Heart Rate Variability Monitoring During Strength and High-Intensity Interval Training Overload Microcycles

Classification of exercise fatigue levels by multi-class SVM from ECG and HRV

Among the various physiological signals, electrocardiogram (ECG) is a valid criterion for the classification of various exercise fatigue. In this study, we combine features extracted by deep neural networks with linear features from ECG and heart rate variability (HRV) for exercise fatigue classification. First, the ECG signals are converted into 2-D images by using the short-term Fourier transform (STFT), and image features are extracted by the visual geometry group (VGG) . The extracted image and linear features of ECG and HRV are sent to the different types of classifiers to distinguish distinct exercise fatigue level. To validate performance, the proposed methods are tested on (i) an open-source EPHNOGRAM dataset and (ii) a self-collected dataset (n = 51). The results reveal that the classification based on the concatenated features has the highest accuracy, and the calculation time of the system is also significantly reduced. This demonstrates that the proposed novel hybrid approach can be used to assist in improving the accuracy and timeliness of exercise fatigue classification in a real-time exercise environment. The experimental results show that the proposed method outperforms other recent state-of-the-art methods in terms of accuracy 96.90%, sensitivity 96.90%, F1-score of 0.9687 in EPHNOGRAM and accuracy 92.17%, sensitivity 92.63%, F1-score of 0.9213 in self-collected dataset.

Heart rate variability, recovery and stress analysis of an elite rally driver and co-driver during a competition period

To ensure both optimal health and performances, monitoring physiological and psychological states is of main importance for athletes. It is well known that monitoring heart rate variability and using validated questionnaires is useful for monitoring both the health and training status of athletes of different sports. Motorsports such as rally require high levels of physical and mental preparation thus information about psychophysiological status of rally athletes is fundamental. The aim of this study was to assess the autonomic regulation, stress, recovery conditions of one driver and one co-driver competing at the Italian National Rally Championship during their competition period. Heart rate variability parameters, acute recovery and stress states were assessed the day before, during the two days of race and the day following the races. Results showed that driver and co-driver had a sharp decrease of mean RR intervals, root mean square of successive differences between normal heartbeats, and standard deviation of the N-N interval during race days, while the stress index showed the inverse trend, and this behaviour was clearly visible in the Poincaré plots and power spectrum density graphs. The acute recovery and stress states questionnaire showed significant differences in recovery and stress scoring for the driver but not for the co-driver, although the trends were similar. This study describes the psychophysiological demands of a rally competition period suggesting that a daily evaluation of heart rate variability, recovery, stress states is useful for monitoring health status in rally athletes and could be implemented to make decision about training and recovery strategies.

Cardiorespiratory dynamics during respiratory maneuver in athletes

Introduction: The modern practice of sports medicine and medical rehabilitation requires the search for subtle criteria for the development of conditions and recovery of the body after diseases, which would have a prognostic value for the prevention of negative effects of training and rehabilitation tools, and also testify to the development and course of mechanisms for counteracting pathogenetic processes in the body. The purpose of this study was to determine the informative directions of the cardiorespiratory system parameters dynamics during the performing a maneuver with a change in breathing rate, which may indicate the body functional state violation.

Methods: The results of the study of 183 healthy men aged 21.2 ± 2.3 years who regularly engaged in various sports were analyzed. The procedure for studying the cardiorespiratory system included conducting combined measurements of indicators of activity of the respiratory and cardiovascular systems in a sitting position using a spiroarteriocardiograph device. The duration of the study was 6 min and involved the sequential registration of three measurements with a change in breathing rate (spontaneous breathing, breathing at 0.1 Hz and 0.25 Hz).

Results: Performing a breathing maneuver at breathing 0.1 Hz and breathing 0.25 Hz in comparison with spontaneous breathing leads to multidirectional significant changes in heart rate variability indicators–TP (ms2), LF (ms2), LFHF (ms2/ms2); of blood pressure variability indicators–TPDBP (mmHg2), LFSBP (mmHg2), LFDBP (mmHg2), HFSBP (mmHg2); of volume respiration variability indicators - LFR, (L×min-1)2; HFR, (L×min-1)2; LFHFR, (L×min-1)2/(L×min-1)2; of arterial baroreflex sensitivity indicators - BRLF (ms×mmHg-1), BRHF (ms×mmHg-1). Differences in indicators of systemic hemodynamics and indicators of cardiovascular and respiratory systems synchronization were also informative.

Conclusion: According to the results of the study, it is shown that during performing a breathing maneuver with a change in the rate of breathing, there are significant changes in cardiorespiratory parameters, the analysis of which the increments made it possible to determine of the changes directions dynamics, their absolute values and informative limits regarding the possible occurrence of the cardiorespiratory interactions dysregulation.

Cardiorespiratory dynamics during respiratory maneuver in athletes

Introduction: The modern practice of sports medicine and medical rehabilitation requires the search for subtle criteria for the development of conditions and recovery of the body after diseases, which would have a prognostic value for the prevention of negative effects of training and rehabilitation tools, and also testify to the development and course of mechanisms for counteracting pathogenetic processes in the body. The purpose of this study was to determine the informative directions of the cardiorespiratory system parameters dynamics during the performing a maneuver with a change in breathing rate, which may indicate the body functional state violation. Methods: The results of the study of 183 healthy men aged 21.2 ± 2.3 years who regularly engaged in various sports were analyzed. The procedure for studying the cardiorespiratory system included conducting combined measurements of indicators of activity of the respiratory and cardiovascular systems in a sitting position using a spiroarteriocardiograph device. The duration of the study was 6 min and involved the sequential registration of three measurements with a change in breathing rate (spontaneous breathing, breathing at 0.1 Hz and 0.25 Hz). Results: Performing a breathing maneuver at breathing 0.1 Hz and breathing 0.25 Hz in comparison with spontaneous breathing leads to multidirectional significant changes in heart rate variability indicators-TP (ms2), LF (ms2), LFHF (ms2/ms2); of blood pressure variability indicators-TPDBP (mmHg2), LFSBP (mmHg2), LFDBP (mmHg2), HFSBP (mmHg2); of volume respiration variability indicators - LFR, (L×min-1)2; HFR, (L×min-1)2; LFHFR, (L×min-1)2/(L×min-1)2; of arterial baroreflex sensitivity indicators - BRLF (ms×mmHg-1), BRHF (ms×mmHg-1). Differences in indicators of systemic hemodynamics and indicators of cardiovascular and respiratory systems synchronization were also informative. Conclusion: According to the results of the study, it is shown that during performing a breathing maneuver with a change in the rate of breathing, there are significant changes in cardiorespiratory parameters, the analysis of which the increments made it possible to determine of the changes directions dynamics, their absolute values and informative limits regarding the possible occurrence of the cardiorespiratory interactions dysregulation.

Racial Differences in Blood Pressure and Autonomic Recovery Following Acute Supramaximal Exercise in Women

Despite the growing popularity of high-intensity anaerobic exercise, little is known about the acute effects of this form of exercise on cardiovascular hemodynamics or autonomic modulation, which might provide insight into the individual assessment of responses to training load. The purpose of this study was to compare blood pressure and autonomic recovery following repeated bouts of acute supramaximal exercise in Black and White women. A convenience sample of twelve White and eight Black young, healthy women were recruited for this study and completed two consecutive bouts of supramaximal exercise on the cycle ergometer with 30 min of recovery in between. Brachial and central aortic blood pressures were assessed by tonometry (SphygmoCor Xcel) at rest and 15-min and 30-min following each exercise bout. Central aortic blood pressure was estimated using brachial pressure waveforms and customized software. Autonomic modulation was measured in a subset of ten participants by heart-rate variability and baroreflex sensitivity. Brachial mean arterial pressure and diastolic blood pressure were significantly higher in Blacks compared to Whites across time (race effect, p = 0.043 and p = 0.049, respectively). Very-low-frequency and low-frequency bands of heart rate variability, which are associated with sympathovagal balance and vasomotor tone, were 22.5% and 24.9% lower, respectively, in Blacks compared to Whites (race effect, p = 0.045 and p = 0.006, respectively). In conclusion, the preliminary findings of racial differences in blood pressure and autonomic recovery following supramaximal exercise warrant further investigations of tailored exercise prescriptions for Blacks and Whites.

Comparison of Two Types of High-Intensity Interval Training: Heart Rate Based vs. Speed/Time Based

Background: Monitoring exercise intensity accurately is a constant concern for athletes and researchers. Objectives: The objective of this study was to compare the effects of controlling high-intensity interval training (HIIT) with heart rate (HTHR) and speed/time (HTST) on some fatigue-related variables. Methods: Twenty young male athletes (age 22.75 ± 2.5 years, weight 76.6 ± 8.8 kg, height 179.7 ± 6.5 cm) were randomly allocated to one of the two arms. Then two-time acute running was performed with intensity control based on heart rates (HR) and speed/time for 40 min on the treadmill with a one-week washout. In order to measure vVo2max, a VIFT test (30 - 15 intermittent fitness test) was taken. Serum levels of glucose, lactate, glycerol, pyruvate, and creatine kinase were measured before and at the end of each exercise. The normality of data was determined by the Shapiro-Wilk test. The t-test and univariate test were used to analyze within- and inter-group changes between the two types of HIIT, respectively. Results: The speed decreases at the identical intensity HTHR over time. The average speed in HTST was significantly higher (P < 0.05), but the maximum and minimum speed in HTHR was significantly higher and lower, respectively. The average distance covered by subjects in HTST was significantly higher (P < 0.05). The post-exercise blood fatigue indexes (i.e., pH, creatine kinase, lactate, glycerol, lactate/pyruvate, and glucose) in HTHR was significantly less compared to those in HTST. Heart rate increases at the identical intensity based on vVIFT in HTST gradually. Conclusions: In general, HTHR can exert the recovery and relative intensity between subjects more accurately. In fact, training based on HR, in contrast to speed/time, decreases internal load differences and increases external load differences between individuals.

Heart Rate Estimation in Sports Based on Multi-Sensor Data for Sports Intensity Prediction

The heart rate (HR) is the most common measurement of the cardiovascular system. It reflects not only the cardiovascular function, but also the degree of recovery, and has high reliability. The heart rate monitoring can be used in athlete selection, sports training, medical supervision, and fitness to avoid the blindness of exercise intensity arrangement, provide an objective quantitative standard for scientific fitness, and improve the sports performance through monitoring sports intensity. In order to accurately predict the sports intensity, this paper adopts ECG signals and pulse wave to learn an ordinal regression model that can utilize the order relation between different sports intensity level. The experimental results have demonstrated the effectiveness of the proposed sports intensity method.

A Validation Study of Heart Rate Variability Index in Monitoring Basketball Training Load

This study aimed to investigate whether the heart rate variability index (TL_HRV) during five ball-drills could be used to quantify training load (TL) in collegiate basketball players. Ten elite male college basketball athletes (18.2 ± 0.4 years) were recruited to perform five ball-drills (1V1, 2V2, 3V3, 4V4, and 5V5) which lasted 10 min and varied in intensity. During each drill, TL_HRV, training impulse (TRIMP), rating of perceived exertion (RPE), speed, and distance were recorded by Firstbeat, Foster’s RPE scale, and SiMi Scout. The correlation (Spearman’s and Pearson’s correlation coefficient), reliability (intra-class correlation coefficient, ICC), and agreement (Bland-Altman plots) among TL_HRV, TRIMP, RPE, speed, and distance were examined. TL_HRV was significantly correlated with TRIMP (r = 0.34, p = 0.015) and RPE (r = 0.42, p = 0.002). TL_HRV was significantly correlated with training intensity (r = 0.477, p = 0.006) but not with volume (r = 0.272, p = 0.056). TL_HRV and TRIMP, RPE showed significant intraclass relationships (ICC = 0.592, p = 0.0003). Moreover, TL_HRV differentiated basketball drills of equal volume and varying intensity. We concluded that TL_HRVmay serve as an objective and rational measure to monitor TL in basketball players.

Impact of sodium citrate ingestion during recovery after strenuous exercise in the heat on heart rate variability: A randomized, crossover study

Changes in hydration status influence plasma volume (PV) which is associated with post-exercise parasympathetic reactivation. The present study hypothesized that, after dehydrating cycling exercise in the heat (DE), stimulation of PV expansion with sodium citrate (CIT) supplementation would promote heart rate variability (HRV) recovery in endurance-trained men. Twelve participants lost 4% of body mass during DE. During subsequent 16-h recovery, participants consumed water ad libitum (CIT =5.5-L, PLC =5.1-L) and ate prescribed food supplemented with CIT or placebo in a randomized, double-blind, crossover manner. Relative changes in PV were assessed across DE and 16-h recovery. HRV was analyzed before and 16 h after DE in three conditions for altogether four 5-min periods: supine in a thermoneutral environment, supine in the heat (32°C, 46% relative humidity; 2 periods), and standing in the heat. A larger expansion of PV across 16-h recovery occurred in CIT compared to placebo trial (p < 0.0001). However, no between-trial differences appeared in HRV parameters (lnRMSSD, lnSDNN, lnLF/HF) in any 5-min period analyzed before or 16 h after DE (in all cases p > 0.05). Increases in HR (p < 0.001) and lnLF/HF (p = 0.005) and decreases in lnRMSSD (p < 0.001) and lnSDNN (p < 0.001) occurred following DE in both trials. Larger PV expansion induced by CIT supplementation after DE does not improve recovery of HRV at rest and has no influence on HRV responsiveness in endurance-trained men.

Effects of Acute Partial Sleep Deprivation and High-Intensity Interval Exercise on Postprandial Network Interactions

Introduction: High-intensity interval exercise (HIIE) is deemed effective for cardiovascular and autonomic nervous system (ANS) health-related benefits, while ANS disturbance increases the risk for cardiovascular disease (CVD). Postprandial lipemia and acute-partial sleep deprivation (APSD) are considered as CVD risk factors due to their respective changes in ANS. Exercising in the morning hours after APSD and have a high-fat breakfast afterwards may alter the interactions of the cardiovascular, autonomic regulation, and postprandial lipemic systems threatening individuals' health. This study examined postprandial network interactions between autonomic regulation through heart rate variability (HRV) and lipemia via low-density lipoprotein (LDL) cholesterol in response to APSD and HIIE. Methods: Fifteen apparently healthy and habitually good sleepers (age 31 ± 5.2 SD yrs) completed an acute bout of an isocaloric HIIE (in form of 3:2 work-to-rest ratio at 90 and 40% of VO₂ reserve) after both a reference sleep (RSX) and 3-3.5 h of acute-partial sleep deprivation (SSX) conditions. HRV time and frequency domains and LDL were evaluated in six and seven time points surrounding sleep and exercise, respectively. To identify postprandial network interactions, we constructed one correlation analysis and one physiological network for each experimental condition. To quantify the interactions within the physiological networks, we also computed the number of links (i.e., number of significant correlations). Results: We observed an irruption of negative links (i.e., negative correlations) between HRV and LDL in the SSX physiological network compared to RSX. Discussion: We recognize that a correlation analysis does not constitute a true network analysis due to the absence of analysis of a time series of the original examined physiological variables. Nonetheless, the presence of negative links in SSX reflected the impact of sleep deprivation on the autonomic regulation and lipemia and, thus, revealed the inability of HIIE to remain cardioprotective under APSD. These findings underlie the need to further investigate the effects of APSD and HIIE on the interactions among physiological systems.

High-Intensity Functional Training Guided by Individualized Heart Rate Variability Results in Similar Health and Fitness Improvements as Predetermined Training with Less Effort

Heart rate variability (HRV) may be useful for prescribing high-intensity functional training (HIFT) exercise programs. This study aimed to compare effects of HRV-guided and predetermined HIFT on cardiovascular function, body composition, and performance.

METHODS

Recreationally-active adults (n = 55) were randomly assigned to predetermined HIFT (n = 29, age = 24.1 ± 4.1 years) or HRV-guided HIFT (n = 26, age = 23.7 ± 4.5) groups. Both groups completed 11 weeks of daily HRV recordings, 6 weeks of HIFT (5 d·week-1), and pre- and post-test body composition and fitness assessments. Meaningful changes in resting HRV were used to modulate (i.e., reduce) HRV-guided participants' exercise intensity. Linear mixed models were used with Bonferroni post hoc adjustment for analysis.

RESULTS

All participants significantly improved resting heart rate, lean mass, fat mass, strength, and work capacity. However, no significant between-groups differences were observed for cardiovascular function, body composition, or fitness changes. The HRV-guided group spent significantly fewer training days at high intensity (mean difference = -13.56 ± 0.83 days; p < 0.001).

CONCLUSION

HRV-guided HIFT produced similar improvements in cardiovascular function, body composition, and fitness as predetermined HIFT, despite fewer days at high intensity. HRV shows promise for prescribing individualized exercise intensity during HIFT.

Effects of High-Intensity Interval Exercise and Acute Partial Sleep Deprivation on Cardiac Autonomic Modulation

Sleep deprivation in healthy adults has been associated with disrupted autonomic nervous system function, which in turn has been linked to cardiovascular health. High-intensity interval exercise (HIIE) may affect both sleep and cardiac autonomic modulation. Purpose: To investigate the impact of acute partial sleep deprivation on autonomic cardiac regulation before and after an acute bout of HIIE and the length of time for the autonomic system to return to resting levels. Methods: Fifteen healthy males with body mass index (BMI) of 25.8 ± 2.7 kg·m^-2 and age 31 ± 5 y participated in a reference sleep (~9.5 hr) with no HIIE (RS), a reference sleep with HIIE (RSX), and an acute partial sleep deprivation (~3.5 hr) with HIIE (SDX). HIIE was performed in 3:2 intervals at 90% and 40% of VO₂ reserve. Autonomic regulation through HRV selected time and frequency domain indices were recorded the night before, the morning of the next day, 1 hr-, 2 hr-, 4hr-, and 6-hr post-exercise. Results: HIIE performed in a 3:2 W:R ratio decreased the HRV (p < .05) at 1-hr post exercise and it took up to 4 hr to return to baseline levels. Parasympathetic related HRV indices increased the morning of the next day for SDX (p < .05). Acute partial sleep deprivation and HIIE did not modify the HRV responses compared to reference sleep and HIIE. Conclusion: HRV disturbance typically seen in responses to an acute episode of HIIE is not influenced by acute partial sleep deprivation.

Cardiac Autonomic Modulation in Response to Muscle Fatigue and Sex Differences During Consecutive Competition Periods in Young Swimmers: A Longitudinal Study

Objective: To study the differences in cardiac autonomic modulation in response to muscle fatigue caused by high-intensity exercise during two consecutive competition periods in young swimmers. Methods: Twenty-six competitive swimmers, selected by their training volume, were separated in two groups, females (n = 12 [46%], age: 13.5 ± 1.4 years) and males (n = 14 [54%], age: 13.9 ± 1.7 years), aged between 10 and 16 years, were evaluated five times as follow: (i) 21 days before the first competition (t-0); (ii) two days before (t-1; t-3); and (iii) two days after (t-2; t-4) of the first and second competitions. Morphological measurements (body mass, percentage of total body fat and height), blood pressure, power, and resting heart rate variability (RR with Polar band) were recorded before and after Wingate test at each time. Results: Body fat was higher in females compared to males. However, no differences were found in other morphological parameters. An intra-subject analysis grouped by sex in cardiovascular parameters shows longitudinal variations in systolic pressure and mean pressure among females. Additionally, females depicted higher, very low frequency (VLF, which is intrinsically generated by the heart and strongly associated with emotional stress) after physical fatigue compared to males at t-1. Further, before the competition, the high frequency (HF) component of HRV (parasympathetic drive) was higher in males than females at t-0 and t-4. Conclusion: Our data revealed that males displayed greater parasympathetic reactivity after an anaerobic muscle fatigue test during their competition periods. Contrarily, females had a less cardiac autonomic modulation when comparing the pre-post Wingate test after two consecutive competition periods.

Trends in Heart-Rate Variability Signal Analysis

Heart rate variability (HRV) is the rate of variability between each heartbeat with respect to time. It is used to analyse the Autonomic Nervous System (ANS), a control system used to modulate the body's unconscious action such as cardiac function, respiration, digestion, blood pressure, urination, and dilation/constriction of the pupil. This review article presents a summary and analysis of various research works that analyzed HRV associated with morbidity, pain, drowsiness, stress and exercise through signal processing and machine learning methods. The points of emphasis with regards to HRV research as well as the gaps associated with processes which can be improved to enhance the quality of the research have been discussed meticulously. Restricting the physiological signals to Electrocardiogram (ECG), Electrodermal activity (EDA), photoplethysmography (PPG), and respiration (RESP) analysis resulted in 25 articles which examined the cause and effect of increased/reduced HRV. Reduced HRV was generally associated with increased morbidity and stress. High HRV normally indicated good health, and in some instances, it could signify clinical events of interest such as drowsiness. Effective analysis of HRV during ambulatory and motion situations such as exercise, video gaming, and driving could have a significant impact toward improving social well-being. Detection of HRV in motion is far from perfect, situations involving exercise or driving reported accuracy as high as 85% and as low as 59%. HRV detection in motion can be improved further by harnessing the advancements in machine learning techniques.

Utilizing Heart Rate Variability for Coaching Athletes During and After Viral Infection: A Case Report in an Elite Endurance Athlete

Background: Viral diseases have different individual progressions and can lead to considerable risks/long-term consequences. Therefore, it is not suitable to give general recommendations on a time off from training for athletes. This case report aims to investigate the relevance of detecting heart rate (HR) and HR variability (HRV) during an orthostatic test (OT) to monitor the progression and recovery process during and after a viral disease in an elite endurance athlete.

Methods: A 30-year-old elite marathon runner contracted a viral infection (upper respiratory tract infection) 4 weeks after a marathon race. RR intervals in HR time series in supine and standing positions were monitored daily in the morning. Analyzed parameters included HR, the time-domain HRV parameter root mean square of successive difference (RMSSD), peak HR (HRpeak) in a standing position, and the time to HR peak (tHRpeak).

Results: During the 6-day viral infection period, HR increased significantly by an average of 11 bpm in the supine position and by 22 bpm in the standing position. In addition, the RMSSD decreased from 20.8 to 4.2 ms, the HRpeak decreased by 13 bpm, and the tHRpeak increased by 18 s in the standing position significantly. There were no significant changes in the pre-viral infection RMSSD values in the supine position. The viral infection led to a significant change in HR and HRV parameters. The cardiac autonomic system reacted more sensitively in the standing position compared to the supine position after a viral infection in the present case study.

Conclusion: These data have provided supportive rationale as to why the OT with a change from supine to standing body position and the detection of different indicators based on HR and a vagal driven time-domain HRV parameter (RMSSD) is likely to be useful to detect viral diseases early on when implemented in daily routine. Given the case study nature of the findings, future research has to be conducted to investigate whether the use of the OT might be able to offer an innovative, non-invasive, and time-efficient possibility to detect and evaluate the health status of (elite endurance) athletes.

Applying Heart Rate Variability to Monitor Health and Performance in Tactical Personnel: A Narrative Review

Human performance optimization of tactical personnel requires accurate, meticulous, and effective monitoring of biological adaptations and systemic recovery. Due to an increased understanding of its importance and the commercial availability of assessment tools, the use of heart rate variability (HRV) to address this need is becoming more common in the tactical community. Measuring HRV is a non-invasive, practical method for objectively assessing a performer's readiness, workload, and recovery status; when combined with additional data sources and practitioner input, it provides an affordable and scalable solution for gaining actionable information to support the facilitation and maintenance of operational performance. This narrative review discusses the non-clinical use of HRV for assessing, monitoring, and interpreting autonomic nervous system resource availability, modulation, effectiveness, and efficiency in tactical populations. Broadly, HRV metrics represent a complex series of interactions resulting from internal and external stimuli; therefore, a general overview of HRV applications in tactical personnel is discussed, including the influence of occupational specific demands, interactions between cognitive and physical domains, and recommendations on implementing HRV for training and recovery insights into critical health and performance outcomes.

An Attempt to Predict Changes in Heart Rate Variability in the Training Intensification Process among Cyclists

Individual changes in resting heart rate variability (HRV) parameters were assessed in seven Polish cyclists during a training process consisting of: a six-week period (P1) of predominantly low- and moderate-intensity training (L-MIT) and a six-week period (P2) where the proportion of high-intensity interval training (HIT) increased. Daily recorded HRV parameters included high-frequency spectral power (HF), square root of the mean squared difference between successive normal-to-normal RR intervals (RMSSD), and standard deviation of normal-to-normal RR intervals (SDNN). In each training microcycle, the average values of HF_av, RMSSD_av, and SDNN_av were calculated individually for each participant. In three cyclists, HF was higher in P2 compared to P1, whereas in one cyclist, HF was higher in P1 than in P2. Each of these four cyclists presented an individual correlation between the average daily duration HIT effort in training microcycles (HIT_av) and HF_av. Cyclists with low baseline values of HRV parameters showed increased activity of the parasympathetic nervous system, while in the cyclist with high baseline values of HRV parameters, an opposite change was observed. In conclusion, changes in resting HRV parameters between period P1 and P2 can be individualised. In the investigated group, it was possible to predict how HRV would change as a result of training intensification on the basis of HRV baseline values.

Wearable and telemedicine innovations for Olympic events and elite sport

Rapid advances in wearable technologies and real-time monitoring have resulted in major inroads in the world of recreational and elite sport. One such innovation is the application of real-time monitoring, which comprises a smartwatch application and ecosystem, designed to collect, process and transmit a wide range of physiological, biomechanical, bioenergetic and environmental data using cloud-based services. We plan to assess the impact of this wireless technology during Tokyo 2020, where this technology could help characterize the physiological and thermal strain experienced by an athlete, as well as determine future management of athletes during a medical emergency as a result of a more timely and accurate diagnosis. Here we describe some of the innovative technologies developed for numerous sports at Tokyo 2020 ranging from race walking (20 km and 50 km events), marathon, triathlon, road cycling (including the time trial event), mountain biking, to potentially team sports played outdoors. A more symbiotic relationship between sport, health and technology needs to be encouraged that harnesses the unique demands of elite sport (e.g., the need for unobtrusive devices that provide real-time feedback) and serves as medical and preventive support for the athlete's care. The implementation of such applications would be particularly welcome in the field of medicine (i.e., telemedicine applications) and the workplace (with particular relevance to emergency services, the military and generally workers under extreme environmental conditions). Laboratory and field-based studies are required in simulated scenarios to validate such emerging technologies, with the field of sport serving as an excellent model to understand and impact disease.

The Advantage of Supine and Standing Heart Rate Variability Analysis to Assess Training Status and Performance in a Walking Ultramarathon

Cardiac autonomic modulation of heart rate, assessed by heart rate variability (HRV), is commonly used to monitor training status. HRV is usually measured in athletes after awakening in the morning in the supine position. Whether recording during standing reveals additional information compared to supine remains unclear. We aimed to evaluate the association between short-duration HRV, assessed both in the supine and standing position, and a low-intensity long-duration performance (walking ultramarathon), as well as training experience. Twenty-five competitors in a 100 km walking ultramarathon underwent pre-race supine (12 min) and standing (6 min) HR recordings, whereas performance and subjective training experience were assessed post-race. There were no significant differences in both supine and standing HRV between finishers (n = 14) and non-finishers (n = 11, mean distance 67 km). In finishers, a slower race velocity was significantly correlated with a higher decrease in parasympathetic drive during position change [larger decrease in High Frequency power normalized units (HF_nu: r = −0.7, p = 0.01) and higher increase in the detrended fluctuation analysis alpha 1 index (DFA1: r = 0.6, p = 0.04)]. Highly trained athletes accounted for higher HF_nu during standing compared to poorly trained competitors (+11.5, p = 0.01). Similarly, greater training volume (total km/week) would predict higher HF_nu during standing (r = 0.5, p = 0.01). HRV assessment in both supine and standing position may provide additional information on the dynamic adaptability of cardiac autonomic modulation to physiologic challenges and therefore be more valuable for performance prediction than a simple assessment of supine HRV. Self-reported training experience may reliably associate with parasympathetic drive, therefore indirectly predicting long-term aerobic performance in ultramarathon walking races.

Effect of a lactate-guided conditioning program on heart rate variability obtained using 24-Holter electrocardiography in Beagle dogs

The dogs’ responses to training exercise are seldom monitored using physiological variables, and cardiac autonomic regulation (CAR) is a relevant determinant of endurance-training adaptation. There are studies in the literature establishing that regular exercise could interfere with CAR in dogs, measured by heart rate and vagal-derived indexes of heart-rate-variability (HRV). However, few studies were found using a prescribed training program based on the lactate threshold (LT) to determine HRV by a 24-h Holter analysis. The purpose of this study was to test whether an endurance-training program (ETP) guided individually by LT raises time-domain measures of HRV in healthy Beagle dogs. Twenty dogs were assigned to two groups: control (C) and trained (T). The dogs from group T underwent an incremental exercise test (IET) to determine their LT. Both LT and velocity corresponding to the LT (VLT) was determined by visual inspection. T group performed an eight-week endurance-training program consisting of treadmill runs set to 70–80% of the VLT. Next, dogs from the group T have submitted to IET again. The maximal velocities (Vmax) at which achieved by the trained dogs in both IETs were determined. The group S did not undergo IETs or ETP. HRV was determined by the 24-hour-Holter at rest, before and on the 2°, 4°, 6° and 8° training weeks. To examine the HR impact on HRV, standard HRV variables were normalized to prevailing HR. VLT and Vmax rose in group T, indicating an improvement of dogs’ aerobic and anaerobic capacity. The normalized standard HRV indexes were relatively attenuated since these variables had a reduction in the degree of correlation concerning an average HR. The ETP resulted in decreased resting heart rate and increased time-domain indices, highlighting the log-transformed square root of the mean sum of the squared differences between R–R intervals (Ln rMSSD). The lactate-guided endurance-training program could lead to better parasympathetic cardiac modulation in Beagle dogs.

Daily Resting Heart Rate Variability in Adolescent Swimmers during 11 Weeks of Training

Adolescent athletes are particularly vulnerable to stress. The current study aimed to monitor one of the most popular and accessible stress markers, heart rate variability (HRV), and its associations with training load and sleep duration in young swimmers during an 11-week training period to evaluate its relevance as a tool for monitoring overtraining. National-level swimmers (n = 22, age 14.3 ± 1.0 years) of sprint and middle distance events followed individually structured training programs prescribed by their swimming coach with the main intention of preparing for the national championships. HRV after awakening, during sleep and training were recorded daily. There was a consistent ~4.5% reduction in HRV after 3–5 consecutive days of high (>6 km/day) swimming volume, and an inverse relationship of HRV with large (>7.0 km/day) shifts in total training load (r = −0.35, p < 0.05). Day-to-day HRV did not significantly correlate with training volume or sleep duration. Taken together, these findings suggest that the value of HRV fluctuations in estimating the balance between the magnitude of a young athlete’s physical load and their tolerance is limited on a day-to-day basis, while under sharply increased or extended training load the lower HRV becomes an important indicator of potential overtraining.

Heart rate and heart rate variability comparison between postural orthostatic tachycardia syndrome versus healthy participants; a systematic review and meta-analysis

Background

A number of published literature has reported that, physiologically, heart rate variability (HRV) in patients with postural orthostatic tachycardia syndrome (POTS) to be greatly confounded by age, sex, race, physical fitness, and circadian rhythm. The purpose of this study was to compare between POTS patients versus healthy participants, in terms of heart rate (HR) and HRV after Head-Up tilt test (HUTT), by systematic review and meta-analysis of available published literature.

Methods

MEDLINE (using PubMed interphase), EMBASE and SCOPUS were systematically searched for observational studies comparing POTS patients versus healthy patients, in terms of HR and HRV. HRV was grouped into Time and frequency domain outcome measurements. The time domain was measured as mean RR- interval and mean the square root of the mean of squares of successive R-R waves (rMSSD) in milliseconds. The frequency domain was measured as mean values of Low frequency power (LF), High frequency power (HF), LF/HF-ratio, LF-normalized units (LF(n.u)) and HF-normalized units (HF(n.u)). Demographic data, comorbidities, and mean values of HR, RR- interval, rMSSD, LF, HF, LF/HF-ratio, LF-(n.u) and H.F-n.u were extracted from each group and compared, by their mean differences as an overall outcome measure. Computer software, RevMan 5.3 was utilized, at a 95% significance level.

Results

Twenty (20) eligible studies were found to report 717 POTS and 641 healthy participants. POTS group had a higher mean HR (p < 0.05), lower mean RR-Interval (p < 0.05), lower rMSSD (p < 0.05) than healthy participants. Furthermore, POTS group had lower mean HF(p > 0.05), lower mean LF(p > 0.05), and lower mean HF(n.u) (p > 0.05), higher LF/HF-Ratio (p > 0.05) and higher LF(n.u) (p > 0.05) as compared to healthy participants.

Conclusion

POTS patients have a higher HR than healthy patients after HUTT and lower HRV in terms of time domain measure but not in terms of frequency domain measure. HR and time domain analyses of HRV are more reliable than frequency domain analysis in differentiating POTS patients from the healthy participants. We call upon sensitivity and specificity studies.

Heart Rate Variability, Neuromuscular and Perceptual Recovery Following Resistance Training

We quantified associations between changes in heart rate variability (HRV), neuromuscular and perceptual recovery following intense resistance training (RT). Adult males (n = 10) with >1 year RT experience performed six sets to failure with 90% of 10 repetition maximum in the squat, bench press, and pull-down. Changes (∆) from pre- to immediately (IP), 24 and 48 h post-RT were calculated for neuromuscular performance markers (counter-movement jump peak power and mean concentric bench press and squat velocity with load corresponding to 1.0 m∙s⁻¹) and perceived recovery and soreness scales. Post-waking natural logarithm of the root-mean square of successive differences (LnRMSSD) in supine and standing positions were recorded pre-RT (5 day baseline), IP and two mornings post-RT. All parameters worsened at IP (p < 0.05). LnRMSSD measures were not different from baseline by 24 h. Neuromuscular markers were not different from pre-RT by 48 h. Perceptual measures remained suppressed at 48 h. No significant associations among ∆ variables were observed (p = 0.052–0.978). These data show varying timeframes of recovery for HRV, neuromuscular and perceptual markers at the group and individual level. Thus, post-RT recovery testing should be specific and the status of one metric should not be used to infer that of another.