High-Intensity Interval or Continuous Moderate Exercise: A 24-Week Pilot Trial

Locke, Sean; Bourne, Jessica; Beauchamp, Mark R.; Little, Jonathan P.; Barry, Julianne; Singer, Joel; Jung, Mary E.

doi:10.1249/mss.0000000000001668

Cited by 27 publications

(20 citation statements)

References 30 publications

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“…HIIT has been reported to be safe, even in selected high‐risk populations with cardiovascular disease, but many HIIT protocols for clinical populations with elevated cardiovascular risk have been modified to be less strenuous and some authors advocate to be cautious when prescribing HIIT to patients with cardiometabolic disease . A recent large‐scale study concluded that HIIT feasibility in heart failure patients remains unsolved, while a pilot trial in obese, middle‐aged subjects (mostly women) concluded that HIIT may be appropriate and attainable for this population …”

Section: Discussionmentioning

confidence: 99%

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Effects of one‐legged high‐intensity interval training on insulin‐mediated skeletal muscle glucose homeostasis in patients with type 2 diabetes

et al. 2019

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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.

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Section: Discussionmentioning

confidence: 99%

“…65 A recent large-scale study concluded that HIIT feasibility in heart failure patients remains unsolved, 66 while a pilot trial in obese, middle-aged subjects (mostly women) concluded that HIIT may be appropriate and attainable for this population. 67…”

Section: Perspectives and Potential Implementation Of Hiitmentioning

confidence: 99%

Effects of one‐legged high‐intensity interval training on insulin‐mediated skeletal muscle glucose homeostasis in patients with type 2 diabetes

et al. 2019

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“…The aim of this study was to a) characterize the content of an exercise-based intervention for individuals at risk of type 2 diabetes, Small Steps for Big Changes (Small Steps) using a common vocabulary as set out by the 93-item Behavior Change Technique Taxonomy (BCTTv1) Findings from the Small Steps pilot study revealed a significant increase in physical activity adherence at 6-month follow-up for both the high intensity interval training intervention (HIIT) and the moderate intensity continuous training intervention (MICT), however adherence was greater in HIIT than MICT with a 53 and 34-minute increase in moderate to vigorous physical activity of 10-minutes or greater from baseline to 24-weeks respectively [27]. In addition, increases in self-efficacy, self-regulatory efficacy and outcome expectations were seen post intervention with self-efficacy beliefs remaining higher at 6-month follow-up to a similar extent between conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Mapping BCTs onto the theoretical domains framework is necessary to capture these additional evidence-based mechanisms of action that move beyond SCT given the explicit inclusion of techniques known to positively influence physical activity behavior. Initial findings from a pilot of the Small Steps program showed significant increases in self-efficacy, outcome expectations, and higher engagement in moderate-vigorous physical activity at 1-and 6-months post-program completion [26,27]. Reporting the outcomes of Small…”

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confidence: 99%

Mapping behavior change techniques to characterize a social cognitive theory informed physical activity intervention for adults at risk of type 2 diabetes mellitus

Bourne

Ivanova

Gainforth

et al. 2019

Translational Behavioral Medicine

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Behavior change techniques (BCTs) are used to target theoretical mechanisms of action predicted to bring about behavior change. Reporting BCTs and connecting them to mechanisms of action is critical to understanding intervention processes of change. This article identifies the BCTs associated with an exercise intervention for individuals at risk of type 2 diabetes and determines the extent to which these BCTs target associated mechanisms of action. BCTs were mapped onto social cognitive theory (SCT) and the theoretical domains framework (TDF) using published literature identifying links between BCTs and SCT/TDF and expert consensus. Two coders then used the 93-item BCT taxonomy (BCTTv1) to independently code BCTs within the intervention. The BCTs used in the current intervention enabled identification of the theoretical mechanisms of action targeted in the intervention. More than 70% of the intervention content incorporated at least one BCT. More than 50% of the BCTs used targeted SCT constructs and more than 70% of BCTs used targeted at least one of the 14 TDF domains. Five BCTs did not map onto either SCT or TDF. This research provides a systematic method of linking BCTs to mechanisms of action. This process increases the transparency of intervention content and identification of the mechanisms of action targeted in the current intervention. Reporting interventions in this manner will enable the most potent mechanisms of actions associated with long-term behavior change to be identified and utilized in future work. Trial Registration: ClinicalTrials.gov # NCT02164474. Registered on June 12, 2014.

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“…The FITT characteristic most commonly manipulated is “time” . In particular, high‐intensity interval training (HIIT) has become popular, not least because HIIT training tends to be of shorter duration and the most commonly cited barrier to exercise participation is a lack of time . However, HIIT also manipulates time and removal of a barrier to exercise, either perceived or real, may not translate to increased adherence.…”

Section: Introductionmentioning

confidence: 99%

The effects of manipulation of Frequency, Intensity, Time, and Type (FITT) on exercise adherence: A meta‐analysis

et al. 2020

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This meta-analysis quantified the effect of FITT (frequency, intensity, time, and type) manipulation on exercise adherence. Databases were searched from inception to 09-2018. Manipulation of intensity resulted in a moderate, significant decrease in adherence (MD: −3.3, 95% CI: −6.1 to −0.5), and for the remaining FITT components, there were trivial-small, non-significant effects. When stratified by chronic disease status, for populations with chronic diseases increasing Intensity resulted in a moderate but non-significant decrease in adherence (MD: −3.6, 95% CI: −7.4, 0.3) and increasing time resulted in a small, significant decrease in exercise adherence (MD: −4.9, 95% CI: −9.4 to −0.4). Additionally, omission of a behavioral model resulted in a moderate but non-significant decrease in exercise adherence (MD: −4.0, CI: −8.3 to 0.2). For healthy populations, FITT manipulation and omission of behavioral model resulted in trivial-small, non-significant effects. In conclusion, manipulation of FITT and use of behavioral models may be of greater importance to exercise adherence in diseased population. In particular, increasing intensity and time and omitting a behavioral model may decrease adherence. The current meta-analysis elucidates gaps in the literature and can assist clinicians and clinical exercise physiologists in determining the importance of FITT manipulation to exercise adherence. K E Y W O R D S adherence, behavioral model, chronic disease, exercise prescription, physical activity | 223 BURNET ET al.

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High-Intensity Interval or Continuous Moderate Exercise: A 24-Week Pilot Trial

Abstract: This pilot intervention was successful in increasing, and maintaining, free-living MVPA over a 24-wk period in individuals at high risk of T2D. Speculation that HIIT is inappropriate or unattainable for overweight individuals at high risk of T2D may be unfounded.

Cited by 27 publications

References 30 publications

Effects of one‐legged high‐intensity interval training on insulin‐mediated skeletal muscle glucose homeostasis in patients with type 2 diabetes

Effects of one‐legged high‐intensity interval training on insulin‐mediated skeletal muscle glucose homeostasis in patients with type 2 diabetes

Mapping behavior change techniques to characterize a social cognitive theory informed physical activity intervention for adults at risk of type 2 diabetes mellitus

The effects of manipulation of Frequency, Intensity, Time, and Type (FITT) on exercise adherence: A meta‐analysis

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