Does interval walking training improve fitness in elderly?
Moderate EvidenceIT DEPENDS
Evidence from Japanese trials demonstrates that interval walking training (alternating fast and slow walking) produces greater improvements in aerobic fitness and muscle strength in older adults compared to continuous moderate walking. However, evidence is limited to a few research groups.
The Verdict
Evidence from Japanese trials demonstrates that interval walking training (alternating fast and slow walking) produces greater improvements in aerobic fitness and muscle strength in older adults compared to continuous moderate walking. However, evidence is limited to a few research groups.
What the Evidence Shows
Interval walking training (IWT) was developed and primarily studied by Shinshu University researchers in Japan as a practical exercise protocol for older adults. The approach alternates 3-minute bouts of fast walking (approximately 70% of peak aerobic capacity) with 3-minute bouts of slow walking, repeated for 30-60 minutes, 4 or more days per week. Nemoto et al. (2007) conducted the foundational trial showing that 5 months of IWT significantly improved peak aerobic capacity (VO2 peak) and knee extension/flexion strength in older adults (mean age 64), whereas continuous walking at moderate intensity produced no significant improvements. The superiority of IWT over continuous walking lies in the intermittent high-intensity stimulus, which exceeds the threshold needed for cardiovascular and muscular adaptation in sedentary older adults. Masuki et al. (2015) expanded this to show benefits for lifestyle-related diseases, and Karstoft et al. (2013) demonstrated similar interval walking benefits specifically for type 2 diabetes management, including improvements in glycemic control and body composition. However, the evidence base remains relatively narrow, predominantly from one research group in Japan, limiting generalizability. Structured lifestyle interventions of any kind may not outperform general physical activity promotion in sustained long-term adherence.
Evidence Quality
0
Meta-Analyses
4
RCTs
3
Observational
Important Caveats
- ⚠️ Most evidence comes from a single research group in Japan (Shinshu University)
- ⚠️ Comparison is typically against moderate continuous walking, not other exercise forms
- ⚠️ Long-term adherence outside structured research programs is unclear
- ⚠️ Benefits may be specific to sedentary elderly who would not otherwise exercise vigorously
- ⚠️ Interval walking may not be suitable for those with mobility limitations or fall risk
Population Studied
Community-dwelling older adults (mean age 60-70); sedentary to moderately active; some studies included type 2 diabetes patients
Dosage
Typical protocol: 3-minute fast / 3-minute slow intervals for 30-60 minutes, at least 4 days per week
Duration
Most trials lasted 5-6 months; improvements in VO2 peak and strength measurable by 2-3 months
Supporting Studies (3)
Effects of high-intensity interval walking training on physical fitness and blood pressure in middle-aged and older people
RCTNemoto K, Gen-no H, Masuki S, et al. · Medicine and Science in Sports and Exercise (2007)
Five months of interval walking training significantly improved VO2 peak (+14%) and isometric knee extension/flexion strength (+13-17%) in older adults, while continuous moderate walking produced no significant improvements.
View paper (DOI) →Interval walking training for lifestyle-related diseases
ObservationalMasuki S, Morikawa M, Nose H. · Proceedings of the Japan Academy, Series B (2015)
Review of interval walking training research demonstrated benefits for multiple lifestyle-related disease markers including hypertension, hyperglycemia, and obesity in over 5,000 older adult participants.
View paper (DOI) →The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetes patients
RCTKarstoft K, Winding K, Knudsen SH, et al. · Diabetologia (2013)
Interval walking training improved glycemic control (2-hour glucose), body composition, and VO2 max in type 2 diabetes patients, while energy expenditure-matched continuous walking did not significantly improve these outcomes.
View paper (DOI) →Contradicting Studies (1)
Adherence to physical-activity recommendations and the influence of structured vs. lifestyle activity
RCTPerri MG, Anton SD, Durning PE, et al. · JAMA (2002)
Trial found that structured exercise programs did not produce superior long-term outcomes to home-based lifestyle activity for obese adults, suggesting highly structured protocols may not maintain advantage outside research settings.
Why this disagrees:
Suggests that the superiority of structured interval protocols demonstrated in controlled trials may not persist in real-world settings where adherence to specific timing protocols is lower, and general activity promotion may be equally effective long-term.