High Intensity Interval Training

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Description[edit | edit source]

High-intensity interval training (HIIT), refers to exercise that is characterized by relatively short bursts of vigorous activity, interspersed by periods of rest or low-intensity exercise for recovery. [1]

Despite having various sub-categories, HIIT is generally sub-categorized into low (less than 15 min), and high-volume (greater than 15 min) HIIT based on the total time spent in active intervals. [2]

Evidence-Based Effects[edit | edit source]

Growing evidence-based research, both original research and meta-analysis studies, shows that interval training programs ranging from 5 days to 12 months are effective in improving: [2]


Besides, interval training has been shown to decrease the risk for:[2]

Prescription[edit | edit source]

According to a guideline [26]:

Step 1 involves measuring or estimating maximal heart rate (HRmax).

While maximal exercise testing is the ideal method for determining HRmax and heart rate (HR) target zones, prediction equations can be utilised (e.g. HRmax = 211 − (0.64 × age)). [27]

Step 2 involves calculating the HR target zone corresponding to 85– 95%HRmax.

Step 3 involves validation of the HR target zone using rating of perceived exertion (RPE). For this process, we recommend starting the high intensity interval at a workload corresponding to a participant/observer RPE 15 (hard) on the Borg 6–20 scale, and finishing the interval at an RPE 17–18 (very hard). Patients should display heavy breathing but still be able to talk in short sentences.

Step 4 During validation, the highest HR should be recorded during each interval. The HR target zone is then validated (Step 4a) if HR remains within the HR target zone (calculated in Step 2) during the validation process. If HR increases above HRmax (calculated in Step 1) or remains below the HR target zone (calculated in Step 2), this indicates the HR target zone is inaccurate. Step 4b involves calibration of HR target zone if deemed inaccurate by the validation process. Options for calibration include: repeating maximal exercise test or estimating a new HRmax from a prediction equation. Another option is to recalculate the HR target zone (Step 2) using percentage of heart rate reserve (%HRR) corresponding to 80–90%HRR.

References[edit | edit source]

  1. ↑ Gibala MJ, Jones AM. Physiological and performance adaptations to high-intensity interval training. Limits of human endurance. 2013;76:51-60.
  2. ↑ 2.0 2.1 2.2 Atakan MM, Li Y, Koşar ŞN, Turnagöl HH, Yan X. Evidence-based effects of high-intensity interval training on exercise capacity and health: A review with historical perspective. International journal of environmental research and public health. 2021 Jul 5;18(13):7201.
  3. ↑ Batacan RB, Duncan MJ, Dalbo VJ, Tucker PS, Fenning AS. Effects of high-intensity interval training on cardiometabolic health: a systematic review and meta-analysis of intervention studies. British journal of sports medicine. 2017 Mar 1;51(6):494-503.
  4. ↑ Atakan MM, Güzel Y, Bulut S, Koşar ŞN, McConell GK, Turnagöl HH. Six high-intensity interval training sessions over 5 days increases maximal oxygen uptake, endurance capacity, and sub-maximal exercise fat oxidation as much as 6 high-intensity interval training sessions over 2 weeks. Journal of sport and health science. 2021 Jul 1;10(4):478-87.
  5. ↑ Rosenblat MA, Perrotta AS, Thomas SG. Effect of high-intensity interval training versus sprint interval training on time-trial performance: a systematic review and meta-analysis. Sports Medicine. 2020 Jun;50:1145-61.
  6. ↑ Schubert MM, Clarke HE, Seay RF, Spain KK. Impact of 4 weeks of interval training on resting metabolic rate, fitness, and health-related outcomes. Applied Physiology, Nutrition, and Metabolism. 2017;42(10):1073-81.
  7. ↑ Whyte LJ, Gill JM, Cathcart AJ. Effect of 2 weeks of sprint interval training on health-related outcomes in sedentary overweight/obese men. Metabolism. 2010 Oct 1;59(10):1421-8.
  8. ↑ Talanian JL, Galloway SD, Heigenhauser GJ, Bonen A, Spriet LL. Two weeks of high-intensity aerobic interval training increases the capacity for fat oxidation during exercise in women. Journal of applied physiology. 2007 Apr 1.
  9. ↑ Sultana RN, Sabag A, Keating SE, Johnson NA. The effect of low-volume high-intensity interval training on body composition and cardiorespiratory fitness: a systematic review and meta-analysis. Sports Medicine. 2019 Nov;49:1687-721.
  10. ↑ 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. 2015, 16, 942–961. [CrossRef]
  11. ↑ Babraj JA, Vollaard NB, Keast C, Guppy FM, Cottrell G, Timmons JA. Extremely short duration high intensity interval training substantially improves insulin action in young healthy males. BMC endocrine disorders. 2009 Dec;9(1):1-8.
  12. ↑ Drigny J, Gremeaux V, Dupuy O, Gayda M, Bherer L, Juneau M, Nigam A. Effect of interval training on cognitive functioning and cerebral oxygenation in obese patients: a pilot study. Journal of rehabilitation medicine. 2014 Nov 1;46(10):1050-4.
  13. ↑ Hsieh SS, Chueh TY, Huang CJ, Kao SC, Hillman CH, Chang YK, Hung TM. Systematic review of the acute and chronic effects of high-intensity interval training on executive function across the lifespan. Journal of Sports Sciences. 2021 Jan 2;39(1):10-22.
  14. ↑ Mekari, S.; Neyedli, H.F.; Fraser, S.; O’Brien, M.W.; Martins, R.; Evans, K.; Earle, M.; Aucoin, R.; Chiekwe, J.; Hollohan, Q.; et al. High-Intensity Interval Training Improves Cognitive Flexibility in Older Adults. Brain Sci. 2020, 10, 796. [CrossRef]
  15. ↑ Cassidy S, Thoma C, Houghton D, Trenell MI. High-intensity interval training: a review of its impact on glucose control and cardiometabolic health. Diabetologia. 2017 Jan;60(1):7-23.
  16. ↑ Weston KS, Wisløff U, Coombes JS. High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. British journal of sports medicine. 2014 Aug 1;48(16):1227-34.
  17. ↑ Mijwel S, Jervaeus A, Bolam KA, Norrbom J, Bergh J, Rundqvist H, Wengström Y. High-intensity exercise during chemotherapy induces beneficial effects 12 months into breast cancer survivorship. Journal of Cancer Survivorship. 2019 Apr 15;13:244-56.
  18. ↑ Dun Y, Thomas RJ, Smith JR, Medina-Inojosa JR, Squires RW, Bonikowske AR, Huang H, Liu S, Olson TP. High-intensity interval training improves metabolic syndrome and body composition in outpatient cardiac rehabilitation patients with myocardial infarction. Cardiovascular diabetology. 2019 Dec;18(1):1-1.
  19. ↑ Keogh, J.W.L.; Grigg, J.; Vertullo, C.J. Is Home-Based, High-Intensity Interval Training Cycling Feasible and Safe for Patients With Knee Osteoarthritis?: Study Protocol for a Randomized Pilot Study. Orthop. J. Sports Med. 2017, 5, 2325967117694334. [CrossRef]
  20. ↑ Smith-Ryan, A.E.; Blue, M.N.M.; Anderson, K.C.; Hirsch, K.R.; Allen, K.D.; Huebner, J.L.; Muehlbauer, M.J.; Ilkayeva, O.R.; Kraus, V.B.; Kraus, W.E.; et al. Metabolic and physiological effects of high intensity interval training in patients with knee osteoarthritis: A pilot and feasibility study. Osteoarthr. Cartil. Open 2020, 2, 100083. [CrossRef]
  21. ↑ Verbrugghe J, Agten A, Stevens S, Hansen D, Demoulin C, Eijnde BO, Vandenabeele F, Timmermans A. High intensity training to treat chronic nonspecific low back pain: Effectiveness of various exercise modes. Journal of Clinical Medicine. 2020 Jul 27;9(8):2401.
  22. ↑ Helmhout PH, Harts CC, Staal JB, Candel MJ, De Bie RA. Comparison of a high-intensity and a low-intensity lumbar extensor training program as minimal intervention treatment in low back pain: a randomized trial. European spine journal. 2004 Oct;13:537-47.
  23. ↑ da Cruz Fernandes IM, Pinto RZ, Ferreira P, Lira FS. Low back pain, obesity, and inflammatory markers: exercise as potential treatment. Journal of Exercise Rehabilitation. 2018 Apr;14(2):168.
  24. ↑ Koes BW, Van Tulder M, Thomas S. Diagnosis and treatment of low back pain. Bmj. 2006 Jun 15;332(7555):1430-4.
  25. ↑ Bartlett DB, Willis LH, Slentz CA, Hoselton A, Kelly L, Huebner JL, Kraus VB, Moss J, Muehlbauer MJ, Spielmann G, Kraus WE. Ten weeks of high-intensity interval walk training is associated with reduced disease activity and improved innate immune function in older adults with rheumatoid arthritis: a pilot study. Arthritis research & therapy. 2018 Dec;20:1-5.
  26. ↑ Taylor JL, Holland DJ, Spathis JG, Beetham KS, Wisløff U, Keating SE, Coombes JS. Guidelines for the delivery and monitoring of high intensity interval training in clinical populations. Progress in cardiovascular diseases. 2019 Mar 1;62(2):140-6.
  27. ↑ Nes BM, Janszky I, Wisløff U, Støylen A, Karlsen T. Age‐predicted maximal heart rate in healthy subjects: The HUNT F itness S tudy. Scandinavian journal of medicine & science in sports. 2013 Dec;23(6):697-704.
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