Does High-Intensity Interval Training Lower Inflammatory Disease Activity?

These interventions have been linked to few adverse events. Dr. Huffman notes in one study, the only concern was one woman who complained of a sore ankle. This was remedied by changing shoes. Another participant was injured when they felt so much better they got on an ATV with their grandson and strained their back.

“HIIT allow our patients, especially those who have low levels of fitness, to start low, and more rapidly than would be attainable with traditional continuous moderate intensity training, get to a level where they can perform more challenging activities longer and with greater intensities,” said Dr. Huffman. “I like to call HIIT a gateway drug to long term physical activity behaviors and overall health improvements.”

HIIT as a Disease-Modifying Drug

Dr. Alexanderson

Studies have found that multiple types of HIIT have positive outcomes for patients with myositis and systemic sclerosis as well. HIIT is more effective in improving aerobic capacity compared to home exercise and brisk walks. Helene Alexanderson, PhD, PT, an associate professor at Karolinska University Hospital in Stockholm, Sweden, called HIIT a kind of “disease modifying drug” that is underused.

“The take-home message is that patients with systemic inflammatory disease have reduced peak oxygen uptake and aerobic capacity, and there is strong dose-dependent association between fitness and lower all-cause mortality and cardiovascular disease,” said Dr. Alexanderson. “It is essential that we train aerobic capacity to optimize health.”

Proper supervision is essential when starting a HIIT regimen for a sense of safety and to maximize compliance. Patients should start at a low dose of exercise. Taking into account pain, fatigue, muscle function and goal, intensity can be ramped up over several weeks.

Recovery is important as well. Patients should understand it is necessary to take a day off. Alexanderson said that is when “all the really good metabolic things happen.”

“Also tell your patients that late onset muscle soreness is a good thing,” said Dr. Alexanderson. “It is a kind of receipt showing they did something beneficial for their muscles.”

HIIT & Flares

Both presenters said that in their experience they have seen very few flares, but when they do occur, the response should be made with the patient in consultation with their healthcare team. It may be something as easy as shifting exercise to later in the day. Medication adjustments might be needed.