# High intensity interval training for older adults - from the laboratory towards a home setting: a co-creation study

PMID: 41572142
Journal: European Review of Aging and Physical Activity
Published: 2026 Jan 22
Authors: Sandström S, Frankel J, Lindelöf N, Hedlund M, Frykholm E, Fridberg H, Rosendahl E, Boraxbekk CJ, Sandlund M

## Question

How can a supervised supramaximal cycling HIT protocol for older adults be adapted for potential home use while preserving intensity, controllability, and safety?

## Summary

Older adults with prior supramaximal HIT experience helped adapt a supervised cycling protocol toward a home format. After workshops and lab testing, a metronome-paced chair-stand protocol best matched cycling's acute responses while meeting safety and intensity-modulation goals; this was protocol-development evidence, not proof of long-term effectiveness.

## Population

- Older adults with prior experience in a supramaximal HIT cycling RCT
- Sample size: 11
- Age: Phase one median 70 years (range 69-74); phase two median 70 years (range 69-72)
- Sex: Phase one 6 women; phase two 5 women
- Fitness level: Older adults previously exposed to supramaximal HIT
- Health status: Relatively healthy older co-creators after phase-two medical screening

## Methodology

- Exploratory two-phase co-creation and laboratory modality-testing study
- Two co-creation workshops plus acute laboratory modality testing
- Home-like laboratory workshops and exercise laboratory testing

## Protocol

- Metronome-controlled chair-stand supramaximal HIT prototype.
- Modality: Chair stand.
- Work intervals: 10 seconds.
- Recovery: 50 seconds passive recovery.
- Sets or repetitions: 10 intervals.
- Intensity: Individualized cadence based on max30 calibration and controlled by audio metronome.
- Session duration: About 10-minute interval block plus warm-up.
- Program length: Protocol development/acute testing only.
- Progression: Not tested; possible lower starting cadence and progression over time.
- Candidate modalities and cycling reference.
- Modality: Walking up steps, rubber-band cross-country double poling, and stationary cycling.
- Work intervals: 10 seconds.
- Recovery: 50 seconds passive recovery.
- Sets or repetitions: 10 intervals.
- Intensity: Modality-specific calibration.
- Session duration: About 10-minute interval block plus warm-up.
- Program length: Acute testing only.

## Outcomes

### Chair stand
Status: improved
Chair stand best matched cycling responses while fulfilling intensity, modulation, and safety core components.

Descriptive results; no inferential statistics.

### Steps
Status: worse/safety concern
Walking up steps resembled cycling physiologically but was disqualified because of safety and implementation concerns.

Test leaders ranked safety level 2 during two incidents.

### Home XC
Status: no clear change
Rubber-band double poling did not elicit responses consistent with supramaximal cycling and had intensity-modulation problems.

Descriptive modality assessment.

### Effectiveness
Status: unclear
Long-term fitness or health effects were not tested.

## Practical Insights

- Fast chair-stand intervals are a promising bodyweight HIIT concept for older adults, but only after screening and feasibility testing.
- Audio cadence cues can turn bodyweight movement into an individually controlled intensity prescription.
- Warn users about expected soreness and consider lower starting intensity.

## Limitations

- Co-creation/protocol-development study, not an efficacy trial.
- Small sample with prior HIT experience.
- Phase-two participants were screened and relatively healthy.
- No maximal fitness test, so HR was reported in absolute terms.
- Home delivery was not tested.

## Safety And Adherence

- Three co-creators were excluded from phase two after medical screening.
- Walking up steps caused balance/safety concerns.
- Most co-creators experienced muscle soreness after chair stand and wanted future users warned.
- No serious adverse events were reported.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/41572142/) (pubmed)
- [DOI](https://doi.org/10.1186/s11556-026-00401-5) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12918434/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.