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  1. Article: Fidelity and tolerability of two high-intensity interval training protocols in patients with COPD: a randomised cross-over pilot study.

    Nymand, Stine Buus / Hartmann, Jacob / Rasmussen, Iben Elmerdahl / Iepsen, Ulrik Winning / Ried-Larsen, Mathias / Christensen, Regitse Højgaard / Berg, Ronan Martin Griffin

    BMJ open sport & exercise medicine

    2023  Volume 9, Issue 1, Page(s) e001486

    Abstract: Objectives: High-intensity interval training (HIIT) during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) may alleviate the symptom burden, but the fidelity and tolerability of HIIT using long or short intervals ... ...

    Abstract Objectives: High-intensity interval training (HIIT) during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) may alleviate the symptom burden, but the fidelity and tolerability of HIIT using long or short intervals in patients with COPD are unknown.
    Methods: Twelve patients with moderate-to-severe COPD were included in a randomised cross-over pilot study. They completed two supervised HIIT protocols (4×4 and 10×1). To compare the two HIIT protocols, completed training amount, exercise intensity and perceived tolerability (assessed by a 10-point Likert scale) were integrated in a red-amber-green rating system. If a training session received a red ranking, it was considered unacceptable, if it received an amber ranking it was applicable with precautions, and if it received a green ranking it was considered feasible.
    Results: All patients completed the total training amount in both protocols. The 4×4 protocol resulted in three amber training sessions due to low perceived tolerability. The 10×1 protocol resulted in two red training sessions due to intensity reductions, and two amber training sessions because of low perceived tolerability. There was no statistical difference in perceived tolerability or time spent with an HR ≥85% of HR
    Conclusions: HIIT using longer intervals (4×4) at a relatively lower intensity resulted in higher fidelity expressed by fewer adjustments to the protocol, whereas there was no difference between protocols in perceived tolerance. The 4×4 protocol seems to have a higher fidelity compared with the 10×1 protocol in patients with moderate-to-severe COPD.
    Trial registration number: NCT05273684.
    Language English
    Publishing date 2023-03-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2817580-3
    ISSN 2055-7647
    ISSN 2055-7647
    DOI 10.1136/bmjsem-2022-001486
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Effect of a 12-week high-intensity exercise intervention: a comparison of cardiac exercise adaptations during biological disease-modifying antirheumatic drug treatment (TNF inhibitors vs IL-6 signalling inhibitors) in patients with rheumatoid arthritis - study protocol for a randomised controlled trial.

    Jønck, Simon / Adamsen, Malte Lund / Højgaard, Pil / Rasmussen, Iben Elmerdahl / Ellingsgaard, Helga / Lund, Morten Asp Vonsild / Jørgensen, Peter Godsk / Jacobsen, Søren / Køber, Lars / Vejlstrup, Niels / Dreyer, Lene / Pedersen, Bente Klarlund / Berg, Ronan M G / Christensen, Regitse Højgaard

    BMJ open

    2023  Volume 13, Issue 5, Page(s) e068600

    Abstract: Introduction: The chronic inflammatory state in rheumatoid arthritis (RA) augments the risk of cardiovascular disease (CVD), with pro-inflammatory cytokines tumour necrosis factor (TNF) and interleukin 6 (IL-6) playing a vital role. Consequently, ... ...

    Abstract Introduction: The chronic inflammatory state in rheumatoid arthritis (RA) augments the risk of cardiovascular disease (CVD), with pro-inflammatory cytokines tumour necrosis factor (TNF) and interleukin 6 (IL-6) playing a vital role. Consequently, biological disease-modifying antirheumatic drugs (bDMARDs) may attenuate that risk. IL-6 is also a myokine, secreted from exercising skeletal muscles, where IL-6 exhibits anti-inflammatory effects that may ameliorate the risk of CVD. In healthy humans treated with IL-6 signalling inhibitors (IL-6i), exercise induced loss of visceral fat mass and cardiac adaptations were abolished. We hypothesise that IL-6 signalling inhibition will impair the cardiac and metabolic adaptions to exercise training compared with TNF inhibition in RA patients.
    Methods and analysis: 80 RA patients treated with IL-6i (n=40) or TNF inhibitors (n=40) are included in a 12-week randomised investigator-blinded 4×4 min high-intensity interval training (HIIT) study. Patients are stratified for medical treatment and sex and allocated 1:1 to an exercise or a no exercise control group (four groups). The supervised exercise intervention comprises 3 weekly HIIT sessions on an ergometer bicycle. The primary outcome is the change in left ventricular mass (LVM), and key secondary outcome is change in visceral fat mass. Both outcomes are measured by MRI. Primary statistical analysis will evaluate LVM at follow-up in a regression model. Intention-to-treat and per protocol analyses will be conducted. The latter necessitates a minimum attendance rate of 80%, adherence to bDMARDs treatment of ≥80% and minimum 8 min (50%) of maximal heart rate above 85% per session.
    Ethics and dissemination: The study has been approved by the Capital Region Ethics Committee (H-21010559 amendments 86424, 87463 and 88044) and the Danish Medicines Agency (2021-b005287-21). The trial will follow ICH-GCP guidelines. Regardless of outcome, results will be published in relevant peer-reviewed journals.
    Trial registration numbers: Eudra-CT: 2021-b005287-21 and NCT05215509.
    MeSH term(s) Humans ; Antirheumatic Agents/therapeutic use ; Interleukin-6 ; Tumor Necrosis Factor Inhibitors/therapeutic use ; Arthritis, Rheumatoid/drug therapy ; Exercise ; Exercise Therapy/methods ; Tumor Necrosis Factor-alpha ; Cardiovascular Diseases/drug therapy ; Randomized Controlled Trials as Topic
    Chemical Substances Antirheumatic Agents ; Interleukin-6 ; Tumor Necrosis Factor Inhibitors ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2023-05-11
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2022-068600
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Fidelity, tolerability and safety of acute high-intensity interval training after hospitalisation for COVID-19: a randomised cross-over trial.

    Foged, Frederik / Rasmussen, Iben Elmerdahl / Bjørn Budde, Josephine / Rasmussen, Rasmus Syberg / Rasmussen, Villads / Lyngbæk, Mark / Jønck, Simon / Krogh-Madsen, Rikke / Lindegaard, Birgitte / Ried-Larsen, Mathias / Berg, Ronan Martin Griffin / Christensen, Regitse Højgaard

    BMJ open sport & exercise medicine

    2021  Volume 7, Issue 3, Page(s) e001156

    Abstract: Objectives: Many patients with COVID-19 suffer from persistent symptoms, many of which may potentially be reversed by high-intensity interval training (HIIT). Yet, the safety and tolerability of HIIT after COVID-19 is controversial. This study aimed to ... ...

    Abstract Objectives: Many patients with COVID-19 suffer from persistent symptoms, many of which may potentially be reversed by high-intensity interval training (HIIT). Yet, the safety and tolerability of HIIT after COVID-19 is controversial. This study aimed to investigate the fidelity, tolerability and safety of three different HIIT protocols in individuals that had recently been hospitalised due to COVID-19.
    Methods: The study was a randomised cross-over trial. We compared three supervised HIIT protocols (4×4, 6×1, 10-20-30) in 10 individuals recently discharged after hospitalisation for severe COVID-19. Each HIIT protocol had a duration of 38 min and was performed with a 1-week washout between them. Outcomes included adverse events, exercise training intensity and tolerability assessed by the Likert scale (1-10).
    Results: All 10 participants aged 61 (mean, SD 8) years (5 males) completed all three HIIT protocols with no adverse events. High intensities were achieved in all three protocols, although they differed in terms of time spent with a heart rate ≥85% of maximum (mean (SD); 4×4: 13.7 (6.4) min; 10-20-30: 12.1 (3.8) min; 6×1: 6.1 (5.6) min; p=0.03). The three protocols were all well tolerated with similar Likert scale scores (mean (SD); 4×4: 8 (2), 10-20-30: 8 (2), 6×1: 9 (2), p=0.72).
    Conclusion: Our findings indicate that recently hospitalised individuals for severe COVID-19 may safely tolerate acute bouts of supervised HIIT as per protocol. This warrants future studies testing the potential of regular HIIT as a rehabilitation strategy in this context.
    Language English
    Publishing date 2021-09-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2817580-3
    ISSN 2055-7647
    ISSN 2055-7647
    DOI 10.1136/bmjsem-2021-001156
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Impact of high-intensity interval training on cardiac structure and function after COVID-19: an investigator-blinded randomized controlled trial.

    Rasmussen, Iben Elmerdahl / Løk, Mathilde / Durrer, Cody Garett / Foged, Frederik / Schelde, Vera Graungaard / Budde, Josephine Bjørn / Rasmussen, Rasmus Syberg / Høvighoff, Emma Fredskild / Rasmussen, Villads / Lyngbæk, Mark / Jønck, Simon / Krogh-Madsen, Rikke / Lindegaard, Birgitte / Jørgensen, Peter Godsk / Køber, Lars / Vejlstrup, Niels / Klarlund Pedersen, Bente / Ried-Larsen, Mathias / Lund, Morten Asp Vonsild /
    Christensen, Regitse Højgaard / Berg, Ronan M G

    Journal of applied physiology (Bethesda, Md. : 1985)

    2023  Volume 135, Issue 2, Page(s) 421–435

    Abstract: A large proportion of patients suffer from a persistent reduction in cardiorespiratory fitness after recovery from COVID-19, of which the effects on the heart may potentially be reversed through the effect of high-intensity interval training (HIIT). In ... ...

    Abstract A large proportion of patients suffer from a persistent reduction in cardiorespiratory fitness after recovery from COVID-19, of which the effects on the heart may potentially be reversed through the effect of high-intensity interval training (HIIT). In the present study, we hypothesized that HIIT would increase left ventricular mass (LVM) and improve functional status and health-related quality of life (HRQoL) in individuals previously hospitalized for COVID-19. In this investigator-blinded, randomized controlled trial, 12 wk of supervised HIIT (4 × 4 min, three times a week) was compared with standard care (control) in individuals recently discharged from hospital due to COVID-19. LVM was assessed by cardiac magnetic resonance imaging (cMRI, primary outcome), whereas the pulmonary diffusing capacity (D
    MeSH term(s) Female ; Humans ; Quality of Life ; High-Intensity Interval Training ; COVID-19 ; Heart ; Cardiorespiratory Fitness
    Language English
    Publishing date 2023-06-30
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 219139-8
    ISSN 1522-1601 ; 0021-8987 ; 0161-7567 ; 8750-7587
    ISSN (online) 1522-1601
    ISSN 0021-8987 ; 0161-7567 ; 8750-7587
    DOI 10.1152/japplphysiol.00078.2023
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Protective potential of high-intensity interval training on cardiac structure and function after COVID-19: protocol and statistical analysis plan for an investigator-blinded randomised controlled trial.

    Rasmussen, Iben Elmerdahl / Foged, Frederik / Bjørn Budde, Josephine / Rasmussen, Rasmus Syberg / Rasmussen, Villads / Lyngbæk, Mark / Jønck, Simon / Krogh-Madsen, Rikke / Lindegaard, Birgitte / Ried-Larsen, Mathias / Jørgensen, Peter Godsk / Lund, Morten Asp Vonsild / Køber, Lars / Vejlstrup, Niels / Pedersen, Bente Klarlund / Berg, Ronan M G / Christensen, Regitse Højgaard

    BMJ open

    2021  Volume 11, Issue 11, Page(s) e048281

    Abstract: Introduction: COVID-19 is associated with a marked systemic inflammatory response with concomitant cardiac injury and remodelling, but it is currently unknown whether the latter is reversible. Given that high-intensity interval training (HIIT) is a ... ...

    Abstract Introduction: COVID-19 is associated with a marked systemic inflammatory response with concomitant cardiac injury and remodelling, but it is currently unknown whether the latter is reversible. Given that high-intensity interval training (HIIT) is a powerful stimulus to improve cardiorespiratory fitness while also eliciting marked anti-inflammatory effects, it may be an important countermeasure of reducing cardiopulmonary morbidity following COVID-19.
    Methods and analysis: 40 COVID-19 survivors who have been discharged from hospital will be included in this investigator-blinded randomised study with a 12-week HIIT intervention. Patients will be 1:1 block-randomised by sex to either a supervised HIIT exercise group or standard care (control group). The main hypothesis is that a 12-week HIIT scheme is a safe way to improve loss of cardiac mass and associated cardiorespiratory fitness, despite hypothesised limited HIIT-induced changes in conventional lung function indices per se. Ultimately, we hypothesise that the HIIT scheme will reduce post-COVID-19 symptoms and improve quality of life.
    Ethics and dissemination: This study is approved by the Scientific Ethical Committee at the Capital Region of Denmark (H-20033733, including amendments 75068 and 75799) and registered at ClinicalTrials.gov (NCT04647734, pre-results). The findings will be published in a peer-reviewed journal, including cases of positive, negative and inconclusive results.
    MeSH term(s) COVID-19 ; Cardiorespiratory Fitness ; High-Intensity Interval Training ; Humans ; Quality of Life ; Randomized Controlled Trials as Topic ; SARS-CoV-2 ; Treatment Outcome
    Language English
    Publishing date 2021-11-18
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2020-048281
    Database MEDical Literature Analysis and Retrieval System OnLINE

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