# Feasibility of procedures for a randomised pilot study of reduced exertion, high-intensity interval training (REHIT) with non-diabetic hyperglycaemia patients

PMID: 32099663
Journal: Pilot and feasibility studies
Published: 2020
Authors: Haines M

## Question

Is it feasible and acceptable to deliver a randomized pilot study of REHIT for non-diabetic hyperglycemia patients in a real NHS specialist diabesity service?

## Summary

This feasibility study tried to run a short REHIT cycling program in a UK hospital diabesity service for people with non-diabetic hyperglycemia. Recruitment and trial procedures were not feasible as designed, but the small group who started exercise showed very high session adherence, no adverse events, and acceptable exertion and enjoyment.

## Population

- Patients with non-diabetic hyperglycemia recruited from a specialist diabesity clinic
- Sample size: 6
- Age: Completers n=5 mean age 46.4 +/- 6.1 years
- Sex: Male or female eligible; final sex distribution not clearly reported in extracted text
- Fitness level: Not currently in a structured exercise intervention; low or medium exercise risk
- Health status: Non-diabetic hyperglycemia by HbA1c 42-46 mmol/mol

## Methodology

- Feasibility pilot study originally intended as randomized controlled pilot
- 5-7 week REHIT intervention, depending on two or three sessions per week
- Single UK NHS specialist diabesity clinic/hospital setting

## Protocol

- Cycling REHIT.
- Modality: Magnetically braked cycle ergometer.
- Work intervals: 5 seconds maximal effort.
- Recovery: Low-intensity cycling between sprints within 10-minute session.
- Sets or repetitions: 2 sprints in session 1; 4 in sessions 2-3; 6 in sessions 4-7; 8 in sessions 8-15.
- Intensity: Maximal effort against 7.5% body mass braking force.
- Session duration: 10 minutes.
- Frequency: 2-3 sessions/week.
- Program length: 5-7 weeks.
- Progression: Sprint count increased over the 15 sessions.

## Outcomes

### Recruitment
Status: worse/safety concern
Recruitment and consent were too low for the planned randomized pilot design.

7% of screened and 16% of eligible patients were recruited; control arm abandoned.

### Session adherence
Status: improved
Participants who did not drop out completed nearly all prescribed sessions.

73/75 sessions completed, 97% among non-dropouts.

### Acceptability
Status: improved
REHIT was tolerable and enjoyable by the study's affect, RPE, and enjoyment thresholds.

Peak FS 1.4-2.6; peak RPE 12.7-13.9; EES 5.1-6.

### Adverse events
Status: improved
No adverse events were reported during or because of REHIT.

0 adverse events.

## Practical Insights

- A protocol can look very acceptable among completers but still fail because recruitment, staffing, location, and eligibility processes do not work.
- For app onboarding, reducing workout duration is not enough; perceived burden includes travel, scheduling, confidence, and trust.
- Track affect and exertion alongside attendance when testing intense short workouts.

## Limitations

- Very small sample.
- Control arm abandoned.
- No randomization feasibility data.
- No clinical efficacy inference.
- No qualitative interviews to explain nonparticipation.

## Safety And Adherence

- No adverse events were reported during or because of REHIT.
- Participants were screened as low or medium exercise risk; high-risk patients were excluded.
- ECG screening and HbA1c confirmation were used before starting.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/32099663/) (pubmed)
- [DOI](https://doi.org/10.1186/s40814-020-00571-8) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7031996/) (full text)

## Agent Guidance

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