Dataset Information

Short term high-intensity interval training in patients scheduled for major abdominal surgery increases aerobic fitness.

ABSTRACT:

Background

Prehabilitation may improve postoperative clinical outcomes among patients undergoing major abdominal surgery. This study evaluated the potential effects of a high-intensity interval training (HIIT) program performed before major abdominal surgery on patients' cardiorespiratory fitness and functional ability (secondary outcomes of pilot trial NCT02953119).

Methods

Patients were included before surgery to engage in a low-volume HIIT program with 3 sessions per week for 3 weeks. Cardiopulmonary exercise and 6-min walk (6MWT) testing were performed pre- and post-prehabilitation.

Results

Fourteen patients completed an average of 8.6 ± 2.2 (mean ± SD) sessions during a period of 27.9 ± 6.1 days. After the program, [Formula: see text]O₂ peak (+ 2.4 ml min^-1 kg^-1, 95% CI 0.8-3.9, p = 0.006), maximal aerobic power (+ 16.8 W, 95% CI 8.2-25.3, p = 0.001), [Formula: see text]O₂ at anaerobic threshold (+ 1.2 ml min^-1 kg^-1, 95%CI 0.4-2.1, p = 0.009) and power at anaerobic threshold (+ 12.4 W, 95%CI 4.8-20, p = 0.004) were improved. These changes were not accompanied by improved functional capacity (6MWT: + 2.6 m, 95% CI (- 19.6) to 24.8, p = 0.800).

Conclusion

A short low-volume HIIT program increases cardiorespiratory fitness but not walking capacity in patients scheduled for major abdominal surgery. These results need to be confirmed by larger studies.

SUBMITTER: Michel A

PROVIDER: S-EPMC8991597 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Short term high-intensity interval training in patients scheduled for major abdominal surgery increases aerobic fitness.

Michel Anna A Gremeaux Vincent V Muff Guillaume G Pache Basile B Geinoz Sandrine S Larcinese Ana A Benaim Charles C Kayser Bengt B Demartines Nicolas N Hübner Martin M Martin David D Besson Cyril C

BMC sports science, medicine & rehabilitation 20220407 1

<h4>Background</h4>Prehabilitation may improve postoperative clinical outcomes among patients undergoing major abdominal surgery. This study evaluated the potential effects of a high-intensity interval training (HIIT) program performed before major abdominal surgery on patients' cardiorespiratory fitness and functional ability (secondary outcomes of pilot trial NCT02953119).<h4>Methods</h4>Patients were included before surgery to engage in a low-volume HIIT program with 3 sessions per week for 3 ...[more]

PMID: 35392968

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Project description:PurposeImproving cardiopulmonary reserve, or peak oxygen consumption( V˙ O2peak ), may reduce postoperative complications; however, this may be difficult to achieve between diagnosis and surgery. Our primary aim was to assess the efficacy of an approximate 14-session, preoperative high-intensity interval training(HIIT) program to increase V˙ O2peak by a clinically relevant 2 ml·kg-1 ·min-1 . Our secondary aim was to document clinical outcomes.MethodologyIn this prospective study, participants aged 45-85 undergoing major abdominal surgery were randomized to standard care or 14 sessions of HIIT over 4 weeks. HIIT sessions involved approximately 30 min of stationary cycling. Interval training alternated 1 min of high (with the goal of reaching 90% max heart rate at least once during the session) and low/moderate-intensity cycling. Cardiopulmonary exercise testing(CPET) measured the change in V˙ O2peak from baseline to surgery. Clinical outcomes included postoperative complications, length of stay(LOS), and Short Form 36 quality of life questionnaire(SF-36).ResultsOf 63 participants, 46 completed both CPETs and 50 completed clinical follow-up. There was a significant improvement in the HIIT group's mean ± SD V˙ O2peak (HIIT 2.87 ± 1.94 ml·kg1 ·min-1 vs standard care 0.15 ± 1.93, with an overall difference of 2.73 ml·kg1 ·min-1 95%CI [1.53, 3.93] p < 0.001). There were no statistically significant differences between groups for clinical outcomes, although the observed differences consistently favored the exercise group. This was most notable for total number of complications (0.64 v 1.16 per patient, p = 0.07), SF-36 physical component score (p = 0.06), and LOS (mean 5.5 v 7.4 days, p = 0.07).ConclusionsThere was a significant improvement in V˙ O2peak with a four-week preoperative HIIT program. Further appropriately powered work is required to explore the impact of preoperative HIIT on postoperative clinical outcomes.

Project description:Ten healthy male participants were recruited and successfully completed all preliminary testing and the two exercise bouts (Figure 1A). This randomized crossover design permitted signaling responses to workload- and duration-matched HIIT and MICT exercise to be mapped and interrogated within the same participant. Baseline whole-body anthropometric and blood glucose and lipid measurements confirmed these participants (age 25.4 ± 3.2 y; BMI 23.5 ± 1.6 kg/m2) were metabolically healthy, and maximal exercise capacity testing confirmed they were recreationally active but relatively untrained (relative V̇O2 peak 37.9 ± 5.2) in line with our recruitment strategy to maximize detection of skeletal muscle signaling responses to exercise (Figure 1B). Peak power output (Wpeak; 207.5 ± 40.3 W) was used to prescribe the relative work-matched intensities for HIIT and MICT. Lean mass from the DXA scan and resting metabolic rate (Figure 1B) were used to prescribe a standardized meal for each participant to consume prior to each exercise trial day. Following consumption of a standardized dinner meal the night before the HIIT or MICT exercise trial, blood and skeletal muscle biopsy samples were collected in the fasted state at baseline and at 5 min and 10 min of each respective exercise intensity. Participants completing the acute bout of HIIT, which consisted of 10 min total of 1-min ‘on’ intervals at 85 ± 0.1% of individual Wpeak (176 ± 34 W) and 1-min ‘off’ intervals at 50 W, displayed increased plasma lactate concentrations at 5 and 10 min of exercise relative to pre-exercise baseline (Figure 1C; P < 0.0001 and P < 0.001, respectively; main effect of time P < 0.0001) and no changes in plasma glucose (Figure 1D). In response to total work- and duration-matched acute bout of MICT at 55 ± 2% individual Wpeak (113 ± 17 W), participants displayed increased plasma lactate concentrations at 5 and 10 min of exercise versus baseline (Figure 1C; P < 0.001; main effect of time P < 0.0001) and no changes in plasma glucose (Figure 1D), with a main effect of higher plasma lactate levels in response to HIIT (Figure 1C; P < 0.05). To map the signaling networks regulated by HIIT and MICT, proteins from each skeletal muscle biopsy sample were extracted, digested to peptides with trypsin, isobarically labelled prior to phosphopeptide enrichment, fractionation and LC-MS/MS phosphoproteomic analysis (Figure 2A).

Project description:Background and aimExercise training regimes can lead to improvements in measures of cardiorespiratory fitness (CRF), improved general health, and reduced morbidity and overall mortality risk. High-intensity interval training (HIIT) offers a time-efficient approach to improve CRF in healthy individuals, but the relative benefits of HIIT compared with traditional training methods are unknown in across different disease cohorts.MethodsThis systematic review and meta-analysis compares CRF gains in randomized controlled trials of short-term (<8 wk) HIIT versus either no exercise control (CON) or moderate continuous training (MCT) within diseased cohorts. Literature searches of the following databases were performed: MEDLINE, EMBASE, CINAHL, AMED, and PubMed (all from inception to December 1, 2017), with further searches of Clinicaltrials.gov and citations via Google Scholar. Primary outcomes were effect on CRF variables: V˙O2peak and anaerobic threshold.ResultsThirty-nine studies met the inclusion criteria. HIIT resulted in a clinically significant increase in V˙O2peak compared with CON (mean difference [MD] = 3.32 mL·kg·min, 95% confidence interval [CI] = 2.56-2.08). Overall HIIT provided added benefit to V˙O2peak over MCT (MD = 0.79 mL·kg·min, 95% CI = 0.20-1.39). The benefit of HIIT was most marked in patients with cardiovascular disease when compared with MCT (V˙O2peak: MD = 1.66 mL·kg·min, 95% CI = 0.60-2.73; anaerobic threshold: MD = 1.61 mL·kg·min, 95% CI = 0.33-2.90).ConclusionsHIIT elicits improvements in objective measures of CRF within 8 wk in diseased cohorts compared with no intervention. When compared with MCT, HIIT imparts statistically significant additional improvements in measures of CRF, with clinically important additional improvements in V˙O2peak in cardiovascular patients. Comparative efficacy of HIIT versus MCT combined with an often reduced time commitment may warrant HIIT's promotion as a viable clinical exercise intervention.

Project description:Similar to muscles, the intestine is also insulin resistant in obese subjects and subjects with impaired glucose tolerance. Exercise training improves muscle insulin sensitivity, but its effects on intestinal metabolism are not known. We studied the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on intestinal glucose and free fatty acid uptake from circulation in humans. Twenty-eight healthy, middle-aged, sedentary men were randomized for 2 wk of HIIT or MICT. Intestinal insulin-stimulated glucose uptake and fasting free fatty acid uptake from circulation were measured using positron emission tomography and [18F]FDG and [18F]FTHA. In addition, effects of HIIT and MICT on intestinal GLUT2 and CD36 protein expression were studied in rats. Training improved aerobic capacity (P = 0.001) and whole body insulin sensitivity (P = 0.04), but not differently between HIIT and MICT. Insulin-stimulated glucose uptake increased only after the MICT in the colon (HIIT = 0%; MICT = 37%) (P = 0.02 for time × training) and tended to increase in the jejunum (HIIT = -4%; MICT = 13%) (P = 0.08 for time × training). Fasting free fatty acid uptake decreased in the duodenum in both groups (HIIT = -6%; MICT = -48%) (P = 0.001 time) and tended to decrease in the colon in the MICT group (HIIT = 0%; MICT = -38%) (P = 0.08 for time × training). In rats, both training groups had higher GLUT2 and CD36 expression compared with control animals. This study shows that already 2 wk of MICT enhances insulin-stimulated glucose uptake, while both training modes reduce fasting free fatty acid uptake in the intestine in healthy, middle-aged men, providing an additional mechanism by which exercise training can improve whole body metabolism.NEW & NOTEWORTHY This is the first study where the effects of exercise training on the intestinal substrate uptake have been investigated using the most advanced techniques available. We also show the importance of exercise intensity in inducing these changes.

Project description:This study compared the acute physiological responses and performance changes during an integrated high-intensity interval aerobic and power protocol. Sixteen moderately trained athletes (age: 20.1 ± 2.2 years, body height: 180.0 ± 6.5 cm, body mass: 75.7 ± 6.4 kg, VO2max: 55.8 ± 4.3 mL/kg/min) performed a 2 × 6 min interval training protocol with 2 min passive recovery between sets on two different occasions in random and counterbalanced order. Each 6 min set included repeated periods of 15 s exercise interspersed with 15 s passive rest. On one occasion (RUN), all exercise periods included running at 100% of maximal aerobic speed, while on the other occasion an integrated protocol was used (INT) in which each of the two 6 min sets included 4 × 1.5 min periods of running exercise at 100% of maximal aerobic speed in combination with jumping (i.e., 2 × 15 running with 15 s rest and 1 × 15 s drop jumping with 15 s rest). Time spent above 85% HRmax was two-fold higher in INT compared to RUN (8.5 ± 3.6 vs. 4.3 ± 3.9 min, respectively, p = 0.0014). Interestingly, heart rate increased above 95% HRmax only in INT and almost no time was spent above 95% HRmax in RUN (1.4 ± 1.9 vs. 0.1 ± 0.2 min, respectively, p = 0.008). Blood lactate concentration at the end of the second set of INT was higher than RUN (7.3 ± 3.2 vs. 4.6 ± 2.7 mmol/L, p = 0.002). Countermovement jump was higher in INT after the end of second set by 6.4% (p = 0.04), 6.7% (p = 0.04), 7.8% (p < 0.01) and 7.3% (p < 0.001), at 2, 6 and 8 min after set 2. In conclusion, the comparison between INT and RUN shows that INT not only elicits higher physiological and metabolic responses, but also acutely enhances neuromuscular performance for at least 8 min after the end of exercise. The integrated running/jumping high-intensity interval exercise approach could be a very useful and time efficient method for strength and conditioning coaches, especially in team sports, in which the time available for the improvement of physical parameters is limited.

Dataset Information

Short term high-intensity interval training in patients scheduled for major abdominal surgery increases aerobic fitness.

Background

Methods

Results

Conclusion

Publications

Short term high-intensity interval training in patients scheduled for major abdominal surgery increases aerobic fitness.

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