The Acute And Chronic Vascular Function Responses To Heat Therapy And Exercise Training: A Randomized Controlled Trial

PURPOSE: Heat therapy and exercise training have been independently shown to improve vascular function in both the acute and chronic time frames. However, no research has examined the synergistic effects of combining heating and exercise interventions in recreationally active individuals. Furthermore, heat therapies that have been previously proven to be effective typically involve the whole body, which is not feasible or tolerable for the general population, emphasizing the need for studies using local heating protocols. This study aimed to determine the acute and chronic vascular function responses to heat therapy and exercise training, alone or in combination. METHODS: This randomized controlled trial compared the effects of 8 weeks of no intervention (CON), lower limb heat therapy (HEAT), moderate-intensity cycling training (EX), or combined training (HEATEX) on vascular function in young, healthy recreationally active adults. Endothelial function was the primary outcome and was assessed using a brachial artery flow-mediated dilation test (BA FMD). Arterial stiffness was a secondary outcome and was quantified by pulse wave velocity centrally between the carotid and femoral arteries (cfPWV) and peripherally between the femoral and dorsalis pedis arteries (ffPWV). Each vascular function outcome was assessed acutely, before and after each participant’s first training session, as well as chronically, before and after 8 weeks of training. RESULTS: Sixty participants (23 ± 3 years, 30 females) were randomly allocated into either CON (n = 15), HEAT (n = 15), EX (n = 14), or HEATEX (n = 16). Absolute, relative, and shear-corrected BA FMD did not change acutely or chronically in any of the groups (all p > 0.05). There were no acute changes in cfPWV (p = 0.79) or ffPWV (group effect: p = 0.047; all pairwise comparisons: p > 0.05). Both interventions with a heating component were associated with chronic within-subject reductions in cfPWV after 8 weeks (HEAT: -0.27 [-0.53,-0.02] and HEATEX: -0.33 [-0.58,-0.09]), despite a lack of between-group differences (p = 0.25). CONCLUSIONS: In a young, recreationally active cohort, 8 weeks of lower limb heat therapy or combined training may elicit reductions in arterial stiffness but not endothelial function. Supported by an NSERC Discovery Grant #20011033 to MJM.

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