KIN366/ConceptLibrary/HighIntensityIntervalTraining

Movement Experiences for Children
KIN 366
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Instructor:	Dr. Shannon S.D. Bredin
Email:	shannon.bredin@ubc.ca
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Introduction

This page is intended to enlighten an audience of exercise instructors and healthcare professionals on how High Intensity Interval Training (HIIT) can be integrated into an exercise programs for various populations, specifically demonstrate if and how it can be applied to children. Additionally, it will provide a clear definition, history and background, current relevance, specific health benefits, application and utilization, and limitations of HIIT.

Definition

High-intensity interval training (HIIT) refers to exercise that is characterized by relatively short bursts of vigorous activity, interspersed by periods of rest or low-intensity exercise for recovery. In untrained and recreationally active individuals, short-term HIIT is a potent stimulus to induce physiological remodelling similar to traditional endurance training despite a markedly lower total exercise volume and training time commitment. (Gibala and Jones, 2013).

History and Background

HIIT has been recognized and prescribed by sports scientists and coaches to be used by athletes for several decades. (Hawley, Myburgh, Noakes, and Dennis, 2012). It has been used in various drills have been prescribed by coaches in their practices in sports such as track and field, cycling, basketball, football, soccer, racquetball, and handball. (Buchheit and Laursen, 2013).

Due to some of the perceived success found in athletes utilizing this training method, it was tested scientifically to analyze the benefits. An example of an early study in with this type of training was done a study done in 1960 by Christensen, Hedman, Saltin working with intermittent and continuous running. In this study, participants intermittently ran on a tread mill at a speed of 20 km/h (12.4 miles/h) which was compared with continuous running at the same speed with the results showing potential for increased respiratory and circulatory functions. (Christensen, Hedman, and Saltin, 1960).

It was further found that an interval training regime is a very effective method of producing a high total work output in a relatively short training session and thereby improves aerobic power, glycolytic capacity and ability to tolerate the short duration interval work encountered in many games. (Pyke, Elliot, Morton, Roberts, 1974)

Throughout the decades there have been numerous studies which found similar results, but there was still unspecified and undefined amount of time and output required to maximize the health benefits for people in a healthy population, and recreational, novice or elite athletes (Greig, Logan, Harris, Duncan, Schofield, 2014)

It has only been until recently, that research has been done to apply the benefits to a childhood and adolescent perspective.

Contemporary Relevance of (HIIT)

The following sub headings are how HIIT is currently being researched in Child and Adolescents and also other notably populations:

Child and Adolescents Acceptability to an exercise program

In a recent study, researchers tested the feasibility of HIIT to increase participation of obese and overweight adolescents in an exercise program compared to traditional Aerobic Exercise (AE), which is the standard care for paediatric weight management programs in the United States. Results showed that the participants were subjects were satisfied with the structured, realistic, and desirable form of exercise over AE (Murphy Kist, Grier, Edwards, Gao, Siegel, 2014)

Also, it has been demonstrated that continuous, aerobic, longer exercise programs garner low child acceptability and adherence to this this type of program, due to the monotony of the exercise (Borel, et al. 2010) But HIIT is an alternative to because this type of exercise is close to the pattern of children’s spontaneous chosen physical activity, in terms of intensity and duration (Borel, et al. 2010)

Elite or Competitive Athletes

Studies have demonstrated that for athletes who are already trained, improvements in endurance performance can be achieved only through high-intensity interval training (HIIT). (Paul B. Laursen, David G. Jenkins 2012). A short-term period (six to eight sessions over 2-4 weeks) of high-intensity interval training (consisting of repeated exercise bouts performed close to or well above the maximal oxygen uptake intensity, interspersed with low-intensity exercise or complete rest) can elicit increases in intense exercise performance of 2-4% in well-trained athletes. (Laursen, 2010)

General Healthy Population

High Intensity Interval Training techniques are time-efficient strategies that have been shown to be effective in healthy populations. (Currie, Dubberley, Mckelvie, and Macdonald, 2013). It has recently garnered attention for being a time-efficient exercise option for improving cardiovascular and metabolic health (Little, Francois, 2014).

Heart Disease and Stroke Rehabilitation

Given that “lack of time” is one of the commonly cited barriers to exercise adherence in cardiac rehabilitation, a low-volume, high-intensity interval protocol may be a superior treatment strategy in terms of adherence if the resultant physiological benefits are comparable. (Currie, Dubberley, Mckelvie, & Macdonald, 2013)

Type 2 Diabetes (T2D)

New research demonstrates that HIIT may be particularly effective for improving postprandial hyperglycaemia in individuals with or at for, T2D. This is due to postprandial hyperglycemia being a risk factor for cardiovascular morbidity and mortality (Little, Francois, 2014)

Substance Use Disorder (SUD)

SUD patients are shown to have a low aerobic power, thus they are at risk for developing cardiovascular disease. As it is important that SUD patients receive both a physical and psychological treatments in the clinic and current results indicate that the conventional treatment is not sufficient to reduce the risk of cardiovascular disease (Flemmen, Unhjem, and Wang, 2014). High-intensity interval training has been recommended as part of the clinical treatment to effectively improve the patient groups’ aerobic power. (Flemmen, Unhjem, and Wang, 2014) Additionally, it has been found that SUD patients have a high rate of nonattendance, discontinuation and relapse rates with their conventional treatment. (Flemmen, Unhjem, and Wang, 2014). Their results found that HIIT in increased the level of attendance for SUD patients.

Health Benefits

Increased participation and enjoyment in exercise for adolescents (Borel et al 2012)
Increased V02 Max (Greig R. M. Logan, 2013)
Increased Anaerobic Metabolism (Greig R. M. Logan, 2013)
Fatigue Resistance (Hawley, et al, 2014)
Endurance Performance (Hawley, et al, 2014)
Lowered risk to metabolic syndrome (Greeley, S., Martinez, N., & Campbell, B. (2013)
Improving exercise capacity in heart transplant patients (i.e. maximal oxygen uptake) (Mathur S et al (2014)

Practical Applications and Utilization for Healthcare Professionals and Exercise Instructors for general population

Prescription for HIIT consists of the manipulation of up to nine variables which include:

Work interval intensity (i.e. 80%, 90% 100% effort)
Work interval duration (i.e. 30s, 60s, 120s time of work)
Rest interval intensity (i.e. complete rest, 10% relaxed, 20% relaxed)
Rest interval duration (i.e. 30s, 60s, 120s time of work)
Exercise type (i.e. running, cycling, swimming, rowing etc)
Number of repetitions (i.e. how many times one performs same exercise in one series)
Number of series (i.e. number total series)
Between-series recovery duration(i.e. recovery time between series)
Between-series recovery intensity. (i.e. recovery intensity between series)

(Buchheit, & Laursen, 2013)

Although there are up to nine variables to manipulate, effective prescription of HIIT training should be targeted to a specific audience depending on their state of health any physical skill. Not all variables needed to be specified, but ensure you allow for flexibly in each of the variables.

Below find some examples of how to apply a basic High Intensity Training Program

Exercise Type	Training Period	Work Interval (Repetition x Time)	Work Intensity	Rest Interval (Duration and Intensity)	Number of Series	Rest Interval in between Series (Duration/Intensity
Treadmill or Cycle	2 Weeks	4 x 30s	100% effort	2 minutes @10-20% effort	3-5	2-3 mins
Treadmill or Cycle	3 Weeks	6 x 3 Minutes	80% effort	1 minutes @10-20% effort	3-5	3-4 mins
Treadmill or Cycle	6 Weeks	10 x 1 minutes	80%-90% effort	1 minute @10-20% effort	2-3	3-4 mins
Treadmill or Cycle	4 Weeks	4-7 x 30s	100% effort	2 Minutes @10-20% effort	2-3	3-4 mins

(Adapted and modified from Whitehurst, 2012; Buchheit & Laursen, 2013)

It it important to note that this was just a sample of a basic HIIT program. All of the variables can be modified, especially the exercise type. One can adjust the exercise type and to almost any sport that requires cardiovascular aerobic or anaerobic function.

Basis for the use of HIIT in Childhood Movement Applications

Initial research has established promising reductions in cardiovascular and metabolic risk factors using HIIT in an adolescent age group, supporting short bouts of high-intensity exercise as an alternative approach to achieve the health benefits of physical activity in this cohort. (Greig R. M. Logan, 2013). Improvements in aerobic fitness, insulin sensitivity, adiponectin and HDL, and reductions in BMI, percentage body fat, SBP, waist circumference, fasting plasma glucose and insulin, LDL and TAG were common themes throughout the current studies. (Greig R. M. Logan, 2013)

Additionally, there has been effectiveness in HIIT and regular continuous exercise training programs with juvenile obese children. HIIT was found to be equally as effective in improving important health parameters (e.g. aerobic fitness, insulin sensitivity, BMI) in obese children. (Araujo, et. al, 2014)

Furthermore, initial research seems to suggest HIIT might benefit kids in areas like BMI, fitness, waist circumference and off task behaviour (i.e behaviour that is disengaged from and unrelated to the learning task at hand) in the classroom. (Ma, Mare, & Gurd, 2014)  However, there is still more research needed to be done in pre pubescent children. Further research should be done to assess health and overall movement experiences for pre pubescent children. (Ma, Mare, & Gurd, 2014) 

Preliminary Application of HIIT in Childhood Movement Application

This is a relatively new field of study and has been recommended for more research to define what would be appropriate for juvenile children. However, below is a model of effective protocols that was used in a study done by Logan, et al, 2014, used to improve the metabolic profile in adolescents.

Type of Exercise	Work Interval/Effort	Rest Interval	Repetitions	Rest after first series
Sprinting	30 Seconds @ 90% Maximum Heart Rate	30 Seconds Rest	4-6	3 Mins
Sprinting	60 Seconds @ 100% Maximum Heart Rate	60 Seconds Rest	6	3 mins

It is worth noting that future studies and practitioners may choose to adapt these effective protocols or create new training programmes for youth. The current studies concerning HIIT in adolescence leaves prospective research to further our understanding of its effects on the metabolic condition and perceived enjoyment of exercise. (Logan, Harris, Duncan, Schofield, 2014)

Limitations/Safety Concerns/Issues for Applying High Interval Intensity Training

Certain Approaches/Applications of HIIT should be reserved for highly experienced coaches and well trained athletes, and health professionals for whom durations of exercise, limits of intensity of individuals are known. (Buchheit, M., & Laursen, 2013)

It has been shown that interval training is a commonly used exercise paradigm with adults, there is no standard by which the exercise training intensity is actually determined. (Whitehurst, 2012). Furthermore, given the scarcity of data on the subject, the question of exactly how much intensity to safely elicit via interval training in an at-risk population remains largely unanswered. (Whitehurst, M 2012)

It is important to point out that 100% effort of HIIT of less than 1 minute may be unrealistic for older deconditioned persons and those suffering from diseases.The effort required for the very brief work bouts may be beyond both the muscular and cardiovascular capacity of this population. Finally, considering the ability to adaptation and modify HIIT, older individuals should consider HIIT as a viable alternative to traditional exercise programs. (Whitehurst, 2012)

A popular method of setting exercise intensity using Heart Rate zones (i.e. 100% effort = 160 heart rate) is well suited to prolonged and sub maximal exercise bouts. However, its effectiveness for controlling or adjusting the intensity of an HIT session may be limited. (Buchheit, M., & Laursen, 2013).

Conclusion

Much of the current research has been done in the area for the general healthy adult population dealing with health issues like obesity, heart disease, and Type 2 Diabetes. In these areas, HIIT training has shown a benefit in improving cardiovascular, circulatory, and metabolic functions. (Whitehurst, 2012).

An intriguing benefit for most people to incorporate HIIT is that it is time efficient. It is a time efficient strategy where one can receive equal or better health benefits compared to traditional continuous exercise programs. (Logan, Harris, Duncan, Schofield, 2014)

Furthermore, HIIT has been demonstrated to be more desirable and potentially more engaging for people to use. The exercise can be tailored to any sport or activity and has been shown to keep people motivated to exercise. (Logan, Harris, Duncan, Schofield, 2014)

However, the minimum duration and frequency of HIIT activity must be clearly determined if it is to be used as an alternative to current physical activity recommendations. (Logan, Harris, Duncan, Schofield, 2014) Although, various types of HIIT has been prescribed by sport scientists, exercise instructors, and coaches there is still limited and continuing research to specify and define an exact duration and effort required in for HIIT training to maximize health benefits. (Whitehurst, 2012)

Future studies must examine the effects of various HIIT protocols to determine the optimum strategy to deliver cardiometabolic health benefits. Exercise intensity measures must also be stated and easily translated to practice by the subjects. Intensity and bout-duration cutoffs must also be agreed upon to develop a clear definition as to what constitutes HIIT. Most notably there is lacking research with movement development in juvenile children and resulting potential health benefits. (Logan, Harris, Duncan, Schofield, 2014)

References

Ana Carolina Corte de Araujo, Hamilton Roschel, Andreia Rossi Picanço, Danilo Marcelo Leite do Prado, Sandra Mara Ferreira Villares, Ana Lúcia de Sá Pinto,Bruno Gualano . (2014). Correction: Similar health benefits of endurance and high-intensity interval training in obese children. PloS One, 9(8), e105486. doi:10.1371/journal.pone.0105486

Anonymous. (2014). Stable heart transplant patients benefit from high-intensity interval training. Nursing Standard, 28(52), 16.

Borel, B., Leclair, E., Thevenet, D., Beghin, L., Berthoin, S., & Fabre, C. (2010). Correspondences between continuous and intermittent exercises intensities in healthy prepubescent children. European Journal of Applied Physiology, 108(5), 977-985. doi:10.1007/s00421-009-1296-y

Boyne, P., Dunning, K., Carl, D., Gerson, M., Khoury, J., & Kissela, B. (2013). High-intensity interval training in stroke rehabilitation. TOPICS IN STROKE REHABILITATION, 20(4), 317-330. doi:10.1310/tsr2004-317

Buchheit, M., & Laursen, P. B. (2013). High-intensity interval training, solutions to the programming puzzle: Part I: Cardiopulmonary emphasis. Sports Medicine, 43(5), 313-338. doi:10.1007/s40279-013-0029-x

Logan, G. R. M., Harris, N., Duncan, S., & Schofield, G. (2014). A review of adolescent high-intensity interval training. Sports Medicine, 44(8), 1071-1085. doi:10.1007/s40279-014-0187-5

Little, J. P., & Francois, M. E. (2014). High-intensity interval training for improving postprandial hyperglycemia. Research Quarterly for Exercise and Sport, 85(4), 451-456. doi:10.1080/02701367.2014.963474

Greeley, S., Martinez, N., & Campbell, B. (2013). The impact of high-intensity interval training on metabolic syndrome. STRENGTH AND CONDITIONING JOURNAL, 35(2), 63-65. doi:10.1519/SSC.0b013e31827764da

Flemmen, G., Unhjem, R., & Wang, E. (2014). High-intensity interval training in patients with substance use disorder. BioMed Research International, 2014, 616935.

Christensen, E. H., Hedman, R. and Saltin, B. (1960), Intermittent and Continuous Running (A further contribution to the physiology of intermittent work.). Acta Physiologica Scandinavica, 50: 269–286. doi: 10.1111/j.1748-1716.1960.tb00181.

Currie, K. D., Dubberley, J. B., McKelvie, R. S., & MacDonald, M. J. (2013). Low-volume, high-intensity interval training in patients with CAD. Medicine & Science in Sports & Exercise, 45(8), 1436-1442. doi:10.1249/MSS.0b013e31828bbbd4

Dennis, S. C., Myburgh, K. H., A. Hawley, J., & Noakes, T. D. (1997). Training techniques to improve fatigue resistance and enhance endurance performance. Journal of Sports Sciences, 15(3), 325-333. doi:10.1080/026404197367335

Flemmen, G., Unhjem R., & Wang E., “High-Intensity Interval Training in Patients with Substance Use Disorder,” BioMed Research International, vol. 2014, Article ID 616935, 8 pages, 2014. doi:10.1155/2014/616935

Gibala, M. J., & Jones, A. M. (2013). Physiological and performance adaptations to high-intensity interval training. Nestlé Nutrition Institute Workshop Series, 76, 51.

Laursen, P. B. (2010). Training for intense exercise performance: High-intensity or high-volume training? Scandinavian Journal of Medicine & Science in Sports, 20 Suppl 2(s2), 1. doi:10.1111/j.1600-0838.2010.01184.x

Little J.,Francois M., High-Intensity Interval Training for Improving Postprandial Hyperglycemia, Research Quarterly for Exercise and Sport, Vol. 85, Iss. 4, 2014

Ma, J. K., Mare, L. L., & Gurd, B. J. (2014). Classroom-based high-intensity interval activity improves off-task behaviour in primary school students. Applied Physiology, Nutrition, and Metabolism, 39(12), 1332-1337. doi:10.1139/apnm-2014-0125

Murphy, A., Kist, C., Gier, A. J., Edwards, N. M., Gao, Z., & Siegel, R. M. (2015). The feasibility of high-intensity interval exercise in obese adolescents. Clinical Pediatrics, 54(1), 87-90. doi:10.1177/0009922814528038

Whitehurst, M. (2012). High-intensity interval training: An alternative for older adults. American Journal of Lifestyle Medicine, 6(5), 382-386.