# Effect of high-intensity interval training on muscle remodeling in rheumatoid arthritis compared to prediabetes

PMID: 30587230
Journal: Arthritis Research & Therapy
Published: 2018 Dec 27
Authors: Andonian BJ, Bartlett DB, Huebner JL, Willis L, Hoselton A, Kraus VB, Kraus WE, Huffman KM

## Question

How do rheumatoid arthritis and prediabetes groups respond to supervised treadmill HIIT in aerobic capacity, disease activity, and skeletal muscle remodeling markers?

## Summary

This small supervised treadmill HIIT study found that adults with rheumatoid arthritis and adults with prediabetes improved aerobic capacity after 10 weeks. RA disease activity improved, but muscle inflammatory markers and myostatin did not improve consistently.

## Population

- Previously sedentary adults with rheumatoid arthritis or prediabetes
- Sample size: 21
- Age: RA mean 63.9 years; prediabetes mean 71.4 years
- Sex: RA 11 women/1 man; prediabetes 5 women/4 men
- Fitness level: Sedentary
- Health status: Rheumatoid arthritis or prediabetes; cardiovascular disease and diabetes excluded

## Methodology

- Small supervised before-after intervention comparing two clinical groups
- 10 weeks
- Supervised treadmill exercise research setting

## Protocol

- Supervised treadmill walking HIIT.
- Modality: Treadmill walking.
- Work intervals: 60-90 seconds.
- Recovery: 60-90 seconds.
- Sets or repetitions: 10 alternating intervals.
- Intensity: 80-90% HR reserve work; 50-60% HR reserve recovery.
- Session duration: About 20-25 minutes.
- Frequency: 3 sessions/week.
- Program length: 10 weeks.
- Progression: Not fully reported.

## Outcomes

### Peak VO2
Status: improved
Peak VO2 improved in both clinical groups.

RA relative VO2 24.9 to 27.1; prediabetes 19.9 to 23.1; p<0.05.

### Disease activity
Status: improved
RA DAS-28 decreased after training.

DAS-28 3.1 to 2.3.

### Muscle markers
Status: no clear change
No group-level reductions in plasma galectin-3, muscle cytokines, or myostatin.

### Medication subgroups
Status: mixed
Some RA medications were associated with no body-composition improvement.

TNF inhibitor or hydroxychloroquine users did not improve body composition.

## Practical Insights

- Clinically screened walking HIIT can improve aerobic fitness in sedentary RA and prediabetes participants.
- Mechanistic inflammation claims should remain tentative.

## Limitations

- Small pilot sample.
- No nonexercise control group.
- Medication confounding in RA.
- Adverse events and attendance not reported.

## Safety And Adherence

- Adverse events were not reported.
- Participants were screened to exclude cardiovascular disease, diabetes mellitus, and inability to walk unaided on a treadmill.
- Training was supervised with continuous heart-rate monitoring; dropout/adherence counts were not reported.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/30587230/) (pubmed)
- [DOI](https://doi.org/10.1186/s13075-018-1786-6) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307310/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.