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High-intensity interval training produces a significant improvement in fitness in less than 31 days before surgery for urological cancer: a randomised control trial

James Blackwell, Brett Doleman, Catherine Boereboom, Alastair Morton, S. Williams, Philip J. Atherton, Kenneth Smith, John P. Williams, Bethan E. Phillips, Jonathan N. Lund

2020Prostate Cancer and Prostatic Diseases74 citationsDOIOpen Access PDF

Abstract

Abstract Objectives To assess the efficacy of high-intensity interval training (HIIT) for improving cardiorespiratory fitness (CRF) in patients awaiting resection for urological malignancy within four weeks. Subjects/patients and methods A randomised control trial of consecutive patients aged (>65 years) scheduled for major urological surgery in a large secondary referral centre in a UK hospital. The primary outcome is change in anaerobic threshold (VO 2AT ) following HIIT vs. standard care. Results Forty patients were recruited (mean age 72 years, male (39): female (1)) with 34 completing the protocol. Intention to treat analysis showed significant improvements in anaerobic threshold (VO 2AT ; mean difference (MD) 2.26 ml/kg/min (95% CI 1.25–3.26)) following HIIT. Blood pressure (BP) also significantly reduced in following: HIIT (SBP: −8.2 mmHg (95% CI −16.09 to −0.29) and DBP: −6.47 mmHg (95% CI −12.56 to −0.38)). No reportable adverse safety events occurred during HIIT and all participants achieved >85% predicted maximum heart rate during sessions, with protocol adherence of 84%. Conclusions HIIT can improve CRF and cardiovascular health, representing clinically meaningful and achievable pre-operative improvements. Larger randomised trials are required to investigate the efficacy of prehabilitation HIIT upon different cancer types, post-operative complications, socio-economic impact and long-term survival.

Topics & Concepts

MedicineHigh-intensity interval trainingPrehabilitationCardiorespiratory fitnessInterval trainingRandomized controlled trialInternal medicineAnaerobic exercisePhysical therapyHeart rateBlood pressureSurgeryCardiovascular and exercise physiologyEnhanced Recovery After SurgeryCardiac, Anesthesia and Surgical Outcomes