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 include systematically modulated (controlled, individualized, escalated, de-escalated) supramaximal interval intensity and protocol safety. In this co-creation study with older adults, we aimed to adapt the supramaximal HIT protocol to 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, participants engaged in co-creation workshops to identify, explore, and discuss available home-based training modalities. In phase two, suitable modalities were lab-tested and compared to stationary bicycling regarding acute physiological responses, safety, and technique. 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 home-based chair stand protocol with metronome-controlled intensity. This adaptation is the first step towards a safe and scalable implementation of a home-based supramaximal HIT program for older adults.