Key result
Tele-exercise increases HIIT attendance ~54% versus in-person sessions without compromising exercise intensity.
Why the study?
With the COVID-19 pandemic accelerating the use of tele-exercise, providers must determine the most suitable modality of supervised exercise training for patients.
Does tele-exercise improve exercise attendance and maintain intensity compared to in-person sessions in adults with class II/III obesity?
RCT (n=62)
Open-label
1:1 randomization stratified by bariatric surgery status and baseline diabetes status
Yes
Does tele-exercise improve exercise attendance and maintain intensity compared to in-person sessions in adults with class II/III obesity?
Effect estimate: IRR 1.54 (95% CI 1.30 to 1.82)
Absolute Event Rate: 1.54% vs 1%
p-value: p=<0.05
Tele-exercise is a viable modality that improves HIIT attendance without compromising exercise intensity in adults with severe obesity.
Tele-exercise may warrant use to boost HIIT attendance in class II/III obesity; extends observational evidence but leaves open causality pending RCTs.
ABSTRACT Background The COVID-19 pandemic accelerated the use of tele-exercise. Providers must now determine the most suitable modality of supervised exercise training for patients. This study compared exercise attendance and intensity during supervised high-intensity interval training (HIIT) between in-person vs. tele-exercise sessions among adults with class II/III obesity. Methods We conducted a secondary analysis of a randomized controlled trial of 62 participants examining exercise and surgical weight loss effects on neuropathy. Participants underwent two in-person supervised and one unsupervised HIIT sessions weekly for two years. After the pandemic onset, sessions shifted to tele-exercise. We evaluated associations between session attendance and intensity with pre- vs. post-lockdown timing. Results Supervised session attendance increased after switching from in-person to tele-exercise sessions (incident rate ratio[IRR]: 1.50, 95% CI: [1.27, 1.79]). Pre-pandemic follow-up time was associated with decreased attendance (IRR: 0.95, 95% CI: [0.94, 0.97]), but supervised session attendance increased after the COVID-19 shutdown (IRR: 1.05, 95% CI: [1.03, 1.07]). Participants with prediabetes or diabetes showed reduced attendance, while those undergoing bariatric surgery had increased attendance. No change was seen in exercise intensity after switching from in-person to tele-exercise sessions (point estimate: -0.01, 95% CI: [-0.02, -0.01]), but small effects of follow-up time on exercise intensity were seen with increases over time before the pandemic and decreases after the lockdown. Conclusions Tele-exercise resulted in improved attendance for HIIT training among adults with class II/III obesity without meaningful differences in exercise intensity, supporting its use for this population.
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Chionis et al. (2026) conducted an RCT in Class II/III obesity (n=62). Supervised high-intensity interval training (HIIT) via tele-exercise vs. Supervised in-person HIIT sessions was evaluated on Supervised exercise session attendance (number of completed sessions) (IRR 1.54, 95% CI 1.30 to 1.82, p=<0.05). Tele-exercise increased supervised HIIT session attendance by 54% compared to in-person sessions in adults with class II/III obesity without meaningful differences in exercise intensity.
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