High-Intensity Interval Training Is Effective at Increasing Exercise Endurance Capacity and Is Well Tolerated by Adults with Cystic Fibrosis

Abstract

Background: To optimize outcomes in people with cystic fibrosis (CF), guidelines recommend 30 to 60 min of moderate-intensity aerobic exercise on most days. Accumulating this volume of exercise contributes importantly to the substantial treatment burden associated with CF. Therefore, the main aim of this study was to investigate the effects of low-volume high-intensity interval training (HIIT) on exercise capacity in people with CF.

Methods: This randomized controlled trial included people with CF aged ≥15 years, who were allocated to either eight weeks of thrice-weekly 10-min sessions of HIIT (experimental group) or eight weeks of weekly contact (control group). Before and after the intervention period, participants completed measurements of time to symptom limitation (T_lim) during a constant work rate cycle ergometry test (primary outcome), and maximal work rate (W_max) during a ramp-based cycle ergometry test and health-related quality of life (HRQoL).

Results: Fourteen participants (median (IQR) age 31 (28, 35) years, forced expiratory volume in 1 second (FEV₁) 61 (45, 80) % predicted) were included (seven in each group). Compared to the control group, participants in the experimental group demonstrated a greater magnitude of change in T_lim, W_max (p = 0.017 for both) and in the physical function domain of HRQoL (p = 0.03). No other between-group differences were demonstrated. Mild post-exercise muscle soreness was reported on a single occasion by four participants. Overall, participants attended 93% of all HIIT sessions.

Discussion: Eight weeks of low-volume (i.e., 30-min/week) HIIT produced gains in exercise capacity and self-reported physical function and was well tolerated by people with CF.

Keywords: cystic fibrosis; exercise; high intensity interval training.

Figure 1

Study flow diagram. Notes: During the first baseline and follow-up assessments, the maximal incremental ramp-based cycle ergometry test was performed. During the second baseline and follow-up assessment, the constant work rate cycle ergometry test was performed. Questionnaires were completed across all assessment sessions. There were 180 people under the care of the CF center at Sir Charles Gairdner Hospital. Forty-one (23%) were ineligible to participate as they either lived outside the Perth metropolitan area (n = 40) or were unable to read and understand English (n = 1). Of the remaining participants (n = 139), 124 declined to participate. Reasons cited for non-participation included: not willing to travel to hospital locations (n = 59); ongoing medical issues limiting participation (n = 29); already exercising at least twice per week (n = 14); and being time-poor, or having a work schedule that did not permit participation (n = 7). Four potential participants declined without a specific reason. A further nine potential participants expressed interest in the study, but did not respond to subsequent contact attempts. Two potential participants who were colonized with nontuberculous mycobacteria expressed interest in the study, but were not permitted to take part due to the risk of cross-infection in the exercise laboratory. HIIT: high-intensity interval training.