PMID 36767522

Research
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Patients with Adolescent Idiopathic Scoliosis Have Higher Metabolic Cost during High-Intensity Interval Training

Lau RW, Kwan RL, Cheng JC, Hui SS, Lam TP

Question

Do female adolescents with adolescent idiopathic scoliosis experience different oxygen consumption, heart-rate, and perceived-exertion responses than healthy controls when performing the E-Fit HIIT routine?

Summary

Female adolescents with mild-to-moderate adolescent idiopathic scoliosis performed a short whole-body E-Fit HIIT routine at a similar relative intensity to healthy controls but showed signs of higher oxygen cost and possible fatigue. The study evaluated metabolic demand of acute trials, not training outcomes.

Methodology

  • Female adolescents with AIS and age-matched healthy female controls.
  • 22 participants.
  • Whole-body aerobic and resistance exercises.
  • Work intervals: Twelve short and intense exercises across a 7-minute routine.
  • Recovery: Frequent rest intervals within the E-Fit concept; 10-minute rest between the two trials.
  • Intensity: Observed relative intensity around 63-66% predicted VO2peak, interpreted as moderate intensity.
  • About 7 minutes per E-Fit trial.
  • Two acute trials in one testing visit.
  • Acute metabolic testing, not a training program.
  • Prospective case-control acute metabolic-demand study.
  • Oxygen consumption during E-Fit, Heart rate and perceived exertion, Predicted VO2peak, and Body composition and AIS characteristics were tracked.

Outcomes

Relative exercise intensity

AIS and control participants exercised at similar relative percentages of predicted VO2peak.

AIS 62.85% to 64.23% vs controls 62.44% to 65.94% across the two trials.

No clear change

Oxygen consumption and metabolic cost

AIS participants showed higher adjusted oxygen consumption/metabolic cost during E-Fit, especially in the second trial.

Highest measured VO2 in trial 2: AIS 37.46 mL/kg/min vs control 33.87 mL/kg/min, p = 0.010; abstract reports adjusted VO2 average higher in both trials, p = 0.014 and p = 0.011.

Safety concern

Fatigue signs

The AIS group showed reduced HR, RPE, and VO2 average in the second trial, which authors interpreted as possible fatigue or difficulty maintaining rhythm.

Within-group RPE effect p = 0.016; AIS RPE declined from 2.85 to 2.55 (adjusted 2.70 to 2.43).

Mixed

Resting metabolic demand and body composition

AIS participants had lower resting VO2 and higher visceral adipose tissue/body fat percentage than controls.

Resting VO2 AIS 3.19 vs control 4.16 mL/kg/min, p = 0.045; VAT p = 0.037 and body fat p = 0.027.

Mixed

Insights

  • Short whole-body HIIT can be performed by mild-to-moderate AIS adolescents at moderate relative intensity.
  • Programming for AIS may need slower rhythm, larger movements, more rest, and more cueing to avoid early fatigue.
  • This study supports tailoring and monitoring, not unsupervised progression claims.

Limitations

  • Small sample.
  • Female adolescents only and single ethnicity.
  • Mild-to-moderate AIS only; not applicable to severe curves or post-treatment patients.
  • Acute metabolic-demand study, not a training-outcome trial.
  • Physical activity measured by self-report.
  • VO2peak was predicted from a submaximal test rather than directly measured.
  • Respiratory function and muscle strength were not assessed.

Safety

  • Participants with heart conditions or other diseases affecting exercise safety were excluded.
  • All subjects/guardians provided informed consent, and local ethics committees approved the study.
  • No adverse events were reported in the the paper, but authors observed some AIS participants slowing and having difficulty following rhythm in the second trial.