Comparison between HIIT and moderate continuous aerobic exercise in improving cardiorespiratory conditioning in cardiac rehabilitation programs: a systematic review
Abstract
Introduction. Low cardiorespiratory fitness is associated with the development of cardiovascular diseases, which are the leading cause of death in the elderly worldwide. Cardiac rehabilitation emerges as a means of recovering the health of these patients with EACM, but new studies show that choosing HIIT can also be an efficient strategy. Goal. To compare the effect of HIIT and EACM training models in cardiac rehabilitation programs in improving cardiorespiratory fitness under the observation of the V̇O2max variable. Materials anda Methods. The PRISMA methodology was used. Randomized clinical trials between 2012 and 2022 published in English through the PubMed platform were sought. Studies with population undergoing cardiac rehabilitation, intervention group trained with HIIT and control group trained with EACM were selected, other types of exercise were discarded. The tolerance of collected data, gender and age of the sample, intervention time in weeks and number of weekly trainings and result of the percentage variation of V̇O2max. The PEDro scale was also used to assess the methodological quality of the studies. Results. 12 studies were selected, with most participants being male and elderly. Complications ranged from 3 to 24 weeks with training frequency predominantly 3 times a week for most selected studies. The HIIT group showed a greater improvement in cardiorespiratory fitness than the EACM group in most studies. Conclusion. Both models are efficient, but it seems that choosing HIIT is more efficient in improving cardiorespiratory fitness when compared to EACM.
References
-Angadi, S.S.; Mookadam, F.; Lee, C.D.; Tucker, W.J.; Haykowsky, M.J.; Gaesser, G.A. High-intensity interval training vs. moderate-intensity continuous exercise training in heart failure with preserved ejection fraction: a pilot study. J Appl Physiol. Vol. 119. Núm. 6. p.753-758. 2015.
-Astorino, T.A.; Edmunds, R.M.; Clark, A.; King, L.; Gallant, R.M.; Namm, S.; Fischer, A.; Wood, K.A. Increased cardiac output and maximal oxygen uptake in response to ten sessions of high intensity interval training. J Sports Med Phys Fitness. Vol. 58. Núm. 1-2. p.164-171. 2018.
-Baekkerud, F.H.; Solberg, F.; Leinan, I.M.; Wisloff, U.; Karlsen, T.; Rognmo, O. Comparison of Three Popular Exercise Modalities on V O2max in Overweight and Obese. Med Sci Sports Exerc. Vol. 48. Núm. 3. p. 491-498. 2016.
-Batacan, R.B.; Duncan, M.J.; Dalbo, V.J.; Tucker, P.S.; Fenning, A.S. Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies. Br J Sports Med. Vol. 51. p.494-503. 2017.
-Baum, O.; Torchetti, E.; Malik, C.; Hoier, B.; Walker, M.; Walker, P.J.; Odriozola, A.; Graber, F.; Tschanz, S.A.; Bangsbo, J.; Hoppeler, H.; Askew, C.D.; Hellsten, Y. Capillary ultrastructure and mitochondrial volume density in skeletal muscle in relation to reduced exercise capacity of patients with intermittent claudication. Am J Physiol Regul Integr Comp Physiol. Vol. 310. Núm. 10. p. 943-951. 2016.
-Besnier, F.; Labrunée, M.; Richard, L.; Faggianelli, F.; Kerros, H.; Soukarié, L.; Bousquet, M.; Garcia, J.L.; Pathak, A.; Gales, C.; Guiraud, T.; Sénard, J.M. Short-term effects of a 3-week interval training program on heart rate variability in chronic heart failure. A randomised controlled trial. Ann Phys Rehabil Med. Vol. 62. Núm. 5. p. 321-328. 2019.
-Billat, L.V. Interval training for performance: a scientific and empirical practice. Special recommendations for middle- and long-distance running. Part I: aerobic interval training. Sports Med. Vol. 31. Núm. 1. p. 13-31. 2001.
-Blumenthal, J.A.; Emery, C.F.; Madden, D.J.; George, L.K.; Coleman, R.E.; Riddle, M.W.; McKee, D.C.; Reasoner, J.; Williams, R.S. Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. J Gerontol. Vol. 44. Núm. 5. p. 147-157. 1989.
-Booth, F.W.; Roberts, C.K.; Laye, M.J. Lack of exercise is a major cause of chronic diseases. Compr Physiol. Vol. 2. Núm. 2. p. 1143-1211. 2012.
-Boyle, J. 3rd. Graphic analysis of the Fick equation to evaluate oxygen transport. Respiration. Vol. 45. Núm. 4. p.353-359. 1984.
-Cardozo, G.G.; Oliveira, R.B.; Farinatti, P.T. Effects of high intensity interval versus moderate continuous training on markers of ventilatory and cardiac efficiency in coronary heart disease patients. Scientific World Journal. p. 1-8. 2015.
-Conraads, V.M.; Pattyn, N.; De Maeyer, C.; Beckers, P.J.; Coeckelberghs, E.; Cornelissen, V.A.; Denollet, J.; Frederix, G.; Goetschalckx, K.; Hoymans, V.Y.; Possemiers, N.; Schepers, D.; Shivalkar, B.; Voigt, J.U.; Van Craenenbroeck, .M.; Vanhees, L. Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: the SAINTEX-CAD study. Int J Cardiol. Vol. 179. p. 203-210. 2015.
-Cramer, R.; Nieman, D.C.; Lee, J.W.; The effects of moderate exercise training on psychological well-being and mood state in women. J Psychosom Res. Vol. 35. Núm. 4-5. p.437-449. 1991.
-Currie, K.D.; Dubberley, J.B.; McKelvie, R.S.; MacDonald, M.J. Low-volume, high-intensity interval training in patients with CAD. Med Sci Sports Exerc. Vol. 45. Núm. 8. p. 1436-1442. 2013.
-Dunham, C.; Harms, C.A. Effects of high-intensity interval training on pulmonary function. European Journal of Applied Physiology. Vol. 112. Núm. 8. p. 3061-3068. 2012.
-Dunn, A.L.; Marcus, B.H.; Kampert, J.B.; Garcia, M.E.; Kohl, H.W.; Blair, S.N. Reduction in cardiovascular disease risk factors: 6-month results from Project Active. Prev Med. Vol. 26. Núm. 6. p. 883-892. 1997.
-Elkins, M.R.; Herbert, R.D.; Moseley, A.M.; Sherrington, C.; Maher, C. Rating the quality of trials in systematic reviews of physical therapy interventions. Cardiopulm Phys Ther J. Vol. 21. Núm. 3. p. 20-6. 2010.
-Ellingsen, Ø.; Halle, M.; Conraads, V.; Støylen, A.; Dalen, H.; Delagardelle, C.; Larsen, A.I.; Hole, T.; Mezzani, A.; Van Craenenbroeck, E.M.; Videm, V.; Beckers, P.; Christle, J.W.; Winzer, E.; Mangner, N.; Woitek, F.; Höllriegel, R.; Pressler, A.; Monk-Hansen, T.; Snoer, M.; Feiereisen, P.; Valborgland, T.; Kjekshus, J.; Hambrecht, R.; Gielen, S.; Karlsen, T.; Prescott, E.; Linke, A. SMARTEX Heart Failure Study (Study of Myocardial Recovery After Exercise Training in Heart Failure) Group. High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction. Circulation. Vol. 135. Núm. 9. p. 839-849. 2017.
-Eriksen, M.B.; Frandsen, T.F. The impact of patient, intervention, comparison, outcome (PICO) as a Search strategy tool o literature Search quality: a systematic review. JMLA. Vol. 106. Núm. 4. p. 420-431. 2018.
-Esfandiari, S.; Sasson, Z.; Goodman, J.M. Short-term high-intensity interval and continuous moderateintensity training improve maximal aerobic power and diastolic filling during exercise. Eur J Appl Physiol. Vol. 114. Núm. 2. p. 331-343. 2014.
-Farrahi, V.; Rostami, M.; Dumuid, D.; Chastin, S.F.M.; Niemelä, M.; Korpelainen, R.; Jämsä, T.; Oussalah, M. Joint Profiles of Sedentary Time and Physical Activity in Adults and Their Associations with Cardiometabolic Health. Med Sci Sports Exerc. Vol. 54. Núm. 12. p. 2118-2128. 2022.
-Fleg, J.L.; Morrell, C.H.; Bos, A.G.; Brant, L.J.; Talbot, L.A.; Wright, J.G.; Lakatta, E.G. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation. Vol. 112. Núm. 5. p.674-682. 2005.
-Fletcher, G.F.; Balady, G.J.; Amsterdam, E.A.; Chaitman, B.; Eckel, R.; Fleg, J.; Froelicher, V.F.; Leon, A.S.; Piña, I.L.; Rodney, R.; Simons-Morton, D.A.; Williams, M.A.; Bazzarre, T. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. Vol. 104. Núm. 14. p. 1694-740. 2001.
-GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. Vol. 396. Núm. 10258. p. 1204-1222. 2020.
-Gillen, J.B.; Gibala, M.J. Is high-intensity interval training a time-efficient exercise strategy to improve health and fitness? Appl Physiol Nutr Metab. Vol. 39. Núm. 3. p. 409-412. 2014.
-Guadalupe-Grau, A.; Fernandez-Elias, V.E.; Ortega, J.F.; Dela, F.; Helge, J.W.; Mora-Rodriguez, R. Effects of 6-month aerobic interval training on skeletal muscle metabolism in middle-aged metabolic syndrome patients. Scandinavian Journal of Medicine & Science in Sports. Vol. 28. Núm. 2. p. 585-595. 2018.
-lellamo, F.; Caminiti, G.; Sposato, B.; Vitale, C.; Massaro, M.; Rosano, G.; Volterrani, M. Effect of High-Intensity interval training versus moderate continuous training on 24-h blood pressure profile and insulin resistance in patients with chronic heart failure. Intern Emerg Med. Vol. 9. Núm. 5. p.547-552. 2014.
-Jelleyman, C.; Yates, T.; O'Donovan, G.; Gray, L.J.; King, J.A.; Khunti, K.; Davies, M.J. The effects of high-intensity interval training on glucose regulation and insulin resistance: a meta-analysis. Obes Rev. Vol. 16. Núm. 11. p.942-961. 2015.
-Kessler, H.S.; Sisson, S.B.; Short, K.R. The potential for high-intensity interval training to reduce cardiometabolic disease risk. Sports Med. Vol. 42. Núm. 6. p. 489-509. 2012.
-Keteyian, S.J.; Hibner, B.A.; Bronsteen, K.; Kerrigan, D.; Aldred, H.A.; Reasons, L.M.; Saval, M.A.; Brawner, C.A.; Schairer, J.R.; Thompson, T.M.; Hill, J.; McCulloch, D.; Ehrman, J.K. Greater improvement in cardiorespiratory fitness using higher-intensity interval training in the standard cardiac rehabilitation setting. J Cardiopulm Rehabil Prev. Vol. 34. Núm. 2. p. 98-105. 2014.
-Koufaki, P.; Mercer, T.H.; George, K.P.; Nolan, J. Low-volume high-intensity interval training vs continuous aerobic cycling in patients with chronic heart failure: a pragmatic randomised clinical trial of feasibility and effectiveness. J Rehabil Med. Vol. 46. Núm. 4. p.348-356. 2014.
-Levine, B.D. V̇O2máx: what do we know, and what do we still need to know? J Physiol. Vol. 586. Núm. 1. p. 25-34. 2008.
-Matos, M.A.; Vieira, D.V.; Pinhal, K.C.; Lopes, J.F.; Dias-Peixoto, M.F.; Pauli, J.R.; Castro Magalhães, F.; Little, J.P.; Rocha-Vieira, E.; Amorim, F.T. High-Intensity Interval Training Improves Markers of Oxidative Metabolism in Skeletal Muscle of Individuals With Obesity and Insulin Resistance. Front Physiol. Vol. 31. Núm. 9. p.1451. 2018.
-Marcin, T.; Trachsel, L.D.; Dysli, M.; Schmid, J.P.; Eser, P.; Wilhelm, M. Effect of self-tailored high-intensity interval training versus moderate-intensity continuous exercise on cardiorespiratory fitness after myocardial infarction: A randomised controlled trial. Ann Phys Rehabil Med. Vol. 65. Núm. 1. p.1-7. 2022.
-Matsuo, T.; Saotome, K.; Seino, S.; Shimojo, N.; Matsushita, A.; Iemitsu, M.; Ohshima, H.; Tanaka, K.; Mukai, C. Effects of a low-volume aerobic-type interval exercise on VO2max and cardiac mass. Med Sci Sports Exerc. Vol. 46. Núm. 1. p. 42-50. 2014.
-Maturana, F.M.; Martus, P.; Zipfel, S.; Nieb, A.M. Effectiveness of HIIE versus MICT in Improving Cardiometabolic Risk Factors in Health and Disease: A Meta-analysis. Med Sci Sports Exerc. Vol. 53. Núm. 3. p.559-573. 2021.
-McGavock, J.M.; Hastings, J.L.; Snell, P.G.; McGuire, D.K.; Pacini, E.L.; Levine, B.D.; Mitchell, J.H. A forty-year follow-up of the Dallas Bed Rest and Training study: the effect of age on the cardiovascular response to exercise in men. J Gerontol A Biol Sci Med Sci. Vol. 64. Núm. 2. p. 293-299. 2009.
-Meyer, F.J.; Borst, M.M.; Zugck, C.; Kirschke, A.; Schellberg, D.; Kübler, W.; Haass, M. Respiratory muscle dysfunction in congestive heart failure: clinical correlation and prognostic significance. Circulation. Vol. 103. Núm. 17. p.2153-2158. 2001.
-Mueller, S.; Winzer, E.B.; Duvinage, A.; Gevaert, A.B.; Edelmann, F.; Haller, B.; Pieske-Kraigher, E.; Beckers, P.; Bobenko, A.; Hommel, J.; Van de Heyning, C.M.; Esefeld, K.; Von Korn, P.; Christle, J.W.; Haykowsky, M.J.; Linke, A.; Wisløff, U.; Adams, V.; Pieske, B.; Van Craenenbroeck, E.M.; Halle, M.;Optim Ex-Clin Study Group. Effect of High-Intensity Interval Training, Moderate Continuous Training, or Guideline-Based Physical Activity Advice on Peak Oxygen Consumption in Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. JAMA. Vol. 325. Núm. 6. p. 542-551. 2021.
-Nieman, D.C.; Nehlsen-Cannarella, S.L.; Markoff, P.A.; Balk-Lamberton, A.J.; Yang, H.; Chritton, D.B.; Lee, J.W.; Arabatzis, K. The effects of moderate exercise training on natural killer cells and acute upper respiratory tract infections. Int J Sports Med. Vol. 11. Núm. 6. p. 467-473. 1990.
-Olson, T.P.; Joyner, M.J.; Dietz, N.M.; Eisenach, J.H.; Curry, T.B.; Johnson, B.D. Effects of respiratory muscle work on blood flow distribution during exercise in heart failure. J Physiol. Vol. 588. Núm. 13. p.2487-2501. 2010.
-Page, M.J.; Moher, D.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; Chou, R.; Granville, J.; Grimshaw, J.M.; Hróbjartsson, A.; Lalu, M.M.; Li, T.; Loder, E.W.; Wilson, E.M.; McDonald, S.; McGuinness, L.A.; Stewart, L.A.; Thomas, J.; Tricco, A.C.; Welch, V.A.; Whiting, P.; McKenzie, J.E. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. Vol. 372. Núm.160. p. 1-36. 2021.
-PEDro. Physiotherapy Evidence Database. DisponÍvel em: . Acesso em 11/2022.
-Ramos, J.S.; Dalleck, L.C.; Tjonna, A.E.; Beetham, K.S.; Coombes JS. The impact of high-intensity interval training versus moderate-intensity continuous training on vascular function: a systematic review and meta-analysis. Sports Med. Vol. 45. Núm. 5. p. 679-692. 2015.
-Rosenblat, M.A.; Granata, C.; Thomas, S.G. Effect of Interval Training on the Factors Influencing Maximal Oxygen Consumption: A Systematic Review and Meta-Analysis. Sports Med. Vol. 52. Núm. 6. p. 1329-1352. 2022.
-Saltin, B.; Blomqvist, G.; Mitchell, J.H.; Johnson, R.L.; Wildenthal, K.; Chapman, C.B. Response to exercise after bed rest and after training. Circulation. Vol. 38. p.VII1-VII78. 1968.
-Shephard, R.J.; Allen, C.; Benade, A.J.; Davies, C.T.; Di Prampero, P.E.; Hedman, R.; Merriman, J.E.; Myhre, K.; Simmons, R. The maximum oxygen intake. An international reference standard of cardiorespiratory fitness. Bull World Health Organ. Vol. 38. Núm. 5. p. 757-764. 1968.
-Simon, M.; Korn, K.; Cho, L.; Blackburn, G.G.; Raymond, C. Cardiac rehabilitation: A class 1 recommendation. Cleve Clin J Med. Vol. 85. Núm. 7. p. 551-558. 2018.
-Spee, R.F.; Niemeijer, V.M.; Wijn, P.F.; Doevendans, P.A.; Kemps, H.M. Effects of high-intensity interval training on central haemodynamics and skeletal muscle oxygenation during exercise in patients with chronic heart failure. Eur J Prev Cardiol. Vol. 23. Núm. 18. p. 1943-1952. 2016.
-Tasoulis, A.; Papazachou, O.; Dimopoulos, S.; Gerovasili, V.; Karatzanos, E.; Kyprianou, T.; Drakos, S.; Anastasiou-Nana, M.; Roussos, C.; Nanas, S. Effects of interval exercise training on respiratory drive in patients with chronic heart failure. Respir Med. Vol. 104. Núm. 10. p. 1557-1565. 2010.
-Taylor, R.S.; Brown, A.; Ebrahim, S.; Jolliffe, J.; Noorani, H.; Rees, K.; Skidmore, B.; Stone, J.A.; Thompson, D.R.; Oldridge, N. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med. Vol. 116. Núm. 10. p. 682-692. 2004.
-Villelabeitia-Jaureguizar, K.; Vicente-Campos, D.; Berenguel Senen, A.; Hernández Jiménez, V.; Ruiz Bautista, L.; Barrios Garrido-Lestache, M.E.; López Chicharro, J. Mechanical efficiency of high versus moderate intensity aerobic exercise in coronary heart disease patients: A randomized clinical trial. Cardiol J. Vol. 26. Núm. 2. p. 130-137. 2019.
-Warburton, D.E.; Haykowsky, M.J.; Quinney, H.A.; Blackmore, D.; Teo, K.K.; Taylor, D.A.; McGavock, J.; Humen, D.P. Blood volume expansion and cardiorespiratory function: effects of training modality. Med Sci Sports Exerc. Vol. 36. Núm. 6. p. 991-1000. 2004.
-Wehmeier, U.F.; Schweitzer, A.; Jansen, A.; Probst, H.; Grüter, S.; Hähnchen, S.; Hilberg, T. Effects of high-intensity interval training in a three-week cardiovascular rehabilitation: a randomized controlled trial. Clin Rehabil. Vol. 34. Núm. 5. p. 646-655. 2020.
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