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Commentary on “Effects of High-Intensity Interval Training on Fitness and Health in Youth With Physical Disabilities”

Angeli, Jennifer, PT, DPT, PhD; Meyer, Daniel, PT, DPT

Pediatric Physical Therapy: January 2019 - Volume 31 - Issue 1 - p 94
doi: 10.1097/PEP.0000000000000573

Cincinnati Children's Hospital Medical Center Cincinnati, Ohio

The authors declare no conflicts of interest.

“How should I apply this information?”

High-intensity interval training (HIT) is a burst-approach to strength training that has recently been popularized in cardiorespiratory workouts in athlete training programs, in part, due to exercise brevity. Its utility in pediatric clinical populations has not been carefully examined, and we applaud the authors for their pilot work in this area. We regard this approach as a viable and potentially effective physical fitness solution in the clinic setting, where opportunities to adequately dose interventions (ie, time constraints) are limited. We note that HIT may also have applications for wellness arena, and we have successfully employed a time-based, run-walk progression in an inclusive 5-km training program for children with developmental disability.

“What should I be mindful about when applying this information?”

The authors report findings that are mixed and make conclusions difficult for clinical translation, with the exception of a clear lack of demonstration of a relationship between HIT and metabolic health. This finding is unsurprising, as the literature on adult studies suggests that HIT is unlikely to impact metabolic health with a dose that is lower than twice weekly training.1 Although improvements to physical fitness and cardiovascular fitness were detected in some outcome measures, others reflected no statistical gain. The lack of continuity in findings may be due, in part, to the suboptimal approach to HIT employed in this study. It is clear from a broad assessment of HIT literature and the authors own review that HIT is likely to be more effectively administered not less than twice weekly.

Finally, we generally disagree with the reporting of secondary subgroup analyses, when the study was clearly not adequately powered to draw these subgroup conclusions. For example, the physical fitness and cardiovascular demands placed on wheelchair users who engage in “all-out” periods of effort will not surprisingly differ substantially from those occurring in bipedal participants.

Jennifer Angeli, PT, DPT, PhD

Daniel Meyer, PT, DPT

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio

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1. Stavrinou PS, Bogdanis GC, Giannaki CD, Terzis G, Hadjicharalambous M. High-intensity interval training frequency: cardiometabolic effects and quality of life. Int J Sports Med. 2018;39(3):210–217.
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