High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation. [Protocol]

McGregor, Gordon; Nichols, Simon; Hamborg, Thomas; Bryning, Lucy; Tudor-Edwards, Rhiannon; Markland, David; Mercer, Jenny; Birkett, Stefan; Ennis, Stuart; Powell, Richard; Begg, Brian; Haykowsky, Mark J.; Banerjee, Prithwish; Ingle, Lee; Shave, Rob; Backx, Karianne

Abstract

Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the "modern" patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO2 peak). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes. This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice-weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85–90% peak power output (PPO)) and 10 low-intensity (20–25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40–70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes. The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands—Leicester South Research Ethics Committee (16/EM/0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR. This trial has been registered with identifier NCT02784873: https://clinicaltrials.gov/ct2/show/NCT02784873?term=HIIT+or+MISS&rank=1

Citation

MCGREGOR, G., NICHOLS, S., HAMBORG, T. et al. 2016. High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation. [Protocol]. BMJ open [online], 6(11), article number e012843. Available from: https://doi.org/10.1136/bmjopen-2016-012843

• Other Type: Protocol
• Acceptance Date: Oct 5, 2016
• Online Publication Date: Nov 16, 2016
• Publication Date: Nov 30, 2016
• Deposit Date: Dec 13, 2023
• Publicly Available Date: Dec 13, 2023
• Publisher: BMJ Publishing Group
• DOI: https://doi.org/10.1136/bmjopen-2016-012843
• Keywords: Coronary heart disease; Cardiac rehabilitation; High intensity interval training; Moderate intensity steady state training; Exercise therapy
• Public URL: https://rgu-repository.worktribe.com/output/2079766