The aim of this study was to investigate whether 16 weeks of HIIT implemented on PEC, compared to 16 weeks of usual PEC warm-up, can improve physical fitness in high-school adolescents, and determine the gender differences among the participants. The main findings from this study indicate that brief whole-body HIIT (10 min) of an extremely low volume, over 16 weeks (on average, 0.8 sessions per week), can improve CRF and muscular fitness in adolescent girls. Our study registered an increase of 9% in CRF in HITT-G girls and a decrease of 4% in CG girls, representing a medium to large ES (t = -3.6; -5.9 to -1.7 95%IC;
p < .001; ES = 0.65). Within a 10-year scope, we find dozens of works with students aged 15-17 years, but only a few were implemented in the school setting. Notwithstanding some studies have been implemented in the school setting, only a few were implemented in PEC. Along this line of results, at the end of the seventh week, Alonso-Fernández, Fernández-Rodríguez, Taboada-Iglesias and Gutiérrez-Sánchez [
38], in a similar intervention with only 8 min twice a week, registered an increase of 10% in VO2max to baseline (
p < .001; ES = 0.33), with only 13 female adolescents distributed by intervention and CG. Also in a seven week intervention, but with three sessions/week, using six min SPRINT as modality and only two female adolescents in HIIT-G, Buchan, Young, Simpson, Thomas, Cooper and Baker [
37] observed, compared to CG, a significant increase of seven laps in PACER (p < .005), and a significant decrease in muscular fitness of CG (p < .005). Martin-Smith, Buchan, Baker, Macdonald, Sculthorpe, Easton, Knox and Grace [
9], using three sessions/week for only four weeks, replaced the entire PEC session with six min HIIT intervention, with nine female adolescents in HIIT-G, increased CRF 5 ml/kg/min with large ES (
p < .05, ES = 0.92). Years earlier, the same researchers [
40], with seven girls in HIIT-G, reached a large ES in intervention (0.93) due to the significant decrease in CRF of CG (p < .05) in a seven week intervention, three sessions/week. Costigan, Eather, Plotnikoff, Taaffe and Lubans [
24] also did not reach significance in CRF and muscular fitness improvements in an eight week intervention, 10min/session, three sessions/week, with 12 female adolescents distributed in two HIIT-G. An increase in mitochondrial content and induced higher increases in citrate synthase maximal activity [
54], type II fiber activation, and adenosine monophosphate-activated protein kinase activity [
55] can be some of the physiological mechanisms explaining why HIIT may improve CRF. According to Bond et al. [
26], time spent in high-intensity activities is the most important factor in promoting vascular health and autonomic cardiac modulation. Moreover, this could explain the absence of improvements in CRF observed in males. Because this is a high-intensity methodology, it is necessary to regulate the intensity to ensure that subjects hit a high enough threshold in their exercises. The difference in the findings between girls and boys may be a consequence of the higher average intensity, represented as the average time in seconds above 90%HRmax/session, of the girls observed in this study compared with the boys (222s vs 133s, respectively; t = 3.8; 42.0 to 135.5 95%IC;
p < .000; ES = 0.74). Despite men's ability to produce more power, some studies reveal that women may have a higher resistance to exhaustion and/or better recovery during bouts of repetitive activity [
42]. These data support the idea that women may recover faster from high-intensity exercise because they self-select intensities that put their hearts under more pressure. Although VO
2max is frequently used to determine the intensity of HIIT, this method ignores the subjects' anaerobic characteristics, which are critical for HIIT [
56]. Likewise, it seems unlikely that teachers would have access to those technologies in PEC real-world contexts. The use of all-out bouts and plyometrics are also simple and effective approaches since some studies that record Large Effect Sizes chose to use all-out bouts instead of a percentage of MAS [
9,
40,
41].
Regarding body composition, in our study, all groups and genders increased their lean body mass and lowered body fat. Alonso-Fernández, Fernández-Rodríguez, Taboada-Iglesias and Gutiérrez-Sánchez [
38] registered a decrease of 8% in % of body fat to baseline (
p < .001; ES = 0.58) and an increase of 6% in lean body mass (
p < .001; ES = 0.15). In Buchan, Young, Simpson, Thomas, Cooper and Baker [
37] intervention, there were no significant changes in body composition in both groups, and Martin-Smith, Buchan, Baker, Macdonald, Sculthorpe, Easton, Knox and Grace [
9] did not reach significance in the waist and hip circumference. Costigan, Eather, Plotnikoff, Taaffe and Lubans [
24] reduced significantly compared to CG 2 cm in waist circumference (
p < .05; ES = 0.70).
Strengths and Limitations
This study has several strengths, including the randomized design, intervention applied to older adolescents, objectively and subjectively measured internal load and in a PEC real context without, interfering with other aspects of the curriculum. Adolescents, especially older ones, are underrepresented in studies implemented in the school context [
28]. Notwithstanding the fact that some studies have been implemented in the school setting, only a few [
9,
27,
35,
36,
37,
38,
39,
40] were implemented in PEC, some of which replaced the entire session with the intervention [
9,
40]. Adjusting exercise intensity using HR has been a valid option, mainly in prolonged and submaximal periods. Few studies have objectively measured internal load by monitoring HR [
9,
10,
28,
38,
39,
57,
58] or RPE [
38,
41]. HR has become one of the most used outcomes to assess intensity. Optimal exercise duration and rest intervals remain ambiguous and dose-response relationships of HIIT volume and intensity are unsettled. On adolescents, despite differences in protocols on intensity like all-out bouts or % of MAS, modality (sprints vs calisthenics), and volume (6min-35min/session), most of them opted for 1:1 density [
25]. With this study, the authors aim to provide novel HIIT protocols for schools with less volume (only twice a week) and higher density (less rest in each interval), which include resistance exercises through calisthenic exercises and plyometrics that retain the health-enhancing effects and satisfy the adolescents’ desire for enjoyment and variety.
However, some limitations should also be acknowledged, such as the high missing values due to school activities, teaching breaks, weather conditions and lockdown, or the absence of a detailed evaluation to determine intervention fidelity to confirm treatment/protocol adherence. Due to the negative consequences of home confinement, we experienced a significant number of dropouts in several outcomes, so the primary analysis of the data set was not carried out according to the ‘intention to treat’ principle. These simple effects were examined either using separate independent repeated measurement analysis, such as t-tests or – where the analysis of the residuals suggested non-normality – using the non-parametric Wilcoxon’s signed ranks test. The mean attendance for participants involved in the intervention was 12.2 ± 3.5 (47%) of the 26 scheduled exercise sessions. If there had been a higher participation rate, perhaps the differences between baseline and post-intervention and between groups would have been more pronounced as was noted in other studies [
9,
24,
37,
38,
40]. One of the gaps in HIIT research is the small number of volunteers and the short duration of interventions so that significant impacts on public health can be inferred [
59]. However, in a school context, more than seven weeks can be problematic due to activities and teaching breaks provided for in planning and the school calendar [
9]. Although we planned to include a pre- and post-nutrition control and a PA enjoyment scale, home confinement did not allow that assessment.