Benefits and Risks of High-Intensity Interval Training in Patients With Coronary Artery Disease.

Exercise-based cardiac rehabilitation is integral to secondary prevention in patients with coronary artery disease. Recently, the effectiveness and "superiority" of high-intensity interval training (HIIT) is a purported time-saving alternative to "traditional" moderate-intensity continuous training (MICT) in cardiac rehabilitation. The rationale for HIIT adoption is, however, not fully substantiated in the scientific literature. Established guidelines for exercise testing and training, when carefully adhered to, reduce the likelihood of triggering a cardiac event or inducing musculoskeletal injury. Clinicians should likewise consider patient risk stratification and introduce HIIT as an alternative to MICT only after patients exhibit stable and asymptomatic responses to vigorous exercise training. Although HIIT adherence appears comparable with MICT during outpatient rehabilitation, compliance drops dramatically for unsupervised exercise. Despite the enthusiasm surrounding HIIT, its main advantage over MICT appears to be short-term exercise performance outcomes and indices of vascular function. Regarding benefits to cardiovascular disease risk factor modification, management of vital signs, and measures of cardiac performance, current evidence indicates that HIIT does not outperform MICT. Long-term outcomes to HIIT are currently uncertain and logistical constraints to HIIT incorporation need additional clarification. Based on these limited findings, derived from facilities and clinicians at the forefront of cardiac rehabilitation, the routine adoption of HIIT should be viewed cautiously. In conclusion, the current review highlights numerous specific research directives that are needed before the safety and effectiveness of HIIT can be confirmed and widely adopted in patients with known or suspected coronary artery disease, especially in unsupervised, nonmedical settings.

Characterizing free-living light exposure using a wrist-worn light monitor.

It was the purpose of this study to pilot the use of a new wrist-worn light monitoring device to document that indoor lighting for a particular day-shift work environment could serve as the primary light exposure dosage in healthy free-living humans. Twelve employees of a local hospital volunteered to wear a wrist-worn light monitor during all waking hours for an entire workweek (Monday-Friday). Light data were analyzed (3-Factor RM ANOVA) for the dose of light exposure (minutes of exposure x light intensity) within six light intensity categories (< 1, 1-100, 101-200, 201-500, 501-1000, > 1000 1x) relative to time spent within their work environment and all other time of the day. The greatest dose of exposure occurred within the 201-500 1x range during the subjects' work shift. These data support the premise of others that long term exposure to dim indoor light intensities commonly experienced within a variety of work environments may serve as the primary entrainment factor for physiological and behavioral processes following a circadian rhythm.