# Superior Effects of High-Intensity Interval Training vs. Moderate Continuous Training on Arterial Stiffness in Episodic Migraine: A Randomized Controlled Trial PMID: 29311997 Journal: Frontiers in Physiology Published: 2017 Authors: Hanssen H, Minghetti A, Magon S, Rossmeissl A, Papadopoulou A, Klenk C, Schmidt-Trucksäss A, Faude O, Zahner L, Sprenger T, Donath L ## Question Whether high-intensity interval treadmill training has superior effects to moderate continuous treadmill training on arterial stiffness, central blood pressure, physical fitness, and migraine days in patients with episodic migraine. ## Summary This randomized controlled trial tested supervised treadmill HIT, moderate continuous treadmill training, and a control group in adults with episodic migraine. HIT used four 4-minute intervals at 90-95% of maximal heart rate with 3-minute active recovery at 70% HRmax, twice weekly for 12 weeks. HIT reduced augmentation index corrected to 75 bpm and migraine days more than moderate training, while pulse wave velocity did not change; no adverse or serious adverse events were reported. ## Population - Adults with episodic migraine without aura, no regular exercise in prior 6 months, no cardiovascular disease or acute/chronic inflammatory disease. - Sample size: 48 - Age: Completers: 37 (SD 10) years; group means 36.2-37.3 years. - Sex: Completers: 30 female; final groups HIT 3/10 male/female, MCT 2/10, CON 2/10. - Fitness level: Not regularly exercising in prior 6 months; VO2max about 36-37 ml/min/kgBW at baseline. - Health status: Episodic migraine without aura; neurologic examinations normal. ## Methodology - Three-armed randomized controlled trial with 4-week run-in and 12-week intervention. - 4-week run-in plus 12-week intervention - University of Basel, Switzerland; supervised treadmill training at Department of Sport, Exercise and Health - Randomized and controlled study design. ## Protocol - HIT. - Modality: Treadmill running. - Work intervals: 4 minutes at 90-95% HRmax. - Recovery: 3 minutes active rest at 70% HRmax. - Sets or repetitions: 4 intervals. - Intensity: 90-95% HRmax during intervals; target generally reached after 1 minute. - Session duration: Main interval set approximately 25 minutes excluding 400 m warm-up, skipping exercises, 400 m cool-down, and stretching. - Frequency: 2 sessions per week. - Program length: 12 weeks. - Progression: Individual running program based on exercise testing; explicit progression rules not reported. - MCT. - Modality: Treadmill running. - Work intervals: Continuous running. - Sets or repetitions: One continuous 45-minute bout. - Intensity: 70% HRmax (+/-5 bpm). - Session duration: 45 minutes plus 400 m warm-up, skipping exercises, 400 m cool-down, and stretching. - Frequency: 2 sessions per week. - Program length: 12 weeks. - Progression: Individual running program based on exercise testing; explicit progression rules not reported. ## Outcomes ### AIx@75 Status: improved HIT improved AIx@75 from 22.0 (9.7) to 14.9 (13.0), while MCT changed from 16.6 (8.5) to 21.3 (10.4) and CON from 17.9 (15.9) to 18.8 (12.5). ANCOVA p=0.06, eta_p2=0.16; HIT vs MCT SMD -0.80 [90% CI -1.56, -0.03], 91% likely beneficial; HIT vs CON SMD -0.45 [90% CI -0.88, -0.02], 85% likely beneficial. ### Central systolic blood pressure Status: improved HIT lowered central systolic blood pressure from 118.1 (23.4) to 109.8 (15.7) mmHg. SMD 0.42; HIT vs CON 59% possibly beneficial. ### Central diastolic blood pressure Status: improved MCT lowered central diastolic blood pressure from 77.8 (6.8) to 73.7 (6.6) mmHg. SMD 0.61; MCT vs CON 60% possibly beneficial. ### Pulse wave velocity Status: no clear change PWV showed no changes in any of the three groups. ANCOVA p=0.79, eta_p2=0.01. ### Migraine days Status: improved Migraine days were reduced more successfully by HIT than MCT; HIT changed from 3.8 (3.0) to 1.4 (1.2) days/month, MCT from 4.2 (2.2) to 3.1 (2.9), CON from 3.2 (2.4) to 2.0 (1.6). ANCOVA p=0.13, eta_p2=0.13; HIT vs MCT SMD -0.54 [90% CI -0.95, -0.12], 92% likely beneficial. ### VO2max and individual anaerobic threshold Status: improved HIT improved VO2max and IAT more than control and generally more than MCT. VO2max ANCOVA p=0.13, eta_p2=0.12; HIT vs CON SMD 0.79 [90% CI 0.04, 1.54], 91% likely beneficial. IAT ANCOVA p=0.08, eta_p2=0.15; HIT vs CON SMD 1.07 [90% CI 0.52, 1.61], 99% very likely beneficial. ### Adverse and serious adverse events Status: no clear change No adverse and serious adverse events were reported. ## Practical Insights - A 4x4-minute treadmill HIT structure at 90-95% HRmax, twice weekly, is a reproducible protocol with measurable vascular and migraine outcomes in a screened clinical population. - Warm-up, active recovery, cool-down, individualized HR targets, and supervision/monitoring are part of the protocol context and should not be stripped away in translation. - For migraine-related content, HIT can be framed as a potential complementary strategy only for appropriately screened users, not as a universal replacement for medical care. ## Limitations - Pilot sample size was low. - 23% dropout during 12 weeks. - Healthier and physically fitter patients may have self-selected into the exercise trial. - Baseline differences in migraine days, AIx, and AIx@75 remained a concern despite adjustment. - No long-term post-intervention follow-up. - Magnitude-based inference was used for practical-benefit probabilities; several conventional p-values did not reach P <0.05. ## Safety And Adherence - No adverse and serious adverse events were reported. - 11 of 48 patients dropped out due to injury, lack of motivation, or personal reasons; injury details and group allocation were not reported. - Participants were screened with PAR-Q and exercise test, and training was supervised with heart-rate monitoring. ## Original Sources - [PubMed](https://pubmed.ncbi.nlm.nih.gov/29311997/) (pubmed) - [DOI](https://doi.org/10.3389/fphys.2017.01086) (doi) - [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5742195/) (full text) ## Agent Guidance Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.