Kristine Røren Nordén, Anne Grete Semb, Hanne Dagfinrud, Jonny Hisdal, Joseph Sexton, Camilla Fongen, Emilie Bakke, Sigrid Ødegård, Jon Skandsen, Thalita Blanck, George S Metsios, Anne Therese Tveter
Journal: RMD open 2024;10(1):e003440
PMID: 38242550
Inflammatory arthritis (IA) is an autoimmune disease characterised by joint inflammation, pain, fatigue and extra-articular manifestations. Patients with IA have an elevated risk of cardiovascular disease (CVD) driven by the proatherogenic effects of systemic inflammation on the vasculature. In addition to screening of traditional CVD risk factors, class 1a level evidence promotes habitual physical activity to optimise CVD risk management. This study's main aim was to assess the effect of high-intensity interval training (HIIT) delivered in physiotherapy primary care on cardiorespiratory fitness (CRF) in patients with IA. This study was a randomised controlled trial which enrolled 60 patients with IA. Participants were randomly assigned to one of the two groups: control group – receiving usual care or the intervention group - receiving usual care and 12 weeks of individualised HIIT at 90%–95% peak heart rate. Results showed that the intervention group demonstrated a significant increase in CRF (measured as peak oxygen uptake, VO₂peak) at 3 months and 6 months compared to the control group. Additionally, no adverse effects on disease activity, pain, or fatigue were observed. Authors concluded that their findings support the integration of HIIT as an effective and feasible physiotherapy intervention in primary care for patients with IA.
OBJECTIVES
To assess the effect of high-intensity interval training (HIIT) delivered in physiotherapy primary care on the primary outcome of cardiorespiratory fitness (CRF) in patients with inflammatory arthritis (IA). Additionally, to explore the effects of HIIT on secondary outcomes, including cardiovascular disease (CVD) risk factors and disease activity.
METHODS
Single-blinded randomised controlled trial with 60 patients randomly assigned to either a control group receiving usual care or an exercise group receiving usual care and 12 weeks of individualised HIIT at 90%-95% peak heart rate. Outcomes were assessed at baseline, 3 months and 6 months post baseline and included CRF measured as peak oxygen uptake (VO), classic CVD risk factors, disease activity, anthropometry and patient-reported physical activity, pain, fatigue, disease impact and exercise beliefs and self-efficacy.
RESULTS
Intention-to-treat analysis demonstrated a significant between-group difference in VO at 3 months (2.5 mL/kg/min, 95% CI 0.9 to 4.0) and 6 months (2.6 mL/kg/min, 95% CI 0.8 to 4.3) in favour of the exercise group. A beneficial change in self-reported physical activity in favour of the exercise group was observed at 3 and 6 months. The HIIT intervention was well-tolerated with minimal adverse events and no apparent impact on disease activity. Differences in secondary outcomes related to CVD risk factors, disease impact, pain, fatigue and exercise beliefs and self-efficacy were generally small and non-significant.
CONCLUSION
After 12 weeks of supervised HIIT delivered in physiotherapy primary care, patients with IA demonstrated a favourable improvement in CRF, with sustained effects at 6-month follow-up.
TRIAL REGISTRATION NUMBER
NCT04922840.
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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