HIIT for Reducing Frailty in Older Veterans

(HIIT@Home Trial)

Overseen By Bruce R Troen, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Severe COPD, CKD, Severe HTN, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

200 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial tests if short, intense exercises with rest periods can help older Veterans stay healthier and more active. The goal is to see if this method can reduce frailty and improve their ability to recover from stress.

Do I need to stop my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the idea that HIIT for Reducing Frailty in Older Veterans is an effective treatment?

The available research shows that high-intensity walking training, a form of HIIT, significantly reduced frailty in older adults. Participants in a study experienced improvements in walking speed, distance, and balance without any negative side effects. They also rated the program highly and recommended it for others. Compared to other treatments like multicomponent training and resistance training, HIIT showed specific benefits in reducing frailty and improving physical abilities. However, multicomponent training also improved fitness but required ongoing exercise to maintain benefits, while resistance training showed improvements in strength and functional capacity. ^{1 2 3 4 5}

What safety data exists for HIIT in older adults?

The safety of high-intensity interval training (HIIT) in older adults has been evaluated in several studies. A scoping review found that HIIT protocols are generally well-tolerated by older adults, with no significant adverse events reported. A study on high-intensity walking training in frail older adults reported no adverse events and high participant satisfaction. A meta-review of systematic reviews found no acute injuries associated with HIIT and high adherence rates. Additionally, HIIT has been recognized as a safe alternative to moderate-intensity training in cardiac rehabilitation for older patients with cardiovascular disease. Overall, HIIT appears to be safe for older adults, but larger studies are needed to further confirm these findings. ^{1 6 7 8 9}

Is Center-based or Home-based HIIT a promising treatment for reducing frailty in older veterans?

Yes, Center-based and Home-based HIIT (High Intensity Interval Training) are promising treatments for reducing frailty in older veterans. HIIT can improve physical fitness, reduce the risk of falls, and enhance overall health in frail older adults. Home-based HIIT is particularly beneficial as it is more accessible and can reach a larger population at a lower cost. ^{1 2 10 11 12}

Research Team

Bruce R. Troen, MD

Principal Investigator

Kansas City VA Medical Center, Kansas City, MO

Eligibility Criteria

This trial is for older veterans, both male and female of any race, who are at least 60 years old. Participants should be non-frail or pre-frail with a frailty score less than 3 and must be medically cleared to exercise. Those with severe COPD, advanced kidney disease, extreme high blood pressure, or significant cognitive impairment cannot join.

Inclusion Criteria

Medically cleared for exercise

I am not considered frail according to a frailty score.

I am 60 years old or older.

Exclusion Criteria

VA-SLUMS score 20 (Cognition)

I have severe COPD, CKD stage 3, or very high blood pressure.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo 12 weeks of high intensity interval training (HIIT) to improve resilience and reduce frailty

12 weeks

Center-based and home-based sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Center based attention control
• Center based HIIT
• Home based HIIT

Trial Overview The study is testing the effects of different types of High Intensity Interval Training (HIIT) on reducing frailty and enhancing resilience in older adults. It compares center-based HIIT, home-based HIIT against a control group receiving standard attention without intensive training.

Participant Groups

Group I: Home based HIIT Experimental Treatment 1 Intervention

Home based HIIT

Group II: Center based attention control Experimental Treatment 1 Intervention

Center based attention control

Group III: Center based HIIT Experimental Treatment 1 Intervention

Center based HIIT

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

A 12-session high-intensity walking training (HIWT) program significantly reduced frailty and improved physical performance in five prefrail and frail older adults, with notable increases in gait speed and balance.

The intervention was safe, with no adverse events reported, and participants rated their satisfaction highly, indicating strong support for incorporating HIWT into routine care for older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and Impact of High-Intensity Walking Training in Frail Older Adults. Danilovich, MK., Conroy, DE., Hornby, TG.[2018]

A 6-month multicomponent training program significantly improved physical fitness in older adults, including those who are robust, frail, and prefrail, with most fitness measures showing positive changes compared to a control group.

After a 4-month detraining period, participants who underwent training experienced notable declines in balance, strength, and flexibility, highlighting the importance of continuous exercise to maintain fitness gains, especially for those with greater frailty.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of multicomponent training and detraining on the fitness of older adults with or at risk of frailty: results of a 10-month quasi-experimental study. Fernández-García, ÁI., Gómez-Cabello, A., Gómez-Bruton, A., et al.[2023]

Exercise interventions have a positive effect on physical determinants and functional abilities in frail older adults, based on a systematic review of 47 randomized controlled trials.

Multicomponent training programs lasting at least 5 months, with sessions three times a week for 30-45 minutes, showed the best outcomes for managing frailty compared to other exercise types.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of exercise interventions for the management of frailty: a systematic review. Theou, O., Stathokostas, L., Roland, KP., et al.[2022]

A 6-week resistance training program for frail older adults (11 participants over 65 years) showed high uptake and retention rates of over 80%, indicating that such interventions are feasible in residential care settings.

Participants in the resistance training group experienced significant improvements in functional capacity, frailty, and strength compared to controls, suggesting that resistance training could be an effective intervention for enhancing health in frail older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Feasibility Trial Evaluating a Resistance Training Intervention With Frail Older Adults in Residential Care: The Keeping Active in Residential Elderly Trial. Swales, B., Ryde, GC., Whittaker, AC.[2022]

Resistance training (RT) significantly improves functional performance in frail and pre-frail adults aged 65 and older, specifically enhancing sit-to-stand (STS) times and Short Physical Performance Battery (SPPB) scores, based on a systematic review of 10 randomized controlled trials with 1303 participants.

To achieve optimal improvements in SPPB scores, at least two weekly training sessions are necessary, with three sessions being most effective, while higher training volumes per session may limit gains.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Are dose-response relationships of resistance training reliable to improve functional performance in frail and pre-frail older adults? A systematic review with meta-analysis and meta-regression of randomized controlled trials. Nagata, CA., Garcia, PA., Hamu, TCDDS., et al.[2023]

A scoping review of 69 studies on high-intensity interval training (HIIT) in older adults found that HIIT protocols are generally well-tolerated and can provide significant health benefits, particularly in improving cardiorespiratory fitness.

Most research has focused on healthy older adults, highlighting a need for larger studies and more investigation into HIIT's effects on older adults with various health conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training in Older Adults: a Scoping Review. Marriott, CFS., Petrella, AFM., Marriott, ECS., et al.[2021]

High-intensity interval training (HIIT) has been shown to significantly improve various health outcomes, including cardiorespiratory fitness, muscle mass, and mental health indicators like anxiety and depression, across diverse populations, as evidenced by 33 systematic reviews involving both healthy individuals and those with health complications.

HIIT is considered safe, with no reported acute injuries and high adherence rates exceeding 80%, suggesting it is a feasible exercise option for many people.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan. Martland, R., Mondelli, V., Gaughran, F., et al.[2023]

High-intensity interval training (HIIT) significantly improves cardiorespiratory fitness in older adults, as evidenced by a greater increase in peak oxygen consumption (VO2peak) compared to moderate-intensity continuous training, with a weighted mean difference of 1.74.

HIIT also leads to beneficial changes in physical fitness, muscle power, and metabolic health, including lower blood triglyceride and glucose levels, which can help combat age-related muscle loss (sarcopenia) and promote overall health in older individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of high-intensity interval training on cardiorespiratory fitness, body composition, physical fitness, and metabolic parameters in older adults: A meta-analysis of randomized controlled trials. Wu, ZJ., Wang, ZY., Gao, HE., et al.[2021]

High-intensity interval training (HIIT) is a safe and effective alternative to traditional moderate-intensity training for older patients with cardiovascular disease (CVD), particularly in cardiac rehabilitation settings.

HIIT can lead to significant improvements in peak oxygen uptake (Vo2) and overall cardiovascular health in older adults with conditions like coronary artery disease and heart failure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training in Cardiac Rehabilitation. Dun, Y., Smith, JR., Liu, S., et al.[2020]

Both low-speed resistance training (LSRT) and high-speed resistance training (HSRT) effectively reduced frailty status and improved physical performance in older adults over a 16-week period, with 60 participants involved in the study.

LSRT was particularly effective in enhancing lower-limb muscle strength and reversing prefrailty, while HSRT showed superior improvements in mobility and dual-task performance, indicating that different training speeds can target specific physical capabilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Low-Speed and High-Speed Resistance Training Programs on Frailty Status, Physical Performance, Cognitive Function, and Blood Pressure in Prefrail and Frail Older Adults. Coelho-Júnior, HJ., Uchida, MC.[2021]

Home-based exercise interventions for frail older adults have been shown to be feasible and effective in improving frailty, functional performance, and reducing the incidence of falls, based on a review of eight studies with various exercise modes and durations.

While these interventions positively impacted physical and nutritional outcomes, the evidence regarding mental health benefits and effects on skeletal muscle or lean mass remains unclear, indicating a need for further research to optimize home exercise programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home Exercise Interventions in Frail Older Adults. Stookey, AD., Katzel, LI.[2022]

A one-year proprioception training program for 564 older adults (aged 70 and over) led to a moderate reduction in falls and fear of falling, highlighting its effectiveness in improving safety among frail and pre-frail individuals.

The study suggests that home-based proprioception exercises can be a cost-effective alternative to more complex exercise programs, making it accessible to a larger population while still providing significant health benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A home-based exercise program focused on proprioception to reduce falls in frail and pre-frail community-dwelling older adults. Pérez-Ros, P., Vila-Candel, R., Martínez-Arnau, FM.[2021]

References

1. United States pubmed.ncbi.nlm.nih.gov

Feasibility and Impact of High-Intensity Walking Training in Frail Older Adults. [2018]

2. England pubmed.ncbi.nlm.nih.gov

Effects of multicomponent training and detraining on the fitness of older adults with or at risk of frailty: results of a 10-month quasi-experimental study. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

The effectiveness of exercise interventions for the management of frailty: a systematic review. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Feasibility Trial Evaluating a Resistance Training Intervention With Frail Older Adults in Residential Care: The Keeping Active in Residential Elderly Trial. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Are dose-response relationships of resistance training reliable to improve functional performance in frail and pre-frail older adults? A systematic review with meta-analysis and meta-regression of randomized controlled trials. [2023]

6. Switzerland pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training in Older Adults: a Scoping Review. [2021]

7. England pubmed.ncbi.nlm.nih.gov

Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan. [2023]

8. England pubmed.ncbi.nlm.nih.gov

Impact of high-intensity interval training on cardiorespiratory fitness, body composition, physical fitness, and metabolic parameters in older adults: A meta-analysis of randomized controlled trials. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

High-Intensity Interval Training in Cardiac Rehabilitation. [2020]

10. Switzerland pubmed.ncbi.nlm.nih.gov

Effects of Low-Speed and High-Speed Resistance Training Programs on Frailty Status, Physical Performance, Cognitive Function, and Blood Pressure in Prefrail and Frail Older Adults. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Home Exercise Interventions in Frail Older Adults. [2022]

12. United States pubmed.ncbi.nlm.nih.gov

A home-based exercise program focused on proprioception to reduce falls in frail and pre-frail community-dwelling older adults. [2021]