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Santala OE, Lipponen JA, Jäntti H, Rissanen TT, Tarvainen MP, Väliaho ES, Rantula OA, Naukkarinen NS, Hartikainen JEK, Martikainen TJ, Halonen J. Novel Technologies in the Detection of Atrial Fibrillation: Review of Literature and Comparison of Different Novel Technologies for Screening of Atrial Fibrillation. Cardiol Rev 2024; 32:440-447. [PMID: 36946975 PMCID: PMC11296284 DOI: 10.1097/crd.0000000000000526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Atrial fibrillation (AF) is globally the most common arrhythmia associated with significant morbidity and mortality. It impairs the quality of the patient's life, imposing a remarkable burden on public health, and the healthcare budget. The detection of AF is important in the decision to initiate anticoagulation therapy to prevent thromboembolic events. Nonetheless, AF detection is still a major clinical challenge as AF is often paroxysmal and asymptomatic. AF screening recommendations include opportunistic or systematic screening in patients ≥65 years of age or in those individuals with other characteristics pointing to an increased risk of stroke. The popularities of well-being and taking personal responsibility for one's own health are reflected in the continuous development and growth of mobile health technologies. These novel mobile health technologies could provide a cost-effective solution for AF screening and an additional opportunity to detect AF, particularly its paroxysmal and asymptomatic forms.
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Affiliation(s)
- Onni E. Santala
- From the School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Doctoral School, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jukka A. Lipponen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Helena Jäntti
- Centre for Prehospital Emergency Care, Kuopio University Hospital, Kuopio, Finland
| | | | - Mika P. Tarvainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Eemu-Samuli Väliaho
- From the School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Doctoral School, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Olli A. Rantula
- From the School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Doctoral School, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Noora S. Naukkarinen
- From the School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Doctoral School, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Juha E. K. Hartikainen
- From the School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Heart Center, Kuopio University Hospital, Kuopio, Finland
| | | | - Jari Halonen
- From the School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Heart Center, Kuopio University Hospital, Kuopio, Finland
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Castillo-Escamilla J, Ruffo I, Carrasco-Poyatos M, Granero-Gallegos A, Cimadevilla JM. Heart rate variability modulates memory function in a virtual task. Physiol Behav 2024; 283:114620. [PMID: 38925434 DOI: 10.1016/j.physbeh.2024.114620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 06/28/2024]
Abstract
Heart rate variability (HRV) is considered one of the most relevant indicators of physical well-being and relevant biomarker for preventing cardiovascular risks. More recently, a growing amount of research has tracked an association between HRV and cognitive functions (i.e., attention). Research is still scarce on spatial orientation, a basic capability in our daily lives. It is also an important indicator of memory performance, and its malfunctioning working as an early sign of dementia. In this study, a total of 43 female students (M Age = 18.76; SD = 2.02) were measured in their lnRMSSD using the photoplethysmography technique with the Welltory smartphone app. They were also tested in their spatial memory with The Boxes Room, a virtual navigation test. Measures of physical activity were obtained with the International Physical Activity Questionnaire (IPAQ). Correlation analyses and repeated measures ANOVA were performed, comparing participants with high / low lnRMSSD in their spatial performance. Results showed that, at an equal level of physical activity, participants with a higher lnRMSSD were more effective in the early trials of The Boxes Room, being more precise in estimating the correct position of the stimuli. Moreover, a subsequent simple linear regression showed that a higher lnRMSSD was related to a smaller number of errors at the beginning of the spatial task. Overly, these results outline the relationship between HRV and navigation performance in early stages of processing, where the environment is still unknown and the situation is more demanding.
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Affiliation(s)
- Joaquín Castillo-Escamilla
- Department of Psychology, University of Almeria, Carretera de Sacramento s/n, 04120. Almeria, Andalucia, Spain; Centro de Investigación en Salud (Health Research Center), CEINSA-UAL, University of Almeria, Carretera de Sacramento s/n, 04120, Almeria, Andalucia, Spain
| | - Irene Ruffo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi, 78, 00185 Rome, Italy
| | - María Carrasco-Poyatos
- Department of Education, University of Almeria, Carretera de Sacramento s/n, 04120, Almeria, Andalucia, Spain; Centro de Investigación en Salud (Health Research Center), CEINSA-UAL, University of Almeria, Carretera de Sacramento s/n, 04120, Almeria, Andalucia, Spain
| | - Antonio Granero-Gallegos
- Department of Education, University of Almeria, Carretera de Sacramento s/n, 04120, Almeria, Andalucia, Spain; Centro de Investigación en Salud (Health Research Center), CEINSA-UAL, University of Almeria, Carretera de Sacramento s/n, 04120, Almeria, Andalucia, Spain
| | - José Manuel Cimadevilla
- Department of Psychology, University of Almeria, Carretera de Sacramento s/n, 04120. Almeria, Andalucia, Spain; Centro de Investigación en Salud (Health Research Center), CEINSA-UAL, University of Almeria, Carretera de Sacramento s/n, 04120, Almeria, Andalucia, Spain.
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Manser P, de Bruin ED. Test-retest reliability and validity of vagally-mediated heart rate variability to monitor internal training load in older adults: a within-subjects (repeated-measures) randomized study. BMC Sports Sci Med Rehabil 2024; 16:141. [PMID: 38926777 PMCID: PMC11210148 DOI: 10.1186/s13102-024-00929-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Vagally-mediated heart rate variability (vm-HRV) shows promise as a biomarker of internal training load (ITL) during exergame-based training or motor-cognitive training in general. This study evaluated the test-retest reliability of vm-HRV during exergaming in healthy older adults (HOA) and its validity to monitor ITL. METHODS A within-subjects (repeated-measures) randomized study was conducted that included baseline assessments and 4 measurement sessions. Participants played 5 exergames at 3 standardized levels of external task demands (i.e., "easy", "challenging", and "excessive") in random order for 90 s. Test-retest reliability was assessed on the basis of repeated-measures analyses of variance (ANOVA), intraclass correlation coefficients (ICC3,1), standard errors of measurement (SEM), and smallest detectable differences (SDD). Validity was determined by examining the effect of game level on vm-HRV in the ANOVA. RESULTS Fourty-three HOA (67.0 ± 7.0 years; 58.1% females (25 females, 18 males); body mass index = 23.7 ± 3.0 kg·m-2) were included. Mean R-R time intervals (mRR) and parasympathetic nervous system tone index (PNS-Index) exhibited mostly good to excellent relative test-retest reliability with no systematic error. Mean SEM% and SDD% were 36.4% and 100.7% for mRR, and 44.6% and 123.7% for PNS-Index, respectively. Significant differences in mRR and PNS-Index were observed between standardized levels of external task demands, with mostly large effect sizes (mean r = 0.847). These results persisted irrespective of the type of neurocognitive domain trained and when only motoric and cognitive demands were manipulated while physical intensity was kept constant. The remaining vm-HRV parameters showed inconsistent or poor reliability and validity. CONCLUSION Only mRR and PNS-Index demonstrated reliable measurement and served as valid biomarkers for ITL during exergaming at a group level. Nonetheless, the presence of large SEMs hampers the detection of individual changes over time and suggests insufficient precision of these measurements at the individual level. Future research should further investigate the reliability and validity of vm-HRV with a specific focus on comparing different measurement methodologies and exercise conditions, particularly focusing on ultra-short-term HRV measurements, and investigate the potential implications (i.e., superiority to other markers of ITL or monitoring strategies?) of using vm-HRV as a biomarker of ITL.
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Affiliation(s)
- Patrick Manser
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
| | - Eling D de Bruin
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Sammito S, Thielmann B, Klussmann A, Deußen A, Braumann KM, Böckelmann I. Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science. J Occup Med Toxicol 2024; 19:15. [PMID: 38741189 DOI: 10.1186/s12995-024-00414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
This updated guideline replaces the "Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science" first published in 2014. Based on the older version of the guideline, the authors have reviewed and evaluated the findings on the use of heart rate (HR) and heart rate variability (HRV) that have been published in the meantime and incorporated them into a new version of this guideline.This guideline was developed for application in clinical practice and research purposes in the fields of occupational medicine and occupational science to complement evaluation procedures with respect to exposure and risk assessment at the workplace by the use of objective physiological workload indicators. In addition, HRV is also suitable for assessing the state of health and for monitoring the progress of illnesses and preventive medical measures. It gives an overview of factors influencing the regulation of the HR and HRV at rest and during work. It further illustrates methods for measuring and analyzing these parameters under standardized laboratory and real workload conditions, areas of application as well as the quality control procedures to be followed during the recording and evaluation of HR and HRV.
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Affiliation(s)
- Stefan Sammito
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
- German Air Force Centre of Aerospace Medicine, Experimental Aerospace Medicine Research, Flughafenstraße 1, Cologne, 51147, Germany.
| | - Beatrice Thielmann
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Andre Klussmann
- Competence Centre Health (CCG), Department Health Sciences, University of Applied Sciences (HAW) Hamburg, Hamburg, Germany
| | - Andreas Deußen
- Department of Physiology, Medical Faculty, TU Dresden, Dresden, Germany
| | | | - Irina Böckelmann
- Department of Occupational Medicine, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Ortega E, Bryan CYX, Christine NSC. The Pulse of Singapore: Short-Term HRV Norms. Appl Psychophysiol Biofeedback 2024; 49:55-61. [PMID: 37755550 DOI: 10.1007/s10484-023-09603-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 09/28/2023]
Abstract
Short-term heart rate variability (HRV) is increasingly used to assess autonomic nervous system activity and found to be useful for monitoring and providing care due to its quick measurement. With evidence of low HRV associated with chronic diseases, mental disorders, and an increased risk of cardiovascular disease, having normative data of HRV across the age spectrum would be useful for monitoring health and well-being of a population. This study examines HRV of healthy Singapore sample, with ages ranging from 10 to 89 years. Short-term HRV of five minutes was measured from 2,143 participants. 974 males and 1,169 females, and overall HRV was found to be 42.4ms (RMSSD) and 52.0 ms (SDNN) with a further breakdown of HRV by age and gender. Overall HRV declined with age and gender, although gender differences dissipated in the 60s age range onwards, with the 50s age range having the sharpest decline in HRV. Short-term HRV norms were similar to Nunan et al.'s (2010) systematic review in various populations and less similar to Choi et al.'s (2020) study on Koreans.
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Affiliation(s)
- Emily Ortega
- School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore.
| | - Chan Yu Xiu Bryan
- School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore
| | - Ng Su Chin Christine
- School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, Singapore, Singapore
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Kong L, Xie K, Niu K, He J, Zhang W. Remote Photoplethysmography and Motion Tracking Convolutional Neural Network with Bidirectional Long Short-Term Memory: Non-Invasive Fatigue Detection Method Based on Multi-Modal Fusion. SENSORS (BASEL, SWITZERLAND) 2024; 24:455. [PMID: 38257546 PMCID: PMC11154312 DOI: 10.3390/s24020455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024]
Abstract
Existing vision-based fatigue detection methods commonly utilize RGB cameras to extract facial and physiological features for monitoring driver fatigue. These features often include single indicators such as eyelid movement, yawning frequency, and heart rate. However, the accuracy of RGB cameras can be affected by factors like varying lighting conditions and motion. To address these challenges, we propose a non-invasive method for multi-modal fusion fatigue detection called RPPMT-CNN-BiLSTM. This method incorporates a feature extraction enhancement module based on the improved Pan-Tompkins algorithm and 1D-MTCNN. This enhances the accuracy of heart rate signal extraction and eyelid features. Furthermore, we use one-dimensional neural networks to construct two models based on heart rate and PERCLOS values, forming a fatigue detection model. To enhance the robustness and accuracy of fatigue detection, the trained model data results are input into the BiLSTM network. This generates a time-fitting relationship between the data extracted from the CNN, allowing for effective dynamic modeling and achieving multi-modal fusion fatigue detection. Numerous experiments validate the effectiveness of the proposed method, achieving an accuracy of 98.2% on the self-made MDAD (Multi-Modal Driver Alertness Dataset). This underscores the feasibility of the algorithm. In comparison with traditional methods, our approach demonstrates higher accuracy and positively contributes to maintaining traffic safety, thereby advancing the field of smart transportation.
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Affiliation(s)
- Lingjian Kong
- School of Electronic Information and Electrical Engineering, Yangtze University, Jingzhou 434023, China; (L.K.); (K.N.)
| | - Kai Xie
- School of Electronic Information and Electrical Engineering, Yangtze University, Jingzhou 434023, China; (L.K.); (K.N.)
| | - Kaixuan Niu
- School of Electronic Information and Electrical Engineering, Yangtze University, Jingzhou 434023, China; (L.K.); (K.N.)
| | - Jianbiao He
- School of Computer Science, Central South University, Changsha 410083, China;
| | - Wei Zhang
- School of Electronic Information, Central South University, Changsha 410083, China;
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Li K, Cardoso C, Moctezuma-Ramirez A, Elgalad A, Perin E. Heart Rate Variability Measurement through a Smart Wearable Device: Another Breakthrough for Personal Health Monitoring? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7146. [PMID: 38131698 PMCID: PMC10742885 DOI: 10.3390/ijerph20247146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/06/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
Heart rate variability (HRV) is a measurement of the fluctuation of time between each heartbeat and reflects the function of the autonomic nervous system. HRV is an important indicator for both physical and mental status and for broad-scope diseases. In this review, we discuss how wearable devices can be used to monitor HRV, and we compare the HRV monitoring function among different devices. In addition, we have reviewed the recent progress in HRV tracking with wearable devices and its value in health monitoring and disease diagnosis. Although many challenges remain, we believe HRV tracking with wearable devices is a promising tool that can be used to improve personal health.
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Affiliation(s)
- Ke Li
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Cristiano Cardoso
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Angel Moctezuma-Ramirez
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Abdelmotagaly Elgalad
- Center for Preclinical Cardiovascular Research, The Texas Heart Institute, Houston, TX 77030, USA
| | - Emerson Perin
- Center for Clinical Research, The Texas Heart Institute, Houston, TX 77030, USA
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Marçal IR, Abreu RM, Cornelis N, Leicht AS, Forjaz CLM, Cucato G, Brenner I, Novakovic M, Ritti-Dias R, Ciolac EG, Cornelissen VA. Effects of exercise training on heart rate variability in individuals with lower extremity arterial disease and claudication: A systematic review. JOURNAL OF VASCULAR NURSING 2023; 41:226-234. [PMID: 38072577 DOI: 10.1016/j.jvn.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE To perform a systematic review of studies assessing the effects of regular exercise on heart rate variability (HRV) in individuals with lower extremity arterial disease (LEAD) and symptoms of claudication. METHODS A systematic search in the electronic databases MEDLINE, Embase, and Scielo, was conducted and updated on January 21, 2023. Randomized clinical trials investigating patients with LEAD and IC, assessing ≥ 4 wk of exercise interventions, and reporting at least one HRV measure (e.g., time or frequency domains) at baseline and follow-up were included. Two reviewers independently screened studies for inclusion, performed data extraction, and quality assessment of included studies. RESULTS Data from 7 trials were included (i.e., 5 walking, 1 resistance, and 1 isometric handgrip training), totaling 327 patients (66% males; range: 61 - 68 yr; ankle brachial index: 0.4 - 0.7). Following exercise training, three studies investigating walking training reported an increase in parasympathetic modulation indices and/or a decrease in sympathetic modulation indices (n = 2) as well as an increase in non-linear indices (n = 1). CONCLUSION The current evidence is weak, and larger randomized controlled trials are needed to confirm the efficacy of exercise training in improving HRV. Additionally, the high divergence in the methodology of studies indicated the need for standard tools to improve the quality of HRV measurements in exercise trials. It is recommended to use standard procedures in future trials investigating HRV.
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Affiliation(s)
- Isabela R Marçal
- Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa; Exercise and Chronic Disease Research Laboratory, Department of Physical Education, School of Sciences, São Paulo State University (UNESP), Bauru, Brazil
| | - Raphael M Abreu
- Department of Physiotherapy, LUNEX International University of Health Exercise and Sports, Differdange, Luxembourg. LUNEX ASBL Luxembourg Health & Sport Sciences Research Institute, Differdange, Luxembourg
| | - Nils Cornelis
- Research Group for Cardiovascular Rehabilitation, KU Leuven, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Leuven, Belgium
| | - Anthony S Leicht
- Sport and Exercise Science, James Cook University, Townsville, Australia; Australian Institute of Tropical Health & Medicine, James Cook University, Townsville, Australia
| | - Claudia L M Forjaz
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of Sao Paulo, São Paulo, Brazil
| | - Gabriel Cucato
- Department of Sport, Exercise and Rehabilitation, Northumbria University, United Kingdom
| | - Ingrid Brenner
- Department of Kinesiology and Trent/Fleming School of Nursing, Trent University, Peterborough, Ontario, Canada
| | - Marko Novakovic
- Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Raphael Ritti-Dias
- Post-Graduate Program in Rehabilitation Science, University Nove de Julho
| | - Emmanuel G Ciolac
- Exercise and Chronic Disease Research Laboratory, Department of Physical Education, School of Sciences, São Paulo State University (UNESP), Bauru, Brazil
| | - Véronique A Cornelissen
- Research Group for Cardiovascular Rehabilitation, KU Leuven, Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, Leuven, Belgium.
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Welsh MR, Mosley E, Laborde S, Day MC, Sharpe BT, Burkill RA, Birch PDJ. The use of heart rate variability in esports: A systematic review. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 69:102495. [PMID: 37665930 DOI: 10.1016/j.psychsport.2023.102495] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 09/06/2023]
Abstract
Heart rate variability (HRV) is a psychophysiological measure of particular interest in esports due to its potential to monitor player self-regulation. This study aimed to systematically review the utilisation of HRV in esports. Consideration was given to the methodological and theoretical underpinnings of previous works to provide recommendations for future research. The protocol was made available on the Open Science Framework. Inclusion criteria were empirical studies, examining HRV in esports, using esports players, published in English. Exclusion criteria were non-peer-reviewed studies, populations with pre-existing clinical illness other than Internet Gaming Disorder (IGD), opinion pieces or review papers. In November 2022 a search of Web of Science, PubMed, and EBSCOHost identified seven studies using HRV in esports. Risk of bias was assessed using the Mixed Methods Appraisal Tool. Narrative review identified two primary uses of HRV in esports; stress response and IGD. A lack of theoretical and methodological underpinning was identified as a major limitation of current literature. Further investigation is necessary before making recommendations regarding the use of HRV in esports. Future research should employ sound theoretical underpinning such as the use of vagally mediated HRV and the robust application of supporting methodological guidelines when investigating HRV in esports.
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Affiliation(s)
- Matthew R Welsh
- Institute of Applied Sciences, University of Chichester, Chichester, UK.
| | - Emma Mosley
- Department of Rehabilitation and Sport Sciences, Bournemouth University, Bournemouth, UK
| | - Sylvain Laborde
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Koln, Germany; UFR STAPS, Normandie Université Caen, Caen, France
| | - Melissa C Day
- Institute of Applied Sciences, University of Chichester, Chichester, UK
| | - Benjamin T Sharpe
- Institute of Psychology, Business, and Human Sciences, University of Chichester, Chichester, UK
| | | | - Phil D J Birch
- Institute of Applied Sciences, University of Chichester, Chichester, UK
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Kaufmann S, Gronwald T, Herold F, Hoos O. Heart Rate Variability-Derived Thresholds for Exercise Intensity Prescription in Endurance Sports: A Systematic Review of Interrelations and Agreement with Different Ventilatory and Blood Lactate Thresholds. SPORTS MEDICINE - OPEN 2023; 9:59. [PMID: 37462761 DOI: 10.1186/s40798-023-00607-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 07/03/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Exercise intensities are prescribed using specific intensity zones (moderate, heavy, and severe) determined by a 'lower' and a 'higher' threshold. Typically, ventilatory (VT) or blood lactate thresholds (LT), and critical power/speed concepts (CP/CS) are used. Various heart rate variability-derived thresholds (HRVTs) using different HRV indices may constitute applicable alternatives, but a systematic review of the proximity of HRVTs to established threshold concepts is lacking. OBJECTIVE This systematic review aims to provide an overview of studies that determined HRVTs during endurance exercise in healthy adults in comparison with a reference VT and/or LT concept. METHODS A systematic literature search for studies determining HRVTs in healthy individuals during endurance exercise and comparing them with VTs or LTs was conducted in Scopus, PubMed and Web of Science (until January 2022). Studies claiming to describe similar physiological boundaries to delineate moderate from heavy (HRVTlow vs. VTlow and/or LTlow), and heavy from severe intensity zone (HRVThigh vs. VThigh and/or LThigh) were grouped and their results synthesized. RESULTS Twenty-seven included studies (461 participants) showed a mean difference in relative HR between HRVTlow and VTlow of - 0.6%bpm in weighted means and 0.02%bpm between HRVTlow and LTlow. Bias between HR at HRVTlow and VTlow was 1 bpm (limits of agreement (LoA): - 10.9 to 12.8 bpm) and 2.7 bpm (LoA: - 20.4 to 25.8 bpm) between HRVTlow and LTlow. Mean difference in HR between HRVThigh and VThigh was 0.3%bpm in weighted means and 2.9%bpm between HRVThigh and LThigh while bias between HR at HRVThigh and VThigh was - 4 bpm (LoA: - 17.9 to 9.9 bpm) and 2.5 bpm (LoA: - 12.1 to 17.1 bpm) between HRVThigh and LThigh. CONCLUSION HRVTlow seems to be a promising approach for the determination of a 'lower' threshold comparable to VTlow and potentially for HRVThigh compared to VThigh, although the latter needs further empirical evaluation. LoA for both intensity zone boundaries indicates bias of HRVTs on an individual level. Taken together, HRVTs can be a promising alternative for prescribing exercise intensity in healthy, male athletes undertaking endurance activities but due to the heterogeneity of study design, threshold concepts, standardization, and lack of female participants, further research is necessary to draw more robust and nuanced conclusions.
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Affiliation(s)
- Sebastian Kaufmann
- Center for Sports and Physical Education, Faculty of Human Sciences, Julius-Maximilians-University Wuerzburg, Am Hubland/Sports Center, 97074, Würzburg, Germany.
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Olaf Hoos
- Center for Sports and Physical Education, Faculty of Human Sciences, Julius-Maximilians-University Wuerzburg, Am Hubland/Sports Center, 97074, Würzburg, Germany
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Yuksel D, Kiss O, Prouty D, Arra N, Volpe L, Baker FC, de Zambotti M. Stress, hypothalamic pituitary adrenal axis activity and autonomic nervous system function in adolescents with insomnia. Int J Psychophysiol 2023; 187:43-53. [PMID: 36822502 PMCID: PMC10041935 DOI: 10.1016/j.ijpsycho.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023]
Abstract
INTRODUCTION Abnormal stress responses have been linked to the etiology of insomnia. We investigated the relationship between insomnia, stress, hypothalamic-pituitary-adrenal (HPA) axis activity, and autonomic nervous system (ANS) function in adolescence. METHODS Forty-seven post-pubertal adolescents (16-20 years old, 28 female) with (N = 16; insomnia group) and without (N = 31; control group) DSM-5 insomnia symptoms were assessed for stress levels and stress reactivity and underwent a standardized stress protocol (Trier Social Stress Test (TSST)), after an overnight laboratory stay. Cortisol was measured upon awakening and 30-minutes later to calculate the cortisol awakening response (CAR). During the TSST, perceived stress, salivary cortisol (HPA activity), heart rate (HR) and blood pressure (BP) measures were collected. RESULTS Participants in the insomnia group reported more stress from school performance and work overload, with insomnia girls experiencing more stress from peer pressure and future uncertainty than control girls (p < 0.05). No group differences were detected in the CAR and pre-TSST stress levels. All participants showed significant increases in perceived stress (~19 %), HR (~33 %), systolic (~13 %), and diastolic (~15 %) BP in response to the TSST (p < 0.05). Overall HR stress response did not differ between groups, but was lower in boys with insomnia than in girls with insomnia (p < 0.05). Cortisol stress responses were inconclusive, possibly due to a masking effect of CAR, as the task was performed shortly after awakening and larger CARs were associated with blunted cortisol stress responses. DISCUSSION Results mostly show no group difference in physiological stress responses, although some interaction effects suggest a potential sex by insomnia interaction. Larger samples are needed to understand the physiological disturbances of insomnia in adolescence.
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Affiliation(s)
- Dilara Yuksel
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Devin Prouty
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Nicole Arra
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Laila Volpe
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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12
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Romagnoli S, Ripanti F, Morettini M, Burattini L, Sbrollini A. Wearable and Portable Devices for Acquisition of Cardiac Signals while Practicing Sport: A Scoping Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23063350. [PMID: 36992060 PMCID: PMC10055735 DOI: 10.3390/s23063350] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 05/31/2023]
Abstract
Wearable and portable devices capable of acquiring cardiac signals are at the frontier of the sport industry. They are becoming increasingly popular for monitoring physiological parameters while practicing sport, given the advances in miniaturized technologies, powerful data, and signal processing applications. Data and signals acquired by these devices are increasingly used to monitor athletes' performances and thus to define risk indices for sport-related cardiac diseases, such as sudden cardiac death. This scoping review investigated commercial wearable and portable devices employed for cardiac signal monitoring during sport activity. A systematic search of the literature was conducted on PubMed, Scopus, and Web of Science. After study selection, a total of 35 studies were included in the review. The studies were categorized based on the application of wearable or portable devices in (1) validation studies, (2) clinical studies, and (3) development studies. The analysis revealed that standardized protocols for validating these technologies are necessary. Indeed, results obtained from the validation studies turned out to be heterogeneous and scarcely comparable, since the metrological characteristics reported were different. Moreover, the validation of several devices was carried out during different sport activities. Finally, results from clinical studies highlighted that wearable devices are crucial to improve athletes' performance and to prevent adverse cardiovascular events.
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13
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Blok-Husum L, Brcelic MAR, Bassi HKFK, Jensen SE, Nielsen RE, Kragholm K, Fleischer J, Laugesen E, Polcwiartek C. Cardiovascular autonomic reflex tests using a handheld device in the diagnosis of cardiovascular autonomic neuropathy in patients with schizophrenia. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2023; 26:100252. [PMID: 38510185 PMCID: PMC10945952 DOI: 10.1016/j.ahjo.2023.100252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 03/22/2024]
Abstract
Study objective This study investigated whether schizophrenia and the duration of schizophrenia were associated with cardiovascular autonomic neuropathy (CAN) by using heart rate variability (HRV) as a marker. Design Cross-sectional study. Setting The examinations were conducted at the Centre for Psychosis Research and at the Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. Participants 240 patients with first-episode and chronic schizophrenia and 180 controls. Interventions CAN was assessed by the cardiovascular reflex tests (CARTs): HR, RS ratio, E:I ratio, and VM using a handheld device. Main outcome measures One abnormal CART was interpreted as borderline CAN and ≥2 abnormal CARTs established definitive CAN. Borderline CAN and definitive CAN together was categorized as overall CAN. Analyses were adjusted for age, sex, smoking, overweight, and hypercholesterolemia. Results A total of 240 patients with schizophrenia (median age 42.5 [28.8, 52.3], 42.9 % women) and 180 controls (median age 45.8 [24.0, 60.1], 47.8 % women) were included, with 50.8 % of patients with schizophrenia having overall CAN compared to 27.2 % among controls. Dividing patients into patients with first-episode and chronic schizophrenia, 32.9 % vs 10 % (p < 0.001) and 59.1 % vs 41 % (p < 0.001) had overall CAN compared with controls, respectively. Schizophrenia was significantly associated with overall CAN (OR, 2.80; 95%CI, 1.75-4.50), with an OR of 2.31 (95%CI, 1.14-4.68) for first-episode schizophrenia and an OR of 2.97 (95%CI, 1.81-4.87) for chronic schizophrenia. Conclusion It was demonstrated that a diagnosis of schizophrenia was associated with CAN. Patients with chronic schizophrenia had a significantly higher prevalence of CAN compared to patients with first-episode schizophrenia, suggesting an association between the duration of schizophrenia and CAN.
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Affiliation(s)
- Laura Blok-Husum
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | | | | | - Svend Eggert Jensen
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Rene Ernst Nielsen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Aalborg University Hospital, Psychiatry, Aalborg, Denmark
| | - Kristian Kragholm
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - Jesper Fleischer
- Steno Diabetes Center Aarhus, Aarhus, Denmark
- Steno Diabetes Center Zealand, Zealand, Denmark
| | - Esben Laugesen
- Regional Hospital Horsens, Department of Medicine, Horsens, Denmark
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14
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Rinne JKA, Miri S, Oksala N, Vehkaoja A, Kössi J. Evaluation of a wrist-worn photoplethysmography monitor for heart rate variability estimation in patients recovering from laparoscopic colon resection. J Clin Monit Comput 2023; 37:45-53. [PMID: 35394583 PMCID: PMC9852147 DOI: 10.1007/s10877-022-00854-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/25/2022] [Indexed: 01/24/2023]
Abstract
To evaluate the accuracy of heart rate variability (HRV) parameters obtained with a wrist-worn photoplethysmography (PPG) monitor in patients recovering from minimally invasive colon resection to investigate whether PPG has potential in postoperative patient monitoring. 31 patients were monitored for three days or until discharge or reoperation using a wrist-worn PPG monitor (PulseOn, Finland) with a Holter monitor (Faros 360, Bittium Biosignals, Finland) as a reference measurement device. Beat-to-beat intervals (BBI) and HRV information collected by PPG were compared with RR intervals (RRI) and HRV obtained from the ECG reference after removing artefacts and ectopic beats. The beat-to-beat mean error (ME) and mean absolute error (MAE) of good quality heartbeat intervals obtained by wrist PPG were estimated as - 1.34 ms and 10.4 ms respectively. A significant variation in the accuracy of the HRV parameters was found. In the time domain, SDNN (9.11%), TRI (11.4%) and TINN (11.1%) were estimated with low relative MAE, while RMSSD (34.3%), pNN50 (139%) and NN50 (188%) had higher errors. The logarithmic parameters in the frequency domain (VLF Log, LF Log and HF Log) exhibited the lowest relative error, and for non-linear parameters, SD2 (7.5%), DFA α1 (8.25%) and DFA α2 (4.71%) were calculated much more accurately than SD1 (34.3%). The wrist PPG shows some potential for use in a clinical setting. The accuracy of several HRV parameters analyzed post hoc was found sufficient to be used in further studies concerning postoperative recovery of patients undergoing laparoscopic colon resection, although there were large errors in many common HRV parameters such as RMSSD, pNN50 and NN50, rendering them unusable.ClinicalTrials.gov Identifier: NCT04996511, August 9, 2021, retrospectively registered.
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Affiliation(s)
- Juha K A Rinne
- Department of Surgery, Päijät-Häme Central Hospital, Tampere University, Lahti, Finland.
| | - Seyedsadra Miri
- Finnish Cardiovascular Research Center - Tampere, Tampere University, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014, Tampere, Finland
| | - Niku Oksala
- Finnish Cardiovascular Research Center - Tampere, Tampere University, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014, Tampere, Finland
- Vascular Centre, Tampere University Hospital, Elämänaukio 2 (33520 Tampere), P.O. Box 2000, 33521, Tampere, Finland
| | - Antti Vehkaoja
- Finnish Cardiovascular Research Center - Tampere, Tampere University, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34 (33520 Tampere), P.O. Box 100, FI-33014, Tampere, Finland
- PulseOn Ltd, Tekniikantie 12, 02150, Espoo, Finland
| | - Jyrki Kössi
- Department of Surgery, Päijät-Häme Central Hospital, Tampere University, Lahti, Finland
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15
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Pagani E, Gavazzoni N, Bernardelli G, Malacarne M, Solaro N, Giusti E, Castelnuovo G, Volpi P, Carimati G, Lucini D. Psychological Intervention Based on Mental Relaxation to Manage Stress in Female Junior Elite Soccer Team: Improvement in Cardiac Autonomic Control, Perception of Stress and Overall Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:942. [PMID: 36673698 PMCID: PMC9859004 DOI: 10.3390/ijerph20020942] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Chronic stress may represent one of the most important factors that negatively affects the health and performance of athletes. Finding a way to introduce psychological strategies to manage stress in everyday training routines is challenging, particularly in junior teams. We also must consider that a stress management intervention should be regarded as "efficacious" only if its application results in improvement of the complex underlying pathogenetic substratum, which considers mechanistically interrelated factors, such as immunological, endocrine and autonomic controls further to psychological functioning and behavior. In this study, we investigated the feasibility of implementing, in a standard training routine of the junior team of the Italian major soccer league, a stress management program based on mental relaxation training (MRT). We evaluated its effects on stress perception and cardiac autonomic regulation as assessed by means of ANSI, a single composite percentile-ranked proxy of autonomic balance, which is free of gender and age bias, economical, and simple to apply in a clinical setting. We observed that the simple employed MRT intervention was feasible in a female junior soccer team and was associated with a reduced perception of stress, an improved perception of overall health, and a betterment of cardiac autonomic control. This data may corroborate the scientific literature that indicates psychological intervention based on MRT as an efficacious strategy to improve performance, managing negative stress effects on cardiac autonomic control.
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Affiliation(s)
- Eleonora Pagani
- Department of General Psychology, Catholic University, 20123 Milan, Italy
| | | | - Giuseppina Bernardelli
- DISCCO Department, University of Milan, 20122 Milan, Italy
- Exercise Medicine Unit, Istituto Auxologico Italiano, IRCCS, 20135 Milan, Italy
| | - Mara Malacarne
- BIOMETRA Department, University of Milan, 20129 Milan, Italy
| | - Nadia Solaro
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Emanuele Giusti
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, 20123 Milan, Italy
- Clinical Psychology Research laboratory, Istituto Auxologico Italiano, IRCCS, 28824 Verbania, Italy
| | - Piero Volpi
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | | | - Daniela Lucini
- Exercise Medicine Unit, Istituto Auxologico Italiano, IRCCS, 20135 Milan, Italy
- BIOMETRA Department, University of Milan, 20129 Milan, Italy
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16
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Beuchel P, Cramer C. Heart Rate Variability and Perceived Stress in Teacher Training: Facing the Reality Shock With Mindfulness? GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2023; 12:27536130231176538. [PMID: 37216037 PMCID: PMC10196549 DOI: 10.1177/27536130231176538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 02/10/2023] [Accepted: 05/02/2023] [Indexed: 05/24/2023]
Abstract
Background The beginning of the career of teachers is a demanding phase. In the combined roles of teacher and trainee, and in the shift from academic to practical learning, trainee teachers have to acquire competencies in teaching as well as coping with stress. In this phase, the phenomenon of "reality shock" is widely observed. Objective A mindfulness training was developed to support teacher trainees during their first year. This intervention study investigated perceived and physiological stress at teachers' career start and the stress reducing effects of the mindfulness training in this phase. Methods In a quasi-experimental design, 19 out of 42 participants from this sample underwent mindfulness-based stress reduction training and a wait-list control group (N = 23) underwent a compact course after post measurements. We measured physiological stress parameters and perceived stress at 3 different time points. Heart rate signals were acquired in ambulatory assessment sequences, including teaching, rest periods, and cognitive tasks. The data were analyzed in linear mixed-effects models. Results We found high physiological stress in the very beginning of teacher training, which attenuated over time. The mindfulness intervention only led to a greater reduction in heart rate (d = .53 to .74) in situations where the intervention group had shown higher heart rate levels initially, but not in heart rate variability. However, the mindfulness group significantly reduced (d = .63) their perceived stress and maintained (d = .55) this improvement, while the control group maintained a highly elevated perceived stress level throughout. Conclusion The mindfulness training could reduce subjective stress, which otherwise seems to be a long-lasting aspect of beginning teachers' "reality shock". Indications of a superior reduction of physiological stress in demanding situations were weak, while generally, undue physiological stress seems to be a temporary phenomenon in the initial phase of teacher induction.
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Affiliation(s)
- Philipp Beuchel
- Department of Clinical Psychology
and Psychotherapy, University of Tübingen, Tübingen, Germany
- Department of School Education, University of Tübingen, Tübingen, Germany
| | - Colin Cramer
- Department of School Education, University of Tübingen, Tübingen, Germany
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17
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Menezes Junior ADS, Schröder AA, Botelho SM, Resende AL. Cardiac Autonomic Function in Long COVID-19 Using Heart Rate Variability: An Observational Cross-Sectional Study. J Clin Med 2022; 12:jcm12010100. [PMID: 36614901 PMCID: PMC9821736 DOI: 10.3390/jcm12010100] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Heart rate variability is a non-invasive, measurable, and established autonomic nervous system test. Long-term COVID-19 sequelae are unclear; however, acute symptoms have been studied. OBJECTIVES To determine autonomic cardiac differences between long COVID-19 patients and healthy controls and evaluate associations among symptoms, comorbidities, and laboratory findings. METHODS This single-center study included long COVID-19 patients and healthy controls. The heart rate variability (HRV), a quantitative marker of autonomic activity, was monitored for 24 h using an ambulatory electrocardiogram system. HRV indices were compared between case and control groups. Symptom frequency and inflammatory markers were evaluated. A significant statistical level of 5% (p-value 0.05) was adopted. RESULTS A total of 47 long COVID-19 patients were compared to 42 healthy controls. Patients averaged 43.8 (SD14.8) years old, and 60.3% were female. In total, 52.5% of patients had moderate illness. Post-exercise dyspnea was most common (71.6%), and 53.2% lacked comorbidities. CNP, D-dimer, and CRP levels were elevated (p-values of 0.0098, 0.0023, and 0.0015, respectively). The control group had greater SDNN24 and SDANNI (OR = 0.98 (0.97 to 0.99; p = 0.01)). Increased low-frequency (LF) indices in COVID-19 patients (OR = 1.002 (1.0001 to 1.004; p = 0.030)) and high-frequency (HF) indices in the control group (OR = 0.987 (0.98 to 0.995; p = 0.001)) were also associated. CONCLUSIONS Patients with long COVID-19 had lower HF values than healthy individuals. These variations are associated with increased parasympathetic activity, which may be related to long COVID-19 symptoms and inflammatory laboratory findings.
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Affiliation(s)
- Antonio da Silva Menezes Junior
- Internal Medicine Department, Medicine School, Federal University of Goiás, Goiânia 74175-120, Brazil
- Medical and Life Sciences School, Medicine School, Pontifical Catholic University of Goiás, Goiânia 74000-000, Brazil
- Correspondence: or ; Tel.: +55-62982711177
| | - Aline Andressa Schröder
- Medical and Life Sciences School, Medicine School, Pontifical Catholic University of Goiás, Goiânia 74000-000, Brazil
| | - Silvia Marçal Botelho
- Internal Medicine Department, Medicine School, Federal University of Goiás, Goiânia 74175-120, Brazil
- Medical and Life Sciences School, Medicine School, Pontifical Catholic University of Goiás, Goiânia 74000-000, Brazil
| | - Aline Lazara Resende
- Internal Medicine Department, Medicine School, Federal University of Goiás, Goiânia 74175-120, Brazil
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18
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Himariotis AT, Coffey KF, Noel SE, Cornell DJ. Validity of a Smartphone Application in Calculating Measures of Heart Rate Variability. SENSORS (BASEL, SWITZERLAND) 2022; 22:9883. [PMID: 36560256 PMCID: PMC9787958 DOI: 10.3390/s22249883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
The purpose of the current study was to determine the concurrent validity of the Elite HRV smartphone application when calculating heart rate variability (HRV) metrics in reference to an independent software criterion. A total of 5 minutes of R−R interval and natural log of root mean square of the successive differences (lnRMSSD) resting HRV data were simultaneously collected using two Polar H10 heart rate monitors (HRMs) in both the seated and supine positions from 22 participants (14 males, 8 females). One H10 HRM was paired with a Polar V800 watch and one with the Elite HRV application. When no artifact correction was applied, significant, but small, differences in the lnRMSSD data were observed between the software in the seated position (p = 0.022), and trivial and nonstatistically significant differences were observed in the supine position (p = 0.087). However, significant differences (p > 0.05) in the lnRMSSD data were no longer identifiable in either the seated or the supine positions when applying Very Low, Low, or Automatic artifact-correction filters. Additionally, excellent agreements (ICC3,1 = 0.938 − 0.998) and very strong to near-perfect (r = 0.889 − 0.997) relationships were observed throughout all correction levels. The Elite HRV smartphone application is a valid tool for calculating resting lnRMSSD HRV metrics.
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Affiliation(s)
- Andreas T. Himariotis
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Kyle F. Coffey
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - Sabrina E. Noel
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA 01854, USA
| | - David J. Cornell
- Health Assessment Laboratory, University of Massachusetts Lowell, Lowell, MA 01854, USA
- Department of Physical Therapy and Kinesiology, University of Massachusetts Lowell, Lowell, MA 01854, USA
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Aguilar-Rivera M, Kable JA, Yevtushok L, Kulikovsky Y, Zymak-Zakutnya N, Dubchak I, Akhmedzhanova D, Wertelecki W, Chambers C, Coleman TP. Wireless Heart Sensor for Capturing Cardiac Orienting Response for Prediction of Neurodevelopmental Delay in Infants. SENSORS (BASEL, SWITZERLAND) 2022; 22:9140. [PMID: 36501842 PMCID: PMC9739526 DOI: 10.3390/s22239140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/09/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Early identification of infants at risk of neurodevelopmental delay is an essential public health aim. Such a diagnosis allows early interventions for infants that maximally take advantage of the neural plasticity in the developing brain. Using standardized physiological developmental tests, such as the assessment of neurophysiological response to environmental events using cardiac orienting responses (CORs), is a promising and effective approach for early recognition of neurodevelopmental delay. Previous CORs have been collected on children using large bulky equipment that would not be feasible for widespread screening in routine clinical visits. We developed a portable wireless electrocardiogram (ECG) system along with a custom application for IOS tablets that, in tandem, can extract CORs with sufficient physiologic and timing accuracy to reflect the well-characterized ECG response to both auditory and visual stimuli. The sensor described here serves as an initial step in determining the extent to which COR tools are cost-effective for the early screening of children to determine who is at risk of developing neurocognitive deficits and may benefit from early interventions. We demonstrated that our approach, based on a wireless heartbeat sensor system and a custom mobile application for stimulus display and data recording, is sufficient to capture CORs from infants. The COR monitoring approach described here with mobile technology is an example of a desired standardized physiologic assessment that is a cost-and-time efficient, scalable method for early recognition of neurodevelopmental delay.
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Affiliation(s)
- Marcelo Aguilar-Rivera
- Department of Bioengineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Julie A. Kable
- Departments of Psychiatry and Behavioral Science and Pediatrics, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - Lyubov Yevtushok
- OMNI-Net Ukraine Birth Defects Program, 33028 Rivne, Ukraine
- Post-Graduate Extension Program, Rivne Regional Medical Diagnostic Center, Lviv National Medical University, 79010 Lviv, Ukraine
| | - Yaroslav Kulikovsky
- OMNI-Net Ukraine Birth Defects Program, 33028 Rivne, Ukraine
- Post-Graduate Extension Program, Rivne Regional Medical Diagnostic Center, Lviv National Medical University, 79010 Lviv, Ukraine
| | - Natalya Zymak-Zakutnya
- OMNI-Net Ukraine Birth Defects Program, 33028 Rivne, Ukraine
- Khmelnytsky City Perinatal Center, 29008 Khmelnytskyi, Ukraine
| | - Iryna Dubchak
- OMNI-Net Ukraine Birth Defects Program, 33028 Rivne, Ukraine
- Khmelnytsky City Perinatal Center, 29008 Khmelnytskyi, Ukraine
| | | | | | - Christina Chambers
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA 92093, USA
| | - Todd P. Coleman
- Department of Bioengineering, University of California San Diego, La Jolla, CA 92093, USA
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Kapteijn CM, Frippiat T, van Beckhoven C, van Lith HA, Endenburg N, Vermetten E, Rodenburg TB. Measuring heart rate variability using a heart rate monitor in horses ( Equus caballus) during groundwork. Front Vet Sci 2022; 9:939534. [PMID: 36483490 PMCID: PMC9723354 DOI: 10.3389/fvets.2022.939534] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 11/01/2022] [Indexed: 11/26/2023] Open
Abstract
Measuring physiological parameters of stress in horses during groundwork, for example when involved in equine-assisted interventions, is important to gain insight into the stress levels of the horses. Heart rate and heart rate variability can be used as physiological indicators of stress in horses. Heart rate monitors could be easily incorporated into practice, as they are not expensive and easy to use. However, it is questionable whether heart rate monitors present accurate heart rate variability results in exercising horses, similar to electrocardiograms. The aim of this study was to determine the accuracy of heart rate monitors for the assessment of heart rate variability in horses during groundwork exercise. Simultaneous telemetric electrocardiograms (Televet) and heart rate monitor (Polar H10 transmitter and M430 receiver, Hylofit electrodes) recordings were performed on 28 horses (15 mares and 13 geldings). Results indicate that the heart rate monitor accurately determined heart rate and time-domain heart rate variability parameters when compared to electrocardiograms during both baseline and groundwork conditions. As expected, heart rate significantly increased and the heart rate variability significantly decreased during groundwork compared to baseline conditions. This indicates that the heart rate monitor can be used to accurately determine heart rate variability during groundwork.
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Affiliation(s)
- Chantal M Kapteijn
- Animals in Science and Society, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | | | | | - Hein A van Lith
- Animals in Science and Society, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Nienke Endenburg
- Animals in Science and Society, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - T Bas Rodenburg
- Animals in Science and Society, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
- Adaptation Physiology Group, Wageningen University and Research, Wageningen, Netherlands
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Hofbauer LM, Rodriguez FS. How is the usability of commercial activity monitors perceived by older adults and by researchers? A cross-sectional evaluation of community-living individuals. BMJ Open 2022; 12:e063135. [PMID: 36323474 PMCID: PMC9639094 DOI: 10.1136/bmjopen-2022-063135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES Using commercial activity monitors may advance research with older adults. However, usability for the older population is not sufficiently established. This study aims at evaluating the usability of three wrist-worn monitors for older adults. In addition, we report on usability (including data management) for research. DESIGN Data were collected cross-sectionally. Between-person of three activity monitor type (Apple Watch 3, Fitbit Charge 4, Polar A370) were made. SETTING The activity monitors were worn in normal daily life in an urban community in Germany. The period of wear was 2 weeks. PARTICIPANTS Using convenience sampling, we recruited N=27 healthy older adults (≥60 years old) who were not already habitual users of activity monitors. OUTCOMES To evaluate usability from the participant perspective, we used the System Usability Scale (SUS) as well as a study-specific qualitative checklist. Assessment further comprised age, highest academic degree, computer proficiency and affinity for technology interaction. Usability from the researchers' perspective was assessed using quantitative data management markers and a study-specific qualitative check-list. RESULTS There was no significant difference between monitors in the SUS. Female gender was associated with higher SUS usability ratings. Qualitative participant-usability reports revealed distinctive shortcomings, for example, in terms of battery life and display readability. Usability for researchers came with problems in data management, such as completeness of the data download. CONCLUSION The usability of the monitors compared in this work differed qualitatively. Yet, the overall usability ratings by participants were comparable. Conversely, from the researchers' perspective, there were crucial differences in data management and usability that should be considered when making monitor choices for future studies.
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Affiliation(s)
- Lena M Hofbauer
- Research Group Psychosocial Epidemiology & Public Health, German Center for Neurodegenerative Diseases Site Rostock/Greifswald, Greifswald, Germany
| | - Francisca S Rodriguez
- Research Group Psychosocial Epidemiology & Public Health, German Center for Neurodegenerative Diseases Site Rostock/Greifswald, Greifswald, Germany
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22
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Taoum A, Bisiaux A, Tilquin F, Le Guillou Y, Carrault G. Validity of Ultra-Short-Term HRV Analysis Using PPG-A Preliminary Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22207995. [PMID: 36298346 PMCID: PMC9611389 DOI: 10.3390/s22207995] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 05/26/2023]
Abstract
Continuous measurement of heart rate variability (HRV) in the short and ultra-short-term using wearable devices allows monitoring of physiological status and prevention of diseases. This study aims to evaluate the agreement of HRV features between a commercial device (Bora Band, Biosency) measuring photoplethysmography (PPG) and reference electrocardiography (ECG) and to assess the validity of ultra-short-term HRV as a surrogate for short-term HRV features. PPG and ECG recordings were acquired from 5 healthy subjects over 18 nights in total. HRV features include time-domain, frequency-domain, nonlinear, and visibility graph features and are extracted from 5 min 30 s and 1 min 30 s duration PPG recordings. The extracted features are compared with reference features of 5 min 30 s duration ECG recordings using repeated-measures correlation, Bland-Altman plots with 95% limits of agreements, Cliff's delta, and an equivalence test. Results showed agreement between PPG recordings and ECG reference recordings for 37 out of 48 HRV features in short-term durations. Sixteen of the forty-eight HRV features were valid and retained very strong correlations, negligible to small bias, with statistical equivalence in the ultra-short recordings (1 min 30 s). The current study concludes that the Bora Band provides valid and reliable measurement of HRV features in short and ultra-short duration recordings.
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Affiliation(s)
- Aline Taoum
- Laboratoire Traitement du Signal et de l’Image (LTSI-Inserm UMR 1099), Université de Rennes 1, 35042 Rennes, France
| | | | | | | | - Guy Carrault
- Laboratoire Traitement du Signal et de l’Image (LTSI-Inserm UMR 1099), Université de Rennes 1, 35042 Rennes, France
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Relationship between Body Composition and Cardiac Autonomic Regulation in a Large Population of Italian Olympic Athletes. J Pers Med 2022; 12:jpm12091508. [PMID: 36143294 PMCID: PMC9505674 DOI: 10.3390/jpm12091508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 11/17/2022] Open
Abstract
Athletic performance is determined by many factors, such as cardiorespiratory fitness, muscular strength and psychological features, which all interact simultaneously. The large Italian National Olympic Committee database of Olympic athletes offers a unique healthy population to verify the strength of the interplay among a number of major elements of training, including autonomic nervous system (ANS) modulation, biochemical indicators and body composition, in a system medicine approach. This observational, retrospective study involved 583 individuals. As part of the yearly precompetitive examination, cardiac autonomic (heart rate variability), psychological, physical (cycloergometer stress test), biochemical and body composition (BOD POD) evaluations were performed. In subsequent analysis, we first considered the relationship between body composition and single individual variables in a simple correlation matrix, including a multitude of variables; then, Exploratory Factor Analysis (EFA) restricted the information to six latent domains, each combining congruent information in relation to body composition. Finally, we employed a multiple quantile regression model to evaluate possible relationships between ANSIs (index capable of synthetizing ANS regulation) and the latent domains indicated by EFA reflecting body composition. We observed a clear relationship between ANS and body mass composition parameters, as indicated by both bivariate correlations and the quantile regression result of ANSIs versus the latent domain aggregating mainly body composition data expressed in % (p = 0.002). In conclusion, these results suggest that specific training may elicit parallel adaptation of ANS control and body composition. The analysis of Olympic athletes’ data allowed us to obtain a better understanding of the complex, multidimensional factors involved in determining sport performance. The latter appears to be determined by the simultaneous interaction not only of cardiorespiratory fitness, muscular strength and psychological features, but also of ANS cardiovascular modulation and body composition.
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24
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Schaffarczyk M, Rogers B, Reer R, Gronwald T. Validity of the Polar H10 Sensor for Heart Rate Variability Analysis during Resting State and Incremental Exercise in Recreational Men and Women. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22176536. [PMID: 36081005 PMCID: PMC9459793 DOI: 10.3390/s22176536] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 05/09/2023]
Abstract
Heart rate variability (HRV) is frequently applied in sport-specific settings. The rising use of freely accessible applications for its recording requires validation processes to ensure accurate data. It is the aim of this study to compare the HRV data obtained by the Polar H10 sensor chest strap device and an electrocardiogram (ECG) with the focus on RR intervals and short-term scaling exponent alpha 1 of Detrended Fluctuation Analysis (DFA a1) as non-linear metric of HRV analysis. A group of 25 participants performed an exhaustive cycling ramp with measurements of HRV with both recording systems. Average time between heartbeats (RR), heart rate (HR) and DFA a1 were recorded before (PRE), during, and after (POST) the exercise test. High correlations were found for the resting conditions (PRE: r = 0.95, rc = 0.95, ICC3,1 = 0.95, POST: r = 0.86, rc = 0.84, ICC3,1 = 0.85) and for the incremental exercise (r > 0.93, rc > 0.93, ICC3,1 > 0.93). While PRE and POST comparisons revealed no differences, significant bias could be found during the exercise test for all variables (p < 0.001). For RR and HR, bias and limits of agreement (LoA) in the Bland−Altman analysis were minimal (RR: bias of 0.7 to 0.4 ms with LoA of 4.3 to −2.8 ms during low intensity and 1.3 to −0.5 ms during high intensity, HR: bias of −0.1 to −0.2 ms with LoA of 0.3 to −0.5 ms during low intensity and 0.4 to −0.7 ms during high intensity). DFA a1 showed wider bias and LoAs (bias of 0.9 to 8.6% with LoA of 11.6 to −9.9% during low intensity and 58.1 to −40.9% during high intensity). Linear HRV measurements derived from the Polar H10 chest strap device show strong agreement and small bias compared with ECG recordings and can be recommended for practitioners. However, with respect to DFA a1, values in the uncorrelated range and during higher exercise intensities tend to elicit higher bias and wider LoA.
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Affiliation(s)
- Marcelle Schaffarczyk
- Department Sports and Exercise Medicine, Institute of Human Movement Science, University of Hamburg, 20148 Hamburg, Germany
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, 20457 Hamburg, Germany
- Correspondence:
| | - Bruce Rogers
- Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL 32827, USA
| | - Rüdiger Reer
- Department Sports and Exercise Medicine, Institute of Human Movement Science, University of Hamburg, 20148 Hamburg, Germany
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, 20457 Hamburg, Germany
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25
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Santala OE, Lipponen JA, Jäntti H, Rissanen TT, Tarvainen MP, Laitinen TP, Laitinen TM, Castrén M, Väliaho ES, Rantula OA, Naukkarinen NS, Hartikainen JEK, Halonen J, Martikainen TJ. Continuous mHealth Patch Monitoring for the Algorithm-Based Detection of Atrial Fibrillation: Feasibility and Diagnostic Accuracy Study. JMIR Cardio 2022; 6:e31230. [PMID: 35727618 PMCID: PMC9257607 DOI: 10.2196/31230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 12/27/2021] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background The detection of atrial fibrillation (AF) is a major clinical challenge as AF is often paroxysmal and asymptomatic. Novel mobile health (mHealth) technologies could provide a cost-effective and reliable solution for AF screening. However, many of these techniques have not been clinically validated. Objective The purpose of this study is to evaluate the feasibility and reliability of artificial intelligence (AI) arrhythmia analysis for AF detection with an mHealth patch device designed for personal well-being. Methods Patients (N=178) with an AF (n=79, 44%) or sinus rhythm (n=99, 56%) were recruited from the emergency care department. A single-lead, 24-hour, electrocardiogram-based heart rate variability (HRV) measurement was recorded with the mHealth patch device and analyzed with a novel AI arrhythmia analysis software. Simultaneously registered 3-lead electrocardiograms (Holter) served as the gold standard for the final rhythm diagnostics. Results Of the HRV data produced by the single-lead mHealth patch, 81.5% (3099/3802 hours) were interpretable, and the subject-based median for interpretable HRV data was 99% (25th percentile=77% and 75th percentile=100%). The AI arrhythmia detection algorithm detected AF correctly in all patients in the AF group and suggested the presence of AF in 5 patients in the control group, resulting in a subject-based AF detection accuracy of 97.2%, a sensitivity of 100%, and a specificity of 94.9%. The time-based AF detection accuracy, sensitivity, and specificity of the AI arrhythmia detection algorithm were 98.7%, 99.6%, and 98.0%, respectively. Conclusions The 24-hour HRV monitoring by the mHealth patch device enabled accurate automatic AF detection. Thus, the wearable mHealth patch device with AI arrhythmia analysis is a novel method for AF screening. Trial Registration ClinicalTrials.gov NCT03507335; https://clinicaltrials.gov/ct2/show/NCT03507335
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Affiliation(s)
- Onni E Santala
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Doctoral School, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jukka A Lipponen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Helena Jäntti
- Centre for Prehospital Emergency Care, Kuopio University Hospital, Kuopio, Finland
| | | | - Mika P Tarvainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Tomi P Laitinen
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Tiina M Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Maaret Castrén
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Eemu-Samuli Väliaho
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Doctoral School, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Olli A Rantula
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Doctoral School, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Noora S Naukkarinen
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Doctoral School, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Juha E K Hartikainen
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Heart Center, Kuopio University Hospital, Kuopio, Finland
| | - Jari Halonen
- School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Heart Center, Kuopio University Hospital, Kuopio, Finland
| | - Tero J Martikainen
- Department of Emergency Care, Kuopio University Hospital, Kuopio, Finland
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26
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Torkamani-Azar M, Lee A, Bednarik R. Methods and Measures for Mental Stress Assessment in Surgery: A Systematic Review of 20 Years of Literature. IEEE J Biomed Health Inform 2022; 26:4436-4449. [PMID: 35696473 DOI: 10.1109/jbhi.2022.3182869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Real-time mental stress monitoring from surgeons and surgical staff in operating rooms may reduce surgical injuries, improve performance and quality of medical care, and accelerate implementation of stress-management strategies. Motivated by the increase in usage of objective and subjective metrics for cognitive monitoring and by the gap in reviews of experimental design setups and data analytics, a systematic review of 71 studies on mental stress and workload measurement in surgical settings, published in 2001-2020, is presented. Almost 61% of selected papers used both objective and subjective measures, followed by 25% that only administered subjective tools - mostly consisting of validated instruments and customized surveys. An overall increase in the total number of publications on intraoperative stress assessment was observed from mid-2010 s along with a momentum in the use of both subjective and real-time objective measures. Cardiac activity, including heart-rate variability metrics, stress hormones, and eye-tracking metrics were the most frequently and electroencephalography (EEG) was the least frequently used objective measures. Around 40% of selected papers collected at least two objective measures, 41% used wearable devices, 23% performed synchronization and annotation, and 76% conducted baseline or multi-point data acquisition. Furthermore, 93% used a variety of statistical techniques, 14% applied regression models, and only one study released a public, anonymized dataset. This review of data modalities, experimental setups, and analysis techniques for intraoperative stress monitoring highlights the initiatives of surgical data science and motivates research on computational techniques for mental and surgical skills assessment and cognition-guided surgery.
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27
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Kerley L, Meredith P, Harnett P. Investigating autonomic biomarkers of sensory processing patterns in young adults. Br J Occup Ther 2022. [DOI: 10.1177/03080226221089845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Autonomic nervous system functioning is theorised to underpin individual differences in sensory processing, with a small amount of supporting evidence. Despite recognition of the need to measure the balance between sympathetic and parasympathetic activity, most studies have measured only one of these systems. This study investigated whether sensory processing patterns are related to autonomic balance for young adults at rest and in response to a sensory-based stressor. Method In this cross-sectional laboratory study, 100 young adults completed the adolescent/adult sensory profile. Heart rate variability and pre-ejection period were recorded before, during and after a coldpressor task. Results Relationships between sensory processing patterns and autonomic balance varied by gender. In males, low sensory thresholds were generally related to a state of reciprocal sympathetic activation. In females, low thresholds were associated with greater autonomic reactivity in response to the coldpressor. Conclusion This study showed, for the first time in young adults, that sensory processing patterns may be linked to patterns of autonomic balance. Therapists should be aware that young men with low sensory thresholds may be more likely than others to exhibit a resting state of sympathetic hyperarousal and further research should investigate whether this impacts their daily functioning and wellbeing.
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Affiliation(s)
- Lachlan Kerley
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Pamela Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
- School of Health and Behavioural Sciences, Sunshine Coast University, Maroochydore, Queensland, Australia
| | - Paul Harnett
- School of Criminology and Criminal Justice, Griffith University, Mt Gravatt, Queensland, Australia
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28
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Cook P, Jankowski C, Erlandson KM, Reeder B, Starr W, Flynn Makic MB. Low- and High-Intensity Physical Activity Among People with HIV: Multilevel Modeling Analysis Using Sensor- and Survey-Based Predictors. JMIR Mhealth Uhealth 2022; 10:e33938. [PMID: 35436236 PMCID: PMC9135322 DOI: 10.2196/33938] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/13/2022] [Accepted: 02/17/2022] [Indexed: 01/02/2023] Open
Abstract
Background
High-intensity physical activity improves the health of people with HIV. Even when people have good intentions to engage in physical activity, they often find it difficult to maintain physical activity behavior in the long term. Two Minds Theory is a neurocognitive model that explains gaps between people’s intentions and behaviors based on the operations of 2 independent mental systems. This model predicts that everyday experiences will affect physical activity and that factors outside people’s awareness, such as sleep and stress, can have particularly strong effects on physical activity behaviors.
Objective
We designed this study to test the effects of daily experiences on physical activity among people with HIV, including measures of people’s conscious experiences using daily electronic surveys and measures of nonconscious influences using sensor devices.
Methods
In this study, 55 people with HIV wore a Fitbit Alta for 30 days to monitor their physical activity, sleep, and heart rate variability (HRV) as a physiological indicator of stress. Participants also used their smartphones to complete daily electronic surveys for the same 30 days about fatigue, self-efficacy, mood, stress, coping, motivation, and barriers to self-care. Time-lagged, within-person, multilevel models were used to identify the best prospective predictors of physical activity, considering the daily survey responses of people with HIV and sensor data as predictors of their physical activity the following day. We also tested baseline surveys as predictors of physical activity for comparison with daily variables.
Results
Different people had different average levels of physical activity; however, physical activity also varied substantially from day to day, and daily measures were more predictive than baseline surveys. This suggests a chance to intervene based on day-to-day variations in physical activity. High-intensity physical activity was more likely when people with HIV reported less subjective fatigue on the prior day (r=−0.48) but was unrelated to actual sleep based on objective sensor data. High-intensity physical activity was also predicted by higher HRV (r=0.56), indicating less stress, lower HIV-related stigma (r=−0.21), fewer barriers to self-care (r=−0.34), and less approach coping (r=−0.34). Similar variables predicted lower-level physical activity measured based on the number of steps per day of people with HIV.
Conclusions
Some predictors of physical activity, such as HRV, were only apparent based on sensor data, whereas others, such as fatigue, could be measured via self-report. Findings about coping were unexpected; however, other findings were in line with the literature. This study extends our prior knowledge on physical activity by demonstrating a prospective effect of everyday experiences on physical activity behavior, which is in line with the predictions of Two Minds Theory. Clinicians can support the physical activity of people with HIV by helping their patients reduce their daily stress, fatigue, and barriers to self-care.
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Affiliation(s)
- Paul Cook
- College of Nursing, University of Colorado, Aurora, CO, United States
| | | | | | - Blaine Reeder
- Sinclair School of Nursing, University of Missouri, Columbia, MO, United States
| | - Whitney Starr
- School of Medicine, University of Colorado, Aurora, CO, United States
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29
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Moya-Ramon M, Mateo-March M, Peña-González I, Zabala M, Javaloyes A. Validity and reliability of different smartphones applications to measure HRV during short and ultra-short measurements in elite athletes. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 217:106696. [PMID: 35172251 DOI: 10.1016/j.cmpb.2022.106696] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/09/2021] [Accepted: 02/08/2022] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND OBJECTIVE Heart rate variability (HRV) has been proposed as a useful marker that can show the performance adaptation and optimize the training process in elite athletes. The development of wearable technology permits the measurement of this marker through smartphone applications. The purpose of this study is to assess the validity and reliability of short and ultra-short HRV measurements in elite cyclists using different smartphone applications. METHOD Twenty-six professional cyclists were measured at rest in supine and in seated positions through the simultaneous use of an electrocardiogram and two different smartphone applications that implement different technologies to measure HRV: Elite HRV (with a chest strap) and Welltory (photoplethysmography). Level of significance was set at p < 0.05. RESULTS Compared to an electrocardiogram, Elite HRV and Welltory showed no differences neither in supine nor in seated positions (p > 0.05) and they showed very strong to almost perfect correlation levels (r = 0.77 to 0.94). Furthermore, no differences were found between short (5 min) and ultra-short (1 min) length measurements. Intraclass correlation coefficient showed good to excellent reliability and the standard error of measurement remained lower than 6%. CONCLUSION Both smartphone applications can be implemented to monitor HRV using short- and ultra-short length measurements in elite endurance athletes.
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Affiliation(s)
- M Moya-Ramon
- Sport Science Department, Universidad Miguel Hernández de Elche, Spain
| | - M Mateo-March
- Sport Science Department, Universidad Miguel Hernández de Elche, Spain; Spanish Cycling Federation, Spain.
| | - I Peña-González
- Sport Science Department, Universidad Miguel Hernández de Elche, Spain
| | - M Zabala
- Department of Physical Activity and Sport, University of Granada, Spain
| | - A Javaloyes
- Sport Science Department, Universidad Miguel Hernández de Elche, Spain
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30
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Sullivan K, Metoyer CJ, Hornikel B, Holmes CJ, Nickerson BS, Esco MR, Fedewa MV. Agreement Between A 2-Dimensional Digital Image-Based 3-Compartment Body Composition Model and Dual Energy X-Ray Absorptiometry for The Estimation of Relative Adiposity. J Clin Densitom 2022; 25:244-251. [PMID: 34756706 PMCID: PMC8942865 DOI: 10.1016/j.jocd.2021.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/17/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to compare relative adiposity (%Fat) derived from a 2-dimensional image-based 3-component (3C) model (%Fat3C-IMAGE) and dual-energy X-ray absorptiometry (DXA) (%FatDXA) against a 5-component (5C) laboratory criterion (%Fat5C). 57 participants were included (63.2% male, 84.2% White/Caucasian, 22.5±4.7 yrs., 23.9±2.8 kg/m2). For each participant, body mass and standing height were measured to the nearest 0.1 kg and 0.1 cm, respectively. A digital image of each participant was taken using a 9.7 inch, 16g iPad Air 2 and analyzed using a commercially available application (version 1.1.2, made Health and Fitness, USA) for the estimation of body volume (BV) and inclusion in %Fat3C-IMAGE . %Fat3C-IMAGE and %Fat5C included measures of total body water derived from bioimpedance spectroscopy. The criterion %Fat5C included BV estimates derived from underwater weighing and bone mineral content measures via DXA. %FatDXA estimates were calculated from a whole-body DXA scan. A standardized mean effect size (ES) assessed the magnitude of differences between models with values of 0.2, 0.5, and 0.8 for small, moderate, and large differences, respectively. Data are presented as mean ± standard deviation. A strong correlation (r = 0.94, p <.001) and small mean difference (ES = 0.24, p <.001) was observed between %Fat3C-IMAGE (19.20±5.80) and %Fat5C (17.69±6.20) whereas a strong correlation (r = 0.87, p <.001) and moderate-large mean difference (ES = 0.70, p <.001) was observed between %FatDXA (22.01±6.81) and %Fat5C. Furthermore, %Fat3C-IMAGE (SEE = 2.20 %Fat, TE= 2.6) exhibited smaller SEE and TE than %FatDXA (SEE = 3.14 %Fat, TE = 5.5). The 3C image-based model performed slightly better in our sample of young adults than the DXA 3C model. Thus, the 2D image analysis program provides an accurate and non-invasive estimate of %Fat within a 3C model in young adults. Compared to DXA, the 3C image-based model allows for a more cost-effective and portable method of body composition assessment, potentially increasing accessibility to multi-component methods.
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Affiliation(s)
- Katherine Sullivan
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Casey J Metoyer
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Bjoern Hornikel
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Clifton J Holmes
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, USA; Program in Physical Therapy, School of Medicine, Washington University, Saint Louis, Missouri, USA
| | - Brett S Nickerson
- College of Nursing and Health Sciences, Texas A&M International University, Laredo, Texas, USA
| | - Michael R Esco
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Michael V Fedewa
- Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, USA.
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31
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Thielmann B, Hartung J, Böckelmann I. Objective assessment of mental stress in individuals with different levels of effort reward imbalance or overcommitment using heart rate variability: a systematic review. Syst Rev 2022; 11:48. [PMID: 35305680 PMCID: PMC8934447 DOI: 10.1186/s13643-022-01925-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/08/2022] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND Workloads are increasing and could cause mental stress, e.g., in the form of subjective effort reward imbalance (ERI) and overcommitment (OC). The heart rate variability (HRV) is a valid method for objective monitoring of workload. The aim of this project is to systematically evaluate the literature on HRV as an objective indicator for mental stress in individuals with different levels of ERI or OC. METHODS A systematic literature review examining HRV of employees in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for reporting systematic reviews was performed. Electronic databases used were PubMed, Ovid, Cochrane Libary, Scopus and Web of Science, PsyInfo, Psyndex, and Livio. Only articles from 2005 to 2021 were included. Inclusion criteria were case-control studies, intervention studies, cross-sectional studies, or longitudinal studies with different levels of ERI and/or OC, >10 participants in each group, measurement of 24h HRV by using Holter ECG or chest belt, and full-text in English or German language. The methodological quality was evaluated by using a modified STARD for HRV. RESULTS Five studies matched the inclusion criteria by using HRV (24-h ECG) with a different HRV analysis at day and night. It showed an adaptation of HRV with higher ERI or OC with reduced parasympathetic HRV parameters, but the studies were not comparable. CONCLUSIONS There is a need for occupational health studies that examine strains and stress of different employees with predominantly mental stress. The well-established parasympathetic mediated HRV parameters seem to be suitable parameters to objectify the stress.
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Affiliation(s)
- Beatrice Thielmann
- Institute of Occupational Medicine, Medical Faculty, Otto-von-Guericke-University, Magdeburg, Leipziger Str. 44, (Building 20), 39120, Magdeburg, Germany.
| | - Jonas Hartung
- Institute of Occupational Medicine, Medical Faculty, Otto-von-Guericke-University, Magdeburg, Leipziger Str. 44, (Building 20), 39120, Magdeburg, Germany
| | - Irina Böckelmann
- Institute of Occupational Medicine, Medical Faculty, Otto-von-Guericke-University, Magdeburg, Leipziger Str. 44, (Building 20), 39120, Magdeburg, Germany
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Schams P, Feodoroff B, Zacher J, Eibel A, Froböse I. Validation of a smart shirt for heart rate variability measurements at rest and during exercise. Clin Physiol Funct Imaging 2022; 42:190-199. [PMID: 35274441 DOI: 10.1111/cpf.12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/11/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
Heart rate variability (HRV) monitoring is a promising option to estimate the autonomic nervous system regulation responding to exercise. Textiles with embedded sensors recording heartbeat intervals are a simple tool for data collection. So-called smart shirts offer comfort for a daily use and are managed easily. Their measurement accuracy for HRV calculation at rest is promising but remains questionable during exercise. Therefore, the present study validated the Ambiotex smart shirt using HRV indices (RMSSD, rel. HF power and rel. LF power) during exercise. Eighty-three healthy participants (31 ± 6 years; 39 females, 44 males) completed an incremental exercise test on a bicycle ergometer wearing the smart shirt and an electrocardiogram simultaneously. We compared HRV indices of segments at rest (5 min), at warm-up (3 min) and twice at the exercise test (each 5 min). At rest and at warm-up, we observed excellent linear relationship (r > 0.96; R² > 0.94), excellent relative reliability (ICC ≥ 0.98; α ≥ 0.98) and acceptable agreement (bias < 10%). During the exercise test, measurement accuracy declined with increasing intensity but remained high (> 0.8), although results for partial HRV indices were insufficient. In addition, percentage bias was unacceptable during exercise test. However, the findings support the validity of the smart shirt for measuring HRV especially at rest and at warm-up. We suggest using the smart shirt for monitoring HRV indices on a daily basis but caution should be taken in the interpretation of HRV indices obtained during moderate to vigorous exercise intensities. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Peter Schams
- Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation Sciences; German Sport University, Cologne, 50933, Germany
| | - Boris Feodoroff
- Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation Sciences; German Sport University, Cologne, 50933, Germany
| | - Jonas Zacher
- Institute of Cardiology and Sports Medicine; German Sport University, Cologne, 50933, Germany
| | - Angelina Eibel
- Institute of Cardiology and Sports Medicine; German Sport University, Cologne, 50933, Germany
| | - Ingo Froböse
- Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation Sciences; German Sport University, Cologne, 50933, Germany
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Rogers B, Schaffarczyk M, Clauß M, Mourot L, Gronwald T. The Movesense Medical Sensor Chest Belt Device as Single Channel ECG for RR Interval Detection and HRV Analysis during Resting State and Incremental Exercise: A Cross-Sectional Validation Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22052032. [PMID: 35271179 PMCID: PMC8914935 DOI: 10.3390/s22052032] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/26/2022] [Accepted: 03/03/2022] [Indexed: 05/05/2023]
Abstract
The value of heart rate variability (HRV) in the fields of health, disease, and exercise science has been established through numerous investigations. The typical mobile-based HRV device simply records interbeat intervals, without differentiation between noise or arrythmia as can be done with an electrocardiogram (ECG). The intent of this report is to validate a new single channel ECG device, the Movesense Medical sensor, against a conventional 12 channel ECG. A heterogeneous group of 21 participants performed an incremental cycling ramp to failure with measurements of HRV, before (PRE), during (EX), and after (POST). Results showed excellent correlations between devices for linear indexes with Pearson's r between 0.98 to 1.0 for meanRR, SDNN, RMSSD, and 0.95 to 0.97 for the non-linear index DFA a1 during PRE, EX, and POST. There was no significant difference in device specific meanRR during PRE and POST. Bland-Altman analysis showed high agreement between devices (PRE and POST: meanRR bias of 0.0 and 0.4 ms, LOA of 1.9 to -1.8 ms and 2.3 to -1.5; EX: meanRR bias of 11.2 to 6.0 ms; LOA of 29.8 to -7.4 ms during low intensity exercise and 8.5 to 3.5 ms during high intensity exercise). The Movesense Medical device can be used in lieu of a reference ECG for the calculation of HRV with the potential to differentiate noise from atrial fibrillation and represents a significant advance in both a HR and HRV recording device in a chest belt form factor for lab-based or remote field-application.
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Affiliation(s)
- Bruce Rogers
- Department of Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL 32827, USA
- Correspondence:
| | - Marcelle Schaffarczyk
- Department Sports and Exercise Medicine, Institute of Human Movement Science, University of Hamburg, 20148 Hamburg, Germany;
| | - Martina Clauß
- Institute of Movement and Trainings Science in Sport, Faculty of Sport Science, Leipzig University, 04109 Leipzig, Germany;
| | - Laurent Mourot
- EA3920 Pronostic Factors and Regulatory Factors of Cardiac and Vascular Pathologies, Exercise Performance Health Innovation (EPHI) Plaptform, University of Bourgogne Franche-Comté, 25000 Besançon, France;
- Division for Physical Education, National Research Tomsk Polytechnic University, 634040 Tomsk, Russia
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, 20457 Hamburg, Germany;
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Pincu Y, Tryggestad JB, Teague AM, Short KR. The effect of a high fat meal on heart rate variability and arterial stiffness in adolescents with or without type 1 diabetes. J Diabetes Complications 2022; 36:108130. [PMID: 35067450 DOI: 10.1016/j.jdiacomp.2022.108130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/07/2022] [Accepted: 01/09/2022] [Indexed: 10/19/2022]
Abstract
AIM Type 1 diabetes (T1D) is associated with increased arterial stiffness and cardiac autonomic neuropathy. We tested whether those variables are acutely affected by a high fat meal (HFM). METHODS Responses to a HFM were measured in adolescents with T1D (N = 14) or without T1D (Control, N = 21). Heart rate variability (HRV), arterial stiffness, blood pressure (BP), and energy expenditure (EE) were measured before (baseline) and four times over 180 min postprandially. RESULTS T1D had higher blood glucose and insulin, but the suppression of fatty acids (~40%) and rise in triglycerides (~60%) were similar between groups. T1D had 9% higher EE, but postprandial increase in EE was similar to Controls. T1D had ~7 to 24% lower baseline HRV but a similar postprandial decline of ~8 to 25% as Controls. Both groups had a similar 2 to 5% increase in BP after the meal. Rate pressure product increased postprandially in both groups and was higher in T1D. Pulsewave velocity and augmentation index did not differ between groups or change postprandially. CONCLUSION Adolescents with T1D have evidence of cardiac autonomic dysfunction and increased EE, but those variables, along with arterial stiffness, are not acutely made worse by a HFM.
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Affiliation(s)
- Yair Pincu
- Health and Exercise Science, University of Oklahoma, Norman, OK 73019, United States of America; Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States of America
| | - Jeanie B Tryggestad
- Section of Diabetes & Endocrinology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States of America; Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States of America
| | - April M Teague
- Section of Diabetes & Endocrinology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States of America; Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States of America
| | - Kevin R Short
- Section of Diabetes & Endocrinology, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States of America; Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States of America.
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Whinery ED, Musleh A, Brown EA, Alford Z, Anigbogu JC, Ellingwood L, Espinoza MA, Hawkins G, Kammer K, Krause K, Olson LE. Physiological Responses to Narrative Anger Recall and Correlates to Anger, Forgiveness, and Rumination. J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Narrative recall, or describing an event from one’s past, is a common method to study anger in the laboratory. However, most research using this method has not included a neutral speaking control, and therefore the physiological response attributable to emotion versus the act of speech is unknown. We evaluated heart rate, blood pressure, skin conductance level, heart rate variability, and salivary alpha-amylase during silent baseline, neutral speaking, anger recall, and recovery periods, and correlated these measures with trait anger, forgiveness, and rumination ( n = 104). Only systolic blood pressure and skin conductance levels were elevated in the anger recall period above the values in the neutral speaking period, showing the need for this important control. Alpha-amylase was inversely correlated to forgiveness, particularly in females. A neutral speaking control is critical for anger recall protocols because the physiological responses are mostly due to speaking, not anger. Salivary alpha-amylase may be a promising autonomic marker in studies of forgiveness and anger.
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Affiliation(s)
| | - Aya Musleh
- Department of Biology, University of Redlands, Redlands, CA, USA
| | - Emily A. Brown
- Department of Biology, University of Redlands, Redlands, CA, USA
| | - Zachary Alford
- Department of Biology, University of Redlands, Redlands, CA, USA
| | - Joe C. Anigbogu
- Department of Biology, University of Redlands, Redlands, CA, USA
| | | | | | - Greg Hawkins
- Department of Biology, University of Redlands, Redlands, CA, USA
| | - Kaisa Kammer
- Department of Biology, University of Redlands, Redlands, CA, USA
| | - Kevin Krause
- Department of Biology, University of Redlands, Redlands, CA, USA
| | - Lisa E. Olson
- Department of Biology, University of Redlands, Redlands, CA, USA
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Özümerzifon Y, Ross A, Brinza T, Gibney G, Garber CE. Exploring a Dance/Movement Program on Mental Health and Well-Being in Survivors of Intimate Partner Violence During a Pandemic. Front Psychiatry 2022; 13:887827. [PMID: 35722545 PMCID: PMC9204421 DOI: 10.3389/fpsyt.2022.887827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS The aim of this study was to explore the feasibility and benefits of a 12-session dance/movement program for intimate partner violence survivors' mental health and PTSD symptoms during the COVID-19 Pandemic. The specific purposes were fourfold: (1) To determine the feasibility of delivering a virtual dance/movement workshop program; (2) to examine the effects of the program on symptoms of PTSD and psychological distress; (3) to determine whether heart rate variability improves; and (4) to describe the individual and shared experiences of a subgroup of participants of the program. METHODS Forty-five women ages 23-48 years were randomized to a 12-session virtual creative dance/movement program or a usual care control group, and completed questionnaires about PTSD and mental health symptoms, general health, physical activity, and underwent a brief measurement of heart rate variability. A subset of the intervention group participated in a semi-structured focus group. RESULTS The results of the study showed that the female survivors of intimate partner violence who participated in the virtual workshops felt better, and they experienced improved affect and reduced tension. They found new ways to express themselves, attune to their bodies, learn new self-care habits, and build community as they engaged in the workshops. Over the course of the study, the participants' symptoms of PTSD and psychological distress lessened. There were no changes in heart rate variability. CONCLUSIONS This complex study was successfully completed during a global pandemic and resulted in improvements in some mental health symptoms and overall well-being. Given the importance of this work with intimate partner violence survivors, further work exploring dance/movement workshops for participants virtually and in-person is needed.
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Affiliation(s)
| | - Allison Ross
- Sanctuary for Families, Inc., New York, NY, United States
| | - Tessa Brinza
- Gina Gibney Dance, Inc., New York, NY, United States
| | - Gina Gibney
- Gina Gibney Dance, Inc., New York, NY, United States
| | - Carol Ewing Garber
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
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Papadakis Z, Forsse JS, Peterson MN. Effects of High-Intensity Interval Exercise and Acute Partial Sleep Deprivation on Cardiac Autonomic Modulation. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2021; 92:824-842. [PMID: 32841103 DOI: 10.1080/02701367.2020.1788206] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/13/2020] [Indexed: 06/11/2023]
Abstract
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.
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Grässler B, Thielmann B, Böckelmann I, Hökelmann A. Effects of different exercise interventions on heart rate variability and cardiovascular health factors in older adults: a systematic review. Eur Rev Aging Phys Act 2021; 18:24. [PMID: 34789148 PMCID: PMC8597177 DOI: 10.1186/s11556-021-00278-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/01/2021] [Indexed: 01/09/2023] Open
Abstract
Background Aging impairs physiological processes in the autonomic nervous, endocrine, and cardiovascular systems which are associated with increased risk of cardiovascular disease. Heart rate variability (HRV), the beat-to-beat variations of successive heartbeats, is an indicator of cardiac autonomic control and cardiovascular health. Physical activity has beneficial effects on cardiovascular health. However, no review has been conducted to summarize the effects of different exercise modalities on HRV in older adults. Therefore, the aim of this systematic review was to summarize the effects of endurance, resistance, coordinative, and multimodal exercise interventions on resting HRV and secondary health factors in healthy older adults aged 60 years in average and over. Methods Five databases (PubMed, Scopus, SPORTDiscus, Ovid, and Cochrane Library) were searched for eligible studies published between 2005 and September 8th, 2020. Two reviewers independently assessed the studies for potential inclusion. Outcome measures were changes in resting HRV indices, baroreflex sensitivity, blood pressure, body fat, body mass, body mass index, cardiac output, distance in the six-minute walking test, stroke volume, total peripheral resistance, and VO2 max or VO2 peak from pre to post intervention. The methodological quality of the final data set was assessed using two scales (TESTEX and STARDHRV). This review was registered in PROSPERO: CRD42020206606. Results The literature search retrieved 3991 articles, of which 13 were included in the review. Five studies used multimodal, three studies endurance, two studies resistance, two studies coordinative, and one study used an endurance and a resistance training intervention. The majority of the studies revealed significant positive effects on cardiac autonomic control, except for the resistance training interventions. All exercise modalities improved secondary health factors. The methodological quality assessment revealed a few criteria to improve the quality of and comparability between studies. Conclusion This systematic review revealed beneficial effects on cardiac autonomic control in healthy older adults through endurance, coordinative, and multimodal training but not through resistance training. Secondary health factors improved after all types of physical interventions. Future investigations should more thoroughly adhere to methodological standards of exercise interventions and ECG recording for the assessment of autonomic regulation. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-021-00278-6.
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Affiliation(s)
- Bernhard Grässler
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39104, Magdeburg, Germany.
| | - Beatrice Thielmann
- Department of Occupational Medicine, Faculty of Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Irina Böckelmann
- Department of Occupational Medicine, Faculty of Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Anita Hökelmann
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39104, Magdeburg, Germany
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Mestrom E, Deneer R, Bonomi AG, Margarito J, Gelissen J, Haakma R, Korsten HHM, Scharnhorst V, Bouwman RA. Validation of Heart Rate Extracted From Wrist-Based Photoplethysmography in the Perioperative Setting: Prospective Observational Study. JMIR Cardio 2021; 5:e27765. [PMID: 34734834 PMCID: PMC8603171 DOI: 10.2196/27765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/08/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background Measurement of heart rate (HR) through an unobtrusive, wrist-worn optical HR monitor (OHRM) could enable earlier recognition of patient deterioration in low acuity settings and enable timely intervention. Objective The goal of this study was to assess the agreement between the HR extracted from the OHRM and the gold standard 5-lead electrocardiogram (ECG) connected to a patient monitor during surgery and in the recovery period. Methods In patients undergoing surgery requiring anesthesia, the HR reported by the patient monitor’s ECG module was recorded and stored simultaneously with the photopletysmography (PPG) from the OHRM attached to the patient’s wrist. The agreement between the HR reported by the patient’s monitor and the HR extracted from the OHRM’s PPG signal was assessed using Bland-Altman analysis during the surgical and recovery phase. Results A total of 271.8 hours of data in 99 patients was recorded simultaneously by the OHRM and patient monitor. The median coverage was 86% (IQR 65%-95%) and did not differ significantly between surgery and recovery (Wilcoxon paired difference test P=.17). Agreement analysis showed the limits of agreement (LoA) of the difference between the OHRM and the ECG HR were within the range of 5 beats per minute (bpm). The mean bias was –0.14 bpm (LoA between –3.08 bpm and 2.79 bpm) and –0.19% (LoA between –5 bpm to 5 bpm) for the PPG- measured HR compared to the ECG-measured HR during surgery; during recovery, it was –0.11 bpm (LoA between –2.79 bpm and 2.59 bpm) and –0.15% (LoA between –3.92% and 3.64%). Conclusions This study shows that an OHRM equipped with a PPG sensor can measure HR within the ECG reference standard of –5 bpm to 5 bpm or –10% to 10% in the perioperative setting when the PPG signal is of sufficient quality. This implies that an OHRM can be considered clinically acceptable for HR monitoring in low acuity hospitalized patients.
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Affiliation(s)
- Eveline Mestrom
- Department of Anesthesiology, Catharina Hospital Eindhoven, Eindhoven, Netherlands
| | - Ruben Deneer
- Clinical Laboratory, Catharina Hospital Eindhoven, Eindhoven, Netherlands.,Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.,Expert Center Clinical Chemistry Eindhoven, Eindhoven, Netherlands
| | - Alberto G Bonomi
- Department of Personal Health, Philips Research, Eindhoven, Netherlands
| | - Jenny Margarito
- Department of Personal Health, Philips Research, Eindhoven, Netherlands
| | - Jos Gelissen
- Department of Personal Health, Philips Research, Eindhoven, Netherlands
| | - Reinder Haakma
- Department of Personal Health, Philips Research, Eindhoven, Netherlands
| | - Hendrikus H M Korsten
- Department of Anesthesiology, Catharina Hospital Eindhoven, Eindhoven, Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Volkher Scharnhorst
- Clinical Laboratory, Catharina Hospital Eindhoven, Eindhoven, Netherlands.,Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.,Expert Center Clinical Chemistry Eindhoven, Eindhoven, Netherlands
| | - R Arthur Bouwman
- Department of Anesthesiology, Catharina Hospital Eindhoven, Eindhoven, Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
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Abstract
Wearable technology has a history in sleep research dating back to the 1970s. Because modern wearable technology is relatively cheap and widely used by the general population, this represents an opportunity to leverage wearable devices to advance sleep medicine and research. However, there is a lack of published validation studies designed to quantify device performance against accepted gold standards, especially across different populations. Recommendations for conducting performance assessments and using wearable devices are now published with the goal of standardizing wearable device implementation and advancing the field.
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Moon E, Yang M, Seon Q, Linnaranta O. Relevance of Objective Measures in Psychiatric Disorders-Rest-Activity Rhythm and Psychophysiological Measures. Curr Psychiatry Rep 2021; 23:85. [PMID: 34714422 PMCID: PMC8556205 DOI: 10.1007/s11920-021-01291-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW We present a review of recent methods of objective measurement in psychiatry and psychology with a focus on home monitoring and its utility in guiding treatment. RECENT FINDINGS For individualized diagnostics and treatment of insomnia, actigraphy can generate clinically useful graphical presentations of sleep timing and patterns. Psychophysiological measures may complement psychometrics by tracking parallel changes in physiological responses and emotional functioning, especially during therapy for trauma symptoms and emotion regulation. It seems that rather than defining universal cut-offs, an individualised range of variability could characterize treatment response. Wearable actigraphy and psychophysiological sensors are promising devices to provide biofeedback and guide treatment. Use of feasible and reliable technology during experimental and clinical procedures may necessitate defining healthy and abnormal responses in different populations and pathological states. We present a "call for action" towards further collaborative work to enable large scale use of objective measures.
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Affiliation(s)
- Eunsoo Moon
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Department of Psychiatry and Biomedical Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Michelle Yang
- Interdisciplinary Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Quinta Seon
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Outi Linnaranta
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
- Mental Health Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.
- Douglas Centre for Sleep and Biological Rhythms, Douglas Mental Health University Institute, 6875 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada.
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Lauterbach CJ, Romano PA, Greisler LA, Brindle RA, Ford KR, Kuennen MR. Accuracy and Reliability of Commercial Wrist-Worn Pulse Oximeter During Normobaric Hypoxia Exposure Under Resting Conditions. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2021; 92:549-558. [PMID: 32633688 DOI: 10.1080/02701367.2020.1759768] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
Purpose: The present study analyzed peripheral blood oxygen saturation (SpO2) and heart rate (HR) measurements taken on the Garmin fēnix® 5X Plus watch, comparing them to measurements taken on a standard medical-grade pulse oximeter during normobaric hypoxia exposure under resting conditions. Methods: Thirteen women (mean ± SD: Age 20 ± 1 years, height 165 ± 5 cm, mass, 67 ± 9 kg) and ten men (mean ± SD: Age 21 ± 3 years, height 177 ± 6 cm, mass 78 ± 11 kg) sat inside a customized environmental chamber while the fraction of inspired oxygen (FIO2) was adjusted to simulate altitudes of 12,000; 10,000; 8,000; 6,000; and 900 ft. The novel commercial device (Garmin fēnix®) and a medical-grade pulse oximeter (Nonin® 7500) were used to measure SpO2 and HR in triplicate at each simulated altitude. Bland-Altman analyses were used to assess differences between methods. Results: Bland-Altman analysis indicated 3.3% bias for SpO2 measurements taken on the Garmin fēnix® at 12,000 ft of simulated altitude (limits of agreement: -1.9-8.6%). Mean differences in SpO2 measurements were smaller at the remaining simulated altitudes, where bias measurements ranged from 0.7% to 0.8%. The Garmin fēnix® also underestimated heart rate, but those discrepancies were minimal (bias measurements at all simulated altitude exposures were < 1.0 bpm). Conclusions: With the exception of readings taken at 12,000 ft of simulated altitude, the Garmin fēnix® exhibits minimal overestimation of SpO2 and minimal underestimation of HR during simulated altitude exposure. These data suggest the Garmin fēnix® watch may be a viable method to monitor SpO2 and HR under most ambient environmental conditions.
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Affiliation(s)
| | | | | | - Richard A Brindle
- High Point University
- Baylor University - Keller Army Community Hospital
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Lai Y, Huang C, Cheng B, Tsai N, Chiu W, Chang H, Chen J, Lu C. Feasibility of combining heart rate variability and electrochemical skin conductance as screening and severity evaluation of cardiovascular autonomic neuropathy in type 2 diabetes. J Diabetes Investig 2021; 12:1671-1679. [PMID: 33522129 PMCID: PMC8409849 DOI: 10.1111/jdi.13518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS/INTRODUCTION Clinical studies show that either heart rate variability (HRV) or electrochemical skin conductance (ESC) alone can serve as a simple and objective method for screening cardiovascular autonomic neuropathy (CAN). We tested the hypothesis that combining these two quantitative approaches can not only reinforce accuracy in CAN screening but also provide a better estimate of CAN severity in patients with type 2 diabetes (T2DM) who had already had CAN in outpatient clinics. MATERIALS AND METHODS Each patient received a complete battery of cardiovascular autonomic reflex tests (CARTs), with ESC measured by SUDOSCAN, time domain of HRV measured by standard deviation of all normal RR intervals (SDNN) and frequency domain of HRV (low frequency [LF], high frequency [HF], and LF/HF ratio), and peripheral blood studies for vascular risk factors. Severity of CAN was measured by CAN score. RESULTS The 90 T2DM patients included 50 males and 40 females. Those with more severe CAN had lower values in feet ESC (P = 0.023) and SDNN (P < 0.0001). Multiple linear regression analysis also showed that feet ESC and SDNN value (P = 0.003 and P < 0.0001) were significantly associated with CAN score. Combining SDNN and feet ESC also can increase the diagnostic accuracy of CAN with respective to sensitivity and specificity by using receiver operating characteristic analysis. CONCLUSIONS Combining the results of SDNN and feet ESC can not only assess, but also quantitatively reflect the progress or improvement of autonomic nerve function (including sympathetic and parasympathetic activity) in patients with T2DM.
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Affiliation(s)
- Yun‐Ru Lai
- Department of NeurologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Chih‐Cheng Huang
- Department of NeurologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Ben‐Chung Cheng
- Department of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Nai‐Wen Tsai
- Department of NeurologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Wen‐Chan Chiu
- Department of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Hsueh‐Wen Chang
- Department of Biological ScienceNational Sun Yat‐Sen UniversityKaohsiungTaiwan
| | - Jung‐Fu Chen
- Department of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Cheng‐Hsien Lu
- Department of NeurologyKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
- Department of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
- Department of NeurologyXiamen Chang Gung Memorial HospitalXiamen, FujianChina
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Javaloyes A, Mateo-March M, Manresa-Rocamora A, Sanz-Quinto S, Moya-Ramón M. The Use of a Smartphone Application in Monitoring HRV during an Altitude Training Camp in Professional Female Cyclists: A Preliminary Study. SENSORS 2021; 21:s21165497. [PMID: 34450939 PMCID: PMC8401324 DOI: 10.3390/s21165497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/20/2022]
Abstract
Altitude training is a common strategy to improve performance in endurance athletes. In this context, the monitoring of training and the athletes’ response is essential to ensure positive adaptations. Heart rate variability (HRV) has been proposed as a tool to evaluate stress and the response to training. In this regard, many smartphone applications have emerged allowing a wide access to recording HRV easily. The purpose of this study was to describe the changes of HRV using a validated smartphone application before (Pre-TC), during (TC), and after (Post-TC) an altitude training camp in female professional cyclists. Training load (TL) and vagal markers of heart rate variability (LnRMSSD, LnRMSSDcv) of seven professional female cyclists before, during, and after and altitude training camp were monitored. Training volume (SMD = 0.80), LnRMSSD (SMD = 1.06), and LnRMSSDcv (SMD = −0.98) showed moderate changes from Pre-TC to TC. Training volume (SMD = 0.74), TL (SMD = 0.75), LnRMSSD (SMD = −1.11) and LnRMSSDcv (SMD = 0.83) showed moderate changes from TC to Post-TC. Individual analysis showed that heart rate variability responded differently among subjects. The use of a smartphone application to measure HRV is a useful tool to evaluate the individual response to training in female cyclists.
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Affiliation(s)
- Alejandro Javaloyes
- Sports Research Centre, Department of Sports Science, Universidad Miguel Hernández de Elche, 03202 Elche, Spain; (A.J.); (A.M.-R.); (S.S.-Q.)
| | | | - Agustín Manresa-Rocamora
- Sports Research Centre, Department of Sports Science, Universidad Miguel Hernández de Elche, 03202 Elche, Spain; (A.J.); (A.M.-R.); (S.S.-Q.)
| | - Santiago Sanz-Quinto
- Sports Research Centre, Department of Sports Science, Universidad Miguel Hernández de Elche, 03202 Elche, Spain; (A.J.); (A.M.-R.); (S.S.-Q.)
| | - Manuel Moya-Ramón
- Sports Research Centre, Department of Sports Science, Universidad Miguel Hernández de Elche, 03202 Elche, Spain; (A.J.); (A.M.-R.); (S.S.-Q.)
- Correspondence: ; Tel.: +34-9656-62-523
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45
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Substance Use and Addiction Affect More Than the Brain: the Promise of Neurocardiac Interventions. CURRENT ADDICTION REPORTS 2021; 8:431-439. [DOI: 10.1007/s40429-021-00379-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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46
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Grässler B, Thielmann B, Böckelmann I, Hökelmann A. Effects of Different Exercise Interventions on Cardiac Autonomic Control and Secondary Health Factors in Middle-Aged Adults: A Systematic Review. J Cardiovasc Dev Dis 2021; 8:jcdd8080094. [PMID: 34436236 PMCID: PMC8396995 DOI: 10.3390/jcdd8080094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 01/09/2023] Open
Abstract
This systematic review was conducted in accordance with the PRISMA guidelines to summarize the existing literature on the effects of different exercise interventions on cardiac autonomic control and secondary health factors. Resting heart rate variability (HRV) was used as indicator of cardiac autonomic control. Secondary factors were related to factors that contribute to cardiovascular health. Studies examining the effects of endurance, resistance, multimodal, or coordinative training interventions in healthy participants aged between 45 and 60 years old on average were considered. The methodological quality of the studies was examined using two assessment scales (TESTEX and STARDHRV). PROSPERO registration number: CRD42020206606. The literature review retrieved eight studies fulfilling all inclusion criteria. Cardiac autonomic control and cardiovascular health improved after endurance and multimodal interventions. Resistance training had no significant impact on HRV or any secondary health factor. Coordinative exercise interventions showed inconclusive results regarding HRV but showed significant improvements in secondary health factors. The quality assessment tools revealed some methodological and reporting deficits. Despite the small number of studies, we suggest endurance and multimodal interventions including aerobic exercises for the enhancement of cardiac autonomic control and the reduction of cardiovascular risk in middle-aged adults. Further studies need to be conducted to examine the long-term effects of exercise in the midlife period.
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Affiliation(s)
- Bernhard Grässler
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany;
- Correspondence: ; Tel.: +49-391-6756682
| | - Beatrice Thielmann
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.T.); (I.B.)
| | - Irina Böckelmann
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.T.); (I.B.)
| | - Anita Hökelmann
- Department of Sport Science, Faculty of Humanities, Otto von Guericke University, 39106 Magdeburg, Germany;
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Bandeira PM, Reis FJJ, Muniz FDN, Chaves ACS, Fernandes O, Arruda-Sanchez T. Heart Rate Variability and Pain Sensitivity in Chronic Low Back Pain Patients Exposed to Passive Viewing of Photographs of Daily Activities. Clin J Pain 2021; 37:591-597. [PMID: 34108363 DOI: 10.1097/ajp.0000000000000953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/19/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Investigation if emotional reactivity by measuring heart rate variability (HRV) and pressure pain sensitivity during a passive visualization task in participants with chronic low back pain (CLBP). MATERIALS AND METHODS This case-control study was composed of 47 participants with CLBP and 47 asymptomatic participants. Both groups were submitted to a passive visualization task using 27 pictures from PHODA (Photograph Series of Daily Activities). HRV frequency domains were measured before, during, and after the task. Pressure pain threshold and pain intensity were also measured before and after the task. RESULTS The adjusted mean difference was statistically significant for HRV frequency domains during the visualization task, including low frequency [-5.92; 95% confidence interval (CI)=-9.60 to -2.23], high frequency (-0.71; 95% CI=-1.02 to -0.39), and low-frequency/high-frequency ratio (8.82; 95% CI=5.19 to 12.45). Pressure pain threshold decreased after the task in the CLBP group in all body sites, and pain intensity increased (-0.8; 95% CI=-1.16 to -0.39). DISCUSSION Aversive environmental stimuli, such as visual cues, may generate defensive physiological reactions. HRV can provide a measure that reflects the perceptions of threat and safety in the environment. Participants with CLBP presented changes in sympathovagal balance during passive visualization of pictures of daily activities, higher pain sensitivity, and high pain intensity when they were exposed to a passive visualization task using pictures of daily living that may arouse fears of harm.
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Affiliation(s)
| | - Felipe J J Reis
- Postgraduate Program in Medicine (Cardiology)
- Department of Physical Therapy, Federal Institute of Rio de Janeiro (IFRJ)
- Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Fernanda D N Muniz
- Department of Physical Therapy, Federal Institute of Rio de Janeiro (IFRJ)
| | | | - Orlando Fernandes
- Laboratory of Neuroimaging and Psychophysiology, Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ)
- Postgraduate Program in Medicine (Radiology), Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Tiago Arruda-Sanchez
- Postgraduate Program in Medicine (Cardiology)
- Laboratory of Neuroimaging and Psychophysiology, Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ)
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Manser P, Thalmann M, Adcock M, Knols RH, de Bruin ED. Can Reactivity of Heart Rate Variability Be a Potential Biomarker and Monitoring Tool to Promote Healthy Aging? A Systematic Review With Meta-Analyses. Front Physiol 2021; 12:686129. [PMID: 34393813 PMCID: PMC8359814 DOI: 10.3389/fphys.2021.686129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/29/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Monitoring phasic responses of heart rate variability (HRV) in terms of HRV reactivity [i. e., the absolute change from resting state to on-task (i.e., absolute values of HRV measured during exercise)] might provide useful insights into the individual psychophysiological responses of healthy middle-aged to older adults (HOA) to cognitive and physical exercises. Objectives: To summarize the evidence of phasic HRV responses to cognitive and physical exercises, and to evaluate key moderating factors influencing these responses. Methods: A systematic review with meta-analyses was performed. Publications up to May 2020 of the databases Medline (EBSCO), Embase, Cochrane Library, CINAHL, Psycinfo, Web of Science, Scopus, and Pedro were considered. Controlled clinical trials and observational studies measuring phasic HRV responses to cognitive and/or physical exercises in HOA (≥50 years) were included. Results: The initial search identified 6,828 articles, of which 43 were included into the systematic review. Compared to resting state, vagally-mediated HRV indices were significantly reduced during all types of exercises [Hedge's g = -0.608, 95 % CI (-0.999 to -0.218), p = 0.002] indicating a significant parasympathetic withdrawal compared to rest. The key moderating variables of these responses identified included exercise intensity for physical exercises, and participant characteristics (i.e., level of cognitive functioning, physical fitness), task demands (i.e., task complexity and modality) and the individual responses to these cognitive challenges for cognitive exercises. In particular, higher task demands (task complexity and physical exercise intensity) were related to larger HRV reactivities. Better physical fitness and cognition were associated with lower HRV reactivities. Additionally, HRV reactivity appeared to be sensitive to training-induced cognitive and neural changes. Conclusion: HRV reactivity seems to be a promising biomarker for monitoring internal training load and evaluating neurobiological effects of training interventions. Further research is warranted to evaluate the potential of HRV reactivity as a monitoring parameter to guide cognitive-motor training interventions and/or as a biomarker for cognitive impairment. This may facilitate the early detection of cognitive impairment as well as allow individualized training adaptations that, in turn, support the healthy aging process by optimizing individual exercise dose and progression of cognitive-motor training.
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Affiliation(s)
- Patrick Manser
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Melanie Thalmann
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Manuela Adcock
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Ruud H Knols
- Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital of Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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49
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Chaves ACS, Reis FJJ, Bandeira PM, Fernandes O, Arruda Sanchez T. Autonomic dysregulation and impairments in the recognition of facial emotional expressions in patients with chronic musculoskeletal pain. Scand J Pain 2021; 21:530-538. [PMID: 33725753 DOI: 10.1515/sjpain-2020-0132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/12/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Emotions are involved in the identification of safety cues in the environment, and are also related to social interaction through recognition of emotional facial expressions. Heart rate variability (HRV) can be an indicator of the adaptive response of the autonomic nervous system to stressful conditions, including pain. This study aimed to investigate the emotional processing in a sample of patients with chronic musculoskeletal by measuring the resting-state HRV and the ability to recognize facial emotion expressions. METHODS This cross-sectional study was composed of 40 participants with chronic musculoskeletal pain and 40 asymptomatic participants. Resting HRV was measured for 10 min. The facial emotion recognition task was presented in videos and included modification from a neutral expression to faces of fear, anger, sadness, happiness, and disgust. For the facial emotion recognition task, the hit rate (%) and response time for each emotional category were measured. RESULTS The symptomatic group had a mean high frequency (HF) lower (mean = 34.14; SD = 16.95; p<0.001) than the asymptomatic group (mean = 51.11; SD = 13.01; p<0.001). The emotional facial expressions of disgust (H (1, 80)=7.82; p<0.01), anger (H (1, 80)=13.56; p<0.01), sadness (H (1, 80)=6.58; p=0.01), and happiness (H (1, 80)=12.68; p<0.01) were those for which volunteers from the symptomatic group had a lower hit rate of correct answers compared to the asymptomatic group. The response time to corrected answers showed a major group effect (F (1.77)=21.11; p<0.001) and emotional category (F (4.308)=174.21; p<0.001), without presenting any interaction between the factors (F (4.308)=0.446; p=0.775). The symptomatic group was slower to perform the task of identifying facial emotional expression (7.066 s; SD = 1.188) than the participants in the asymptomatic group (6.298 s; SD = 1.203) for all emotional categories. CONCLUSIONS Participants with chronic musculoskeletal pain presented a lower vagal activity evidenced by HRV. Participants in the symptomatic group showed lower ability to recognize faces of disgust, anger, and sadness when compared to asymptomatic participants. Considering that individuals with low resting HF-HRV have difficulties with regulating their emotions, the lower vagal activity and lower ability to recognize faces of emotional expressions observed in chronic musculoskeletal pain may suggest alterations in emotional processing. This study may shed light on changes in the emotional processing and in the autonomic nervous system in this population.
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Affiliation(s)
- Anna C S Chaves
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Felipe J J Reis
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Pamela M Bandeira
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Orlando Fernandes
- Postgraduate Program in Radiology, Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Tiago Arruda Sanchez
- Postgraduate Program in Medicine (Cardiology), Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Abstract
Data are a key resource for modern societies and expected to improve quality, accessibility, affordability, safety, and equity of health care. Dental care and research are currently transforming into what we term data dentistry, with 3 main applications: 1) medical data analysis uses deep learning, allowing one to master unprecedented amounts of data (language, speech, imagery) and put them to productive use. 2) Data-enriched clinical care integrates data from individual (e.g., demographic, social, clinical and omics data, consumer data), setting (e.g., geospatial, environmental, provider-related data), and systems level (payer or regulatory data to characterize input, throughput, output, and outcomes of health care) to provide a comprehensive and continuous real-time assessment of biologic perturbations, individual behaviors, and context. Such care may contribute to a deeper understanding of health and disease and a more precise, personalized, predictive, and preventive care. 3) Data for research include open research data and data sharing, allowing one to appraise, benchmark, pool, replicate, and reuse data. Concerns and confidence into data-driven applications, stakeholders’ and system’s capabilities, and lack of data standardization and harmonization currently limit the development and implementation of data dentistry. Aspects of bias and data-user interaction require attention. Action items for the dental community circle around increasing data availability, refinement, and usage; demonstrating safety, value, and usefulness of applications; educating the dental workforce and consumers; providing performant and standardized infrastructure and processes; and incentivizing and adopting open data and data sharing.
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Affiliation(s)
- F Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Berlin, Germany
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