Evidence-Based, High-Intensity Exercise and Physical Activity for Compressing Morbidity in Older Adults: A Narrative Review

Abstract

Recent research in exercise science has important applications for middle-aged and older adults and points to how the programming of individual and multicomponent interventions including theory-based health behavior change strategies may be improved to compress morbidity by delaying or reducing the disabling process. High-intensity interval training and sprint interval training until recently were seen as only applicable to athletes. But recent lab-based research has adapted these interventions for even older adults and demonstrated their safety with beneficial outcomes on cardiometabolic risk factors comparable to or surpassing the usual lower- to moderate-intensity endurance training, and their potential translatability by showing the efficacy of much lower duration and frequency of training, even by systematic stair climbing. Moreover, people report positive affect while engaged in such training. For a century, resistance training was conceived as weightlifting with heavy weights required. Recent research has shown that using a higher degree of effort with lighter to moderate resistance in simple, time efficient protocols result in gains in strength and muscle mass similar to heavy resistance, as well as improvement of cardiometabolic risk factors, strength, body composition, and cognitive, affective, and functional abilities. More effort-based resistance training with moderate resistance may make resistance training more appealing and accessible to older adults. A key potential translational finding is that with correct technique and a high degree of effort, training with inexpensive, portable elastic bands, useable virtually anywhere, can provide appreciable benefits. More emphasis should be placed on long-term, translational interventions, resources, and programs that integrate interval and resistance trainings. This work may improve public health programs for middle-aged and older adults and reflects an emerging evidence base.

High Intensity Interval Training Does Not Have Compensatory Effects on Physical Activity Levels in Older Adults

“…• VO 2max ) more than traditional, continuous moderate-intensity exercise, with the same caloric expenditure, in trained men, sedentary subjects, and older people [9][10][11][12][13]. HIIT elicited similar or higher enjoyment and adherence levels than moderate-intensity continuous training [14].…”

Physiological basis of brief vigorous exercise to improve health

“…Incorporating traditional ‘cardio’ training with resistance training is one promising area where such a hybrid‐style of brief vigorous exercise may be a time‐efficient exercise model for improving fitness and metabolic health (Fealy et al . ), including in older individuals (Winett and Ogletree ). The concept of ‘exercise snacks’, whereby isolated, short bouts (∼20 s) of vigorous exercise can be incorporated into the day with several hours of rest in between (Jenkins et al .…”

Impact of Whole Body Electromyostimulation on Velocity, Power and Body Composition in Postmenopausal Women: A Randomized Controlled Trial

“…The devices generally allow the activation of the thighs, arms, buttocks, abdomen, chest, lower back, upper back, wide dorsal, and with two auxiliary channels of free choice. In recent years, high-intensity training programs have been developed with older adults, observing increases in strength [14][15][16][17][18] and body composition [19,20]. Taking into account that the WB-EMS can become easily intense and guarantees sufficient effort in those unable or reluctant to do it on their own initiative [21], we hypothesize that it could be an appropriate training methodology for sedentary postmenopausal women.…”