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Meta-Analysis
. 2020 Feb 15:263:629-660.
doi: 10.1016/j.jad.2019.11.039. Epub 2019 Nov 12.

Can high intensity interval training improve health outcomes among people with mental illness? A systematic review and preliminary meta-analysis of intervention studies across a range of mental illnesses

Rebecca Martland  1 , Valeria Mondelli  2 , Fiona Gaughran  3 , Brendon Stubbs  4
Affiliations
Meta-Analysis

Can high intensity interval training improve health outcomes among people with mental illness? A systematic review and preliminary meta-analysis of intervention studies across a range of mental illnesses

Rebecca Martland et al. J Affect Disord. .

Abstract

Background: High intensity interval training (HIIT) may have beneficial effects among people with mental illnesses. The aim of this systematic review was to establish the benefits, safety and adherence of HIIT interventions across all categories of mental illness.

Methods: Major databases were searched from inception to 18/2/2019 for intervention studies investigating HIIT among people with mental illnesses. Study quality was assessed via the PEDro scale, intervention characteristics were reported using the TIDier and CERT checklists and findings narratively summarised. A preliminary meta-analysis was undertaken where possible.

Results: 12 intervention studies, (including 7 RCTs), were included. Evidence suggested HIIT improved cardiorespiratory fitness (5/8 intervention studies,63%), anthropometric variables (3/4,75%), mental health outcomes (9/12, 75%), cardiovascular fitness (5/9,56%), physical fitness (1/1,100%) and motor skills (1/1,100%), compare to pre-training. The preliminary meta-analysis of pre-post changes found HIIT reduced depression severity (Standardised mean difference (SMD):-1.36 [95%CI-1.63;-1.089], p<0.0001) and possibly improved VO2max (SMD:0.18 [95%CI -0.02; 0.37], p = 0.08) in people with depression. HIIT increased High-Density-Lipoprotein (SMD:0.373 [95%CI 0.18; 0.57], p = 0.0002) and possibly reduced general psychopathology (SMD:-1.58 [95%CI -3.35; 0.18], p = 0.08) in people with schizophrenia-spectrum disorders. No acute injuries were reported, mean adherence to HIIT sessions ranged from 64-94%, and dropout ranged from 0--50%.

Limitations: Results were limited to a small number of low-to-moderate quality intervention studies.

Conclusion: These findings suggest HIIT may improve a range of physical and mental health outcomes among people with mental illnesses. Nonetheless, high-quality well-powered trials are needed to reaffirm these findings, and future research should address the seemingly high rate of dropout.

Keywords: Anthropometric; Cardiorespiratory fitness; Cardiovascular; High intensity interval training; Mental health; Systematic review.

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Conflict of interest statement

Declaration of Competing Interest BS is supported by Health Education England and the National Institute for Health Research HEE/ NIHR ICA P1rogram Clinical Lectureship (ICA-CL-2017–03–001). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funding partners had no involvement in the study at any stage, nor did they influence the decision to publish. FG has received support or honoraria for CME, advisory work and lectures from Bristol-Myers Squibb, Janssen, Lundbeck, Otsuka, Roche, and Sunovion, and has a family member with professional links to Lilly and GSK, including shares. FG is in part funded by the National Institute for Health Research’s (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and the South London Collaboration for Leadership in Applied Health Research & Care Funding scheme, and by the Maudsley Charity. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. RM and VM have no conflicts of interest to declare.

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