# Feasibility of Different Exercise Modalities for Community-Dwelling Residents With Physical Inactivity: A Randomized Controlled Trial PMID: 37883059 Journal: The journal of nursing research : JNR Published: 2023-12-01 Authors: Chang YH, Shun SC, Chen MH, Chang YF ## Question Can supervised plus home-based 12-week aerobic exercise, aerobic plus resistance exercise, and HIIT be feasibly implemented among physically inactive community residents, and what preliminary effects do these exercise modalities have on body composition, anthropometric parameters, and lipid profiles? ## Summary This feasibility RCT tested three 12-week exercise programs for physically inactive community-dwelling adults aged 40-70 years in southern Taiwan: aerobic exercise, aerobic plus resistance exercise, and HIIT, compared with a no-intervention control. Exercise was delivered as two supervised community-center sessions plus one home video session weekly. The HIIT arm used 20 minutes of bodyweight and equipment-assisted intervals after a 10-minute warmup and before a 10-minute cooldown. Adherence and safety were acceptable, with no exercise-related adverse events. HIIT improved several within-group body composition, anthropometric, and lipid outcomes, but between-group results mainly showed that exercise groups together reduced body weight and LDL more than control, without clear superiority of HIIT over the other exercise modes. ## Population - Physically inactive community-dwelling residents aged 40-70 years in southern Taiwan. - Sample size: 72 - Age: 40-70 years; mean 58.6 years. - Sex: 88.9% women. - Fitness level: Physically inactive; structured exercise fewer than 3 days/week in prior 3 months. - Health status: Community residents without exercise-limiting stroke, cardiovascular disease, pulmonary disease, disability, or pregnancy; some chronic disease/metabolic syndrome present. ## Methodology - Four-arm randomized controlled feasibility trial with AE, AE plus RE, HIIT, and no-intervention control arms. - 12 weeks - Public health center recruitment and community-center supervised exercise in southern Taiwan, with one weekly home-based video session. - Randomized and controlled study design. ## Protocol - HIIT. - Modality: Mixed bodyweight and light-equipment interval circuit. - Work intervals: 30 seconds per motion. - Recovery: 10 seconds after each motion. - Sets or repetitions: Four sets of eight motions. - Intensity: Moderate to vigorous; target monitored by heart rate reserve. - Session duration: 40 minutes total: 10-minute warmup, 20-minute HIIT, 10-minute cooldown. - Frequency: 3 sessions/week. - Program length: 12 weeks. - Progression: Tailored by experienced interveners; exact progression not reported. - AE, AE plus RE, and control. - Modality: AE continuous core muscle training; AE plus RE continuous aerobic exercise plus free-weight/Thera-Band resistance; control usual activities. - Work intervals: AE: 30 minutes continuous; AE plus RE: 30 minutes AE plus 10 minutes RE. - Recovery: AE plus RE: 30 seconds between resistance sets; AE and control not applicable. - Sets or repetitions: AE plus RE: three to five resistance exercises, three to five sets of 8-12 repetitions; AE continuous; control none. - Intensity: At least moderate intensity for exercise groups; control maintained usual daily activities. - Session duration: AE: 50 minutes including warmup/cooldown; AE plus RE: 60 minutes including warmup/cooldown; control not applicable. - Frequency: Exercise groups 3 sessions/week; control monitored every 2 weeks. - Program length: 12 weeks. - Progression: Tailored by professional interveners; exact progression not reported. ## Outcomes ### Feasibility/adherence Status: improved HIIT adherence was 80.44% for supervised sessions, 65.50% for home-based sessions, 75.71% total exercise frequency, and 82.65% target intensity. No significant differences among exercise groups for supervised adherence (p = .409), home adherence (p = .135), target intensity adherence (p = .343), or attrition (p = .749). ### Safety Status: no clear change No exercise-related adverse events were reported; one HIIT participant had an unrelated leg fracture while descending stairs. ### HIIT within-group anthropometric and lipid outcomes Status: mixed In the HIIT group, body weight, BMI, waist circumference, cholesterol, and LDL decreased significantly, while visceral adipose tissue, body fat, and waist-to-hip ratio increased significantly. BW p = .048; BMI p = .030; WC p = .006; cholesterol p = .014; LDL p = .037; VAT p = .004; body fat p = .008; WHR p = .025. ### Exercise groups versus control Status: improved All exercise groups combined had greater reductions in body weight and LDL than control, but HIIT was not superior to AE or AE plus RE. Helmert contrasts: BW control vs exercise p = .048, eta2 = .109; LDL control vs exercise p = .020, eta2 = .097; HIIT vs AE plus RE and AE nonsignificant for BW p = .345 and LDL p = .981. ## Practical Insights - A 30:10 circuit HIIT format can be feasible for screened inactive community adults when paired with supervision, tailoring, and intensity monitoring. - Home-based exercise adherence may be materially lower than supervised adherence, even when home videos match supervised exercises. - Metabolic and body-composition outcomes may require dietary guidance because compensatory eating can offset expected fat-loss effects. - This paper supports feasibility more than definitive superiority of HIIT over other exercise modalities. ## Limitations - Feasibility study with small sample sizes in each arm. - No BMI or body-fat percentage inclusion thresholds. - High percentage of female participants. - Combined supervised and home-based exercise design prevents isolating the best delivery strategy. - No precise VO2max or energy-expenditure measurement to compare modalities. - Dietary intake was not recorded or controlled. ## Safety And Adherence - No adverse events related to exercise intervention were reported. - One participant in the HIIT group sustained a leg fracture during the study period while descending a staircase; authors stated this was unrelated to the exercise intervention. ## Original Sources - [PubMed](https://pubmed.ncbi.nlm.nih.gov/37883059/) (pubmed) - [DOI](https://doi.org/10.1097/jnr.0000000000000578) (doi) - [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812666/) (full text) ## Agent Guidance Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.