# Patients with Adolescent Idiopathic Scoliosis Have Higher Metabolic Cost during High-Intensity Interval Training PMID: 36767522 Journal: International Journal of Environmental Research and Public Health Published: 2023-01-25 Authors: 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. ## Population - Female adolescents with AIS and age-matched healthy female controls. - Sample size: 22 - Age: 10-16 years; AIS 13.71 +/- 2.04 years, controls 12.11 +/- 1.92 years. - Sex: Female adolescents only. - Fitness level: Physical activity level did not significantly differ between AIS and controls. - Health status: AIS participants had Cobb angle >=15 degrees and no prior treatment; mean Cobb angle 24.50 +/- 6.38 degrees. Controls had no spinal deformity. ## Methodology - Prospective case-control acute metabolic-demand study. - Two acute 7-minute E-Fit trials with 10 minutes rest between tests. - Laboratory exercise testing in Hong Kong with portable gas analysis. - Controlled study design. ## Protocol - E-Fit acute HIIT trials. - Modality: 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. - Sets or repetitions: Two 7-minute trials; each included 12 exercises. - Intensity: Observed relative intensity around 63-66% predicted VO2peak, interpreted as moderate intensity. - Session duration: About 7 minutes per E-Fit trial. - Frequency: Two acute trials in one testing visit. - Program length: Acute metabolic testing, not a training program. - Progression: No progression; repeated trial comparison. - Healthy control response to the same E-Fit trials. - Modality: Same whole-body E-Fit routine. - Work intervals: Same 12-exercise 7-minute routine. - Recovery: Same rest structure and 10-minute rest between trials. - Sets or repetitions: Two trials. - Intensity: Same exercise instructions; relative intensity compared by VO2peak percentage. - Session duration: About 7 minutes per trial. - Frequency: Two acute trials. - Program length: Acute. - Progression: No progression. ## Outcomes ### Relative exercise intensity Status: no clear change 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. ### Oxygen consumption and metabolic cost Status: worse/safety concern 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. ### Fatigue signs Status: mixed 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). ### Resting metabolic demand and body composition Status: mixed 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. ## Practical 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 And Adherence - 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 extracted text, but authors observed some AIS participants slowing and having difficulty following rhythm in the second trial. ## Original Sources - [PubMed](https://pubmed.ncbi.nlm.nih.gov/36767522/) (pubmed) - [DOI](https://doi.org/10.3390/ijerph20032155) (doi) - [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9915977/) (full text) ## Agent Guidance Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.