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

J Vasc Surg. 2023 Oct;78(4):1048-1056.e4. doi: 10.1016/j.jvs.2023.05.045. Epub 2023 Jun 16.

Authors

Affiliations

¹ Academic Vascular Surgical Unit, Hull York Medical School, Hull. Electronic address: s.pymer@nhs.net.
² Department of Cardiovascular Rehabilitation, Centre for Exercise and Health, University Hospital, Coventry.
³ Academic Vascular Surgical Unit, Hull York Medical School, Hull.
⁴ College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield.
⁵ Department of Cardiovascular Rehabilitation, Centre for Exercise and Health, University Hospital, Coventry; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry; Centre for Sport Exercise and Life Sciences, Institute for Health & Wellbeing, Coventry University, Coventry.
⁶ Hull York Medical School, University of Hull, Hull.
⁷ School of Sport, Exercise, and Rehabilitation Science, University of Hull, Hull.
⁸ Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry; Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry.
⁹ Independant PPI Member, Hull, UK.

PMID: 37330704
DOI: 10.1016/j.jvs.2023.05.045

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.

Trial registration: ClinicalTrials.gov NCT04042311.

Keywords: High-intensity interval training; Intermittent claudication; Supervised exercise program.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Exercise
Exercise Therapy / adverse effects
High-Intensity Interval Training* / adverse effects
Humans
Intermittent Claudication* / diagnosis
Intermittent Claudication* / therapy
Physical Examination

Associated data

ClinicalTrials.gov/NCT04042311

Grants and funding

PB-PG-0418-20014/DH_/Department of Health/United Kingdom