1
|
Chiang JK, Lin YC, Hung TY, Kao HH, Kao YH. The Impact on Autonomic Nervous System Activity during and Following Exercise in Adults: A Meta-Regression Study and Trial Sequential Analysis. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1223. [PMID: 39202504 PMCID: PMC11356649 DOI: 10.3390/medicina60081223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: Exercise enhances cardiovascular health through various mechanisms, including the modulation of autonomic nervous system activity. This study aimed to systematically examine the impact of exercise on heart rate variability (HRV) in adults during and within one hour after exercise (WHAE). Materials and Methods: A comprehensive literature review was conducted using the MEDLINE, Embase, Cochrane Library, Scopus, and PubMed databases to identify published studies that reported the impact of exercise on autonomic nervous system activity in adults. The studies measured the absolute power of the low-frequency band (0.04-0.15 Hz) to the absolute power of the high-frequency band (0.015-0.4 Hz) (LF/HF ratio) to assess sympathetic activity and the root mean square of successive differences between normal heartbeats (RMSSD) to assess parasympathetic activity. Results: A total of 3329 studies were screened for relevance, and finally, 10 articles that utilized methods for measuring autonomic nervous system activity, such as the LF/HF ratio and RMSSD, covering 292 adult patients, were included for meta-analysis. In the current meta-analysis, we observed a significant decrease in parasympathetic activity during and after exercise, as indicated by RMSSD, compared to pre-exercise levels (mean difference [MD] = -4.96, 95% confidence interval [CI]: -8.00 to -1.91, p = 0.003). However, sympathetic activity after exercise, represented by the LF/HF ratio, showed a borderline significant increase compared to pre-exercise levels (MD = 1.06, 95% CI: -0.01 to 2.12, p = 0.052). The meta-regression model found that factors associated with RMSSD included mean age, male gender, and duration post-exercise. Additionally, the factor associated with the LF/HF ratio was the healthy condition of participants. The trial sequential analysis provided robust evidence of a decrease in RMSSD and an increase in the LF/HF ratio during and WHAE. Conclusions: Given the limitations of the current study, the findings suggest that a significant decrease in parasympathetic activity and a borderline significant increase in sympathetic activity in adults during and WHAE, as confirmed by trial sequential analysis. Meta-regression analysis indicated that parasympathetic activity was negatively associated with participant age and male gender, but positively associated with duration post-exercise. Additionally, increased sympathetic activity was linked to the healthy conditions of participants. This study suggests that exercise might differentially affect autonomic balance in individuals with chronic conditions compared to healthy individuals. This highlights the potential need for tailored exercise interventions to improve autonomic function across different populations.
Collapse
Affiliation(s)
- Jui-Kun Chiang
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Road, Dalin, Chiayi 622, Taiwan;
| | - Yen-Chang Lin
- Nature Dental Clinic, Puli Township, Nantou 545, Taiwan; (Y.-C.L.); (T.-Y.H.)
| | - Tzu-Ying Hung
- Nature Dental Clinic, Puli Township, Nantou 545, Taiwan; (Y.-C.L.); (T.-Y.H.)
| | - Hsueh-Hsin Kao
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung 407, Taiwan
| | - Yee-Hsin Kao
- Department of Family Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), 670 Chung-Te Road, Tainan 701, Taiwan
| |
Collapse
|
2
|
Chiang JK, Chiang PC, Kao HH, You WC, Kao YH. Exercise Effects on Autonomic Nervous System Activity in Type 2 Diabetes Mellitus Patients over Time: A Meta-Regression Study. Healthcare (Basel) 2024; 12:1236. [PMID: 38921350 DOI: 10.3390/healthcare12121236] [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: 05/15/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Diabetic autonomic neuropathy is a common complication of type 2 diabetes mellitus (T2DM), especially in patients with long-term, poorly controlled diabetes. This study investigates the effects of exercise on autonomic nervous system activity in T2DM patients over time. METHODS A literature review using MEDLINE, Embase, Cochrane Library, Scopus, and PubMed identified studies assessed via heart rate variability. Papers were categorized into three groups: immediate effects (within 60 min), short-term effects (2-3 months), and long-term effects (over 4 months). RESULTS Nine articles with 161 T2DM patients were included in the meta-analysis. RMSSD changes after exercise were -4.3 (p = 0.227), 8.14 (p < 0.001), and 4.17 (p = 0.002) for the immediate, short-term, and long-term groups, respectively. LF/HF ratio changes were 0.21 (p = 0.264), -3.04 (p = 0.102), and -0.05 (p = 0.006) for the respective groups. Meta-regression indicated age, male gender, and exercise duration were associated with increased RMSSD, with coefficients of 2.36 (p = 0.001), 13.76 (p = 0.008), and 1.50 (p = 0.007), respectively. Age positively correlated with the LF/HF ratio, with a coefficient of 0.049 (p = 0.048). CONCLUSIONS Regular exercise (≥3 times per week) for over 2 months increases parasympathetic activity in T2DM patients, while sympathetic activity decreases significantly after 4 months. Further study is needed to validate these findings.
Collapse
Affiliation(s)
- Jui-Kun Chiang
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Road, Dalin, Chiayi 622, Taiwan
| | - Po-Chen Chiang
- Department of Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Hsueh-Hsin Kao
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung 407, Taiwan
| | - Weir-Chiang You
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung 407, Taiwan
| | - Yee-Hsin Kao
- Department of Family Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), 670 Chung-Te Road, Tainan 701, Taiwan
| |
Collapse
|
3
|
Csepregi É, Gyurcsik Z, Veres-Balajti I, Nagy AC, Szekanecz Z, Szántó S. Effects of Classical Breathing Exercises on Posture, Spinal and Chest Mobility among Female University Students Compared to Currently Popular Training Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3728. [PMID: 35329415 PMCID: PMC8950379 DOI: 10.3390/ijerph19063728] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 01/10/2023]
Abstract
Worldwide, university students’ physical health and posture are declining due to a sedentary lifestyle. The aim of our study was to evaluate the effectiveness of physiotherapeutic breathing exercises on posture and spinal mobility among healthy female university students compared to other training methods. Sixty-one female students of the University of Debrecen were assigned to breathing exercise (BE; n = 15), yoga (Y; n = 16), Pilates (P; n = 15) programmes and interval-training (IT; n = 15). Each training session lasted one hour, performed twice a week for 7 weeks. Students were assessed using standardized clinical tests. All programmes resulted in significant improvement in chest expansion. Results of Schober’s test showed substantial improvement using BE (p < 0.05), Y, P (p ≤ 0.01) programmes. Significant changes in occiput-to-wall distance (Y, P p ≤ 0.01) (BE p ≤ 0.001) were observed in three groups except the IT group. Fingertip-to-floor test (Y, P p < 0.05) results showed significant changes in two groups. The most outstanding effects on lateral flexion were achieved using BE (right, left p ≤ 0.001) programme. A comparison with results achieved using yoga and Pilates revealed that the physiotherapeutic breathing exercise programme is an equally effective method to significantly improve spinal mobility and correct postural problems in healthy young women.
Collapse
Affiliation(s)
- Éva Csepregi
- Department of Physiotherapy, Faculty of Public Health, University of Debrecen, 26. Kassai Str., 4028 Debrecen, Hungary;
| | - Zsuzsanna Gyurcsik
- Department of Sports Medicine, Faculty of Medicine, University of Debrecen, 12. Nagyerdei Park, 4032 Debrecen, Hungary; (Z.G.); (S.S.)
| | - Ilona Veres-Balajti
- Department of Physiotherapy, Faculty of Public Health, University of Debrecen, 26. Kassai Str., 4028 Debrecen, Hungary;
| | - Attila Csaba Nagy
- Department of Interventional Epidemiology, Faculty of Public Health, University of Debrecen, 26. Kassai Str., 4028 Debrecen, Hungary;
| | - Zoltán Szekanecz
- Department of Rheumatology, Faculty of Medicine, Institute of Medicine, University of Debrecen, 98. Nagyerdei Boulevard, 4032 Debrecen, Hungary;
| | - Sándor Szántó
- Department of Sports Medicine, Faculty of Medicine, University of Debrecen, 12. Nagyerdei Park, 4032 Debrecen, Hungary; (Z.G.); (S.S.)
| |
Collapse
|
4
|
de la Cruz Torres B, Albornoz Cabello M, García Bermejo P, Naranjo Orellana J. Autonomic responses to ultrasound-guided percutaneous needle electrolysis of the patellar tendon in healthy male footballers. Acupunct Med 2016; 34:275-9. [PMID: 26792776 DOI: 10.1136/acupmed-2015-010993] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Ultrasound (US)-guided percutaneous needle electrolysis (PNE) is a novel minimally invasive approach, which involves the application of a galvanic current via an acupuncture needle. As in any procedure involving needling, vagal reactions have been reported during PNE. OBJECTIVE To examine for changes in autonomic activity during the US-guided PNE technique on healthy patellar tendons by measurement and analysis of heart rate variability (HRV). METHODS Twenty-two male footballers were randomly allocated to: a control group (11 players), for whom HRV was recorded for 10 min, both at rest and during an exhaustive US examination of the patellar tendon and adjacent structures; and an experimental group (11 players), for whom HRV was recorded for 10 min, both at rest and during application of US-guided PNE on the patellar tendon. The following HRV parameters were assessed: mean NN interval, mean heart rate, time domain parameters (SDNN, rMSSD, pNN50), diameters of the Poincaré plot (SD1, SD2), stress score, and sympathetic/parasympathetic ratio. RESULTS There were no differences between groups in any baseline measurements, nor were there any significant differences between control group measurements (baseline vs intervention). The experimental group exhibited statistically significant increases in SDNN/SD1 (p=0.02/p=0.03) and SD2 (p=0.03), indicating increased parasympathetic and decreased sympathetic activity, respectively. CONCLUSIONS US-guided PNE was associated with an autonomic imbalance characterised by greater parasympathetic activity, which could potentially result in a vasovagal reaction. Care should be taken to monitor for adverse reactions during US-guided PNE and simple HRV indicators may have a role in early detection.
Collapse
Affiliation(s)
| | | | - Paula García Bermejo
- Department of Physiotherapy, University of Seville. Avicena Street, Seville, Spain
| | | |
Collapse
|
5
|
Boos CJ, Bakker-Dyos J, Watchorn J, Woods DR, O'Hara JP, Macconnachie L, Mellor A. A comparison of two methods of heart rate variability assessment at high altitude. Clin Physiol Funct Imaging 2016; 37:582-587. [PMID: 26769455 DOI: 10.1111/cpf.12334] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 11/03/2015] [Indexed: 11/30/2022]
Abstract
Heart rate variability (HRV) is a useful index of autonomic function and has been linked to the development of high altitude (HA) related illness. However, its assessment at HA has been undermined by the relative expense and limited portability of traditional HRV devices which have mandated at least a minute heart rate recording. In this study, the portable ithlete™ HRV system, which uses a 55 s recording, was compared with a reference method of HRV which utilizes a 5 min electrocardiograph recording (CheckMyHeart™ ). The root mean squares of successive R-R intervals (RMSSD) for each device was converted to a validated HRV score (lnRMSSD × 20) for comparison. Twelve healthy volunteers were assessed for HRV using the two devices across seven time points at HA over 10 days. There was no significant change in the HRV values with either the ithlete (P = 0·3) or the CheckMyHeart™ (P = 0·19) device over the seven altitudes. There was also a strong overall correlation between the ithlete™ and CheckMyHeart™ device (r = 0·86; 95% confidence interval: 0·79-0·91). The HRV was consistently, though non-significantly higher with ithlete™ than with the CheckMyHeart™ device [mean difference (bias) 1·8 l; 95% CI -12·3 to 8·5]. In summary, the ithlete™ and CheckMyHeart™ system provide relatively similar results with good overall agreement at HA.
Collapse
Affiliation(s)
- Christopher John Boos
- Department of Cardiology, Poole Hospital NHS Foundation trust, UK.,Department of Postgraduate Medical Education, Bournemouth University, Bournemouth, UK
| | | | | | - David Richard Woods
- Defence Medical Services, Lichfield, UK.,Research Institute, for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK.,Northumbria and Newcastle NHS Trusts, Wansbeck General and Royal Victoria Infirmary, Newcastle, UK.,University of Newcastle, Newcastle upon Tyne, UK
| | - John Paul O'Hara
- Research Institute, for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK
| | - Lee Macconnachie
- Department of Cardiology, Poole Hospital NHS Foundation trust, UK
| | - Adrian Mellor
- Defence Medical Services, Lichfield, UK.,Research Institute, for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK.,James Cook University Hospital, Middlesborough, UK
| |
Collapse
|