Effects of supervised high-intensity interval training on motivational outcomes in men with prostate cancer undergoing active surveillance: results from a randomized controlled trial

Kang DW, Boulé NG, Field CJ, Fairey AS, Courneya KS

Question

What motivational effects and perceived barriers are associated with 12 weeks of supervised aerobic HIIT in men with prostate cancer undergoing active surveillance?

Summary

This secondary analysis of the ERASE randomized trial found that men with prostate cancer on active surveillance were already motivated to try supervised HIIT, and after 12 weeks they rated HIIT as more enjoyable, motivating, controllable, and confidence-building than expected. The HIIT group had very high attendance and 100% protocol compliance. Barriers were generally low, but pain/soreness, travel, time, fatigue, and exercise difficulty were the most common barriers.

Methodology

52 men with prostate cancer undergoing active surveillance randomized to HIIT n=26 or usual care n=26; motivational outcome data from 25/26 in each group.
52 participants.
Aerobic HIIT.
Work intervals: 2 min at workload corresponding to 85-95% VO2peak.
Recovery: 2 min light-intensity recovery at 40% VO2peak.
Intensity: 85-95% VO2peak for work intervals.
28-40 min including 5-min warm-up and 5-min cool-down.
3 sessions/week.
12 weeks.
Secondary motivational-outcomes analysis of a randomized controlled trial
Motivational outcomes, Anticipated and experienced outcomes, and Perceived barriers were tracked.

Outcomes

Adherence and protocol compliance

The supervised HIIT intervention had very high attendance and full protocol compliance.

HIIT attendance 96% of planned sessions; 100% compliance to exercise protocol

Improved

Experienced motivation

HIIT participants rated the program as more enjoyable, motivating, controllable, and confidence-building than anticipated.

Enjoyable change +1.0, p<0.001, d=1.38; motivated +0.7, p=0.001, d=0.89; controllable +0.8, p<0.001, d=0.85; confident +0.5, p=0.004, d=0.66

Improved

Next-6-month motivation vs usual care

HIIT participants reported higher perceived controllability and a more specific plan for future HIIT than UC.

Controllable adjusted difference +0.8, p=0.006, d=0.68; specific plan +0.9, p=0.032, d=0.67

Improved

Experienced benefits and barriers

Anticipated versus experienced outcome beliefs did not differ significantly; barriers were low overall, with pain/soreness, travel, time, fatigue, and difficulty most common.

Barrier means ranged 1.0-1.9 on a 1-7 scale; pain/soreness 56%, travel 40%, too busy/time 36%, tired/fatigued 28%, demanding/difficult 28% reported as at least somewhat a barrier

Mixed

Insights

Supervised familiarization can improve HIIT confidence, controllability, motivation, and enjoyment in older clinical users.
For older users or users with musculoskeletal conditions, offer low-impact options and track pain/soreness.
Motivational improvements after supervised HIIT do not prove long-term independent adherence.

Limitations

Secondary outcomes with limited power.
No long-term follow-up of actual exercise behavior in this paper.
Self-selected, highly motivated sample.
Well-educated, higher-income, racially homogeneous sample.
Men with prostate cancer on active surveillance; not general population.

Safety

This secondary paper reports barrier/soreness data and cites six cases of joint pain as adverse events in the parent trial; no detailed adverse event table is included in this article.