High-intensity interval training in patients with substance use disorder

Grete Flemmen, Runar Unhjem, Eivind Wang, Grete Flemmen, Runar Unhjem, Eivind Wang

Abstract

Patients with substance use disorder (SUD) suffer a higher risk of cardiovascular disease and other lifestyle diseases compared to the general population. High intensity training has been shown to effectively reduce this risk, and therefore we aimed to examine the feasibility and effect of such training in SUD patients in clinical treatment in the present study. 17 males and 7 females (32 ± 8 yr) in treatment were randomized to either a training group (TG), treadmill interval training in 4 × 4 minutes at 90-95% of maximal heart rate, 3 days a week for 8 weeks, or a conventional rehabilitation control group (CG). Baseline values for both groups combined at inclusion were 44 ± 8 (males) and 34 ± 9 (females) mL · min(-1) · kg(-1), respectively. 9/12 and 7/12 patients completed the TG and CG, respectively. Only the TG significantly improved (15 ± 7%) their maximal oxygen consumption (VO2max), from 42.3 ± 7.2 mL · min(-1) · kg(-1) at pretest to 48.7 ± 9.2 mL · min(-1) · kg(-1) at posttest. No between-group differences were observed in work economy, and level of insomnia (ISI) or anxiety and depression (HAD), but a significant within-group improvement in depression was apparent for the TG. High intensity training was feasible for SUD patients in treatment. This training form should be implemented as a part of the rehabilitation since it, in contrast to the conventional treatment, represents a risk reduction for cardiovascular disease and premature death.

Figures

Figure 1
Figure 1
Recruitment, randomization, and withdrawal of SUD patients throughout the study.
Figure 2
Figure 2
Maximal oxygen consumption before and after the training intervention. Data are presented as mean ± SE. *P < 0.01, difference within group from pre- to posttest, #P < 0.05, differences in changes from pre- to posttest between groups.

References

    1. Flynn PM, Brown BS. Co-occurring disorders in substance abuse treatment: issues and prospects. Journal of Substance Abuse Treatment. 2008;34(1):36–47.
    1. Amaddeo F, Bisoffi G, Bonizzato P, Micciolo R, Tansella M. Mortality among patients with psychiatric illness. A ten-year case register study in an area with a community-based system of care. British Journal of Psychiatry. 1995;166:783–788.
    1. Nordentoft M, Wahlbeck K, Hallgren J, et al. Excess mortality, causes of death and life expectancy in 270, 770 patients with recent onset of mental disorders in Denmark, Finland and Sweden. PLoS One. 2013;8(1)e55176
    1. Harris EC, Barraclough B. Excess mortality of mental disorder. British Journal of Psychiatry. 1998;173:11–53.
    1. Kaye S, McKetin R, Duflou J, Darke S. Methamphetamine and cardiovascular pathology: a review of the evidence. Addiction. 2007;102(8):1204–1211.
    1. Stenbacka M, Leifman A, Romelsjö A. Mortality and cause of death among 1705 illicit drug users: a 37 year follow up. Drug and Alcohol Review. 2010;29(1):21–27.
    1. Wisløff U, Støylen A, Loennechen JP, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation. 2007;115(24):3086–3094.
    1. Tjønna AE, Lee SJ, Rognmo Ø, et al. Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: a pilot study. Circulation. 2008;118(4):346–354.
    1. Helgerud J, Wang E, Mosti MP, Wiggen ØN, Hoff J. Plantar flexion training primes peripheral arterial disease patients for improvements in cardiac function. European Journal of Applied Physiology. 2009;106(2):207–215.
    1. Heggelund J, Nilsberg GE, Hoff J, Morken G, Helgerud J. Effects of high aerobic intensity training in patients with schizophrenia: a controlled trial. Nordic Journal of Psychiatry. 2011;65(4):269–275.
    1. Myers J, Prakash M, Froelicher V, Do D, Partington S, Edwin Atwood J. Exercise capacity and mortality among men referred for exercise testing. The New England Journal of Medicine. 2002;346(11):793–801.
    1. Gorczynski P, Faulkner G. Exercise therapy for schizophrenia. Schizophrenia Bulletin. 2010;36(4):665–666.
    1. Wei M, Kampert JB, Barlow CE, et al. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. Journal of the American Medical Association. 1999;282(16):1547–1553.
    1. Blair SN, Kampert JB, Kohl HW, III, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. Journal of the American Medical Association. 1996;276(3):205–210.
    1. Martinsen EW, Hoffart A, Solberg O. Comparing aerobic with nonaerobic forms of exercise in the treatment of clinical depression: a randomized trial. Comprehensive Psychiatry. 1989;30(4):324–331.
    1. Brown RA, Abrantes AM, Read JP, et al. Aerobic exercise for alcohol recovery: rationale, program description, and preliminary findings. Behavior Modification. 2009;33(2):220–249.
    1. Collingwood TR, Reynolds R, Kohl HW, Smith W, Sloan S. Physical fitness effects on substance abuse risk factors and use patterns. Journal of Drug Education. 1991;21(1):73–84.
    1. Palmer J, Vacc N, Epstein J. Adult inpatient alcoholics: physical exercise as a treatment intervention. Journal of Studies on Alcohol. 1988;49(5):418–421.
    1. Martinsen EW. Physical activity in the prevention and treatment of anxiety and depression. Nordic Journal of Psychiatry. 2008;62(47):25–29.
    1. Mamen A, Martinsen EW. Development of aerobic fitness of individuals with substance abuse/dependence following long-term individual physical activity. European Journal of Sport Science. 2010;10(4):255–262.
    1. Helgerud J, Høydal K, Wang E, et al. Aerobic high-intensity intervals improve VO2max more than moderate training. Medicine & Science in Sports & Exercise. 2007;39(4):665–671.
    1. Wang E, Solli GS, Nyberg SK, Hoff J, Helgerud J. Stroke volume does not plateau in female endurance athletes. International Journal of Sports Medicine. 2012;33(9):734–739.
    1. McLellan AT, Kushner H, Metzger D, et al. The fifth edition of the Addiction Severity Index. Journal of Substance Abuse Treatment. 1992;9(3):199–213.
    1. Bastien CH, Vallières A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine. 2001;2(4):297–307.
    1. Værøy H. Depression, anxiety, and history of substance abuse among Norwegian inmates in preventive detention: reasons to worry? BMC Psychiatry. 2011;11(article 40)
    1. Loe H, Rognmo Ø, Saltin B, Wisløff U. Aerobic capacity reference data in 3816 healthy men and women 20-90 years. PLoS One. 2013;8(5)e64319
    1. Mamen A, Martinsen EW. The aerobic fitness of substance abusers voluntary participating in a rehabilitation project. Journal of Sports Medicine and Physical Fitness. 2009;49(2):187–193.
    1. Frankel A, Murphy J. Physical fitness and personality in alcoholism. Canonical analysis of measures before and after treatment. Quarterly Journal of Studies on Alcohol. 1974;35(4, part A):1272–1278.
    1. Sinyor D, Brown T, Rostant L, Seraganian P. The role of a physical fitness program in the treatment of alcoholism. Journal of Studies on Alcohol. 1982;43(3):380–386.
    1. Sell EH, Christensen NJ. The effect of physical training on physical, mental and social conditions in drug and/or alcohol addicts. Ugeskrift for Laeger. 1989;151(33):2064–2067.
    1. Roessler KK. Exercise treatment for drug abuse—a danish pilot study. Scandinavian Journal of Public Health. 2010;38(6):664–669.
    1. Kodama S, Saito K, Tanaka S, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. Journal of the American Medical Association. 2009;301(19):2024–2035.
    1. Regensteiner JG, Steiner JF, Hiatt WR. Exercise training improves functional status in patients with peripheral arterial disease. Journal of Vascular Surgery. 1996;23(1):104–115.
    1. Willenheimer R, Erhardt L, Cline C, Rydberg E, Israelsson B. Exercise training in heart failure improves quality of life and exercise capacity. European Heart Journal. 1998;19(5):774–781.
    1. Slørdahl SA, Wang E, Hoff J, Kemi OJ, Amundsen BH, Helgerud J. Effective training for patients with intermittent claudication. Scandinavian Cardiovascular Journal. 2005;39(4):244–249.
    1. Helgerud J, Karlsen T, Kim WY, et al. Interval and strength training in CAD Patients. International Journal of Sports Medicine. 2011;32(1):54–59.
    1. Wang E, Næss MS, Hoff J, et al. Exercise-training-induced changes in metabolic capacity with age: the role of central cardiovascular plasticity. Age. 2013
    1. Wenger HA, Bell GJ. The interactions of intensity, frequency and duration of exercise training in altering cardiorespiratory fitness. Sports Medicine. 1986;3(5):346–356.
    1. Helgerud J, Bjørgen S, Karlsen T, et al. Hyperoxic interval training in chronic obstructive pulmonary disease patients with oxygen desaturation at peak exercise. Scandinavian Journal of Medicine and Science in Sports. 2010;20(1):e170–e176.
    1. Youngstedt SD. Effects of exercise on sleep. Clinics in Sports Medicine. 2005;24(2):355–365.
    1. Martinsen EW, Medhus A, Sandvik L. Effects of aerobic exercise on depression: a controlled study. British Medical Journal. 1985;291(6488):p. 109.
    1. Galper DI, Trivedi MH, Barlow CE, Dunn AL, Kampert JB. Inverse association between physical inactivity and mental health in men and women. Medicine and Science in Sports and Exercise. 2006;38(1):173–178.
    1. Mota-Pereira J, Silverio J, Carvalho S, Ribeiro JC, Fonte D, Ramos J. Moderate exercise improves depression parameters in treatment-resistant patients with major depressive disorder. Journal of Psychiatric Research. 2011;45(8):1005–1011.
    1. Saxena S, Van Ommeren M, Tang KC, Armstrong TP. Mental health benefits of physical activity. Journal of Mental Health. 2005;14(5):445–451.
    1. Passos GS, Poyares DL, Santana MG, Tufik S, Mello MT. Is exercise an alternative treatment for chronic insomnia? Clinics. 2012;67(6):653–660.
    1. Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO. Exercise treatment for depression: efficacy and dose response. American Journal of Preventive Medicine. 2005;28(1):1–8.
    1. Sparr LF, Moffitt MC, Ward MF. Missed psychiatric appointments: who returns and who stays away. American Journal of Psychiatry. 1993;150(5):801–805.
    1. Kranzler HR, Escobar R, Lee D-K, Meza E. Elevated rates of early discontinuation from pharmacotherapy trials in alcoholics and drug abusers. Alcoholism. 1996;20(1):16–20.
    1. Ball SA, Carroll KM, Canning-Ball M, Rounsaville BJ. Reasons for dropout from drug abuse treatment: symptoms, personality, and motivation. Addictive Behaviors. 2006;31(2):320–330.
    1. Mamen A, Pallesen S, Martinsen EW. Changes in mental distress following individualized physical training in patients suffering from chemical dependence. European Journal of Sport Science. 2011;11(4):269–276.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir