Feasibility of REHIT in NDH Patients
Condition: Diabetes; Physical Activity
Study type: Interventional

Summary: 
      The aim of this feasibility study was to describe and report data relevant to the
      acceptability of an exercise intervention (reduced-exertion, high-intensity interval
      training) in non-diabetic hyperglycaemia patients delivered in a National Health Service
      setting.
    

Detailed description: 
      Background Physical activity and exercise interventions to improve health frequently bring
      about intended effects under ideal circumstances but fail to demonstrate effectiveness when
      translated to demonstrable benefits in real-world contexts. The aim of this feasibility study
      was to describe and report data relevant to the acceptability of an exercise intervention
      (reduced-exertion, high-intensity interval training) in non-diabetic hyperglycaemia (NDH)
      patients delivered in a National Health Service (NHS) setting.

      Individuals with NDH are an intermediary group of patients whose blood glucose levels are
      higher than normal but not high enough to be diagnosed as diabetic. Such hyperglycaemic blood
      glucose excursions in 'pre-diabetic' states contribute to the development of macro- and
      micro-vascular disease risk and increases the risk of developing overt type 2 diabetes.
      Interventions - such as increased physical activity - for individuals who are diagnostically
      considered to have NDH are high priority, as they provide a substantial opportunity for
      preventing future burden of diabetes on patients, the NHS, and the economy.

      Evidence supporting the efficacy of exercise and physical activity as preventative or
      therapeutic treatments for a range of chronic diseases, including obesity and diabetes, is
      incontrovertible. However, exercise adherence is considered a significant issue. The most
      commonly cited barrier to undertaking physical activity is perceived 'lack of time'.
      Consequently, there has been a recent interest in high-intensity interval training (HIT)
      which is characterised by brief periods of repeated very high-intensity exercise interspersed
      with longer periods of recovery. More recently attempts have been made to modify HIT to make
      it more time-efficient and tolerable. This approach is known as reduced-exertion,
      high-intensity interval training (REHIT). In this study, issues of acceptability and
      feasibility were considered when implementing a REHIT intervention into usual care within an
      NHS setting.

      Methods The purpose was to assess whether it would be appropriate to progress to a
      larger-scale pragmatic trial, and to optimise the design and conduct of any such trial. The
      intention was to recruit 40 participants from a single centre (specialist diabesity centre).
      Patients were eligible to take part if they were diagnostically defined as non-diabetic
      hyperglycaemic based on a glycated haemoglobin value of 42-46 mmol·mol. Methodological issues
      were used to analyse problems that arose.
    

Intervention name(s): Exercise intervention; Usual care
Intervention type(s): Other; Behavioral
Intervention description(s): Exercise intervention (reduced-exertion, high-intensity interval training) delivered within an NHS setting. Consisted 10 min of cycle ergometry (inclusive of warm-up and cool down) including very brief maximal cycle sprints.; Members of a multi-disciplinary team including a consultant, diabetes specialist nurse, clinical psychologist, physiotherapist, and dietician worked together to promote patient self-management. Care was tailored to the specific circumstances of each patient after initial assessment and focussed on weight management, dietary education, behavioural therapy, and supported pharmacotherapy initiation as appropriate.
Intervention model: Single Group Assignment
Intervention model description: Feasibility study
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Diabetes; Exercise; Feasibility; HbA1c; Interval training