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

J E M Blackwell, B Doleman, C L Boereboom, A Morton, S Williams, P Atherton, K Smith, J P Williams, B E Phillips, J N Lund, J E M Blackwell, B Doleman, C L Boereboom, A Morton, S Williams, P Atherton, K Smith, J P Williams, B E Phillips, J N Lund

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 (VO2AT) 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 (VO2AT; 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 pre-operative improvements. Larger randomised trials are required to investigate the efficacy of prehabilitation HIIT upon different cancer types, post-operative complications, socio-economic impact and long-term survival.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1. Consort diagram showing patient flow…
Fig. 1. Consort diagram showing patient flow through study [19].
HIIT high intensity interval training, CPET cardiopulmonary exercise testing, AF atrial fibrilation.
Fig. 2. Cardiorespiratory fitness.
Fig. 2. Cardiorespiratory fitness.
Baseline (clear) and post intervention (hatched) cardiorespiratory fitness data for individuals before and after a n  =  16) or period of high-intensity interval training (HIIT; n  =  18). a Volume of oxygen utilised at anaerobic threshold (VO2AT). b Peak volume of oxygen utilisation (VO2PEAK); both measured via cardiopulmonary exercise testing (CPET). *p < 0.05 vs. baseline. Analysis via ANCOVA.
Fig. 3. Blood pressure.
Fig. 3. Blood pressure.
Baseline (clear) and post intervention (hatched) non-invasive blood pressure readings (SBP, DBP, MAP; mmHg) for individuals before and after a an = 16) or period of high-intensity interval training (HIIT; b, n = 18). *p < 0.05 vs. baseline. Analysis via ANCOVA.

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