both from non-clinical and clinical populations, with the overarching aim of informing the development of effective and time-efficient pre-surgical exercise training programmes. The development of such exercise training programmes requires the careful consideration of several key principles, namely frequency, intensity, time, type and progression of exercise. Therefore, in light of more recent evidence demonstrating the effectiveness and time efficiency of high-intensity interval training—which involves brief bouts of intense exercise interspersed with longer recovery periods—the principles of exercise training programme design will be discussed mainly in the context of such high-intensity interval training programmes. Other issues pertinent to the development, implementation and evaluation of pre-operative exercise training programmes, such as individual exercise prescription, training session monitoring and potential barriers and risks to high-intensity exercise are also discussed. The evidence presented suggests that individually prescribed and supervised high-intensity interval training programmes, encompassing a variety of exercise modes represent an effective and safe means of exercise therapy prior to surgery.
Collapse
Affiliation(s)
- Matthew Weston
- Department of Sport & Exercise Sciences, School of Social Sciences, Business & Law, Teesside University, Middlesbrough, UK
| | - Kathryn L Weston
- Health and Social Care Institute, Teesside University, Middlesbrough, UK
| | - James M Prentis
- Department of Perioperative and Critical Care Medicine, Freeman Hospital, Newcastle upon Tyne, UK
| | - Chris P Snowden
- Department of Perioperative and Critical Care Medicine, Freeman Hospital, Newcastle upon Tyne, UK ; Institute of Cellular Medicine, The Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| |
Collapse
|
37
|
Holloway TM, Spriet LL. Rebuttal from Tanya M. Holloway and Lawrence L. Spriet. J Physiol 2015; 593:5225. [PMID: 26642302 PMCID: PMC4704529 DOI: 10.1113/jp271581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 10/02/2015] [Indexed: 09/06/2023] Open
Affiliation(s)
- Tanya M Holloway
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Lawrence L Spriet
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| |
Collapse
|
38
|
Wisløff U, Coombes JS, Rognmo Ø. CrossTalk proposal: High intensity interval training does have a role in risk reduction or treatment of disease. J Physiol 2015; 593:5215-7. [PMID: 26642190 DOI: 10.1113/jp271041] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/02/2015] [Indexed: 12/20/2022] Open
Affiliation(s)
- Ulrik Wisløff
- K. G. Jebsen Centre of Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Øivind Rognmo
- K. G. Jebsen Centre of Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
39
|
Murlasits Z. A call for the better utilization of physical activity and exercise training in the defense against cardiovascular disease. PHYSICIAN SPORTSMED 2015; 43:329-32. [PMID: 26478474 DOI: 10.1080/00913847.2015.1095618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Statins, also known as 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, effectively reduce elevated levels of serum LDL-C concentration and in turn lower cardiovascular morbidity and mortality. Regular exercise and physical activity also have significant preventive effects against cardiovascular diseases by simultaneously reducing multiple risk factors. However, statins also produce a number of adverse events, including muscle pain, which increases dramatically in statin users who also exercise, likely limiting the cardiovascular benefits. Most importantly, reduced physical activity participation due to statin-related side effects can cancel out the benefits of the pharmacological treatment. Although exercise training offers more modest benefits compared to pharmacological therapy against traditional risk factors, considering the total impact of exercise on cardiovascular health, it is now evident that this intervention may offer a greater reduction of risks compared to statin therapy alone. However, primary recommendations regarding cardiovascular therapy still center around pharmacological approaches. Thus a new outlook is called for in clinical practice that provides room for physical activity and exercise training, thus lipid targets can be reached by a combined intervention along with improvements in other cardiovascular parameters, such as endothelial function and low-grade inflammation. Databases such as Pubmed and Google Scholar as well as the reference list of the relevant articles were searched to collect information for this opinion article.
Collapse
Affiliation(s)
- Zsolt Murlasits
- a Sport Science Program, College of Arts and Sciences , Qatar University , Doha , Qatar
| |
Collapse
|