Researchers to Detail Benefits of High-Intensity Interval Training for People Living with Rheumatic Conditions

High-intensity interval training (HIIT) is gaining recognition as a safe and effective intervention for people with rheumatic conditions, with emerging research spotlighting the role of HIIT in improving cardiovascular health, enhancing physical fitness, and modulating immune response without exacerbating disease activity. Personalizing treatment plans that integrate HIIT into a comprehensive approach for managing patients with inflammatory conditions can boost overall health and help counter the increased risk of cardiometabolic diseases that affect patients with these conditions.

In fact, Kim M. Huffman, MD, PhD, Associate Professor in the Department of Medicine, Division of Rheumatology and Immunology at Duke University School of Medicine, and her colleagues, have reported that the benefits of HIIT can include improved cardiorespiratory fitness, reduced disease activity, and enhanced skeletal muscle function without increasing inflammatory cytokines. Resistance training also can also play a role in reducing disease activity.

In the session High-Intensity Training in Rheumatology: Impacts on Cardiovascular Health, Physical Function, and Immune Response, Dr. Huffman, along with Helene Alexanderson, PhD, PT, will discuss HIIT benefits and the best way to tailor it to safely maximize those benefits for patients. The session will be held on Sunday, October 26, from 2:45–3:45 p.m. in Room W184A of McCormick Place. On-demand access to recorded presentations will be available to registered attendees of ACR Convergence following the annual meeting through October 31, 2026.

Dr. Huffman said she is passionate about the role of exercise in treating rheumatoid arthritis.

“Our group’s HIIT study showed significant improvements in cardiovascular fitness and disease activity, including tender swollen joints, global assessment scale, sedimentation rate, and CRP (C-reactive protein) levels. The study also involved an exercise immunologist who found improvements in immune cell function,” she noted.

While HIIT is effective for improving fitness and disease activity, the study did not show global improvements in cardiometabolic risk or body composition. As a result, it may not be sufficient for weight loss or body composition changes without dietary modifications, she cautioned.

However, a second intervention, focused on older individuals who were overweight or obese, did include a weight loss component and a more structured aerobic and resistance training program.

“Patients had improvements in disease activity, fitness, and metabolic and drug scores, although the fitness improvements were not as strong as those in the HIIT study,” Dr. Huffman said.

For consistency of activity over the long term, she suggests structuring exercise programs to transition patients from HIIT to more sustainable activities like walking.

Dr. Alexanderson, Adjunct Senior Lecturer, Karolinska University Hospital, Sweden, and her group have done much work to show that high-intensity exercise is a safe and effective adjunct treatment for patients with inflammatory myositis, as well as other rheumatic conditions. She will present her group’s research findings, which have challenged the widely held belief that intense exercise could worsen muscle inflammation in myositis.

In myositis, the traditional focus has been on measuring muscle function. Dr. Alexanderson noted that it is crucial to also consider the health benefits of aerobic training, as aerobic capacity is an important part of overall health, particularly in patients with inflammatory rheumatic diseases.

“Good aerobic capacity is closely linked to the absence of cardiovascular diseases and type 2 diabetes, which are common in patients treated with high doses of corticosteroids,” she said.

Dr. Alexanderson’s team advocates for HIIT as an effective method to improve aerobic capacity. She noted that a trial of patients with myositis who underwent HIIT showed a significant 16% improvement in peak and maximal oxygen uptake, compared to a 2% improvement in a control group performing moderate-intensity exercises.

In the past clinicians were cautioned against pushing patients with pain into intensive exercise. Current evidence shows that intensive exercise is well-tolerated across various rheumatic diseases, Dr. Alexanderson said. She added that an HIIT protocol involving 30-second biking intervals followed by two minutes of active rest has proven effective, though there is still a need for more education in this area.

“We must always tailor exercise programs to individual patients, considering factors like pain, fatigue, age, and conditions like osteoporosis,” she said. “We want healthcare providers to understand that intensive exercise can be safe and beneficial, helping to restore muscle damage from disease and medication, and improving patients’ health and prognosis.”