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The effects of high intensity interval training in women with rheumatic disease: a pilot study



Rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) are inflammatory diseases which involve increased risk of cardiovascular disease (CVD). High intensity interval training (HIIT) is known to be effective in improving cardiovascular health. The aim of this study was to investigate whether 10 weeks of HIIT at 85–95 % of HRmax would improve important risk factors of CVD in rheumatic patients, and if these patients would tolerate exercise intensities above today’s recommendations.


Seven women with RA and eleven with adult-JIA, 20–50 years, were recruited to this cross-over study. Participants performed HIIT, consisting of 4 × 4 min intervals at 85–95 % of HRmax twice a week for 10 weeks on spinning bikes. Maximal oxygen uptake (VO2max), heart rate recovery, blood pressure, body composition, and blood variables were measured before and after the exercise and control period. Disease activity was determined and questionnaire data were collected.


HIIT resulted in 12.2 % increase in VO2max and 2.9 % improvement in heart rate recovery (p < 0.05). BMI, body fat, and waist circumference decreased 1.2, 1.0, and 1.6 %, respectively, whereas muscle mass increased 0.6 % (p < 0.05). A trend toward decreased CRP was detected after HIIT (p = 0.08). No changes were detected in disease activity or pain.


Despite rigorous high intensity exercise, no increase was detected in disease activity or pain, indicating that HIIT was well tolerated by these patients. Furthermore, HIIT had positive effects on several CVD risk factors. In light of this pilot study, HIIT seems like a promising non-pharmacological treatment strategy for patients with RA and adult-JIA.

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Fig. 1
Fig. 2



Body mass index


Cardiovascular disease


Cartilage oligomeric matrix protein


Coronary artery diseases


C-reactive protein


High intensity interval training


High-density lipoprotein


Insulin-like growth factor


Juvenile idiopathic arthritis

HRmax :

Maximal heart rate

VO2max :

Maximal oxygen uptake


One-minute heart rate recovery


Pentraxin 3


Rheumatoid arthritis


Standard deviations


Visual analog scale


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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Correspondence to Anja Bye.

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Communicated by Keith Phillip George.

Norwegian Health Association, Revmafondet (foundation for rheumatic disease in Norway), Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU).

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Sandstad, J., Stensvold, D., Hoff, M. et al. The effects of high intensity interval training in women with rheumatic disease: a pilot study. Eur J Appl Physiol 115, 2081–2089 (2015).

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  • Rheumatology
  • Exercise
  • Cardiovascular diseases