Practitioner Guidance for Implementing Low-Volume High Intensity Interval Training in People with Coronary Artery Disease

Ingle, Lee, Begg, Brian, Powell, Richard, Nichols, Simon, Birkett, Stefan ORCID: https://orcid.org/0000-0003-0422-6843, Young, Susan, Cowie, Aynsley and McGregor, Gordon (2025) Practitioner Guidance for Implementing Low-Volume High Intensity Interval Training in People with Coronary Artery Disease. Physiotherapy, 128. 101777. ISSN 0031-9406

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Abstract

High intensity interval training (HIIT) is recognised within many international cardiac rehabilitation (CR) guidelines. In the United Kingdom (UK), however, similar guidance does not exist; moderate intensity training regimens have traditionally been advocated. The aim is to develop a pragmatic technical report for practitioners working in CR in order to implement low-volume HIIT programmes for people with coronary artery disease (CAD). We describe patient inclusion and exclusion criteria, clinical and safety considerations, and practical implications to support the implementation of low volume HIIT in practice. Detailed methodology relating to low-volume HIIT using the 10 × 1 minutes model is provided, alongside exercise training progression criteria. We provide corresponding percentage heart rate reserve (%HRR) training thresholds which can be used to guide individualised exercise prescription. Key considerations for familiarisation, supervision, monitoring, recording, and reporting are also discussed, underpinned by an overview of the acute physiological response to the training modality. We anticipate that this pragmatic evidence-based technical report will support practitioners in implementing low-volume HIIT in routine clinical practice, thus, allowing it to be offered as standard-care alongside more traditional moderate intensity exercise training programmes.