High intensity interval training for older adults – from the laboratory towards a home setting: a co-creation study

Background: Physical exercise can help prolong healthy aging, yet few options enable older adults to exercise at very high intensities at home. A previous gym-based supramaximal High Intensity interval Training (HIT) protocol on stationary bicycles has shown promising results. Core components were supramaximal interval intensity that could be systematically modulated (controlled, individualized, escalated, and de-escalated) and protocol safety. In this exploratory co-creation study with older adults, we aimed to adapt the supramaximal HIT protocol for potential future implementation in older adults’ home settings. Methods: Eleven older adults (6 females; ages 69–74) with prior supramaximal HIT experience participated in this two-phase co-creation study. In phase one, co-creators engaged in workshops to identify, explore, and discuss available home-based training modalities. In phase two, co-creators took part in lab tests wherein suitable modalities were tested and compared to stationary bicycling regarding acute physiological responses and safety during a supramaximal HIT session (10 × 10-second intervals with 50-second passive recovery). Results were continuously merged with the protocol’s core components. Results: Physiological and emotional reactions to HIT, potential exercise modalities, and necessary protocol adaptations were identified in phase one. When merged with core components three modalities - walking up steps, chair stand, and rubber band cross country double poling - were selected for phase two testing. Of these, chair stand elicited physiological responses most comparable to stationary bicycling, while fulfilling all core components. Conclusions: We adapted a researcher-supervised watt-controlled supramaximal HIT-protocol on stationary bicycles to a chair stand protocol with audio metronome-controlled intensity for potential implementation at home. This adaptation is the first step towards a safe and scalable implementation of a home-based supramaximal HIT program for older adults.