Smartphone-Assisted High-Intensity Interval Training in Inflammatory Rheumatic Disease Patients - Randomized Controlled Trial

Haglo, H. Wang, E. Berg, O. Hoff, J. Helgerud, J.

Patients with inflammatory rheumatic diseases (IRDs), such as rheumatoidarthritis, spondyloarthritis, and systemic lupus erythematosus, are reported to have low cardiorespiratory fitness, commonly assessed as maximal oxygen uptake (VO2max). Considering the characteristic symptoms of pain, joint swelling, fatigue, and stiffness, it is unsurprising that patients with IRDs face disease-related barriers for performing health-enhancing physical training. Hence, patients with IRDs are observed to notonly have decreased VO2max compared to the general population, but also be less physically active, or perform physical activities with lower intensity. Supervised high-intensity interval training (HIIT) is documented to counteract the reduced VO2max and poor cardiovascular health associated with IRDs. However, supervised HIIT is resource demanding.

This study sought to investigate if self-administered 4×4-min HIIT guided by a smartphone app (Myworkout GO) could yield similar effects as standard 4×4-min HIIT performed under the guidance and supervision of health care professionals. The effects studied were on VO2max and health-related quality of life.

Forty patients (33 female patients, mean age 48 years; 7 male patients, mean age 52 years) diagnosed with rheumatoid arthritis, spondyloarthritis, or systemic lupus erythematosus were randomized to a supervised group or an app group. Both groups were instructed to perform 4×4-min intervals with a heart rate between 85% and 95% of the maximalheart rate, twice a week for 10 weeks. Treadmill VO2max and health-related quality of life were assessed before and after the exercise period.

VO2max increased similar in both groups after 10 weeks of HIIT, with improvements of 3 to 4 mL/kg/min. This was accompanied by increases in stroke volume in both groups, with no between-group differences apparent for either measure. Improvements in the health-related quality of life dimensions of bodily pain, vitality, and social functioning were observed for both groups. Again, no between-group differences were detected.

Conclusions: High-intensity 4×4-min interval training increased VO2max, contributing to patients’ reduced cardiovascular disease risk, improved health and performance, and enhanced quality of life. Similar improvements were observed following HIIT when IRD patients were guided using perceived exertion by health care professionals or the training was self-administered and guided by the app Myworkout GO. Utilization of the app may help reduce the cost of HIIT as a treatment strategy in this patient population.

Source: https://pubmed.ncbi.nlm.nih.gov/34673536/