# High-intensity interval training produces a significant improvement in fitness in less than 31 days before surgery for urological cancer: a randomised control trial

PMID: 32157250
Journal: Prostate Cancer and Prostatic Diseases
Published: 2020 Mar 10
Authors: Blackwell JEM, Doleman B, Boereboom CL, Morton A, Williams S, Atherton P, Smith K, Williams JP, Phillips BE, Lund JN

## Question

Can a short preoperative HIIT program improve cardiorespiratory fitness within the cancer surgery waiting-time window in patients scheduled for urological cancer surgery?

## Summary

Older patients awaiting major urological cancer surgery completed up to 12 supervised low-volume cycle HIIT sessions in less than 31 days. Compared with standard care, HIIT improved anaerobic threshold, peak oxygen uptake, exercise wattage, blood pressure, and some muscle architecture measures, with no reportable adverse safety events during HIIT.

## Population

- 40 older patients scheduled for major urological cancer surgery; 34 completed protocol.
- Sample size: 40
- Age: Mean 72 years
- Sex: 39 male, 1 female
- Fitness level: Clinical preoperative population
- Health status: Urological malignancy, predominantly prostate cancer

## Methodology

- Parallel randomized controlled trial
- Less than 31 days
- University exercise laboratory before surgery in a UK hospital pathway
- Randomized and controlled study design.

## Protocol

- Preoperative cycle HIIT.
- Modality: Cycle ergometer.
- Work intervals: 1 min.
- Recovery: Unloaded recovery; exact between-work recovery not fully specified in extracted text.
- Sets or repetitions: 5 exertions.
- Intensity: 100-115% maximal CPET wattage; >85% predicted HRmax achieved.
- Session duration: About 9 min plus setup.
- Frequency: 3-4 sessions/week.
- Program length: Less than 31 days.
- Progression: Wattage increased at midpoint.
- Standard care.
- Modality: No exercise intervention.
- Program length: About 4 weeks.

## Outcomes

### VO2AT
Status: improved
HIIT significantly improved anaerobic threshold versus control.

Mean difference 2.26 ml/kg/min, 95% CI 1.25 to 3.26.

### VO2peak
Status: improved
HIIT significantly improved peak oxygen uptake.

Mean difference 2.16 ml/kg/min, 95% CI 0.24 to 4.08.

### Blood pressure
Status: improved
HIIT reduced resting systolic and diastolic blood pressure.

SBP -8.2 mmHg, 95% CI -16.09 to -0.29; DBP -6.47 mmHg, 95% CI -12.56 to -0.38.

### Safety
Status: no clear change
No reportable adverse safety events occurred during HIIT.

All participants achieved >85% predicted HRmax during sessions; protocol adherence 84%.

## Practical Insights

- Very low-volume supervised HIIT can produce rapid CRF gains when intensity is individualized.
- Clinical HIIT evidence should be presented with supervision and screening context.
- Travel and facility requirements can be barriers even when the workout itself is short.

## Limitations

- Predominantly white male prostate cancer sample.
- Possible selection bias because participants had to be willing to randomize to HIIT.
- Habitual activity and diet were not measured.
- Laboratory, doctor-supervised protocol is resource intensive.
- Not powered to analyze postoperative complications.

## Safety And Adherence

- No reportable adverse safety events occurred during HIIT.
- Two participants reported mild leg pain or cycle-seat discomfort, self-limiting and not requiring intervention.
- Postoperative complications were recorded descriptively but the study was not powered for them.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/32157250/) (pubmed)
- [DOI](https://doi.org/10.1038/s41391-020-0219-1) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7655502/) (full text)

## Agent Guidance

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