PMID 41238358

Research
All papers

Effects of aquatic high-intensity interval training on patient-reported outcome measures and quality-adjusted life-years in adults with rheumatic and musculoskeletal diseases: a secondary analysis of the AquaHigh randomised controlled trial

Bunæs-Næss H, Nilsson BB, Kvæl LAH, Heywood SE, Gerritsen RB, Heiberg KE

Question

Does peer-led aquatic HIIT improve patient-reported outcomes and QALYs more than aquatic moderate continuous training in adults with rheumatic and musculoskeletal diseases?

Summary

In adults with rheumatic and musculoskeletal diseases, 12 weeks of aquatic HIIT was not statistically better than aquatic moderate-intensity continuous training for patient-reported disease activity, fatigue, pain, health-related quality of life, or QALYs. Both aquatic programs were feasible, and no adverse events were reported.

Methodology

  • Adults with rheumatic and musculoskeletal diseases in Norway
  • 89 participants.
  • Aquatic group exercise.
  • Work intervals: 4 min at Borg RPE 14-18.
  • Recovery: 2 to 3 min light recovery.
  • Intensity: Borg RPE 14-18.
  • 45 to 60 min.
  • 2 sessions/week.
  • 12 weeks.
  • Secondary analysis of a single-blind parallel randomized controlled trial
  • Patient global disease activity, Fatigue, Quality-adjusted life-years, and Safety were tracked.

Outcomes

PROMs

No statistically significant between-group differences were found for patient-reported outcomes at 3 or 6 months.

All between-group comparisons p>0.05.

No clear change

QALYs

QALYs were very similar between AHIIT and AMICT.

AHIIT 0.38 versus AMICT 0.37; mean difference 0.012, 95% CI -0.012 to 0.035.

No clear change

Safety

No adverse events were reported with either aquatic program.

Improved

Insights

  • RPE-guided aquatic HIIT can be feasible in a clinical community setting.
  • For clinical aquatic programs, HIIT should be framed as an alternative, not a proven superior option.
  • PROMs may improve within groups even when between-group differences are absent.

Limitations

  • Small sample
  • Attrition by follow-up
  • Mostly women
  • Heterogeneous diagnoses
  • COVID-19 disruptions
  • Self-reported outcomes
  • No non-exercise control

Safety

  • No adverse events reported by participants or instructors.
  • Sixteen COVID-19 infections interrupted training and were equally distributed.