Long-term Exercise Adherence After High-intensity Interval Training in Cardiac Rehabilitation: A Randomized Study

Physiother Res Int. 2016 Mar;21(1):54-64. doi: 10.1002/pri.1619. Epub 2015 Feb 16.


Background and purpose: Exercise adherence in general is reported to be problematic after cardiac rehabilitation. Additionally, vigorous exercise is associated with impaired exercise adherence. As high-intensity interval training (HIT) is frequently used as a therapy to patients with coronary artery disease in cardiac rehabilitation, the objective was to assess long-term exercise adherence following an HIT cardiac rehabilitation programme.

Methods: A multicentre randomized study was carried out. Eligible participants were adults who had previously attended a 12-week HIT cardiac rehabilitation programme, as either a home-based or hospital-based HIT (treadmill exercise or group exercise). The primary outcome was change in peak oxygen uptake; secondary outcomes were self-reported and objectively measured physical activity.

Results: Out of 83 eligible participants, 76 were available for assessment (68 men/8 women, mean age 59 (8) years) at a one-year follow-up. Peak oxygen uptake was significantly elevated above baseline values, (treadmill exercise: 35.8 (6.4) vs. 37.4 (7.4) ml kg(-1) min(-1) , group exercise: 32.7 (6.5) vs. 34.1 (5.8) ml kg(-1) min(-1) and home-based exercise: 34.5 (4.9) vs. 36.7 (5.8) ml kg(-1) min(-1) at baseline and follow-up, respectively), with no significant differences between groups. The majority of the participants (>90%) met the recommended daily level of 30 minutes of moderate physical activity. The home-based group showed a strong trend towards increased physical activity compared with the hospital-based groups.

Discussion: The results from this study have shown that both home-based and hospital-based HIT in cardiac rehabilitation induce promising long-term exercise adherence, with maintenance of peak oxygen uptake significantly above baseline values at a one-year follow-up. The implication for physiotherapy practice is that HIT in cardiac rehabilitation induces satisfactory long-term exercise adherence.

Keywords: coronary artery disease; patient compliance; secondary prevention.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Age Factors
  • Aged
  • Analysis of Variance
  • Cardiac Rehabilitation / methods*
  • Chi-Square Distribution
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / rehabilitation*
  • Exercise Test / methods
  • Female
  • Follow-Up Studies
  • High-Intensity Interval Training / methods*
  • Humans
  • Long-Term Care
  • Male
  • Middle Aged
  • Oxygen Consumption / physiology
  • Patient Compliance / statistics & numerical data*
  • Severity of Illness Index
  • Sex Factors
  • Statistics, Nonparametric
  • Treatment Outcome