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TECNOCIENCIA CHIHUAHUA, Vol. XV (1) e 789 (2021)
https://vocero.uach.mx/index.php/tecnociencia
ISSN-e: 2683-3360
Artículo de revisión
HIIT in a treadmill for people with overweight or
obesity: a systematic review
HIIT en banda sinfín para personas con sobrepeso u obesidad: una
revisión sistemática
*Correspondencia: gdeleon@uach.mx (Lidia G. De León)
DOI: https://doi.org/10.54167/tecnociencia.v15i1.789
Recibido: 22 de marzo de 2021; Aceptado: 26 de julio de 2021
Publicado por la Universidad Autónoma de Chihuahua, a través de la Dirección de Investigación y Posgrado.
Abstract
A systematic review was carried out with the objective to analyze the workloads of the high
intensity interval training (HIIT) protocols in treadmill, in order to identify the most used intensity
percentages, administered in people with overweight or obesity; a bibliographic search was
performed in SCOPUS, Web of Science, EBSCO, SCIELO and PUBMED databases. Inclusion criteria
were: original experimental studies, where one or more HIIT protocols in treadmill were
administered on population with overweight or obesity, regardless their age; studies made in
athletes or using functional exercises were excluded. Eight articles were considered for this review
from a total of 678 articles detected. All of them reported the administration of HIIT protocols at
intensities between 80% and 95% of HRmax, HRpeak, calculated HRmax, or HRreserve; with short
(30 seconds) to large (4 minutes) high intensity intervals. It is concluded that HIIT on a treadmill
can be used on people with overweight or obesity due to its efficacy and safeness at high intensity
levels and can provide optimal results in body composition, cardio respiratory fitness and other
parameters such as IL-6 and TNFalpha, in addition to reduce systolic blood pressure.
Keywords: interval training, treadmill, intensity of exercise, safe exercise, obesity
Resumen
Se realizó una revisión sistemática con el objetivo de analizar las cargas de trabajo de los protocolos
de entrenamiento interválico de alta intensidad (HIIT, por sus siglas en inglés) en banda sinfín, con
el fin de identificar los porcentajes de intensidad más utilizados, administrados en personas con
sobrepeso u obesidad; se realizó una búsqueda bibliográfica en las bases de datos SCOPUS, Web of
Science, EBSCO, SCIELO y PUBMED. Los criterios de inclusión fueron: estudios experimentales
originales, donde se administraron uno o más protocolos HIIT en banda sinfín, en población con
Claudia I. Herrera-Covarrubias1, Lidia G. De León1*, Ramón Candia-Luján1, Briseidy
Ortiz-Rodríguez1, Claudia E. Carrasco-Legleu1
Universidad Autónoma de Chihuahua. Facultad de Ciencias de la Cultura Física.
Perif. de la Juventud y Circuito Universitario S/N, Fracc Campo Bello C.P. 31124 Chihuahua
Chih. México.
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TECNOCIENCIA CHIHUAHUA, Vol. XV (1) e 789 (2021)
sobrepeso u obesidad, sin importar la edad; se excluyeron los estudios realizados en deportistas o
con ejercicios funcionales. Se consideraron ocho artículos de un total de 678 artículos detectados;
todos reportaron la administración de protocolos HIIT a intensidades entre 80% y 95% de FCmáx,
FC pico, FCmáx calculada o FCreserva; con intervalos de alta intensidad cortos (30 segundos),
largos (4 minutos) y períodos de descanso activo por debajo del 70% de esos parámetros. Se
concluye que el HIIT en banda sinfín se puede utilizar en personas con sobrepeso u obesidad
debido a su eficacia y seguridad a niveles de alta intensidad y puede proporcionar resultados
óptimos en la composición corporal, la aptitud cardiorrespiratoria y otros parámetros como IL-6 y
TNFalpha, además de reducir la presión arterial sistólica.
Palabras Clave: entrenamiento intervalado, banda sinfín, ejercicio en obesidad.
1. Introduction
In recent years, literature has shown that high intensity interval training (HIIT) can induce
favorable metabolic adaptations similar to continuous training at a moderate intensity in healthy
populations or in people with non-communicable diseases, specifically obesity (Andreato et al.,
2019). At the beginning of the last century, HIIT emerged as a training methodology used to
prepare high performance athletes; at the present, this method represents a new therapeutic
strategy that has proven to be effective in improving the physical status associated with health in
adult population (Cofré-Bolados et al., 2016). HIIT consists of short bouts of intense exercise,
alternated with short periods of active or passive rest (Pereira-Rodríguez et al., 2020). Current
evidence supports that HIIT is a method that has various health benefits; and the short period of
time needed to complete the training with a minimum of equipment to obtain physical
adaptations, are their main advantages (López, 2018).
HIIT exercise has interesting applications in the control of certain metabolic and cardiovascular
pathologies as latest published studies have recognized the benefits in the biological markers that
HIIT may provide (Milanović et al., 2015). Overweight and obesity are associated with the
development of insulin resistance, type 2 diabetes mellitus and cardiovascular disease. It has been
shown that regular physical exercise with progressive increases of intensity is one of the most
effective solutions to prevent and treat those pathologies (Alarcón et al., 2016). HIIT program can
be developed as an intervention strategy for people with overweight or obesity and other
associated diseases. Increasing the amount of daily physical activity is an essential tool for
controlling such problems (Peñailillo et al., 2016). However, studies with HIIT method in patients
with non-communicable diseases are very limited because its workload intensities can be very high
and varied (Gibala et al., 2012). Hence, it is necessary to know the appropriate intensity of exercise
that can generate safe and effective metabolic changes for the control of these conditions with this
method, especially for the treatment of obesity (Alarcón et al., 2016). The objective was to analyze
the workloads of the high intensity interval training protocols (HIIT) in treadmill, in order to
identify the most used intensity percentages, administered in people with overweight or obesity.
2. Article selection
Bibliographic search was carried out in SCOPUS, Web of Science, EBSCO, SCIELO and
PUBMED databases, using keywords in English only, such as high intensity interval training, HIIT,
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TECNOCIENCIA CHIHUAHUA, Vol. XV (1) e 789 (2021)
obesity and treadmill, with the Boolean AND operator. Inclusion criteria were: original,
experimental studies; where one or more HIIT protocols on treadmill were administered in people
with overweight or obesity, regardless their age; studies made in athletes or using functional
exercises were excluded. There was no restriction of articles by year of publication. 678 articles
were found, of which 666 were eliminated because they did not meet the inclusion criteria. Twelve
potential articles were identified, finding four duplicates, so the review was made with the
remaining eight documents (see Figure 1). Five studies were randomized clinical trials, one was
cuasi-experimental study and the authors did not specify the other two. Two researchers made the
search and analyzed the studies.
3. Article analysis
Eight articles meeting inclusion criteria were selected. Detailed review of these documents
showed different HIIT protocols used as well as the intensities and duration of each one;
workloads of each administered program in the population of interest was analyzed.
Figure 1. Diagram of the selection process for the review articles
Figura 1. Diagrama del proceso de selección de los artículos de la revisión.
Documents found
678
Eliminated for not
meeting inclusion
and exclusion
criteria
666
Potential Articles
12
Articles included
8
Duplicated
4
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Methodological quality of the selected studies was evaluated in the period of February to June
2019; in order to exclude documents of fair and poor quality, PEDro scale was used. Item one (1)
was not taken into account according with PEDro scale instructions (PEDro 2019); items 5, 6 and 7
were not considered due to this kind of studies cannot be blinded, so use so just items 2, 3, 4, 8, 9,
10 and 11 were contemplated. Articles selected in this review had a mean score of 4.87 points,
pondered as good cuality (see Table 1). This review was carried out according to PRISMA
guidelines (Hutton et al., 2017). Four of the selected articles were made in women, two of them
recruited a population between 19 and 27 years of age and the other two were realized with
women at 23 to 39 years of age. Other study was performed in children (7 to 16y), two more were
in adult women and men ages 18 to 55, and only one research was conducted in older adults 50 to
80 years old.
Table 1. Clasification with PEDro of the articles analyzed.
Tabla 1. Escala de clasificación PEDro de los artículos analizados.
ITEMS
REFERENCE
1
2
3
4
5
6
7
8
9
10
11
TOTAL
Dias et al. 2017
-
✔
✔
✔
-
-
-
✔
✖
✔
✔
6
Gerosa-Neto 2016
-
✔
✔
✔
-
-
-
✔
✖
✔
✔
6
Romain et al.
2019
-
✖
✖
✔
-
-
-
✔
✖
✔
✔
4
Streese et al. 2018
-
✔
✔
✔
-
-
-
✖
✖
✖
✔
4
Zhang et al. 2015
-
✖
✖
✔
-
-
-
✔
✔
✔
✔
5
Hornbuckle et al.
2018
-
✔
✔
✖
-
-
-
✔
✖
✔
✔
5
Mirgham,
Yousefi 2014
-
✖
✖
✔
-
-
-
✔
✖
✔
✔
4
Bonsu,
Terblanche 2016
-
✖
✖
✔
-
-
-
✔
✔
✔
✔
5
5
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4. Results
Protocol characteristics
Characteristics of HIIT, number of subjects included in studies, intensity and rest period of
intervals, as well as duration of the program, are shown in Table 2. Most of workouts ranged 12 to
16 weeks of activity, with three times a week sessions. Romain et al., (2019). implemented a 6-
month supervised program, performing trainings twice a week. Two studies used a shorter period
applying only four weeks of activity with three sessions per week (Mirghani y Yousefi, (2015).
Bonsu y Terblanche, (2016), implemented twice a week only for 6 sessions. Regarding the
protocols, four studies had the longest intense and rest intervals with 4 minutes of high intensity
workload and 4 and 3 minutes of active rest. On the other hand, shorter intervals between 30 and
60 seconds of work were reported by four articles. All programs handled intensities between 80%
and 95% of experimental HRmax and HRpeak, or calculated HRmax and HRreserve; the first two
parameters were assessed in treadmill stress test and the other two were calculated. All studies
included in this review applied HIIT treadmill protocols on people with obesity or overweight.
Most of their objectives were to examine the effects of HIIT on body composition and determine its
effectiveness in increasing cardiorespiratory capacity; to identify the effect on inflammatory profile
and insulin resistance in addition to the effects on arterial function; cardiometabolic risk factors,
liver enzymes and serum lipid levels, as well as blood pressure response, were also studied.
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Table 2. Characteristics of the interval and rest intensities of the HIIT sessions.
Tabla 2. Características de las intensidades de intervalos y descansos de las sesiones de HIIT.
HI time=high interval time; HI intensity=high interval intensity; HIIT=high intensity interval training; MICT=moderate intensity continuous training; min=minute;
HRmax=maximum heart rate; IL-6=inteleukin-6; s=second; HRmax calculated=calculated maximum heart rate; HRpeak=peak heart rate; SS=Steady State;
HRreserve=heart rate reserve.
Author
Results
n
Protocol used
HI Time
HI intensity
Recovery time
Recovery intensity
Program time
Dias et al.
2017
Increased
cardiorespiratory
capacity
HIIT=33
MICT=32
Nutrition=34
4X3 min
4 series
4 min
85%- 95% HRmax
3 min
50%-70% HRmax
12 weeks
Gerosa-Neto
2016
Decreased IL-6
and Adiponectin
32
(3 Groups)
4X3 min
4 min
90% HRmax
3 min
70% HRmax
16 weeks
Romain et al.
2019
Decreased waist-
hip index
HIIT=38
Control=28
30 s X 90 s
10 series
30 s
80%-90% HRmax
calculated
90 s
50%-60% HRmax
calculated
6 months
Streese et al.
2018
Reduction of the
stiffness of the
arterial wall
HIIT= 40
HIIT= 80
Control=40
4X3 min
4 series
4 min
80%-90% HRmax
3 min
65%-70% HRmax
12 weeks
Zhang et al.
2015
Decrease in body
fat mass
HIIT=14
MICT=15
4X3 min
4 series
4 min
85%-95% HRpeak
3 min
50%-60% HRpeak
12 weeks
Control=14
Hornbuckle
et al. 2018
Reduced waist
circumference
HIIT=16
EE=11
1X3 min
1 min
80%-90% HRmax
3 min
60%-70% HRmax
16 weeks
Mirghani,
Yousefi 2015
Decreased waist
circumference
HIIT (1)=8
HIIT (2)=8
60 s X 60 s
60 s X 30 s
60 s
80% HRreserve
60 s
30 s
Cool down
4 weeks
Control=8
60 s X 30 s
30 s
Bonsu,
Terblanche
2016
Decrease in blood
pressure
HIIT=20
1x1 min
10 series
1 min
90%-95% HRmax
1 min
70% HRmax.
6 sessions
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5. Discussion
HIIT on a treadmill can be considered as a training modality in people with overweight or obesity,
due to its high levels of efficacy and safety, as evidenced in the literature reviewed. One of the main
findings was the decrease in body fat mass as reported by Zhang et al., (2015), who administered a
twelve week HIIT program to overweight Chinese women, using 85% and 95% of HRpeak in periods
of 4 minutes, and 3 minutes recovery at 50% and 60% of the HRpeak; a moderated intensity continuous
training (MICT) group performed a continuous run between 60% and 70% of the HRpeak, while control
group (CG) received no training but maintained their daily physical activity without altering their
eating habits. HIIT and MICT groups, reveled an increase in VO2max and a decrease in body mass,
body mass index (BMI), and waist and hip circumferences, after intervention. HIIT group, showed a
greater reduction in waist-to-hip ratio compared with the MICT and CG groups.
On the other hand, Hornbuckle et al., (2018), concluded that HIIT performed for one minute at 80%
and 90% of HRmax with a 3 min-recovery of 60% and 70% of HRmax, was more effective in reducing
waist circumference compared to the group that performed a submaximal exercise at steady state (SS)
level; however, they did not observe significant changes on the cardiometabolic risk factors, which
was the main objective of the study; authors indicated the need for further research with a larger
sample to better observe the expected results on these factors. Dias et al., (2018), determined the
efficacy of a twelve-week HIIT to increase cardiorespiratory capacity and reduce adiposity in obese
children; they applied a protocol with a high intensity (HI) of 85% and 95% of HRmax and recovery or
low intensity (LI) at 50% and 70% of HRmax; they concluded that this program increased
cardiorespiratory capacity compared to a traditional continuous moderate intensity training (CT).
Regarding body composition and blood biomarkers, neither of the two training modalities (HIIT/CT)
had a significant effect. All the articles included in this review reported the administration of HIIT
protocols that worked with intensities above 80% and up to 95% of HRmax, HRpeak, calculated
HRmax, or HR reserve. Other authors reported that HIIT should work on anaerobic or ventilatory
threshold II (80% to 85% of VO2max), where central adaptations associated with a sympathetic-adrenal
activation and cardio-vagal improvements take place (Cofré-Bolados et al., 2016). Therefore,
application of this training in sedentary individuals who are also overweight or obese, would have
greater advantages in cardiovascular and metabolic health issues (Reljic et al., 2016); (Laursen Y
Jenkins,2002).
Gerosa-Neto et al., (2016) and Streese et al., (2018), very similar protocols of four minutes of intense
work were performed at 90% of HRmax, for 12 and 16 weeks. First one demonstrated a significantly
decrease in Interleukin-6 (IL-6) and adiponectin concentrations; other variables such as BMI, body
weight and insulin sensitivity did not have significant changes but a tendency to improve was
showed.
Half of the administered HIIT protocols used a longer duration of the intervals, in both exercise and
rest periods, between 4 and 3 minutes, except for the protocols used by Mirghani y Yousefi, (2015),
Romain et al., (2019) and Bonsu y Terblanche, (2016), which had a shorter duration of the intervals or
periods, but the same duration in the training sessions. For 4 weeks, overweight women performed a
HIIT program, executing a protocol of 60 s of intensity for 60 s of recovery, another of 60 s for 30 s, and
a control group. The main purpose of that research was to examine the effect of two HIIT protocols on
liver enzymes and serum lipid levels in the participants. Group that performed HIIT protocol 60 s X
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30 s had a greater decrease in waist circumference, but there were no changes in the blood lipid
profile. Reduction in percentage of fat in the shorter rest interval could be explained because the
activity of glycolysis to synthesize energy decreased which increased aerobic metabolism to replace
energy expended, since the proportion of energy needed in 30 s of high intensity activity, includes 18%
ATP, 2% phosphagens, 25% anaerobic glycolysis and 55% oxidation (Billaut y Bishop 2009).
Consequently, performing HIIT protocols with a shorter recovery time results in an increase in aerobic
metabolism Mirghani y Yousefi, (2015).
In the study carried out by Bonsu y Terblanche, (2016), a significant reduction in blood pressure was
evidenced after 6 sessions of HIIT at 90% and 95% of HRmax in young overweight or obese women,
however training effects were lost two weeks after the execution. On the other hand, A3 (Romain et al.,
2019)., applied a 6 month HIIT program; they investigated the effect of training on body composition,
metabolic markers, psychiatric-functional in overweight people with serious illnesses. Intervals were
administered for 30 s by 90 s at 90%, 50% and 65% of the theoretical HRmax. Study showed no
differences, but waist-hip circumference ratio decreased despite the fact that 50% of the sample
abandoned the intervention before the end of the study.
6. Conclusions
HIIT at intensities between 80% and 90% of HRmax, HRpeak, calculated HRmax or HR reserve is
practical and comfortable; it can be safely administered to overweight or obese people. HIIT, variable
in their duration from 30 seconds to 4 minutes per interval, with a frequency of 2 to 3 sessions per
week, it has also been reported with great improvements in cardiorespiratory capacity, fat mass and
some biological markers, when performed in a treadmill.
Future perspectives
HIIT on treadmill in people with obesity will be an excellent option to transfer this method to the field,
thus the population that does not have an ergometer, can perform this training modality without
complications anywhere outdoors.
Strengths of this review
HIIT method reduces the time and volume of weekly practice, becoming a good strategy to capture
and maintain the practice of exercise in a population with obesity; therefore, compared to the
traditional method of cycling or continuous exercise, it is more convenient for general population. It is
also very useful to know the intensities that can be safely administered with this type of persons.
Weaknesses of this review
There is a large number of studies carried out in people with overweight and obesity, however, there
are not clinical trials and the vast majority does not report the intensities of workloads, so the number
of articles found in this review is not very high.
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Conflict of interest
Authors declare that during the period of completion of this investigation, did not exist, nor is there
now, any economic, personal, political or academic relationship with groups or institutions that could
influence the results of this work or allow bias in the considerations taken into account for discussion
or conclusion. Authors have not received any payment or compensation in money, goods or other
personal benefits from groups or institutions interested in the results of this research.
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