PMID 30934623

Research
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Effects of a Combined High-Intensity Interval Training and Resistance Training Program in Patients Awaiting Bariatric Surgery: A Pilot Study

Picó-Sirvent I, Aracil-Marco A, Pastor D, Moya-Ramón M

Question

What are the effects of a structured 6-month exercise training program combining HIIT and progressive resistance training on anthropometric profile, cardiometabolic risk factors, cardiorespiratory fitness, and strength in patients with morbid obesity awaiting bariatric surgery?

Summary

This pilot study tested whether a 6-month supervised exercise program combining HIIT, moderate continuous aerobic work, resistance training, and stretching could help sedentary adults awaiting bariatric surgery. Three participants performed the program and three continued usual presurgical care. The exercise group attended most sessions, had no reported injuries or adverse events, and showed favorable changes in BMI, excess body weight, fat mass, blood pressure, VO2peak normalized to fat-free mass, and some strength measures, but the sample was extremely small and the authors emphasized that larger studies are needed.

Methodology

  • Six sedentary adults awaiting bariatric surgery, total baseline BMI 38.78 +/- 1.18 kg/m2 and mean age 38.17 +/- 12.06 years.
  • 6 participants.
  • HIIT on cycle ergometer; MICT on treadmill or cycle ergometer; resistance on guided machines.
  • Work intervals: 30 seconds.
  • Recovery: 30 seconds active recovery at 30% VO2peak.
  • Intensity: HIIT 60-95% VO2peak by month; MICT 60-85% HRpeak; resistance 55-75% 1RM.
  • 60 minutes months 1-2; 70 minutes months 3-6.
  • 2 sessions/week month 1, 3 sessions/week month 2, 4 sessions/week months 3-6.
  • 6 months.
  • Pilot controlled intervention with pre-post testing; group assignment depended on participants' suitability to participate in the training program.
  • BMI, Body composition, Blood pressure, and VO2peak were tracked.

Outcomes

BMI

Experimental group BMI decreased from 38.02 +/- 1.16 to 34.61 +/- 1.56 kg/m2, while control changed from 39.54 +/- 0.64 to 39.75 +/- 0.65.

Post-program group difference p=0.006 by ANOVA; EG table marks within-group post value significant.

Improved

Excess body weight percentage

Experimental group excess body weight percentage decreased from 33.55 +/- 3.89 to 27.00 +/- 4.06; control changed from 36.77 +/- 1.04 to 37.10 +/- 1.02.

Post-program group difference p=0.014 by ANOVA; EG within-group p values noted as p=0.052/p=0.059 in table footnote context.

Improved

Fat mass

Experimental group fat mass decreased from 50.48 +/- 10.87 kg to 42.16 +/- 12.52 kg; control changed from 53.25 +/- 7.49 to 52.91 +/- 7.91 kg.

Effect size for EG fat mass kg was 0.81 (-0.30; 1.91); authors describe larger effects for fat mass in EG.

Improved

Blood pressure

Experimental group systolic blood pressure changed from 144.22 +/- 37.39 to 139.28 +/- 28.76 mmHg and diastolic from 83.22 +/- 18.68 to 79.83 +/- 18.37 mmHg.

Authors describe small to moderate effects; table effect sizes were 0.41 for SBP and 0.37 for DBP.

Improved

VO2peak normalized to fat-free mass

Experimental group VO2peak abs/FFM increased from 39.92 +/- 8.01 to 42.58 +/- 6.24 mL/FFM/min.

Authors report likely positive effects with probability >95-99%; table effect size 0.38 (-0.23; 0.99).

Improved

Safety

Experimental group completed the program with no reported injury or adverse event.

Improved

Insights

  • For high-risk sedentary users, HIIT may need to be introduced after a familiarization phase and within a supervised, individualized progression.
  • A short 30-second work / 30-second active recovery structure can be used inside a longer program, but this study used equipment and clinical supervision.
  • Combining HIIT with resistance training and alternating high-intensity sessions with moderate continuous sessions may help manage training strain.

Limitations

  • Very small sample size of 6 participants.
  • Non-randomized assignment based on suitability to participate in training.
  • Combined intervention means HIIT-specific effects cannot be separated from MICT, resistance training, stretching, and supervision.
  • No post-surgery outcomes were available to assess surgical risk reduction or recovery.
  • Special clinical population and supervised setting limit generalization.

Safety

  • Experimental group participated in 93.25 +/- 6.5% of sessions without injury or adverse event.
  • Safety interpretation depends on medical screening, direct supervision, and individualization.