High Intensity Interval Training in UK Cardiac Rehabilitation Programmes
- Conditions
- Coronary Disease
- Interventions
- Other: High intensity interval training
- Registration Number
- NCT02784873
- Brief Summary
The purpose of the trial is to compare the effects of high intensity interval training (HIIT) with usual care - moderate intensity steady state training (MISS) - in UK cardiac rehabilitation (CR) programmes.
- Detailed Description
Current cardiac rehabilitation (CR) guidelines recommend moderate intensity, steady state exercise training (MISS). However, this guideline predates significant advances in interventional and medical treatment for coronary heart disease (CHD) and may not, therefore, be the most effective strategy for the 'modern' patient with CHD. Recent research has indicated that greater benefit may be attained by participating in high intensity interval training (HIIT) which involves repeated short bursts of harder exercise interspersed with short recovery periods. Studies suggest that this can be performed without any compromise in exercise adherence or patient safety. The benefit of this approach in 'real world' CR programmes in the UK cannot be confirmed, as studies have been predominantly conducted in the laboratory and exclusively outside the UK.
In patients attending CR programmes in the UK, the investigators hypothesise that HIIT will improve VO2 peak to a greater extent than MISS. The investigators also hypothesise that HIIT will: 1) be more palatable than MISS and demonstrate greater patient compliance and adherence; 2) improve cardiovascular health to a greater extent than MISS; 3) improve HR-QoL to a greater extent than MISS; 4) lead to more positive motivation and attitudes to exercise than MISS; 5) increase short and medium-term participation in lifestyle physical activity to a greater extent than MISS; 6) be a cost effective alternative to MISS; 7) be as safe as MISS.
The HIIT or MISS study is a pragmatic single-blind, multi-centre, longitudinal, randomised controlled trial. Participants will be randomly allocated to 8 weeks of HIIT or MISS (usual care). Outcomes will be assessed at baseline, 8 weeks and 12 months by assessors blinded to group allocation. Study interventions will be delivered by clinical (not research) staff.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 382
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description High intensity interval training High intensity interval training High intensity interval training within a standard cardiac rehabilitation programme. Warm up: 15 mins total, 10 mins \<40-70% HRR, 5 mins \<70% HRR. Cardiovascular component: exercise bike interval training: 10 x high @ 85-90% peak power output (PPO) from CPEX, 10 x low @ 20-25% PPO (exercise intensity will not to be prescribed from gas exchange data i.e. %VO2 peak). Change in intensity from low to high achieved by altering cadence (rpm). Muscular strength and endurance programme. Cool down: 10 mins, \<40% HRR. Duration of intervals and total programme duration increased in a standardised fashion. Workload increased bi-weekly in response to participant reported RPE (only after the full 10 x 1 protocol has been achieved). If RPE \< 17 then workload will be increased.
- Primary Outcome Measures
Name Time Method Change in peak oxygen uptake (VO2 peak) Baseline, 8 weeks and 12 months Cardiopulmonary exercise test
- Secondary Outcome Measures
Name Time Method Psychological factors associated with compliance and adherence (3) Baseline, 8 weeks Quantitative psychology - questionnaires: 3) the Psychological Need Satisfaction in Exercise Scale (PNSES)
Psychological factors associated with compliance and adherence (4) Baseline, 8 weeks Quantitative psychology - questionnaires: 4) Courneya and Bobick's 7-point bipolar adjectival rating scale;
Arterial remodelling Baseline, 8 weeks and 12 months Arterial oscillometry - pulse wave velocity
Service and resource use Baseline, 8 weeks and 12 months Questionnaire - client service receipt inventory (CSRI)
Compliance and adherence Every exercise session (8 week exercise programme duration) Compliance and adherence will be determined by recording the number of training sessions attended and successfully completed in accordance with the exercise protocol. Drop-out from the programme will also be documented for both study groups in addition to reason for drop-out, where provided voluntarily by participants.
Psychological factors associated with compliance and adherence (1) Baseline, 8 weeks Quantitative psychology - questionnaires: 1) the Multidimensional Self-Efficacy for Exercise Scale (MSES)
Psychological factors associated with compliance and adherence (2) Baseline, 8 weeks Quantitative psychology - questionnaires: 2) the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2)
HR-QOL Baseline, 8 weeks and 12 months Questionnaire - EQ-5D-5L
Metabolic reserve Baseline, 8 weeks and 12 months Cardiopulmonary exercise test - ventilatory threshold (VT)
Cardiac remodelling Baseline, 8 weeks and 12 months Echocardiography - left ventricular volumes
Palatability 8 weeks Qualitative psychology - thematic analysis of semi structured interviews
Lifestyle physical activity Baseline, 8 weeks and 12 months Physical activity monitor (worn for 1 week) - total energy expenditure
Ventilatory efficiency Baseline, 8 weeks and 12 months Cardiopulmonary exercise test - slope of ratio of ventilation to carbon dioxide (VE/VC02 slope)
Cardiovascular health Baseline, 8 weeks and 12 months CHD risk factor assessment
Trial Locations
- Locations (1)
University Hospital
🇬🇧Coventry, United Kingdom