Heart rate variability in athletes

Evaluation of frequency of positive exercise-induced bronchospasm between swimmers and sedentary individuals

Abstract Introduction: Despite the prevalence of prescribed asthma, there is uncertainty about the incidence of exercise-induced bronchospasm (EIB). Objective: Compare the frequency of EIB between swimmers and sedentary individuals, and observe heart rate variability during bronchial activity. Methods: In total, 18 swimmers (group 1) and 18 sedentary individuals (group 2) were included. The participants rested for 30 minutes for evaluation of HRV. Blood pressure (PA), respiratory rate (RR), and pulse oxygen saturation (SpO2) were measured. The volunteers remained seated for the spirometry test (maneuver of forced vital capacity - FVC). This was repeated 5, 10, 15, 20, and 30 minutes after the exercise test. The statistical analysis used the Student t, Mann Whitney, and Shapiro-Wilks tests. The significance level was p <0.05. Results: The spirometry findings showed 3 sedentary individuals and 10 swimmers with obstructive ventilatory disorder (OVD). Only 2 of the sedentary and none of the swimmer group demonstrated positive bronchial provocation. A key criterion for diagnosing OVD, the relationship between forced expiratory volume in one second and FVC (FEV1/FVC), was statistically lower in the swimmer group. The measures of the root mean square of the successive differences between adjacent normal RR intervals, in a time interval (RMSSD), and the standard deviation of all normal RR intervals recorded in a time interval (SDNN) were significantly higher among the athletes. Conclusion: The bronchial provocation test identified a higher prevalence of bronchospasm among sedentary individuals. However, there was a reduction in the FEV1/FVC ratio and higher HRV in the group of swimmers.

An experimental examination of the effort-reward imbalance model of occupational stress: Increased financial reward is related to reduced stress physiology

Effort-reward imbalance in the workplace is linked to a variety of negative health and organisational outcomes, but it has rarely been assessed experimentally. We manipulated reward (while keeping effort constant) in a within-subjects design with female participants (N=60) who were randomly assigned to high and standard reward conditions within a simulated office environment. Self-report, behavioural (task performance), and physiological (heart rate variability, salivary alpha amylase) measures assessed the impact of increased financial reward. Participants reported increased perceptions of reward, performed moderately better on the task, and were less physiologically reactive in the high reward versus the standard condition. These findings highlight the importance of assessing both subjective self-reports of stress together with objective physiological measures of stress, and suggest that increasing monetary rewards has the potential to decrease stress physiological reactivity, and in turn, reduce the risk of ill-health in employees, and may also positively influence task efficacy.

The Influence of Exercise Intensity on Postexercise Baroreflex Sensitivity

PURPOSE

The purpose of this study was to investigate the influence of exercise intensity on postexercise supine and tilt baroreflex sensitivity (BRS).

METHOD

Nine healthy, active men performed 2 conditions of interval cycling of 40% maximal work rate (WR_max) and 75% WR_max of matched work done and a control condition of no exercise in a counterbalanced order. BRS outcome measures were determined at preexercise and postexercise up to +24 hr in supine and tilt positions. R-R interval and blood pressure data were collected over consecutive 10-min periods and were analyzed by Fast Fourier transformation analysis.

RESULTS

A fully repeated analysis of variance revealed a significant interaction (p < .05) between time and condition in supine for BRS_αLF, F(3, 134) = 5.19, p < .05, ES = .39, and BRS_TFTG, F(3, 134) = 5.65, p < .05, ES = .41, and in tilt for BRS_UpUp, F(3, 134) = 3.54, p < .05, ES = .31, BRS_DownDown, F(3, 134) = 5.94, p < .05, ES = .43, BRS_αLF, F(4, 134) = 6.23, p < .05, ES = .44, and BRS_TFTG, F(4, 134) = 9.22, p < .05, ES = .54. There were significant differences (p < .05) between condition comparisons at +15 min and between control and 75% WR_max and between the 40% WR_max and 75% WR_max conditions at +60 min. At +15 min, BRS was lower in the 75% WR_max condition compared with the 40% WR_max condition and the control condition, and it was lower in the 40% WR_max condition than in the control condition.

CONCLUSION

The findings demonstrate an intensity-dependent relationship in the BRS response following exercise.

Ayurgenomics for stratified medicine: TRISUTRA consortium initiative across ethnically and geographically diverse Indian populations

BACKGROUND

Genetic differences in the target proteins, metabolizing enzymes and transporters that contribute to inter-individual differences in drug response are not integrated in contemporary drug development programs. Ayurveda, that has propelled many drug discovery programs albeit for the search of new chemical entities incorporates inter-individual variability "Prakriti" in development and administration of drug in an individualized manner. Prakriti of an individual largely determines responsiveness to external environment including drugs as well as susceptibility to diseases. Prakriti has also been shown to have molecular and genomic correlates. We highlight how integration of Prakriti concepts can augment the efficiency of drug discovery and development programs through a unique initiative of Ayurgenomics TRISUTRA consortium.

METHODS

Five aspects that have been carried out are (1) analysis of variability in FDA approved pharmacogenomics genes/SNPs in exomes of 72 healthy individuals including predominant Prakriti types and matched controls from a North Indian Indo-European cohort (2) establishment of a consortium network and development of five genetically homogeneous cohorts from diverse ethnic and geo-climatic background (3) identification of parameters and development of uniform standard protocols for objective assessment of Prakriti types (4) development of protocols for Prakriti evaluation and its application in more than 7500 individuals in the five cohorts (5) Development of data and sample repository and integrative omics pipelines for identification of genomic correlates.

RESULTS

Highlight of the study are (1) Exome sequencing revealed significant differences between Prakriti types in 28 SNPs of 11 FDA approved genes of pharmacogenomics relevance viz. CYP2C19, CYP2B6, ESR1, F2, PGR, HLA-B, HLA-DQA1, HLA-DRB1, LDLR, CFTR, CPS1. These variations are polymorphic in diverse Indian and world populations included in 1000 genomes project. (2) Based on the phenotypic attributes of Prakriti we identified anthropometry for anatomical features, biophysical parameters for skin types, HRV for autonomic function tests, spirometry for vital capacity and gustometry for taste thresholds as objective parameters. (3) Comparison of Prakriti phenotypes across different ethnic, age and gender groups led to identification of invariant features as well as some that require weighted considerations across the cohorts.

CONCLUSION

Considering the molecular and genomics differences underlying Prakriti and relevance in disease pharmacogenomics studies, this novel integrative platform would help in identification of differently susceptible and drug responsive population. Additionally, integrated analysis of phenomic and genomic variations would not only allow identification of clinical and genomic markers of Prakriti for application in personalized medicine but also its integration in drug discovery and development programs.

Musical Auditory Stimulation Influences Heart Rate Autonomic Responses to Endodontic Treatment

We aimed to evaluate the acute effect of musical auditory stimulation on heart rate autonomic regulation during endodontic treatment. The study included 50 subjects from either gender between 18 and 40 years old, diagnosed with irreversible pulpitis or pulp necrosis of the upper front teeth and endodontic treatment indication. HRV was recorded 10 minutes before (T1), during (T2), and immediately (T3 and T4) after endodontic treatment. The volunteers were randomly divided into two equal groups: exposed to music (during T2, T3, and T4) or not. We found no difference regarding salivary cortisol and anxiety score. In the group with musical stimulation heart rate decreased in T3 compared to T1 and mean RR interval increased in T2 and T3 compared to T1. SDNN and TINN indices decreased in T3 compared to T4, the RMSSD and SD1 increased in T4 compared to T1, the SD2 increased compared to T3, and LF (low frequency band) increased in T4 compared to T1 and T3. In the control group, only RMSSD and SD1 increased in T3 compared to T1. Musical auditory stimulation enhanced heart rate autonomic modulation during endodontic treatment.

The Difference Between Exercise-Induced Autonomic and Fitness Changes Measured After 12 and 20 Weeks of Medium-to-High Intensity Military Training

Grant, CC, Mongwe, L, Janse van Rensburg, DC, Fletcher, L, Wood, PS, Terblanche, E, and du Toit, PJ. The difference between exercise-induced autonomic and fitness changes measured after 12 and 20 weeks of medium-to-high intensity military training. J Strength Cond Res 30(9): 2453-2459, 2016-The aim of this study was to compare the physical fitness, based on VO2max and exercise-induced cardiac autonomic changes, measured by heart rate variability (HRV) of 12 weeks with 20 weeks of training in the South African National Defence Force. Recruits (n = 154) participated in a medium-to-high intensity exercise intervention (daily energy expenditure: 8,485 kJ·d). The significant effect on VO2max between weeks 1 and 12 (48.57, SD = 9.25 vs. 53.36, SD = 7.21] did not continue during weeks 12-20 (53.36, SD = 7.21 vs. 53.87, SD = 7.87). No changes in the supine low frequency (LF)/high frequency (HF) (0.48, SD = 0.51 vs. 0.41, SD = 0.64) or the standing LF/HF (4.02, SD = 5.14 vs. 3.91, SD = 5.28), an indicator of autonomic balance and a possible indicator of overtraining syndrome, suggests that overtraining did not take place during weeks 12-20. This was confirmed with further decreases in supine and standing heart rate. However, the power of the vagal-induced variability continued to increase after 12 weeks. Increased vagal influence without concurrent change in autonomic balance may be interpreted as decreased sympathetic cardiac control. It is important to note that although no fitness changes were detected, positive cardiac autonomic conditioning did continue between weeks 12 and 20, as measured by increased vagal-induced HRV and decreased sympathetic influence on cardiac control. Results may be extrapolated to training in the normal population/athletes after a medium-to-high intensity exercise program, as this intervention was a closely monitored and standardized exercise program.

Somatic, Endurance Performance and Heart Rate Variability Profiles of Professional Soccer Players Grouped According to Age

This cross-sectional study compared somatic, endurance performance determinants and heart rate variability (HRV) profiles of professional soccer players divided into different age groups: GI (17–19.9 years; n = 23), GII (20–24.9 years; n = 45), GIII (25–29.9 years; n = 30), and GIV (30–39 years; n = 26). Players underwent somatic and HRV assessment and maximal exercise testing. HRV was analyzed by spectral analysis of HRV, and high (HF) and low (LF) frequency power was transformed by a natural logarithm (Ln). Players in GIV (83 ± 7 kg) were heavier (p < 0.05) compared to both GI (73 ± 6 kg), and GII (78 ± 6 kg). Significantly lower maximal oxygen uptake (VO2max, ml•kg^-1•min^-1) was observed for GIV (56.6 ± 3.8) compared to GI (59.6 ± 3.9), GII (59.4 ± 4.2) and GIV (59.7 ± 4.1). All agegroups, except for GII, demonstrated comparable relative maximal power output (Pmax). For supine HRV, significantly lower Ln HF (ms2) was identified in both GIII (7.1 ± 0.8) and GIV (6.9 ± 1.0) compared to GI (7.9 ± 0.6) and GII (7.7 ± 0.9). In conclusion, soccer players aged >25 years showed negligible differences in Pmax unlike the age group differences demonstrated in VO2max. A shift towards relative sympathetic dominance, particularly due to reduced vagal activity, was apparent after approximately 8 years of competing at the professional level.

Heart Rate Variability (HRV) Analysis: A Methodology for Organizational Neuroscience

Recently, the application of neuroscience methods and findings to the study of organizational phenomena has gained significant interest and converged in the emerging field of organizational neuroscience. Yet, this body of research has principally focused on the brain, often overlooking fuller analysis of the activities of the human nervous system and associated methods available to assess them. In this article, we aim to narrow this gap by reviewing heart rate variability (HRV) analysis, which is that set of methods assessing beat-to-beat changes in the heart rhythm over time, used to draw inference on the outflow of the autonomic nervous system (ANS). In addition to anatomo-physiological and detailed methodological considerations, we discuss related theoretical, ethical, and practical implications. Overall, we argue that this methodology offers the opportunity not only to inform on a wealth of constructs relevant for management inquiries but also to advance the overarching organizational neuroscience research agenda and its ecological validity.

Wrist Pulse Rate Monitor Using Self-Injection-Locked Radar Technology

To achieve sensitivity, comfort, and durability in vital sign monitoring, this study explores the use of radar technologies in wearable devices. The study first detected the respiratory rates and heart rates of a subject at a one-meter distance using a self-injection-locked (SIL) radar and a conventional continuous-wave (CW) radar to compare the sensitivity versus power consumption between the two radars. Then, a pulse rate monitor was constructed based on a bistatic SIL radar architecture. This monitor uses an active antenna that is composed of a SIL oscillator (SILO) and a patch antenna. When attached to a band worn on the subject’s wrist, the active antenna can monitor the pulse on the subject’s wrist by modulating the SILO with the associated Doppler signal. Subsequently, the SILO’s output signal is received and demodulated by a remote frequency discriminator to obtain the pulse rate information.

The physiological basis and measurement of heart rate variability in humans

Cardiovascular variabilities were recognized over 250 years ago, but only in the past 20 years has their apparent utility come to be appreciated. Technological advancement has allowed precise measurement and quantification of short-term cardiovascular fluctuations; however, our understanding of the integrated mechanisms which underlie these oscillations is inadequate for their widespread application. Both autonomic branches, the parasympathetic and sympathetic nervous system, are key determinants of the magnitude of these spontaneous cardiovascular fluctuations. Heart rate variability can be an indicator of an individual cardiovascular condition. In this review, we will discuss the two primary rhythmic oscillations that underlie the complexity of the heart rate waveform. The first oscillation occurs over several cardiac cycles, is respiratory related, and termed respiratory sinus arrhythmia. The second oscillation occurs at an approximate 10 s cycle. Due to the closed-loop nature of the control system of cardiovascular oscillations, it is difficult to define specific relations among cardiovascular variables. In this review, we will present the feedforward and feedback mechanism that underlie both oscillations and their implication as quantitative measures of autonomic circulatory control. We will also review the various methodologies to assess them.

Influence diagram of physiological and environmental factors affecting heart rate variability: an extended literature overview

Heart rate variability (HRV) corresponds to the adaptation of the heart to any stimulus. In fact, among the pathologies affecting HRV the most, there are the cardiovascular diseases and depressive disorders, which are associated with high medical cost in Western societies. Consequently, HRV is now widely used as an index of health.

In order to better understand how this adaptation takes place, it is necessary to examine which factors directly influence HRV, whether they have a physiological or environmental origin. The primary objective of this research is therefore to conduct a literature review in order to get a comprehensive overview of the subject.

The system of these factors affecting HRV can be divided into the following five categories: physiological and pathological factors, environmental factors, lifestyle factors, non-modifiable factors and effects. The direct interrelationships between these factors and HRV can be regrouped into an influence diagram. This diagram can therefore serve as a basis to improve daily clinical practice as well as help design even more precise research protocols.

A computationally efficient nonparametric approach for changepoint detection

In this paper we build on an approach proposed by Zou et al. (2014) for nonparametric changepoint detection. This approach defines the best segmentation for a data set as the one which minimises a penalised cost function, with the cost function defined in term of minus a non-parametric log-likelihood for data within each segment. Minimising this cost function is possible using dynamic programming, but their algorithm had a computational cost that is cubic in the length of the data set. To speed up computation, Zou et al. (2014) resorted to a screening procedure which means that the estimated segmentation is no longer guaranteed to be the global minimum of the cost function. We show that the screening procedure adversely affects the accuracy of the changepoint detection method, and show how a faster dynamic programming algorithm, pruned exact linear time (PELT) (Killick et al. 2012), can be used to find the optimal segmentation with a computational cost that can be close to linear in the amount of data. PELT requires a penalty to avoid under/over-fitting the model which can have a detrimental effect on the quality of the detected changepoints. To overcome this issue we use a relatively new method, changepoints over a range of penalties (Haynes et al. 2016), which finds all of the optimal segmentations for multiple penalty values over a continuous range. We apply our method to detect changes in heart-rate during physical activity.

Heart Rate Variability as a Method for Assessment of the Autonomic Nervous System and the Adaptations to Different Physiological and Pathological Conditions

The autonomic nervous system controls the smooth muscles of the internal organs, the cardiovascular system and the secretory function of the glands and plays a major role in the processes of adaptation. Heart rate variability is a non-invasive and easily applicable method for the assessment of its activity. The following review describes the origin, parameters and characteristics of this method and its potential for evaluation of the changes of the autonomic nervous system activity in different physiological and pathological conditions such as exogenous hypoxia, physical exercise and sleep. The application of heart rate variability in daily clinical practice would be beneficial for the diagnostics, the outcome prognosis and the assessment of the effect of treatment in various diseases.

The Swiss Preschoolers' health study (SPLASHY): objectives and design of a prospective multi-site cohort study assessing psychological and physiological health in young children

Background

Children’s psychological and physiological health can be summarized as the child’s thinking, feeling, behaving, eating, growing, and moving. Children’s psychological and physiological health conditions are influenced by today’s life challenges: Thus, stress exposure and lack of physical activity represent important health challenges in older children. However, corresponding evidence for young children is scarce. The aim of Swiss Preschoolers’ Health Study (SPLASHY) is to examine the role of stress and physical activity on children’s psychological and physiological health, particularly on cognitive functioning, psychological well-being, adiposity and motor skills in children at an early stage of childhood. We will also assess the role of child and environmental characteristics and aim to define sensitive time points.

Methods/design

In a total of 84 child care centers, children at preschool age (2–6 years) are recruited and are assessed immediately and one year later. Assessments include direct measurements of the children in the child care centers and at home as well as assessments of children’s behavior and environmental factors through informants (parents and child care educators).

Discussion

SPLASHY is one of the first studies in early childhood aiming to investigate the influence of stress and physical activity on children’s psychological and physiological health in a community-based longitudinal design.

Trial registration

Current Controlled Trials ISRCTN41045021 (date of registration: 21.03.14)

Transient autonomic responses during sustained attention in high and low fit young adults

Maintaining vigilance over long periods of time is especially critical in performing fundamental everyday activities and highly responsible professional tasks (e.g., driving, performing surgery or piloting). Here, we investigated the role of aerobic fitness as a crucial factor related to the vigilance capacity. To this end, two groups of young adult participants (high-fit and low-fit) were compared in terms of reaction time (RT) performance and event-related heart rate responses in a 60′ version of the psychomotor vigilance task. The results showed shorter RTs in high-fit participants, but only during the first 24′ of the task. Crucially, this period of improved performance was accompanied by a decelerative cardiac response pattern present only in the high-fit group that also disappeared after the first 24′. In conclusion, high aerobic fitness was related to a pattern of transient autonomic responses suggestive of an attentive preparatory state that coincided with improved behavioural performance, and that was sustained for 24′. Our findings highlight the importance of considering the role of the autonomic nervous system reactivity in the relationship between fitness and cognition in general, and sustained attention in particular.

Graphite Based Electrode for ECG Monitoring: Evaluation under Freshwater and Saltwater Conditions

We proposed new electrodes that are applicable for electrocardiogram (ECG) monitoring under freshwater- and saltwater-immersion conditions. Our proposed electrodes are made of graphite pencil lead (GPL), a general-purpose writing pencil. We have fabricated two types of electrode: a pencil lead solid type (PLS) electrode and a pencil lead powder type (PLP) electrode. In order to assess the qualities of the PLS and PLP electrodes, we compared their performance with that of a commercial Ag/AgCl electrode, under a total of seven different conditions: dry, freshwater immersion with/without movement, post-freshwater wet condition, saltwater immersion with/without movement, and post-saltwater wet condition. In both dry and post-freshwater wet conditions, all ECG-recorded PQRST waves were clearly discernible, with all types of electrodes, Ag/AgCl, PLS, and PLP. On the other hand, under the freshwater- and saltwater-immersion conditions with/without movement, as well as post-saltwater wet conditions, we found that the proposed PLS and PLP electrodes provided better ECG waveform quality, with significant statistical differences compared with the quality provided by Ag/AgCl electrodes.

Universal structures of normal and pathological heart rate variability

The circulatory system of living organisms is an autonomous mechanical system softly tuned with the respiratory system, and both developed by evolution as a response to the complex oxygen demand patterns associated with motion. Circulatory health is rooted in adaptability, which entails an inherent variability. Here, we show that a generalized N-dimensional normalized graph representing heart rate variability reveals two universal arrhythmic patterns as specific signatures of health one reflects cardiac adaptability, and the other the cardiac-respiratory rate tuning. In addition, we identify at least three universal arrhythmic profiles whose presences raise in proportional detriment of the two healthy ones in pathological conditions (myocardial infarction; heart failure; and recovery from sudden death). The presence of the identified universal arrhythmic structures together with the position of the centre of mass of the heart rate variability graph provide a unique quantitative assessment of the health-pathology gradient.

The role of heart rate variability in sports physiology

Heart rate variability (HRV) is a relevant marker reflecting cardiac modulation by sympathetic and vagal components of the autonomic nervous system (ANS). Although the clinical application of HRV is mainly associated with the prediction of sudden cardiac death and assessing cardiovascular and metabolic illness progression, recent observations have suggested its applicability to physical exercise training. HRV is becoming one of the most useful tools for tracking the time course of training adaptation/maladaptation of athletes and in setting the optimal training loads leading to improved performances. However, little is known regarding the role of HRV and the internal effects of physical exercise on an athlete, which may be useful in designing fitness programs ensuring sufficient training load that may correspond with the specific ability of the athlete. In this review, we offer a comprehensive assessment of investigations concerning the interrelation between HRV and ANS, and examine how the application of HRV to physical exercise may play a role in sports physiology.

[Options and limitations of heart rate measurement and analysis of heart rate variability by mobile devices: A systematic review]

BACKGROUND

Heart rate (HR) and heart rate variability (HRV) have been established in the last few years as a non-invasive method for recording the demands on the cardiovascular system. The development enables us today to measure the interbeat intervals with different technologies for calculating HR and HRV.

MATERIALS AND METHODS

This review is based on a systematic literature search in PubMed for validity of different measurement techniques and their pros and cons for the measurement of HR and the analysis of HRV.

RESULTS

Measurement equipment for recording of interbeat intervals should have a high storage capacity and a sampling rate of 1000 Hz ideally. The quality criteria of freedom of feedback (small, little disruptive), robustness and a non-invasive measurement (e. g. freeze-electrodes or sensors) have to be fulfilled. In addition to the Holter ECG, several portable heart rate watch and chest belt systems provide adequate validity and good applicability.

DISCUSSION

The Holter ECG is still the gold standard for the measurement of NN intervals and for the analysis of HRV. Modern heart rate watches show a good correlation with the conformance of freedom from discomfort, robustness and non-invasive measurement and are a good alternative due to the lower disturbance of test persons.

[INFLUENCE OF INTERMITTENT NORMOBARIC HYPOXIA ON THE VEGETATIVE HOMEOSTASIS IN CHILDREN FROM RADIOECOLOGICALLY AFFECTED REGIONS]

The effect of intermittent normobaric hypoxia (INH) of sanogenic level on children living in radioactively contaminated territories has been investigated. Children divided into three groups: 37 patients were included in the main group (the 1st group--medical therapy according to the protocols and INH sessions), 35 persons--in the comparison group (the 2nd group--medical therapy), 30 persons--in the control group (the 3rd group--healthy persons). A significant increase in RMSSD index by 36% in phone registration was established in children aged 6-11 years of the main group after combined treatment with INH sessions (10-12% oxygen in nitrogen), and by 27% under the use of orthoclinostatic test in children aged 12-17 years. A decrease of the sympathovagal index by 23% in children aged 6-11 years was demonstrated concerning the group of comparison. The tension index of regulatory systems was decreased in children of both groups, that is indicative of the decrease in the central contour of cardiac rhythm control.

Attenuation of the influence of cardiolocomotor coupling in heart rate variability interpretation during exercise test

During exercise test, cardiolocomotor coupling related components appear in heart rate variability (HRV), blurring its interpretation as autonomic nervous system (ANS) marker. These cardiolocomotor coupling related components are centered at the pedalling and running stride frequency, as well as at their aliases, and may overlap with the low frequency (LF) and high frequency (HF) components of HRV. In this work cardiolocomotor-related HRV components are studied during maximal exercise test on treadmill and cycle ergometer. Power in the bands related to cardiolocomotor coupling increases with exercise intensity in cycle ergometer but not in treadmill exercise test, where it displays higher values for all exercise intensities. A method is proposed to reduce the effect of this coupling in the interpretation of HRV. Evolution of the power in the low frequency (LF) and high frequency (HF) bands are studied after the proposed reduction of cardiolocomotor coupling, showing more significant changes with exercise intensity than before the method is applied.

A Novel Time-Varying Spectral Filtering Algorithm for Reconstruction of Motion Artifact Corrupted Heart Rate Signals During Intense Physical Activities Using a Wearable Photoplethysmogram Sensor

Accurate estimation of heart rates from photoplethysmogram (PPG) signals during intense physical activity is a very challenging problem. This is because strenuous and high intensity exercise can result in severe motion artifacts in PPG signals, making accurate heart rate (HR) estimation difficult. In this study we investigated a novel technique to accurately reconstruct motion-corrupted PPG signals and HR based on time-varying spectral analysis. The algorithm is called Spectral filter algorithm for Motion Artifacts and heart rate reconstruction (SpaMA). The idea is to calculate the power spectral density of both PPG and accelerometer signals for each time shift of a windowed data segment. By comparing time-varying spectra of PPG and accelerometer data, those frequency peaks resulting from motion artifacts can be distinguished from the PPG spectrum. The SpaMA approach was applied to three different datasets and four types of activities: (1) training datasets from the 2015 IEEE Signal Process. Cup Database recorded from 12 subjects while performing treadmill exercise from 1 km/h to 15 km/h; (2) test datasets from the 2015 IEEE Signal Process. Cup Database recorded from 11 subjects while performing forearm and upper arm exercise. (3) Chon Lab dataset including 10 min recordings from 10 subjects during treadmill exercise. The ECG signals from all three datasets provided the reference HRs which were used to determine the accuracy of our SpaMA algorithm. The performance of the SpaMA approach was calculated by computing the mean absolute error between the estimated HR from the PPG and the reference HR from the ECG. The average estimation errors using our method on the first, second and third datasets are 0.89, 1.93 and 1.38 beats/min respectively, while the overall error on all 33 subjects is 1.86 beats/min and the performance on only treadmill experiment datasets (22 subjects) is 1.11 beats/min. Moreover, it was found that dynamics of heart rate variability can be accurately captured using the algorithm where the mean Pearson’s correlation coefficient between the power spectral densities of the reference and the reconstructed heart rate time series was found to be 0.98. These results show that the SpaMA method has a potential for PPG-based HR monitoring in wearable devices for fitness tracking and health monitoring during intense physical activities.

Musculoskeletal overuse injuries and heart rate variability: Is there a link?

Accurate detection and prevention of overuse musculoskeletal injuries is limited by the nature of somatic tissue injury. In the pathogenesis of overuse injuries, it is well recognized that an abnormal inflammatory response occurs within somatic tissue before pain is perceived which can disrupt the normal remodeling process and lead to subsequent degeneration. Current overuse injury prevention methods focused on biomechanical faults or performance standards lack the sensitivity needed to identify the status of tissue injury or repair. Recent evidence has revealed an apparent increase in the prevalence and impact of overuse musculoskeletal injuries in athletics. When compared to acute injuries, overuse injuries have a potentially greater negative impact on athletes' overall health burden. Further, return to sport rehabilitation following overuse injury is complicated by the fact that the absence of pain does not equate to complete physiological healing of the injured tissue. Together, this highlights the need for exercise monitoring and injury prevention methods which incorporate assessment of somatic tissue response to loading. One system primarily involved in the activation of pathways and neuromediators responsible for somatic tissue repair is the autonomic nervous system (ANS). Although not completely understood, emerging research supports the critical importance of peripheral ANS activity in the health and repair of somatic tissue injury. Due to its significant contributions to cardiac function, ANS activity can be measured indirectly with heart rate monitoring. Heart rate variability (HRV) is one index of ANS activity that has been used to investigate the relationship between athletes' physiological response to accumulating training load. Research findings indicated that HRV may provide a reflection of ANS homeostasis, or the body's stress-recovery status. This noninvasive marker of the body's primary driver of recovery has the potential to incorporate important and as yet unmonitored physiological mechanisms involved in overuse injury development. We hypothesize that abnormal somatic tissue response to accumulating microtrauma may modulate ANS activity at the level of HRV. Exploring the link between HRV modulation and somatic tissue injury has the potential to reveal the putative role of ANS homeostasis on overuse musculoskeletal injury development.

Does a 20-week aerobic exercise training programme increase our capabilities to buffer real-life stressors? A randomized, controlled trial using ambulatory assessment

PURPOSE

The cross-stressor adaptation hypothesis suggests that regular exercise leads to adaptations in the stress response systems that induce decreased physiological responses to psychological stressors. Even though an exercise intervention to buffer the detrimental effects of psychological stressors on health might be of utmost importance, empirical evidence is mixed. This may be explained by the use of cross-sectional designs and non-personally relevant stressors. Using a randomized controlled trial, we hypothesized that a 20-week aerobic exercise training does reduce physiological stress responses to psychological real-life stressors in sedentary students.

METHODS

Sixty-one students were randomized to either a control group or an exercise training group. The academic examination period (end of the semester) served as a real-life stressor. We used ambulatory assessment methods to assess physiological stress reactivity of the autonomic nervous system (heart rate variability: LF/HF, RMSSD), physical activity and perceived stress during 2 days of everyday life and multilevel models for data analyses. Aerobic capacity (VO2max) was assessed pre- and post-intervention via cardiopulmonary exercise testing to analyze the effectiveness of the intervention.

RESULTS

During real-life stressors, the exercise training group showed significantly reduced LF/HF (β = -0.15, t = -2.59, p = .01) and increased RMSSD (β = 0.15, t = 2.34, p = .02) compared to the control group.

CONCLUSIONS

Using a randomized controlled trial and a real-life stressor, we could show that exercise appears to be a useful preventive strategy to buffer the effects of stress on the autonomic nervous system, which might result into detrimental health outcomes.

The Effects of 17 Weeks of Ballet Training on the Autonomic Modulation, Hormonal and General Biochemical Profile of Female Adolescents

This study aimed to examine the alterations in physiological and biochemical markers, after 17 weeks of ballet training in high level ballet dancers. Twenty four female ballet dancers from 12 to 15 years old took part in the study. The study followed 17 weeks of ballet training and analyzed changes in body composition, the autonomic nervous system and biochemical variables before and after (post) training. The internal training load was obtained using the session rating of perceived exertion (session-RPE) method, calculated as the mean weekly session-RPE, monotony and strain. After 17 weeks of training there were significant increases in body mass, height, lean body mass, total protein, urea, hemoglobin concentration, testosterone and thyroxine. During this period, decreases in relative body fat, uric acid, red blood cells, C-reactive protein, and ferritin were also found. After the training period, the autonomic modulation demonstrated significant positive alterations, such as increases in parasympathetic related indices. Based on the results obtained we concluded that ballet training led to improvements in body composition and autonomic modulation. In general hematological and biochemical variables demonstrated that the training did not have adverse effects on the health state of the adolescents.

Effect of a Six-Week Preparation Period on Acute Physiological Responses to a Simulated Combat in Young National-Level Taekwondo Athletes

The aim of this study was to examine changes in physical attributes, physiological characteristics and responses that occurred in a simulated combat during a six-week preparatory period in young taekwondo athletes. Seven athletes (age 12.17 ± 1.11 years) were examined before (pre-intervention) and after (post-intervention) a preparatory period for physical fitness and physiological responses to a 2×90 s simulated bout with a 30 s rest period. The heart rate (HR) was monitored during the simulated combat, and handgrip muscle strength (HMS) along with the countermovement jump (CMJ) were recorded before and after the combat. When compared with pre-intervention values, in post-intervention we observed a decrease in body mass, body fat percentage, and the HR at rest and during recovery after a 3 min step test, and an increase in maximal velocity of the cycle ergometer force-velocity test, the CMJ and mean power during the 30 s continuous jumping test (p<0.05). Furthermore, HR responses to a simulated combat were lower in the post-intervention session (p<0.05). CMJ values increased after the bout in both pre and post-intervention, with higher absolute values in the latter case (p<0.05), whereas there was no difference in HMS. Based on these findings, it can be concluded that the acute physiological responses to a simulated taekwondo combat vary during a season, which might be explained by changes in physical fitness.

Effects of exercise on cardiac autonomic modulation in children: literature update

AbstractIntroduction It is known that physical exercise is beneficial and precipitates adjustments to the autonomic nervous system. However, the effect of exercise on cardiac autonomic modulation in children, despite its importance, is poorly investigated.Objective To bring together current information about the effects of exercise on heart rate variability in healthy and obese children.Methods The literature update was performed through a search for articles in the following databases; PubMed, PEDro, SciELO and Lilacs, using the descriptors “exercise” and “child” in conjunction with the descriptors “autonomic nervous system”, “sympathetic nervous system”, “parasympathetic nervous system” and also with no descriptor, but the key word of this study, “heart rate variability”, from January 2005 to December 2012.Results After removal of items that did not fit the subject of the study, a total of 9 articles were selected, 5 with healthy and 4 with obese children.Conclusion The findings suggest that exercise can act in the normalization of existing alterations in the autonomic nervous system of obese children, as well as serve as a preventative factor in healthy children, enabling healthy development of the autonomic nervous system until the child reaches adulthood.

Brazilian Jiu-Jitsu Simulated Competition Part I: Metabolic, Hormonal, Cellular Damage, and Heart Rate Responses

The aim of this study was to analyze physiological responses in Brazilian jiu-jitsu athletes during simulated competition. To this end, 10 athletes (age: 28 ± 4 years, body mass: 81.8 ± 7.4 kg, body fat: 13.0 ± 4.8%, systematic practice: 11 ± 4 years) were analyzed in simulated competition (4 matches of 10 minutes). Blood samples were taken to assess energy demand, hormonal responses, and cell damage. Additionally, the heart rate variability (HRV) response was analyzed. The main results show that in simulated competition, during the last matches, athletes had lower lactate (p < 0.001), epinephrine (p < 0.001), norepinephrine (p < 0.001), and insulin (p = 0.002) concentrations. Increases observed in creatine kinase (p < 0.001), aspartate aminotransferase (p < 0.001), alanine aminotransferase (p = 0.007), and creatinine (p < 0.001) seen, especially, in the last matches are indicative of possible cell damage. The HRV reflected a decrease in the RR medium (average of the normal R-R intervals) (p = 0.001) during the competition. Thus, it is concluded that successive matches from competition generate a gradual decrease of adrenergic and glycolytic activities, which is accompanied by a gradual increase in cell damage markers and decrease in the RR medium of the HRV.

Variations of high frequency parameter of heart rate variability following osteopathic manipulative treatment in healthy subjects compared to control group and sham therapy: randomized controlled trial

Context: Heart Rate Variability (HRV) indicates how heart rate changes in response to inner and external stimuli. HRV is linked to health status and it is an indirect marker of the autonomic nervous system (ANS) function.

Objective: To investigate the influence of osteopathic manipulative treatment (OMT) on cardiac autonomic modulation in healthy subjects, compared with sham therapy and control group.

Methods: Sixty-six healthy subjects, both male and female, were included in the present 3-armed randomized placebo controlled within subject cross-over single blinded study. Participants were asymptomatic adults (26.7 ± 8.4 y, 51% male, BMI 18.5 ± 4.8), both smokers and non-smokers and not on medications. At enrollment subjects were randomized in three groups: A, B, C. Standardized structural evaluation followed by a patient need-based osteopathic treatment was performed in the first session of group A and in the second session of group B. Standardized evaluation followed by a protocoled sham treatment was provided in the second session of group A and in the first session of group B. No intervention was performed in the two sessions of group C, acting as a time-control. The trial was registered on clinicaltrials.gov identifier: NCT01908920.

Main Outcomes Measures: HRV was calculated from electrocardiography before, during and after the intervention, for a total amount time of 25 min and considering frequency domain as well as linear and non-linear methods as outcome measures.

Results: OMT engendered a statistically significant increase of parasympathetic activity, as shown by High Frequency power (p < 0.001), expressed in normalized and absolute unit, and possibly decrease of sympathetic activity, as revealed by Low Frequency power (p < 0.01); results also showed a reduction of Low Frequency/High Frequency ratio (p < 0.001) and Detrended fluctuation scaling exponent (p < 0.05).

Conclusions: Findings suggested that OMT can influence ANS activity increasing parasympathetic function and decreasing sympathetic activity, compared to sham therapy and control group.

Autonomic dysfunction in early breast cancer: Incidence, clinical importance, and underlying mechanisms

Autonomic dysfunction represents a loss of normal autonomic control of the cardiovascular system associated with both sympathetic nervous system overdrive and reduced efficacy of the parasympathetic nervous system. Autonomic dysfunction is a strong predictor of future coronary heart disease, vascular disease, and sudden cardiac death. In the current review, we will discuss the clinical importance of autonomic dysfunction as a cardiovascular risk marker among breast cancer patients. We will review the effects of antineoplastic therapy on autonomic function, as well as discuss secondary exposures, such as psychological stress, sleep disturbances, weight gain/metabolic derangements, and loss of cardiorespiratory fitness, which may negatively impact autonomic function in breast cancer patients. Lastly, we review potential strategies to improve autonomic function in this population. The perspective can help guide new therapeutic interventions to promote longevity and cardiovascular health among breast cancer survivors.

Monitoring athletic training status using the maximal rate of heart rate increase

OBJECTIVES

Reductions in maximal rate of heart rate increase (rHRI) correlate with performance reductions when training load is increased. This study evaluated whether rHRI tracked performance changes across a range of training states.

DESIGN

Prospective intervention.

METHODS

rHRI was assessed during five min of cycling at 100W (rHRIcyc) and running at 8km/h (rHRIrun) in 13 male triathletes following two weeks of light-training (LT), two weeks of heavy-training (HT) and a two-day recovery period (RP). A five min cycling time-trial assessed performance and peak oxygen consumption (V˙O2peak).

RESULTS

Performance likely decreased following HT (Effect size±90% confidence interval=-0.18±0.09), then very likely increased following RP (0.32±0.14). rHRIcyc very likely decreased (-0.48±0.24), and rHRIrun possibly decreased (-0.33±0.48), following HT. Changes in both measures were unclear following RP. Steady-state HR was almost certainly lower (-0.81±0.31) during rHRIcyc than rHRIrun. A large correlation was found between reductions in performance and rHRIrun (r±90%; CI=0.65±0.34) from LT to HT, but was unclear for rHRIcyc. Trivial within-subject correlations were found between rHRI and performance, but the strength of relationship between rHRIrun and performance was largely associated with V˙O2peak following LT (r=-0.58±0.38).

CONCLUSIONS

Performance reductions were most sensitively tracked by rHRIrun following HT. This may be due to rHRIrun being assessed at a higher intensity than rHRIcyc, inferred from a higher steady-state HR and supported by a stronger within-subject relationship between rHRIrun and performance in individuals with a lower V˙O2peak, in whom the same exercise intensity would represent a greater physiological stress. rHRI assessed at relatively high exercise intensities may better track performance changes.

Heart rate recovery in elite athletes: the impact of age and exercise capacity

There is compelling evidence that postexercise heart rate recovery (HRR) is a valid indicator of sympaticovagal balance. It is also used in prescription and monitoring of athletic training. The purpose of our study was to determine HRR after maximal exercise among elite athletes with respect to age. A total of 274 elite male Caucasian athletes were randomly selected from the larger sample and divided into two groups: adolescent (group Y) and adult athletes (≥18 years; group A). They performed maximal cardiopulmonary exercise testing on a treadmill. Heart rate recovery was calculated as the rate of decline of HR from peak exercise to rates 1, 2 and 3 min after cessation of exercise (HRR1, HRR2 and HRR3). A significantly higher HRR1 was found in group A (29·5 ± 15·6 versus 22·4 ± 10·8, P<0·001), but HRR3 was higher in group Y (82·7 ± 10·2 versus 79·9 ± 12·25; P = 0·04). Stepwise multivariate linear regression analysis showed that, among all subjects, the HRR1 alone was independently associated with age (P<0·001). The maximal oxygen consumption (VO₂ max) was in a negative relationship with HRR1 and in a positive one with HRR3 (P<0·05) with respect to all athletes. The HRR during 3 min postexercise should be reported for the purpose of better assessing functional adaptation to exercise among elite athletes as well as the age-associated differences in recovery. Higher values of HRR1 should be expected in older athletes, and HRR3 could be used as an index of aerobic capacity, irrespective of age.

Dynamic heart rate measurements from video sequences

This paper shows how dynamic heart rate measurements that are typically obtained from sensors mounted near to the heart can also be obtained from video sequences. In this study, two experiments are carried out where a video camera captures the facial images of the seven subjects. The first experiment involves the measurement of subjects' increasing heart rates (79 to 150 beats per minute (BPM)) while cycling whereas the second involves falling heart beats (153 to 88 BPM). In this study, independent component analysis (ICA) is combined with mutual information to ensure accuracy is not compromised in the use of short video duration. While both experiments are going on measures of heartbeat using the Polar heart rate monitor is also taken to compare with the findings of the proposed method. Overall experimental results show the proposed method can be used to measure dynamic heart rates where the root mean square error (RMSE) and the correlation coefficient are 1.88 BPM and 0.99 respectively.

Response of cardiac autonomic modulation after a single exposure to musical auditory stimulation

The acute effects after exposure to different styles of music on cardiac autonomic modulation assessed through heart rate variability (HRV) analysis have not yet been well elucidated. We aimed to investigate the recovery response of cardiac autonomic modulation in women after exposure to musical auditory stimulation of different styles. The study was conducted on 30 healthy women aged between 18 years and 30 years. We did not include subjects having previous experience with musical instruments and those who had an affinity for music styles. The volunteers remained at rest for 10 min and were exposed to classical baroque (64-84 dB) and heavy metal (75-84 dB) music for 10 min, and their HRV was evaluated for 30 min after music cessation. We analyzed the following HRV indices: Standard deviation of normal-to-normal (SDNN) intervals, root mean square of successive differences (RMSSD), percentage of normal-to-normal 50 (pNN50), low frequency (LF), high frequency (HF), and LF/HF ratio. SDNN, LF in absolute units (ms 2 ) and normalized (nu), and LF/HF ratio increased while HF index (nu) decreased after exposure to classical baroque music. Regarding the heavy metal music style, it was observed that there were increases in SDNN, RMSSD, pNN50, and LF (ms 2 ) after the musical stimulation. In conclusion, the recovery response of cardiac autonomic modulation after exposure to auditory stimulation with music featured an increased global activity of both systems for the two musical styles, with a cardiac sympathetic modulation for classical baroque music and a cardiac vagal tone for the heavy metal style.