High-intensity interval training in patients with intermittent claudication

Sean Pymer; Amy E. Harwood; Jonathon Prosser; Alexander Waddell; Bharadhwaj Rhavindhran; Said Ibeggazene; Gordon McGregor; Chao Huang; Maureen Twiddy; Adam R. Nicholls; Lee Ingle; Sean Carroll; Heije He; Judith Long; Marjorie Rooms; Ian C. Chetter

doi:10.1016/j.jvs.2023.05.045

High-intensity interval training in patients with intermittent claudication

Sean Pymer, Amy E. Harwood, Jonathon Prosser, Alexander Waddell, Bharadhwaj Rhavindhran, Said Ibeggazene, Gordon McGregor, Chao Huang, Maureen Twiddy, Adam R. Nicholls, Lee Ingle, Sean Carroll, Heije He, Judith Long, Marjorie Rooms, Ian C. Chetter

Centre for Physical Activity, Sport and Exercise Sciences

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

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Abstract

Objective: Provision, uptake, adherence, and completion rates for supervised exercise programs (SEP) for intermittent claudication (IC) are low. A shorter, more time-efficient, 6-week, high-intensity interval training (HIIT) program may be an effective alternative that is more acceptable to patients and easier to deliver. The aim of this study was to determine the feasibility of HIIT for patients with IC.
Methods: A single arm proof-of-concept study, performed in secondary care, recruiting patients with IC referred to usual-care SEPs. Supervised HIIT was performed three times per week for 6 weeks. The primary outcome was feasibility and tolerability. Potential efficacy and potential safety were considered, and an integrated qualitative study was undertaken to consider acceptability.
Results: A total of 280 patients were screened: 165 (59%) were eligible, and 40 (25%) were recruited. The majority (n = 31; 78%) of participants completed the HIIT program. The remaining nine patients were withdrawn or chose to withdraw. Completers attended 99% of training sessions, completed 85% of sessions in full, and performed 84% of completed intervals at the required intensity. There were no related serious adverse events. Maximum walking distance (+94 m; 95% confidence interval, 66.6-120.8 m) and the SF-36 physical component summary (+2.2; 95% confidence interval, 0.3-4.1) were improved following completion of the program.
Conclusions: Uptake to HIIT was comparable to SEPs in patients with IC, but completion rates were higher. HIIT appears feasible, tolerable, and potentially safe and beneficial for patients with IC. It may provide a more readily deliverable, acceptable form of SEP. Research comparing HIIT with usual-care SEPs appears warranted.

Original language	English
Pages (from-to)	1048-1056.e4
Number of pages	13
Journal	Journal of Vascular Surgery
Volume	78
Issue number	4
Early online date	16 Jun 2023
DOIs	https://doi.org/10.1016/j.jvs.2023.05.045
Publication status	Published - Oct 2023

Bibliographical note

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Funder

This study was funded by the National Institute for Health and Care Research (Research for Patient Benefit programme [PB-PG-0418-20014])

Keywords

High-intensity interval training
Intermittent claudication
Supervised exercise program

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10.1016/j.jvs.2023.05.045Licence: CC BY

PublishedFinal published version, 917 KBLicence: CC BY

Cite this

Pymer, S., Harwood, A. E., Prosser, J., Waddell, A., Rhavindhran, B., Ibeggazene, S., McGregor, G., Huang, C., Twiddy, M., Nicholls, A. R., Ingle, L., Carroll, S., He, H., Long, J., Rooms, M., & Chetter, I. C. (2023). High-intensity interval training in patients with intermittent claudication. Journal of Vascular Surgery, 78(4), 1048-1056.e4. https://doi.org/10.1016/j.jvs.2023.05.045

Pymer, S, Harwood, AE, Prosser, J, Waddell, A, Rhavindhran, B, Ibeggazene, S, McGregor, G, Huang, C, Twiddy, M, Nicholls, AR, Ingle, L, Carroll, S, He, H, Long, J, Rooms, M & Chetter, IC 2023, 'High-intensity interval training in patients with intermittent claudication', Journal of Vascular Surgery, vol. 78, no. 4, pp. 1048-1056.e4. https://doi.org/10.1016/j.jvs.2023.05.045

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abstract = "Objective: Provision, uptake, adherence, and completion rates for supervised exercise programs (SEP) for intermittent claudication (IC) are low. A shorter, more time-efficient, 6-week, high-intensity interval training (HIIT) program may be an effective alternative that is more acceptable to patients and easier to deliver. The aim of this study was to determine the feasibility of HIIT for patients with IC. Methods: A single arm proof-of-concept study, performed in secondary care, recruiting patients with IC referred to usual-care SEPs. Supervised HIIT was performed three times per week for 6 weeks. The primary outcome was feasibility and tolerability. Potential efficacy and potential safety were considered, and an integrated qualitative study was undertaken to consider acceptability. Results: A total of 280 patients were screened: 165 (59%) were eligible, and 40 (25%) were recruited. The majority (n = 31; 78%) of participants completed the HIIT program. The remaining nine patients were withdrawn or chose to withdraw. Completers attended 99% of training sessions, completed 85% of sessions in full, and performed 84% of completed intervals at the required intensity. There were no related serious adverse events. Maximum walking distance (+94 m; 95% confidence interval, 66.6-120.8 m) and the SF-36 physical component summary (+2.2; 95% confidence interval, 0.3-4.1) were improved following completion of the program. Conclusions: Uptake to HIIT was comparable to SEPs in patients with IC, but completion rates were higher. HIIT appears feasible, tolerable, and potentially safe and beneficial for patients with IC. It may provide a more readily deliverable, acceptable form of SEP. Research comparing HIIT with usual-care SEPs appears warranted.",

keywords = "High-intensity interval training, Intermittent claudication, Supervised exercise program",

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doi = "10.1016/j.jvs.2023.05.045",

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T1 - High-intensity interval training in patients with intermittent claudication

AU - Pymer, Sean

AU - Harwood, Amy E.

AU - Prosser, Jonathon

AU - Waddell, Alexander

AU - Rhavindhran, Bharadhwaj

AU - Ibeggazene, Said

AU - McGregor, Gordon

AU - Huang, Chao

AU - Twiddy, Maureen

AU - Nicholls, Adam R.

AU - Ingle, Lee

AU - Carroll, Sean

AU - He, Heije

AU - Long, Judith

AU - Rooms, Marjorie

AU - Chetter, Ian C.

N1 - This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

PY - 2023/10

Y1 - 2023/10

N2 - Objective: Provision, uptake, adherence, and completion rates for supervised exercise programs (SEP) for intermittent claudication (IC) are low. A shorter, more time-efficient, 6-week, high-intensity interval training (HIIT) program may be an effective alternative that is more acceptable to patients and easier to deliver. The aim of this study was to determine the feasibility of HIIT for patients with IC. Methods: A single arm proof-of-concept study, performed in secondary care, recruiting patients with IC referred to usual-care SEPs. Supervised HIIT was performed three times per week for 6 weeks. The primary outcome was feasibility and tolerability. Potential efficacy and potential safety were considered, and an integrated qualitative study was undertaken to consider acceptability. Results: A total of 280 patients were screened: 165 (59%) were eligible, and 40 (25%) were recruited. The majority (n = 31; 78%) of participants completed the HIIT program. The remaining nine patients were withdrawn or chose to withdraw. Completers attended 99% of training sessions, completed 85% of sessions in full, and performed 84% of completed intervals at the required intensity. There were no related serious adverse events. Maximum walking distance (+94 m; 95% confidence interval, 66.6-120.8 m) and the SF-36 physical component summary (+2.2; 95% confidence interval, 0.3-4.1) were improved following completion of the program. Conclusions: Uptake to HIIT was comparable to SEPs in patients with IC, but completion rates were higher. HIIT appears feasible, tolerable, and potentially safe and beneficial for patients with IC. It may provide a more readily deliverable, acceptable form of SEP. Research comparing HIIT with usual-care SEPs appears warranted.

AB - Objective: Provision, uptake, adherence, and completion rates for supervised exercise programs (SEP) for intermittent claudication (IC) are low. A shorter, more time-efficient, 6-week, high-intensity interval training (HIIT) program may be an effective alternative that is more acceptable to patients and easier to deliver. The aim of this study was to determine the feasibility of HIIT for patients with IC. Methods: A single arm proof-of-concept study, performed in secondary care, recruiting patients with IC referred to usual-care SEPs. Supervised HIIT was performed three times per week for 6 weeks. The primary outcome was feasibility and tolerability. Potential efficacy and potential safety were considered, and an integrated qualitative study was undertaken to consider acceptability. Results: A total of 280 patients were screened: 165 (59%) were eligible, and 40 (25%) were recruited. The majority (n = 31; 78%) of participants completed the HIIT program. The remaining nine patients were withdrawn or chose to withdraw. Completers attended 99% of training sessions, completed 85% of sessions in full, and performed 84% of completed intervals at the required intensity. There were no related serious adverse events. Maximum walking distance (+94 m; 95% confidence interval, 66.6-120.8 m) and the SF-36 physical component summary (+2.2; 95% confidence interval, 0.3-4.1) were improved following completion of the program. Conclusions: Uptake to HIIT was comparable to SEPs in patients with IC, but completion rates were higher. HIIT appears feasible, tolerable, and potentially safe and beneficial for patients with IC. It may provide a more readily deliverable, acceptable form of SEP. Research comparing HIIT with usual-care SEPs appears warranted.

KW - High-intensity interval training

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VL - 78

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JO - Journal of Vascular Surgery

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High-intensity interval training in patients with intermittent claudication

Abstract

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Keywords

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