Equipment-free, unsupervised high intensity interval training elicits significant improvements in the physiological resilience of older adults

Tanvir S Sian, Thomas B Inns, Amanda Gates, Brett Doleman, Joseph J Bass, Philip J Atherton, Jonathan N Lund, Bethan E Phillips, Tanvir S Sian, Thomas B Inns, Amanda Gates, Brett Doleman, Joseph J Bass, Philip J Atherton, Jonathan N Lund, Bethan E Phillips

Abstract

Background: Reduced cardiorespiratory fitness (CRF) is an independent risk factor for dependency, cognitive impairment and premature mortality. High-intensity interval training (HIIT) is a proven time-efficient stimulus for improving both CRF and other facets of cardiometabolic health also known to decline with advancing age. However, the efficacy of equipment-free, unsupervised HIIT to improve the physiological resilience of older adults is not known.

Methods: Thirty independent, community-dwelling older adults (71(SD: 5) years) were randomised to 4 weeks (12 sessions) equipment-free, supervised (in the laboratory (L-HIIT)) or unsupervised (at home (H-HIIT)) HIIT, or a no-intervention control (CON). HIIT involved 5, 1-minute intervals of a bodyweight exercise each interspersed with 90-seconds recovery. CRF, exercise tolerance, blood pressure (BP), body composition, muscle architecture, circulating lipids and glucose tolerance were assessed at baseline and after the intervention period.

Results: When compared to the control group, both HIIT protocols improved the primary outcome of CRF ((via anaerobic threshold) mean difference, L-HIIT: +2.27, H-HIIT: +2.29, both p < 0.01) in addition to exercise tolerance, systolic BP, total cholesterol, non-HDL cholesterol and m. vastus lateralis pennation angle, to the same extent. There was no improvement in these parameters in CON. There was no change in diastolic BP, glucose tolerance, whole-body composition or HDL cholesterol in any of the groups.

Conclusions: This is the first study to show that short-term, time-efficient, equipment-free, HIIT is able to elicit improvements in the CRF of older adults irrespective of supervision status. Unsupervised HIIT may offer a novel approach to improve the physiological resilience of older adults, combating age-associated physiological decline, the rise of inactivity and the additional challenges currently posed by the COVID-19 pandemic.

Trial registration: This study was registered at clinicaltrials.gov and coded: NCT03473990 .

Keywords: Cardiometabolic; Cardiorespiratory fitness; Exercise; HIIT; Supervision.

Conflict of interest statement

No author has a competing interest to declare.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Schematic representation of the high intensity interval training (HIIT) protocol perform with and without supervision. Abbreviations: HRmax, age-predicted maximum heart rate (220-age); s, seconds
Fig. 2
Fig. 2
Anaerobic threshold (A), VO2peak (B) and maximum wattage (C) in older individuals before and after laboratory (L-HIIT; n = 10) or home-based (H-HIIT; n = 10) high intensity interval training (HIIT) or a no intervention control (CON; n = 10) period. **= p < 0.01 versus pre-intervention
Fig. 3
Fig. 3
Systolic blood pressure (A), total cholesterol (B) and non-HDL cholesterol (C) in older individuals before and after laboratory (L; n = 10) or home-based (H; n = 10) high intensity interval training (HIIT) or a no intervention control (CON; n = 10) period. *=p < 0.05, **= p < 0.01 versus pre-intervention
Fig. 4
Fig. 4
Whole-body fat (A) and lean (B) mass and m. vastus lateralis pennation angle (C) in older individuals before and after laboratory (L; n = 10) or home-based (H; n = 10) high intensity interval training (HIIT) or a no intervention control (CON; n = 10) period. **= p < 0.01, ***=p < 0.01 versus pre-intervention

References

    1. Ryan A, Heath S, Cook P. Managing dyslipidaemia for the primary prevention of cardiovascular disease. BMJ. 2018;360:k946.
    1. LaMonte MJ, Eisenman PA, Adams TD, Shultz BB, Ainsworth BE, Yanowitz FG. Cardiorespiratory Fitness and Coronary Heart Disease Risk Factors. Circulation. 2000;102:1623–1628.
    1. McPhee JS, French DP, Jackson D, Nazroo J, Pendleton N, Degens H. Physical activity in older age: perspectives for healthy ageing and frailty. Biogerontol. 2016;17:567–580.
    1. Paul Greenhaff P, Charlotte Bolton P, Faulkner J, Carolyn Greig P, Stephen Harridge PD, Lambrick D, et al. A National COVID-19 Resilience Programme: Improving the health and wellbeing of older people during the pandemic Expert Panel.
    1. Gonzales TI, Westgate K, Strain T, Hollidge S, Jeon J, Christensen DL, et al. Cardiorespiratory fitness assessment using risk-stratified exercise testing and dose–response relationships with disease outcomes. Sci Rep. 2021;11:15315.
    1. Ross R, Blair SN, Arena R, Church TS, Després J-P, Franklin BA, et al. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation. 2016;134. 10.1161/CIR.0000000000000461
    1. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and Women. JAMA. 2009;301:2024.
    1. Al-Mallah MH, Keteyian SJ, Brawner CA, Whelton S, Blaha MJ. Rationale and design of the Henry Ford Exercise Testing Project (the FIT project) Clin Cardiol. 2014;37:456–61.
    1. Hakola L, Komulainen P, Hassinen M, Savonen K, Litmanen H, Lakka TA, et al. Cardiorespiratory fitness in aging men and women: the DR’s EXTRA study. Scand J Med Sci Sports. 2011;21:679–687.
    1. Seo DY, Lee SR, Kim N, Ko KS, Rhee BD, Han J. Age-related changes in skeletal muscle mitochondria: the role of exercise. Integr Med Res. 2016;5:182–186.
    1. Nair KS. Aging muscle. Am J Clin Nutr. 2005;81:953–63.
    1. Myers J. Exercise and Cardiovascular Health. Circulation. 2003;107. 10.1161/01.CIR.0000048890.59383.8D
    1. Booth FW, Roberts CK, Laye MJ. Lack of Exercise Is a Major Cause of Chronic Diseases. Yet to Come Compr Physiol. 2012;7:1143–1211.
    1. Lee DH, Keum N, Hu FB, Orav EJ, Rimm EB, Willett WC, et al. Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study. BMJ. 2018;362:k2575.
    1. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:16–31.
    1. Boo S-H, Joo MC, Lee JM, Kim SC, Yu YM, Kim M-S. Association between skeletal muscle mass and cardiorespiratory fitness in community-dwelling elderly men. Aging Clin Exp Res. 2019;31:49–57.
    1. Batsis JA, Zagaria AB. Addressing Obesity in Aging Patients. Med Clin North Am. 2018;102:65–85.
    1. Bruseghini P, Calabria E, Tam E, Milanese C, Oliboni E, Pezzato A, et al. Effects of eight weeks of aerobic interval training and of isoinertial resistance training on risk factors of cardiometabolic diseases and exercise capacity in healthy elderly subjects. Oncotarget. 2015;6:16998.
    1. Marzetti E, Calvani R, Tosato M, Cesari M, Di Bari M, Cherubini A, et al. Physical activity and exercise as countermeasures to physical frailty and sarcopenia. Aging Clin Exp Res. 2017;29:35–42.
    1. Herrod PJJ, Blackwell JEM, Boereboom CL, Atherton PJ, Williams JP, Lund JN, et al. The time course of physiological adaptations to high-intensity interval training in older adults. Aging Med. 2020;3:245–251.
    1. Snijders T, Leenders M, de Groot LCPGM, van Loon LJC, Verdijk LB. Muscle mass and strength gains following 6 months of resistance type exercise training are only partly preserved within one year with autonomous exercise continuation in older adults. Exp Gerontol. 2019;121:71–78.
    1. MacInnis MJ, Gibala MJ. Physiological adaptations to interval training and the role of exercise intensity. J Physiol. 2017;595:2915.
    1. Korkiakangas EE, Alahuhta MA, Laitinen JH. Barriers to regular exercise among adults at high risk or diagnosed with type 2 diabetes: a systematic review. Health Promot Int. 2009;24:416–427.
    1. Cohen-Mansfield J, Marx MS, Guralnik JM. Motivators and Barriers to Exercise in an Older Community-Dwelling Population. J Aging Phys Act. 2003;11:242–253.
    1. Seals DR, Nagy EE, Moreau KL. Aerobic exercise training and vascular function with ageing in healthy men and women. J Physiol. 2019;597:4901–4914.
    1. Ye Y, Lin H, Wan M, Qiu P, Xia R, He J, et al. The Effects of Aerobic Exercise on Oxidative Stress in Older Adults: A Systematic Review and Meta-Analysis. Front Physiol. 2021;12:701151.
    1. Chen F-T, Etnier JL, Chan K-H, Chiu P-K, Hung T-M, Chang Y-K. Effects of Exercise Training Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis. Sports Med. 2020;50:1451–1467.
    1. Wyckelsma VL, Levinger I, McKenna MJ, Formosa LE, Ryan MT, Petersen AC, et al. Preservation of skeletal muscle mitochondrial content in older adults: relationship between mitochondria, fibre type and high-intensity exercise training. J Physiol. 2017;595:3345–3359.
    1. Marriott CFS, Petrella AFM, Marriott ECS, Boa Sorte Silva NC, Petrella RJ. High-Intensity Interval Training in Older Adults: a Scoping Review. Sport Med - Open. 2021;7:49.
    1. Blackwell JEM, Gharahdaghi N, Brook MS, Watanabe S, Boereboom CL, Doleman B, et al. The physiological impact of high-intensity interval training in octogenarians with comorbidities. J Cachexia Sarcopenia Muscle. 2021;12:866–879.
    1. Reitlo LS, Sandbakk SB, Viken H, Aspvik NP, Ingebrigtsen JE, Tan X, et al. Exercise patterns in older adults instructed to follow moderate- or high-intensity exercise protocol - the generation 100 study. BMC Geriatr. 2018;18:208.
    1. Letnes JM, Berglund I, Johnson KE, Dalen H, Nes BM, Lydersen S, et al. Effect of 5 years of exercise training on the cardiovascular risk profile of older adults: the Generation 100 randomized trial. Eur Heart J. Published Online First: 8 November 2021. 10.1093/eurheartj/ehab721
    1. Blackwell J, Atherton PJ, Smith K, Doleman B, Williams JP, Lund JN, et al. The efficacy of unsupervised home-based exercise regimens in comparison to supervised laboratory-based exercise training upon cardio-respiratory health facets. Physiol Rep. 2017;5. 10.14814/phy2.13390
    1. Sian TS, Inns T, Gates A, Doleman B, Gharahdaghi N, Atherton PJ, et al. Short-Term, Equipment-Free High Intensity Interval Training Elicits Significant Improvements in Cardiorespiratory Fitness Irrespective of Supervision in Early Adulthood. Front Sport Act Living. 2021;3:207.
    1. Weisman IM, Marciniuk D, Martinez FJ, Sciurba F, Sue D, Myers Bruce, Johnson J, et al. ATS/ACCP Statement on Cardiopulmonary Exercise Testing. Am J Respir Crit Care Med. 2003;167:211–277.
    1. Levett DZH, Jack S, Swart M, Carlisle J, Wilson J, Snowden C, et al. Perioperative cardiopulmonary exercise testing (CPET): consensus clinical guidelines on indications, organization, conduct, and physiological interpretation. Br J Anaesth. 2018;120:484–500.
    1. British and Irish Hypertension Society. Blood pressure measurement; using automated blood pressure monitors. 2017.
    1. World Health Organisation (WHO), International Diabetets Federation (IDF). Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: Report of a WHO/IDF Consultation. 2006.
    1. Franchi MV, Longo S, Mallinson J, Quinlan JI, Taylor T, Greenhaff PL, et al. Muscle thickness correlates to muscle cross-sectional area in the assessment of strength training-induced hypertrophy. Scand J Med Sci Sports. 2018;28:846–853.
    1. Rueden CT, Schindelin J, Hiner MC, DeZonia BE, Walter AE, Arena ET, et al. ImageJ2: ImageJ for the next generation of scientific image data. BMC Bioinformatics. 2017;18:529.
    1. Kaczmarek S, Habedank D, Obst A, Dörr M, Völzke H, Gläser S, et al. Interobserver variability of ventilatory anaerobic threshold in asymptomatic volunteers. Multidiscip Respir Med. 2019;14:20.
    1. Boereboom C, Phillips BE, Williams JP, Lund JN. A 31-day time to surgery compliant exercise training programme improves aerobic health in the elderly. Tech Coloproctol. 2016;20:375–382.
    1. Fox SM, Naughton JP, Haskell WL. Physical activity and the prevention of coronary heart disease. Ann Clin Res. 1971;3:404–32.
    1. de Boer MR, Waterlander WE, Kuijper LDJ, Steenhuis IHM, Twisk JWR. Testing for baseline differences in randomized controlled trials: an unhealthy research behavior that is hard to eradicate. Int J Behav Nutr Phys Act. 2015;12:4.
    1. Blackwell JEM, Doleman B, Boereboom CL, Morton A, Williams S, Atherton P, et al. High-intensity interval training produces a significant improvement in fitness in less than 31 days before surgery for urological cancer: a randomised control trial. Prostate Cancer Prostatic Dis. 2020;23(4):696-704.
    1. Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults’ participation in physical activity: review and update. Med Sci Sports Exerc. 2002;34:1996–2001.
    1. Costello E, Kafchinski M, Vrazel J, Sullivan P. Motivators, Barriers, and Beliefs Regarding Physical Activity in an Older Adult Population. J Geriatr Phys Ther. 2011;34:138–147.
    1. World Health Organisation (WHO). Physical Activity. 2018.
    1. Hardcastle SJ, Ray H, Beale L, Hagger MS. Why sprint interval training is inappropriate for a largely sedentary population. Front Psychol 2014;5. 10.3389/FPSYG.2014.01505
    1. Hunter JR, Gordon BA, Lythgo N, Bird SR, Benson AC. Exercise at an onsite facility with or without direct exercise supervision improves health-related physical fitness and exercise participation: An 8-week randomised controlled trial with 15-month follow-up. Heal Promot J Aust. 2018;29:84–92.
    1. Scott SN, Shepherd SO, Strauss JA, Wagenmakers AJM, Cocks M. Home-based high‐intensity interval training reduces barriers to exercise in people with type 1 diabetes. Exp Physiol. 2020;105:571–578.
    1. Scott SN, Shepherd SO, Hopkins N, Dawson EA, Strauss JA, Wright DJ, et al. 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.
    1. Youssef EF, Shanb AA elhameed. Supervised Versus Home Exercise Training Programs on Functional Balance in Older Subjects. Malays J Med Sci. 2016;23:83–93.
    1. Lacroix A, Hortobágyi T, Beurskens R, Granacher U. Effects of Supervised vs. Unsupervised Training Programs on Balance and Muscle Strength in Older Adults: A Systematic Review and Meta-Analysis. Sport Med. 2017;47:2341–2361.
    1. Morgan F, Battersby A, Weightman AL, Searchfield L, Turley R, Morgan H, et al. Adherence to exercise referral schemes by participants – what do providers and commissioners need to know? A systematic review of barriers and facilitators. BMC Public Health. 2016;16:227.
    1. Ashton LM, Hutchesson MJ, Rollo ME, Morgan PJ, Collins CE. Motivators and Barriers to Engaging in Healthy Eating and Physical Activity: A Cross-Sectional Survey in Young Adult Men. Am J Mens Health. 2017;11:330–343.
    1. Liu Y, Yang Y, Liu H, Wu W, Wu X, Wang T. A systematic review and meta-analysis of fall incidence and risk factors in elderly patients after total joint arthroplasty. Medicine (Baltimore) 2020;99:e23664.
    1. Hwang C-L, Yoo J-K, Kim H-K, Hwang M-H, Handberg EM, Petersen JW, et al. Novel all-extremity high-intensity interval training improves aerobic fitness, cardiac function and insulin resistance in healthy older adults. Exp Gerontol. 2016;82:112–9.
    1. Bruseghini P, Tam E, Calabria E, Milanese C, Capelli C, Galvani C. High Intensity Interval Training Does Not Have Compensatory Effects on Physical Activity Levels in Older Adults. Int J Environ Res Public Health 2020;17. 10.3390/IJERPH17031083
    1. Knowles A-M, Herbert P, Easton C, Sculthorpe N, Grace FM. Impact of low-volume, high-intensity interval training on maximal aerobic capacity, health-related quality of life and motivation to exercise in ageing men. Age (Dordr) 2015;37:25.
    1. Silveira-Coswig V, Barbalho M, Raiol R, Boscolo F, Vecchio D, Ramirez-Campillo R, et al. Effects of high vs moderate-intensity intermittent training on functionality, resting heart rate and blood pressure of elderly women. J Transl Med. 2020;18:88.
    1. Dunne DFJ, Jack S, Jones RP, Jones L, Lythgoe DT, Malik HZ, et al. Randomized clinical trial of prehabilitation before planned liver resection. Br J Surg. 2016;103:504–512.
    1. SPRINT Research Group TSR. Wright JT, Williamson JD, Whelton PK, Snyder JK, Sink KM, et al. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med. 2015;373:2103–16.
    1. Grace F, Herbert P, Elliott AD, Richards J, Beaumont A, Sculthorpe NF. High intensity interval training (HIIT) improves resting blood pressure, metabolic (MET) capacity and heart rate reserve without compromising cardiac function in sedentary aging men. Exp Gerontol. 2018;109:75–81.
    1. Herrod PJJ, Doleman B, Blackwell JEM, O’Boyle F, Williams JP, Lund JN, et al. Exercise and other nonpharmacological strategies to reduce blood pressure in older adults: a systematic review and meta-analysis. J Am Soc Hypertens. 2018;12:248–267.
    1. Mann S, Beedie C, Jimenez A. Differential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: review, synthesis and recommendations. Sports Med. 2014;44:211–21.
    1. Søgaard D, Lund MT, Scheuer CM, Dehlbaek MS, Dideriksen SG, Abildskov CV, et al. High-intensity interval training improves insulin sensitivity in older individuals. Acta Physiol. 2018;222:e13009.
    1. Robinson MM, Dasari S, Konopka AR, Johnson ML, Manjunatha S, Esponda RR, et al. Enhanced Protein Translation Underlies Improved Metabolic and Physical Adaptations to Different Exercise Training Modes in Young and Old Humans. Cell Metab. 2017;25:581.
    1. Little JP, Gillen JB, Percival ME, Safdar A, Tarnopolsky MA, Punthakee Z, et al. Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2 diabetes. J Appl Physiol. 2011;111:1554–60.
    1. Francois ME, Little JP. Effectiveness and Safety of High-Intensity Interval Training in Patients With Type 2 Diabetes. Diabetes Spectr. 2015;28:39–44.
    1. Jelleyman C, Yates T, O’Donovan G, Gray LJ, King JA, Khunti K, et al. The effects of high-intensity interval training on glucose regulation and insulin resistance: a meta-analysis. Obes Rev. 2015;16:942–961.
    1. Beard JR, Officer A, de Carvalho IA, Sadana R, Pot AM, Michel J-P, et al. The World report on ageing and health: a policy framework for healthy ageing. Lancet (London, England) 2016;387:2145–2154.
    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet (London, England) 2013;381:752–62.
    1. Giovannini S, Brau F, Forino R, Berti A, D’Ignazio F, Loreti C, et al. Sarcopenia: Diagnosis and Management, State of the Art and Contribution of Ultrasound. J Clin Med. 2021;10. 10.3390/jcm10235552
    1. Lee D, Li Z, Sohail QZ, Jackson K, Fiume E, Agur A. A three-dimensional approach to pennation angle estimation for human skeletal muscle. Comput Methods Biomech Biomed Engin. 2015;18:1474–1484.
    1. Aagaard P, Andersen JL, Dyhre-Poulsen P, Leffers AM, Wagner A, Magnusson SP, et al. A mechanism for increased contractile strength of human pennate muscle in response to strength training: changes in muscle architecture. J Physiol. 2001;534:613–23.
    1. Gluvic Z, Zaric B, Resanovic I, Obradovic M, Mitrovic A, Radak D, et al. Link Between Metabolic Syndrome and Insulin Resistance. Curr Vasc Pharmacol. 2017;15. 10.2174/1570161114666161007164510
    1. Wewege M, van den Berg R, Ward RE, Keech A. The effects of high-intensity interval training vs. moderate-intensity continuous training on body composition in overweight and obese adults: a systematic review and meta-analysis. Obes Rev. 2017;18:635–646.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe