Feasibility of HIIT as a Secondary Prevention Treatment in Patients with Coronary Artery Disease

Background Evidence shows that high-intensity interval training (HIIT) is a safe and feasible alternative to moderate-intensity continuous training (MICT) and is superior in improving clinical outcomes in patients with coronary artery disease (CAD). However, due to the absence of consensus on an optimal HIIT protocol, it has not yet been included in cardiac rehabilitation (CR) guidelines. Novel, evidence-based HIIT protocols are therefore warranted for patients with CAD.

Research Question Is the low-volume whole-body HIIT program of Kristiansen et al. (2022) internally valid, and can the proposed training program thus be applied with confidence in clinical physiotherapy practice?

Methods Internal validity was assessed using the JBI Critical Appraisal Checklist. External validity was assessed using the i-CONTENT tool. Considerations regarding clinical relevance were made to ensure a comprehensive recommendation for clinical practice.

Results Nine out of thirteen items on the JBI checklist were met, two were not met, and two were unclear. Six out of seven items on the i-CONTENT tool indicated a low risk of ineffectiveness. One item indicated a high risk of ineffectiveness. The effect size estimate on peak VO2 is subject to debate.

Conclusion Low-volume HIIT could serve as an additional alternative to traditional endurance training in CR. However, the protocol by Kristiansen et al. (2022) is not sufficiently effective in its current form. Further high-quality research is needed to determine optimal protocol variables such as intensity, duration, frequency and recovery.

Reference to the congress theme This critical appraisal bachelor thesis reflects the “PhysioForward” theme by highlighting the potential of HIIT as a time-efficient and individualized alternative in physiotherapy-led CR. Future studies should focus on optimizing HIIT models rather than comparing them to MICT. Improving long-term adherence in patients with CAD is essential; early evidence suggests HIIT may encourage better compliance due to lower time demands. By bridging the gap between evidence and practice, this bachelor thesis supports physiotherapists in shaping the future of CR through innovative, evidence-based interventions.