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

• Published in: Prostate cancer and prostatic diseases Vol. 23; no. 4; pp. 696 - 704
• Main Authors: Blackwell, J. E. M., Doleman, B., Boereboom, C. L, Morton, A., Williams, S., Atherton, P., Smith, K., Williams, J. P., Phillips, B. E., Lund, J. N.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.12.2020; Nature Publishing Group
• Subjects: 692/699/67/1059; 692/699/67/589/466; Aged; Anaerobic threshold; Analysis; Biomedical and Life Sciences; Biomedicine; Blood pressure; Cancer; Cancer Research; Cardiorespiratory fitness; Cardiorespiratory Fitness - physiology; Clinical trials; Economic impact; Exercise; Female; Fitness; Heart beat; Heart rate; High-Intensity Interval Training - methods; Humans; Impact analysis; Interval training; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Male; Malignancy; Patient Acceptance of Health Care - statistics & numerical data; Patient Safety; Patients; Preoperative Exercise - physiology; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Surgery; Training; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery; Urological cancer; United Kingdom
• ISSN: 1365-7852; 1476-5608; 1476-5608
• DOI: 10.1038/s41391-020-0219-1

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.