# Effects of supervised high-intensity interval training on motivational outcomes in men with prostate cancer undergoing active surveillance: results from a randomized controlled trial PMID: 36175907 Journal: The International Journal of Behavioral Nutrition and Physical Activity Published: 2022-09-29 Authors: 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. ## Population - 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. - Sample size: 52 - Age: 63.4 +/- 7.1 years - Sex: Men only - Fitness level: Average moderate-intensity exercise at baseline 61 +/- 99 min/week; no structured vigorous-intensity exercise allowed - Health status: Prostate cancer on active surveillance; 83% had comorbidities including 60% arthritis/arthralgia and 31% hypertension ## Methodology - Secondary motivational-outcomes analysis of a randomized controlled trial - 12 weeks - Supervised exercise facility near the cancer center at the University of Alberta, Edmonton - Randomized and controlled study design. ## Protocol - ERASE supervised aerobic HIIT. - Modality: Aerobic HIIT. - Work intervals: 2 min at workload corresponding to 85-95% VO2peak. - Recovery: 2 min light-intensity recovery at 40% VO2peak. - Sets or repetitions: Progression from 5 to 8 intervals. - Intensity: 85-95% VO2peak for work intervals. - Session duration: 28-40 min including 5-min warm-up and 5-min cool-down. - Frequency: 3 sessions/week. - Program length: 12 weeks. - Progression: Intervals increased from 5 to 8. - Usual care. - Modality: No structured high-intensity exercise. - Intensity: Asked not to begin structured high-intensity exercise during 12-week intervention. - Program length: 12 weeks. - Progression: After the trial, participants were offered a 4-week HIIT program or 12-week community exercise program. ## Outcomes ### Adherence and protocol compliance Status: improved The supervised HIIT intervention had very high attendance and full protocol compliance. HIIT attendance 96% of planned sessions; 100% compliance to exercise protocol ### Experienced motivation Status: improved 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 ### Next-6-month motivation vs usual care Status: improved 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 ### Experienced benefits and barriers Status: mixed 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 ## Practical 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 And Adherence - 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. ## Original Sources - [PubMed](https://pubmed.ncbi.nlm.nih.gov/36175907/) (pubmed) - [DOI](https://doi.org/10.1186/s12966-022-01365-2) (doi) - [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524100/) (full text) ## Agent Guidance Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.