Indicators of response to exercise training: a systematic review and meta-analysis

Abstract

Background: Means-based analysis of maximal rate of oxygen consumption (VO_2max) has traditionally been used as the exercise response indicator to assess the efficacy of endurance (END), high intensity interval (HIIT) and resistance exercise training (RET) for improving cardiorespiratory fitness and whole-body health. However, considerable heterogeneity exists in the interindividual variability response to the same or different training modalities.

Objectives: We performed a systematic review and meta-analysis to investigate exercise response rates in the context of VO_2max: (1) in each training modality (END, HIIT and RET) versus controls, (2) in END versus either HIIT or RET and (3) exercise response rates as measured by VO_2max versus other indicators of positive exercise response in each exercise modality.

Methods: Three databases (EMBASE, MEDLINE, CENTRAL) and additional sources were searched. Both individual response rate and population average data were incorporated through continuous data, respectively. Of 3268 identified manuscripts, a total of 29 studies were suitable for qualitative synthesis and a further 22 for quantitative. Stratification based on intervention duration (less than 12 weeks; more than or equal to 12 weeks) was undertaken.

Results: A total of 62 data points were procured. Both END and HIIT training exhibited differential improvements in VO_2max based on intervention duration. VO_2max did not adequately differentiate between END and HIIT, irrespective of intervention length. Although none of the other exercise response indicators achieved statistical significance, LT and HR_rest demonstrated common trajectories in pooled and separate analyses between modalities. RET data were highly limited. Heterogeneity was ubiquitous across all analyses.

Conclusions: The potential for LT and HR_rest as indicators of exercise response requires further elucidation, in addition to the exploration of interventional and intrinsic sources of heterogeneity.

Keywords: clinical physiology; health policy; sports medicine.

Figure 1

PRISMA flow diagram of the study selection and identification process. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; VO_2max, maximal rate of oxygen consumption.

Figure 2

(A) END versus controls using VO_2max (<12 or ≥12 week subgrouping), (B) HIIT versus controls using VO_2max (<12 or ≥12 weeks subgrouping). END, endurance; HIIT, high intensity interval; VO_2max, maximal rate of oxygen consumption.

Figure 3

END versus HIIT using VO_2max (<12 or ≥12 weeks subgrouping). END, endurance; HIIT, high intensity interval training; IV, inverse variance; VO_2max, maximal rate of oxygen consumption.

Figure 4

(A) END versus controls using HR_max (<12 or ≥12 weeks subgrouping), (B) HIIT versus controls using HR_max (<12 or ≥12 weeks subgrouping). END, endurance; HIIT, high intensity interval training; HR_max, maximum heart rate; IV, inverse variance.

Figure 5

(A) HIIT versus controls using HR_rest (≥12 weeks subgrouping), (B) HIIT versus controls using PO (<12 weeks subgrouping). HIIT, high intensity interval training; IV, inverse variance; PO, high intensity interval training.