The Effects of High-Intensity Interval Training (HIIT) on Fall Risk Factors in Healthy Older Adults: A Systematic Review

Abstract

High-intensity interval training (HIIT) improves functional capacity, muscle power and physical performance in older adults with and without comorbidities. The aim of this study was to explore the effectiveness of HIIT as a method for reducing major fall risk factors (balance, muscle strength and physical activity) in older adults. A systematic literature search was conducted following the PRISMA guidelines. A computerized search was conducted using electronic databases (PubMed, CINAHL, Cochrane Library, APA PsycInfo, Web of Science, Scopus, PEDro, and AgeLine) published up to July 2021. Eleven papers (9 studies) of moderate quality (mean of 5.5 in Pedro scale) involving 328 healthy older adults met the inclusion criteria. Studies were characterized by high heterogeneity in terms of methodology, HIIT modality and protocol, subject characteristics, and outcome measures. Results indicate that HIIT cannot be recommended as a single modality for fall prevention in older adults due to insufficient data and no consensus among the studies. HIIT appears to be a safe and well-tolerated supplement to proven fall prevention programs, due to its effects on lower limb strength reflected in functional performance tests, and on dynamic balance and subjective balance perception. However, caution is warranted following HIIT, especially after the first session, due to possible temporary instability.

Community-based group physical activity and/or nutrition interventions to promote mobility in older adults: an umbrella review

“… MEDLINE, HealthStar to June 2013 1998–2013 I: RT and Creatine supplementation C: RT and placebo 10 RCTs Inclusion: > 45 Range: 55–71 357 NR; 20% F only, 40% M only Low-moderate (Jadad) Ebner 2021 [ 37 ] To determine the effects of mind-body interventions on physical fitness in healthy community dwelling older adults. Web of Knowledge, PubMed, SPORTDiscus to Nov 2019 2005–2019 I: Yoga, Qi Gong, Tai Chi, Pilates C: Active and inactive controls 30 RCTs Inclusion: ≥65 Mean: 71.2 2792 37 3% poor 17% fair 63% good 17% excellent (PEDro) Elboim-Gabyzon 2021 [ 38 ] To explore the effectiveness of high-intensity interval training for reducing fall risk factors in older adults. PubMed, CINAHL, Cochrane, APA PsycInfo, Web of Science, Scopus, PEDro, AgeLine, ClinicalTrials.gov , Google Scholar to July 2021 2015–2020 I: High-intensity exercise (90–95% peak heart rate, 90% maximal oxygen uptake, at least 75% peak work rate) separated by periods of low to moderate-intensity or rest (e.g., walking/running, cycling).…”

“…No reviews included group-based nutrition interventions alone. Exercise or PA interventions were categorized as resistance exercise ( n = 12) [ 26 , 35 , 47 , 49 , 52 , 60 , 65 , 69 , 72 , 78 , 80 , 81 ], aerobic exercise ( n = 5) [ 28 , 29 , 33 , 38 , 66 ], combined aerobic and resistance exercise ( n = 9) [ 27 , 34 , 47 , 50 , 57 , 60 , 64 , 65 , 81 ], general PA ( n = 12) [ 42 , 44 , 45 , 49 , 54 , 58 , 62 , 63 , 67 , 69 , 70 , 86 ], mind-body exercise (e.g., Tai Chi, yoga, Pilates) ( n = 11) [ 31 , 32 , 37 , 40 , 49 , 56 , 59 , 71 , 74 , 75 , 84 ], dance ( n = 5) [ 39 , 51 , 61 , 73 , 81 ], and other (e.g., aquatics, stretching) ( n = 10) [ 30 , 47 , 49 , 53 , 55 , 68 , 77 , 81 – 83 ]. Nutritional supplements included protein ( n = 5) [ 41 , 43 , 48 ...…”

“…Nutritional supplements included protein ( n = 5) [ 41 , 43 , 48 , 79 , 85 ], creatine ( n = 2) [ 36 , 76 ], vitamin D ( n = 1) [ 25 ], or dairy ( n = 1) [ 46 ]. Meta-analyses were undertaken in 39 reviews [ 25 , 26 , 29 , 31 – 37 , 40 – 42 , 44 , 46 – 50 , 54 – 56 , 60 , 61 , 65 , 66 , 68 – 70 , 72 , 75 , 78 – 81 , 83 – 86 ], 22 reviews presented findings narratively [ 27 , 28 , 38 , 39 , 43 , 45 , 51 – 53 , 57 – 59 , 62 – 64 , 67 , 71 , 73 , 74 , 76 , 77 , 82 ], and one performed a network meta-analysis [ 30 ]. Total sample sizes ranged from 153 to 28,523 when reported.…”

“…2 , full assessment in Additional file 3 ), with one review [ 49 ] rated as having high confidence in findings. The confidence for the remaining reviews were moderate ( n = 21) [ 25 , 28 , 30 , 35 , 36 , 42 – 44 , 46 , 50 , 53 , 66 , 67 , 71 , 72 , 75 , 77 , 80 – 83 ], low ( n = 17) [ 31 , 34 , 39 , 40 , 48 , 54 – 56 , 60 , 63 , 69 , 70 , 73 , 74 , 76 , 85 , 86 ], and critically low ( n = 23) [ 26 , 27 , 29 , 32 , 33 , 37 , 38 , 41 , 45 , 47 , 51 , 52 , 57 – 59 , 61 , 62 , 64 , 65 , 68 , 78 , 79 , 84 ]. Most reviews did not report protocol registration, describe an adequate search strategy, justify excluded studies, or incorporate risk of bias in interpreting review findings.…”

“…Number of falls, risk of falling, and fall-related injuries were measured across 14 reviews [ 27 , 28 , 38 , 40 , 44 , 56 , 59 , 60 , 62 , 63 , 69 , 72 , 73 , 82 ] including 108 single studies, 98 of which were unique (9.3% overlap). Interventions that combine aerobic and resistance exercise and interventions focused on general PA are likely to result in a small reduction in the risk of falls or fall-related injuries in older adults, based on moderate certainty evidence (Additional file 7 ).…”