{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:38:51Z","timestamp":1793723931573,"version":"4.6.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Moderate-intensity continuous training (MICT) is strongly recommended for polycystic ovarian syndrome (PCOS) treatment. However, recent studies have suggested that high-intensity interval training (HIIT) would promote great benefits for cardiac autonomic control. Therefore, we investigated whether the benefits of HIIT related to cardiovascular autonomic control were greater than those of MICT in women with PCOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women with PCOS were randomly allocated through a blind draw into three groups: control, MICT, and HIIT. The control group did not undergo exercise, whereas those in the MICT and HIIT groups underwent 16 weeks of aerobic physical training. All groups were evaluated before and after the 16 weeks of intervention in the following aspects: quantification of serum lipids, testosterone, fasting insulin and blood glucose; physical fitness through cardiopulmonary testing; analysis of heart rate variability (HRV) by linear (time domain and frequency domain) and non-linear (symbolic analysis) methods, analysis of blood pressure variability (BPV) and spontaneous baroreflex sensitivity (BRS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The final analysis, each group comprised 25 individuals. All groups had similar baseline parameters. After 16 weeks, intragroup comparison showed that the MICT and HIIT groups had a reduction in baseline heart rate (P &amp;lt; 0.001; P &amp;lt; 0.001, respectively) and testosterone levels P &amp;lt; 0.037; P &amp;lt; 0.012, respectively) associated with an increase in VO2<jats:sub>peak<\/jats:sub> (MICT, P &amp;lt; 0.001; HIIT, P &amp;lt; 0.001). The MICT (P &amp;lt; 0.36) and HIIT (P &amp;lt; 0.17) groups also showed an increase in cardiac vagal modulation, however only observed in the non-linear analysis. The intergroup comparison showed no differences between the MICT and HIIT groups in any of the hormonal, metabolic and autonomic parameters evaluated, including testosterone, peak oxygen uptake (VO2<jats:sub>peak<\/jats:sub>), HRV, BPV and BRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HIIT and MICT showed similar results for the different parameters evaluated. This suggests that both training protocols can be recommended for the treatment of PCOS. Brazilian Clinical Trials Registry (RBR-78qtwy).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.1024844","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T05:14:00Z","timestamp":1669353240000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":33,"title":["Cardiovascular autonomic modulation differences between moderate-intensity continuous and high-intensity interval aerobic training in women with PCOS: A randomized trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Stella V.","family":"Philbois","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor B.","family":"Ribeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Tank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosana Maria dos","family":"Reis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darius A.","family":"Gerlach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo C. D.","family":"Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dew218","article-title":"The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis","volume":"31","author":"Bozdag","year":"2016","journal-title":"Hum Reprod"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2147\/CLEP.S37559","article-title":"Epidemiology, diagnosis, and management of polycystic ovary syndrome","volume":"6","author":"Sirmans","year":"2013","journal-title":"Clin Epidemiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.fertnstert.2011.09.024","article-title":"Consensus on women\u2019s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE\/ASRM-sponsored 3rd PCOS consensus workshop group","volume":"97","author":"Fauser","year":"2012","journal-title":"Fertil Steril"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.05.004","article-title":"Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"110","author":"Teede","year":"2018","journal-title":"Fertil Steril"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61345-2","article-title":"Polycystic ovary syndrome","volume":"370","author":"Norman","year":"2007","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.ijcard.2007.08.037","article-title":"Altered autonomic neural control of the cardiovascular system in patients with polycystic ovary syndrome","volume":"130","author":"Tekin","year":"2008","journal-title":"Int J Cardiol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmy045","article-title":"Overview of systematic reviews of non-pharmacological interventions in women with polycystic ovary syndrome","volume":"25","author":"Pundir","year":"2019","journal-title":"Hum Reprod Update"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.09.031","article-title":"Aerobic exercise improves cardiac autonomic modulation in women with polycystic ovary syndrome","volume":"202","author":"S\u00e1","year":"2016","journal-title":"Int J Cardiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.rehab.2016.07.002","article-title":"Exercise training-induced modification in autonomic nervous system: An update for cardiac patients","volume":"60","author":"Besnier","year":"2017","journal-title":"Ann Phys Rehabil Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1007\/s11892-017-0941-9","article-title":"Physical exercise improves heart rate variability in patients with type 2 diabetes: A systematic review","volume":"17","author":"Villafaina","year":"2017","journal-title":"Curr Diabetes Rep"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.675041","article-title":"Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study","volume":"115","author":"Wisl\u00f8ff","year":"2007","journal-title":"Circulation"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e0166299","DOI":"10.1371\/journal.pone.0166299","article-title":"High-intensity interval training elicits higher enjoyment than moderate intensity continuous exercise","volume":"12","author":"Thum","year":"2017","journal-title":"PloS One"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.22122\/arya.v14i6.1781","article-title":"The effects of low-volume high-intensity interval versus moderate intensity continuous training on heart rate variability, and hemodynamic and echocardiography indices in men after coronary artery bypass grafting: A randomized clinical trial study","volume":"14","author":"Ghardashi-Afousi","year":"2018","journal-title":"ARYA Atheroscler"},{"key":"B14","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1097\/HCR.0000000000000156","article-title":"Effect of high-intensity interval versus continuous exercise training on functional capacity and quality of life in patients with coronary artery disease: A RANDOMIZED CLINICAL TRIAL","volume":"36","author":"Jaureguizar","year":"2016","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"B15","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.autneu.2016.03.003","article-title":"Effect of continuous and interval aerobic exercise training on baroreflex sensitivity in heart failure","volume":"197","author":"Masson","year":"2016","journal-title":"Auton Neurosci"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.12965\/jer.1734914.457","article-title":"Interval and continuous aerobic exercise training similarly increase cardiac function and autonomic modulation in infarcted mice","volume":"13","author":"Abad","year":"2017","journal-title":"J Exerc Rehabil"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1080\/00015385.2017.1304712","article-title":"The effect of aerobic interval training and continuous training on exercise capacity and its determinants","volume":"72","author":"Pattyn","year":"2017","journal-title":"Acta Cardiol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.07.063","article-title":"High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: A randomised trial","volume":"245","author":"Ramos","year":"2017","journal-title":"Int J Cardiol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1080\/13813455.2019.1662450","article-title":"The effects of high intensity-interval training on vaspin, adiponectin and leptin levels in women with polycystic ovary syndrome","volume":"128","author":"Akta\u015f","year":"2022","journal-title":"Arch Physiol Biochem"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14194","article-title":"Effects of continuous and intermittent aerobic physical training on hormonal and metabolic profile, and body composition in women with polycystic ovary syndrome: A randomized controlled trial","volume":"93","author":"Ribeiro","year":"2020","journal-title":"Clin Endocrinol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1177\/1359105319869806","article-title":"Continuous versus intermittent aerobic exercise in the improvement of quality of life for women with polycystic ovary syndrome: A randomized controlled trial","volume":"26","author":"Ribeiro","year":"2021","journal-title":"J Health Psychol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2018.09.002","article-title":"Comparison of the effect of intermittent and continuous aerobic physical training on sexual function of women with polycystic ovary syndrome: Randomized controlled trial","volume":"15","author":"Lopes","year":"2018","journal-title":"J Sex Med"},{"key":"B23","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.fertnstert.2003.10.004","article-title":"Revised 2003 consensus on diagnostic criteria and long-term health risks related ?A3B2 show [#,32] ?>to polycystic ovary syndrome","volume":"81","year":"2004","journal-title":"Fertil Steril"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2005.10.017","article-title":"The threshold value for insulin resistance (HOMA-IR) in an admixtured population IR in the Brazilian metabolic syndrome study","volume":"72","author":"Geloneze","year":"2006","journal-title":"Diabetes Res Clin Pract"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.5.1043","article-title":"Heart rate variability","volume":"93","year":"1996","journal-title":"Circulation"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.5935\/abc.20190031","article-title":"Women with polycystic ovarian syndrome exhibit reduced baroreflex sensitivity that may be associated with increased body fat","volume":"112","author":"Philbois","year":"2019","journal-title":"Arq Bras Cardiol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1109\/10.959324","article-title":"Entropy, entropy rate, and pattern classification as tools to typify complexity in short heart period variability series","volume":"48","author":"Porta","year":"2001","journal-title":"IEEE Trans BioMed Eng"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00006.2007","article-title":"Assessment of cardiac autonomic modulation during graded head-up tilt by symbolic analysis of heart rate variability","volume":"293","author":"Porta","year":"2007","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"B29","article-title":"A new approach to analysis of the arterial baroreflex","volume":"3","author":"Bertinieri","year":"1985","journal-title":"J Hypertens Suppl"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.2001.280.3.R744","article-title":"Baroreflex effectiveness index: an additional measure of baroreflex control of heart rate in daily life","volume":"280","author":"Di Rienzo","year":"2001","journal-title":"Am J Physiology-Regulatory Integr Comp Physiol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s40798-020-00257-8","article-title":"Should Heartbeats\/Training session be considered when comparing the cardiovascular benefits of high-intensity interval aerobic and moderate-intensity continuous training? a critical appraisal","volume":"6","author":"Rodrigues","year":"2020","journal-title":"Sports Med Open"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1038\/288373a0","article-title":"The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine","volume":"288","author":"Furchgott","year":"1980","journal-title":"Nature"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.83.23.9164","article-title":"Mechanism of action of some inhibitors of endothelium-derived relaxing factor","volume":"83","author":"Moncada","year":"1986","journal-title":"Proc Natl Acad Sci USA"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1681.2008.04866.x","article-title":"Increased cardiac sympathetic drive and reduced vagal modulation following endothelin receptor antagonism in healthy conscious rats","volume":"35","author":"Souza","year":"2008","journal-title":"Clin Exp Pharmacol Physiol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/s0828-282x(10)70395-0","article-title":"Improvements in heart rate variability with exercise therapy","volume":"26","author":"Routledge","year":"2010","journal-title":"Can J Cardiol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-7133.2011.00282.x","article-title":"Exercise training improves heart rate variability in older patients with heart failure: a randomized, controlled, single-blinded trial","volume":"18","author":"Murad","year":"2012","journal-title":"Congest Heart Fail"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2011.00086","article-title":"Heart rate variability - a historical perspective","volume":"2","author":"Billman","year":"2011","journal-title":"Front Physiol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.10.082","article-title":"Dose-response relationship of baroreflex sensitivity and heart rate variability to individually-tailored exercise training in patients with heart failure","volume":"166","author":"Iellamo","year":"2013","journal-title":"Int J Cardiol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2015.09.009","article-title":"Decreased baroreflex sensitivity is linked to sympathovagal imbalance, body fat mass and altered cardiometabolic profile in pre-obesity and obesity","volume":"64","author":"Indumathy","year":"2015","journal-title":"Metab Clin Exp"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2016.00461","article-title":"Ovarian hormone deprivation reduces oxytocin expression in paraventricular nucleus preautonomic neurons and correlates with baroreflex impairment in rats","volume":"7","author":"De Melo","year":"2016","journal-title":"Front Physiol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"e77092","DOI":"10.1371\/journal.pone.0077092","article-title":"Cardiac autonomic modulation is determined by gender and is independent of aerobic physical capacity in healthy subjects","volume":"8","author":"Dutra","year":"2013","journal-title":"PloS One"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1097\/MBP.0000000000000338","article-title":"The blood pressure variability and baroreflex sensitivity in healthy participants are not determined by sex or cardiorespiratory fitness","volume":"23","author":"Facioli","year":"2018","journal-title":"Blood Press Monit"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.518449","article-title":"Symbolic dynamics of heart rate variability: a probe to investigate cardiac autonomic modulation","volume":"112","author":"Guzzetti","year":"2005","journal-title":"Circulation"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1995.tb13689.x","article-title":"Pelvic ultrasound measurements in normal girls","volume":"84","author":"Griffin","year":"1995","journal-title":"Acta Paediatr"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.1024844\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T11:46:49Z","timestamp":1670586409000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.1024844\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,25]]},"references-count":44,"alternative-id":["10.3389\/fendo.2022.1024844"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.1024844","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,25]]},"article-number":"1024844"}}