![]() The trial was prospectively registered with : NCT02784873 and reported in accordance with the Consolidated Standards of Reporting Trials (CONSORT) guideline. The trial protocol was published previously, 16 and the protocol v1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands-Leicester South Research Ethics Committee-on 4 March 2016 (16/EM/0079). We conducted a pragmatic, parallel-group, assessor-blind, RCT to test the effectiveness of low-volume HIIT compared with MISS in six UK CR programmes (July 2016 to March 2020). ![]() Secondary objectives included assessment of adverse events, fidelity, tolerability, cardiovascular disease risk markers, cardiac structure and function, and health-related quality of life (HRQoL). 16 The primary objective was to evaluate changes in cardiorespiratory fitness (VO 2 peak). 14, 15 The safety and effectiveness of low-volume HIIT protocols have not been tested in a definitive clinical trial.Īgainst the backdrop of an equivocal evidence base and the need to assess the safety and effectiveness of low-volume HIIT in routine CR, we conducted a pragmatic, multi-centre, randomized controlled trial to evaluate the effectiveness of two CR exercise prescriptions: (i) low-volume HIIT and (ii) MISS training. 12, 13 In contrast, small proof-of-concept studies have shown low-volume HIIT (1 min high-intensity intervals interspersed with 1 min periods of recovery) to be effective and well tolerated. 12, 13 This was likely due to participants not achieving the prescribed intensity for the duration of the 4 min high-intensity intervals. ![]() 11 However, studies using a 4 min high-intensity interval protocol in cardiac patients showed no additional benefit with HIIT. Progression from moderate-intensity (85% VO 2 peak) interspersed with periods of recovery, has been proposed as a more effective alternative. 6 On the basis that greater improvements in cardiorespiratory fitness are likely to be achieved, 7 guidelines from some countries in North America and Europe recommend higher-intensity exercise whilst others, including the UK, do not. However, current guidelines for CAD vary considerably, most notably in terms of exercise intensity. 1, 2 With the intention of improving quality of life, maintaining functional independence, and as a proxy for survival, 3–5 cardiac rehabilitation (CR) exercise training guidelines explicitly target improvements in cardiorespiratory fitness, an important clinical outcome. As an integral component of contemporary secondary prevention models, exercise training can contribute to improved physical and mental health but, in its current form, may not reduce all-cause or cardiovascular mortality. Only one serious adverse event was possibly related to HIIT.Ĭardiac rehabilitation, Exercise training, High-intensity interval training, Coronary artery disease, Cardiorespiratory fitness, National Health Service IntroductionĮxercise training is a central pillar of multidisciplinary rehabilitation for people with coronary artery disease (CAD). After adjusting for age, sex, and study site, the difference between arms was 1.04 mL.kg −1.min −1 (95% CI, 0.38 to 1.69 P = 0.002). Secondary outcomes included cardiovascular disease risk markers, cardiac structure and function, adverse events, and health-related quality of life. The primary outcome was the change in cardiorespiratory fitness at 8 week follow-up. MISS was 20–40 min of moderate-intensity continuous exercise (60–80% maximum capacity). HIIT consisted of 10 × 1 min intervals of vigorous exercise (>85% maximum capacity) interspersed with 1 min periods of recovery. Participants were randomized to twice-weekly HIIT ( n = 187) or MISS ( n = 195) for 8 weeks. We conducted a multi-centre RCT, recruiting 382 patients from 6 outpatient CR centres.
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