Exercise Dose Equalization in High-Intensity Interval Training: A Scoping Review

Abstract

Based on comparisons to moderate continuous exercise (MICT), high-intensity interval training (HIIT) is becoming a worldwide trend in physical exercise. This raises methodological questions related to equalization of exercise dose when comparing protocols. The present scoping review aims to identify in the literature the evidence for protocol equalization and the soundness of methods used for it. PubMed and Scopus databases were searched for original investigations comparing the effects of HIIT to MICT. A total of 2041 articles were identified, and 169 were included. Of these, 98 articles equalized protocols by utilizing energy-based methods or exercise volume (58 and 31 articles, respectively). No clear consensus for protocol equalization appears to have evolved over recent years. Prominent equalization methods consider the exercise dose (i.e., energy expenditure/production or total volume) in absolute values without considering the nonlinear nature of its relationship with duration. Exercises resulting from these methods induced maximal exertion in HIIT but low exertion in MICT. A key question is, therefore, whether exercise doses are best considered in absolute terms or relative to individual exercise maximums. If protocol equalization is accepted as an essential methodological prerequisite, it is hypothesized that comparison of program effects would be more accurate if exercise was quantified relative to intensity-related maximums.

Keywords: athletes; effort; patients; physical activity; training programs.

Figure 1

Phases of study selection during data collection.

Figure 2

Percentage and absolute number of studies using equalized protocols (dashed blue line and black bars, respectively) and number of studies without using equalization of protocols (grey bars) from 1979 to November 2020.

Figure 3

From article-selection process to equalization methods and exercise sessions.