Exercise training is a clinically proven, cost-effective, primary intervention that delays and in many cases prevents the health burdens associated with many chronic diseases. However, the precise type and dose of exercise needed to accrue health benefits is a contentious issue with no clear consensus recommendations for the prevention of inactivity-related disorders and chronic diseases. A growing body of evidence demonstrates that high-intensity interval training (HIT)canserveasaneffectivealternatetotraditionalendurance-basedtraining,inducingsimilar or even superior physiological adaptations in healthy individuals and diseased populations, at least when compared on a matched-work basis. While less well studied, low-volume HIT can also stimulate physiological remodelling comparable to moderate-intensity continuous training despite a substantially lower time commitment and reduced total exercise volume. Such findings areimportantgiventhat'lackoftime'remainsthemostcommonlycitedbarriertoregularexercise participation. Here we review some of the mechanisms responsible for improved skeletal muscle metabolic control and changes in cardiovascular function in response to low-volume HIT. We also consider the limited evidence regarding the potential application of HIT to people with, or at risk for, cardiometabolic disorders including type 2 diabetes. Finally, we provide insight on the utility of low-volume HIT for improving performance in athletes and highlight suggestions for future research.

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Physiological adaptations to low-volume, high-intensity interval training in health and disease

While the physiological adaptations that occur following endurance training in previously sedentary and recreationally active individuals are relatively well understood, the adaptations to training in already highly trained endurance athletes remain unclear. While significant improvements in endurance performance and corresponding physiological markers are evident following submaximal endurance training in sedentary and recreationally active groups, an additional increase in submaximal training (i.e. volume) in highly trained individuals does not appear to further enhance either endurance performance or associated physiological variables [e.g. peak oxygen uptake (VO2peak), oxidative enzyme activity]. It seems that, for athletes who are already trained, improvements in endurance performance can be achieved only through high-intensity interval training (HIT). The limited research which has examined changes in muscle enzyme activity in highly trained athletes, following HIT, has revealed no change in oxidative or glycolytic enzyme activity, despite significant improvements in endurance performance (p < 0.05). Instead, an increase in skeletal muscle buffering capacity may be one mechanism responsible for an improvement in endurance performance. Changes in plasma volume, stroke volume, as well as muscle cation pumps, myoglobin, capillary density and fibre type characteristics have yet to be investigated in response to HIT with the highly trained athlete. Information relating to HIT programme optimisation in endurance athletes is also very sparse. Preliminary work using the velocity at which VO2max is achieved (V(max)) as the interval intensity, and fractions (50 to 75%) of the time to exhaustion at V(max) (T(max)) as the interval duration has been successful in eliciting improvements in performance in long-distance runners. However, V(max) and T(max) have not been used with cyclists. Instead, HIT programme optimisation research in cyclists has revealed that repeated supramaximal sprinting may be equally effective as more traditional HIT programmes for eliciting improvements in endurance performance. Further examination of the biochemical and physiological adaptations which accompany different HIT programmes, as well as investigation into the optimal HIT programme for eliciting performance enhancements in highly trained athletes is required.

/pdf/the-scientific-basis-for-high-intensity-interval-training-475s32uoh8.pdf

The Scientific Basis for High-Intensity Interval Training: Optimising Training Programmes and Maximising Performance in Highly Trained Endurance Athletes

This article traces the history of scientific and empirical interval training. Scientific research has shed some light on the choice of intensity, work duration and rest periods in so-called ‘interval training’. Interval training involves repeated short to long bouts of rather high intensity exercise (equal or superior to maximal lactate steady-state velocity) interspersed with recovery periods (light exercise or rest). Interval training was first described by Reindell and Roskamm and was popularised in the 1950s by the Olympic champion, Emil Zatopek. Since then middle- and long- distance runners have used this technique to train at velocities close to their own specific competition velocity. In fact, trainers have used specific velocities from 800 to 5000m to calibrate interval training without taking into account physiological markers. However, outside of the competition season it seems better to refer to the velocities associated with particular physiological responses in the range from maximal lactate steady state to the absolute maximal velocity. The range of velocities used in a race must be taken into consideration, since even world records are not run at a constant pace.

http://anneclairepannier.free.fr/files/aerobie/Billat(2001)IntervalTraining_PartI.pdf

Interval training for performance: a scientific and empirical practice. Special recommendations for middle- and long-distance running. Part II: anaerobic interval training.

Our aim was to examine the effects of seven high-intensity aerobic interval training (HIIT) sessions over 2 wk on skeletal muscle fuel content, mitochondrial enzyme activities, fatty acid transport...

http://www.carnevalijunior.com.br/wp-content/uploads/2010/03/two-weeks-of-high-intensity-aerobic-interval-training-increases-the-capacity-for-fat-oxidation-during-exercise-in-women-2007.pdf

Two weeks of high-intensity aerobic interval training increases the capacity for fat oxidation during exercise in women

Our laboratory recently showed that six sessions of sprint interval training (SIT) over 2 wk increased muscle oxidative potential and cycle endurance capacity (Burgomaster KA, Hughes SC, Heigenhauser GJF, Bradwell SN, and Gibala MJ. J Appl Physiol 98: 1895–1900, 2005). The present study tested the hypothesis that short-term SIT would reduce skeletal muscle glycogenolysis and lactate accumulation during exercise and increase the capacity for pyruvate oxidation via pyruvate dehydrogenase (PDH). Eight men [peak oxygen uptake (Vo2 peak) = 3.8 ± 0.2 l/min] performed six sessions of SIT (4–7 × 30-s “all-out” cycling with 4 min of recovery) over 2 wk. Before and after SIT, biopsies (vastus lateralis) were obtained at rest and after each stage of a two-stage cycling test that consisted of 10 min at ∼60% followed by 10 min at ∼90% of Vo2 peak. Subjects also performed a 250-kJ time trial (TT) before and after SIT to assess changes in cycling performance. SIT increased muscle glycogen content by ∼50% (main effect,...

https://www.physiology.org/doi/pdf/10.1152/japplphysiol.01220.2005

Effect of short-term sprint interval training on human skeletal muscle carbohydrate metabolism during exercise and time-trial performance

This study examined the effects of sustained high-intensity interval training (HIT) on the athletic performances and fuel utilisation of eight male endurance-trained cyclists. Before HIT, each subject undertook three baseline peak power output Wpeak tests and two simulated 40-km time-trial cycling performance (TT40) tests, of which the variabilities were 1.5 (1.3)% and 1.0 (0.5)%, respectively [mean (SD)]. Over 6 weeks, the cyclists then replaced 15 (2)% of their 300 (66) km.week-1 endurance training with 12 HIT sessions, each consisting of six to nine 5-min rides at 80% of Wpeak, separated by a l-min recovery. HIT increased Wpeak from 404 (40) to 424 (53) W (P < 0.01) and improved TT40 speeds from 42.0 (3.6) to 43.0 (4.2) km.h-1 (P < 0.05). Faster TT40 performances were due to increases in both the absolute work rates from 291 (43) to 327 (51) W (P < 0.05) and the relative work rates from 72.6 (5.3)% of pre-HIT Wpeak to 78.1 (2.8)% of post-HIT Wpeak (P < 0.05). HIT decreased carbohydrate (CHO) oxidation, plasma lactate concentration and ventilation when the cyclists rode at the same absolute work rates of 60, 70 and 80% of pre-HIT Wpeak (P < 0.05), but not when they exercised at the same relative (% post-HIT Wpeak) work rates. Thus, the ability of the cyclists to sustain higher percentages of Wpeak in TT40 performances after HIT was not due to lower rates of CHO oxidation. Higher relative work rates in the TT40 rides following HIT increased the estimated rates of CHO oxidation from approximately 4.3 to approximately 5.1 g.min-1.

Metabolic and performance adaptations to interval training in endurance-trained cyclists

Pre-peritoneal pelvic packing for haemodynamic instability following unstable pelvic fracture has recently been added to the trauma surgeon’s armamentarium, as a means of controlling venous and bone haemorrhage. We present a child who underwent this procedure as a lifesaving measure in a level 2 hospital prior to transfer to a tertiary setting. We review the background of the technique and highlight potential complications and poor outcomes in the paediatric patient if incorrect technique is used.

Christopher James Westgarth-Taylor

Papers

Metabolic and performance adaptations to interval training in endurance-trained cyclists

Pre-peritoneal pelvic packing in a paediatric unstable pelvic fracture: an undescribed complication of lower limb compartment syndrome.

Single-stage procedures for anorectal malformations: a systematic review and meta-analysis

The epidemiology of paediatric burn injuries in Johannesburg, South Africa.

65. Assessing Compliance with Human Papillomavirus Vaccination Series in Patients with Cloacal Malformations in a Multidisciplinary Clinic