High-intensity interval training produces a significant improvement in fitness in less than 31 days before surgery for urological cancer: a randomised control trial

Abstract

Objectives To assess the efficacy of high-intensity interval training (HIIT) for improving cardiorespiratory fitness (CRF) in patients awaiting resection for urological malignancy within four weeks. Subjects/patients and methods A randomised control trial of consecutive patients aged (>65 years) scheduled for major urological surgery in a large secondary referral centre in a UK hospital. The primary outcome is change in anaerobic threshold (VO 2AT) following HIIT vs. standard care. Results Forty patients were recruited (mean age 72 years, male (39): female (1)) with 34 completing the protocol. Intention to treat analysis showed significant improvements in anaerobic threshold (VO 2AT ; mean difference (MD) 2.26 ml/kg/min (95% CI 1.25-3.26)) following HIIT. Blood pressure (BP) also significantly reduced in following: HIIT (SBP: −8.2 mmHg (95% CI −16.09 to −0.29) and DBP: −6.47 mmHg (95% CI −12.56 to −0.38)). No reportable adverse safety events occurred during HIIT and all participants achieved >85% predicted maximum heart rate during sessions, with protocol adherence of 84%. Conclusions HIIT can improve CRF and cardiovascular health, representing clinically meaningful and achievable preoperative improvements. Larger randomised trials are required to investigate the efficacy of prehabilitation HIIT upon different cancer types, post-operative complications, socioeconomic impact and long-term survival.

Efficacy of Prehabilitation Including Exercise on Postoperative Outcomes Following Abdominal Cancer Surgery: A Systematic Review and Meta-Analysis

“…Meta-analysis was limited by methodological, clinical and statistical heterogeneity within the included studies. Additional data were requested for four of the studies ( 8 , 26 – 28 ) with two able to provide the data requested ( 8 , 27 ). Therefore, data was interpreted from a study figure ( 28 ), or calculated from other data within the study ( 26 ) for meta-analysis.…”

“…Additional data were requested for four of the studies ( 8 , 26 – 28 ) with two able to provide the data requested ( 8 , 27 ). Therefore, data was interpreted from a study figure ( 28 ), or calculated from other data within the study ( 26 ) for meta-analysis. For pooled data summary please see Supplementary Table 11 .…”

“…In total, this review included 22 studies, of which 21 were RCTs and one a pseudo-RCT. The majority of the studies were conducted in Canada [five studies ( 8 , 13 , 26 , 29 , 30 )] and the UK [five studies ( 14 , 15 , 28 , 31 , 32 )]. Two were international multicentre RCTs, conducted in Australasia ( 27 ) and Europe ( 33 ).…”

High‐intensity interval training and essential amino acid supplementation: Effects on muscle characteristics and whole‐body protein turnover

“…The results of this study showed minimal changes in muscle architecture. In contrast, an increase in PA (+2.5°), but not FL (−0.08 mm), accompanied by increases in muscle thickness, has previously been reported following 4 weeks of HIIT (3-4 d/wk) in cancer patients (Blackwell et al, 2020). Changes in muscle architecture are commonly seen following resistance training, which incorporates both concentric and eccentric muscle actions (Franchi et al, 2014).…”

“…In addition to quantification of mCSA, ultrasonography can also be used to evaluate muscle quality, via grayscale analysis of echo intensity which estimates the amount of contractile and noncontractile tissue within a muscle, as well as architectural features, such as fascicle length and pennation angle, that influence muscular strength and force production (Ahtiainen et al., 2010; Narici et al., 2016; Young et al., 2015). These muscle characteristics provide insight into muscular health and functionality, but have been minimally evaluated in response to HIIT (Blackwell et al., 2020; Blue et al., 2017; Moghaddam et al., 2020).…”