PMID 37577222

Research
All papers

High-intensity Interval Training for the Management of Nonalcoholic Steatohepatitis: Participant Experiences and Perspectives

Keating SE, Croci I, Wallen MP, Cox ER, Coombes JS, Burton NW, Macdonald GA, Hickman IJ

Question

How do people with NASH experience supervised and self-directed HIIT as a management strategy?

Summary

This qualitative study interviewed adults with biopsy-confirmed NASH who took part in a 12-week supervised 4 x 4 minute HIIT program followed by self-directed HIIT. Participants described initial uncertainty and many medical and time barriers, but those who completed supervised HIIT valued specialist support, felt safer with monitoring, and reported positive functional experiences. Self-directed adherence was harder.

Methodology

  • Adults with biopsy-confirmed NASH who were physically inactive before trial enrollment.
  • 12 participants.
  • Primarily treadmill; cycle, rowing, and arm ergometry as needed.
  • Work intervals: 4 minutes.
  • Recovery: 3 minutes active recovery.
  • Intensity: 85-95% HRmax or RPE 15-18.
  • About 38 minutes including warmup and cooldown at full dose.
  • 3 days/week.
  • 12 weeks supervised, then 12 weeks self-directed.
  • Qualitative interview study nested within a randomized trial
  • Participant experience, Adherence experience, and Safety perceptions were tracked.

Outcomes

Acceptability

Completers described supervised HIIT positively and valued professional support.

Qualitative themes; no p values

Improved

Adherence

Supervised attendance was high among completers, but self-directed adherence was poor.

9 completers >90% attendance; 4/12 did not complete full pathway

Mixed

Barriers

Medical and life barriers frequently interfered with participation.

Qualitative themes

Safety concern

Insights

  • Clinical HIIT programs need screening, support, accountability, and individualized exercise modes.
  • Self-directed HIIT after supervised training may require stronger behavior-change supports.
  • Participants with NASH may value functional and symptom benefits, not only liver outcomes.

Limitations

  • Qualitative sample was small.
  • Exercise trial recruitment may select more willing participants.
  • Interviewers were known to participants.
  • Non-completer perspectives were limited by dropout.
  • No systematic adverse-event table in this qualitative report.

Safety

  • The qualitative paper did not provide a systematic adverse-event table.
  • Participants were medically screened, cleared, and monitored before and during supervised HIIT.
  • Interview data indicated participants felt safer with professional support and monitoring; acute illness was a common reason for missed attendance.