Lifestyle Modification for Enhancing Autonomic Cardiac Regulation in Children: The Role of Exercise

Does Physical Exercise Improve Resting Autonomic Cardiac Modulation in Overweight and Obese Children and Adolescents? A Systematic Review and Meta-Analysis

PURPOSE

The objective of this study was to analyze the impact of interventions with physical exercise on cardiac autonomic modulation of overweight and/or obese children and adolescents.

METHOD

The present systematic review was registered in PROSPERO. Searches were performed in the MEDLINE, CENTRAL, SciELO, Scopus, CINAHL, SportDiscus, LILACS, EMBASE, and Web of Science databases. The methodological quality was assessed using the Cochrane Risk of Bias tool. A meta-analysis was performed using the standardized mean difference. The quality of evidence was rated by the Grading of Recommendations, Assessment, Development, and Evaluation system.

RESULTS

From 1866 records identified, 15 randomized clinical trials were included in the systematic review; however, only 4 randomized clinical trials were pooled in the meta-analysis (69 participants in the experimental group and 71 in the control group). The meta-analysis showed a positive effect on the experimental group for the high-frequency power (%; standardized mean difference = 2.22; 95% CI, 1.46-2.98; P < .01), and low-frequency power (%) was reduced after the intervention (standardized mean difference = -1.66; 95% CI, -2.19 to -1.12; P < .01).

CONCLUSION

This study showed that interventions had a positive effect on frequency domain variables of cardiac autonomic modulation in overweight and/or obese children and adolescents. However, more studies with lower heterogeneity and higher quality evidence are needed.

Para table tennis improves psychological/mental and cardiovascular health in individuals with spinal cord injury

BACKGROUND

Although rehabilitation exercise is known to be beneficial for cardiovascular and mental health, it remains a daunting challenge for patients with spinal cord injury (SCI) who rely on wheelchairs for mobility.

OBJECTIVE

This study aimed to examine the effectiveness of a 4-week para table tennis program in enhancing self-efficacy and health outcomes in adults with SCI.

METHODS

A total of 39 SCI patients were included and divided into the experimental group (n = 18, a 4-week para table tennis training program) and the control group (n = 21). Frequency domain indices of heart rate variability (HRV) were used to evaluate the function of the autonomic nervous system.

RESULTS

Following para table tennis training, there was a significant reduction in the physical stress index (PSI, P < 0.001), accompanied by shifts in autonomic regulation of vagal dominance. Additionally, the para table tennis training led to significant improvements in vessel state, differential pulse wave index, atrial elasticity, eccentric constriction power, remaining blood volume, and self-efficacy (all P < 0.05).

CONCLUSION

Para table tennis training results in favorable changes in sympathetic tone, enhanced self-efficacy, improved cardiovascular well-being, and an overall positive transformation in HRV.

Relationship between heart rate variability and body mass index: A cross-sectional study of preschool children

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Heart rate variability and BMI are inversely related in preschool children.

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One unit increase in BMI resulted in a reduction in RMSSD(ln) of 0.06%

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Age, sex and physical activity levels did not influence this relationship.

Reduced heart rate variability (HRV) is associated with overweight and obesity in adults. However, little is known about this relationship in early childhood. We investigated the relationship between resting vagally-mediated HRV and body mass index (BMI) in Australian preschool children. Children were recruited from 13 non-government early learning centres located in Queensland and New South Wales, Australia. From this population-based sample, data from 146 healthy children (58 females) between 3 and 5 years of age (mean age 4.35 ± 0.44 years) were analysed. BMI was calculated from child body weight and height. Physical activity was recorded using an Actigraph wGT3x accelerometer worn at the waist of participants over 3 consecutive days. A Polar H10 chest strap measured seated, resting RR intervals for the calculation of HRV with the root mean square of successive differences (RMSSD) reflecting vagally-mediated activity. The relationship between HRV and BMI was analysed using a linear mixed model adjusted for age, sex and physical activity. Analysis revealed that RMSSD (ln) demonstrated a significant inverse relationship with BMI (β = -0.06; 95% CI = -0.12 – −0.01; p = 0.032), and the model accounted for 23% of the variance in RMSSD (ln). Notably, a one unit increase in BMI resulted in a reduction in RMSDD (ln) of 0.06. This investigation demonstrated evidence for a significant inverse linear relationship between vagally-mediated HRV and BMI in 3 – 5-year-old Australian children, similar to that of adults. Furthermore, this relationship was independent of age, sex and physical activity levels. Results may indicate that the cardiometabolic health of preschool children is, in part, influenced by the relationship between vagally-mediated HRV and weight status.

Heart rate variability improves in 3-5-year-old children following a 6-month physical activity-based intervention: the Active Early Learning (AEL) cluster randomised controlled trial

Heart rate variability (HRV) measurement provides non-invasive assessment of autonomic stability and cardiometabolic disease risk. Insufficient physical activity in early childhood may contribute to negative cardiometabolic health. The Active Early Learning (AEL) study was a 6-month randomised controlled trial investigating the effects of a physical activity-based program incorporating movement within the daily curriculum of preschool children. The current study assessed the effects of the AEL intervention on HRV as a measure of cardiac vagal control. Children aged between 3-5 years and enrolled in a preschool with an attendance of ≥15 children were eligible. Physical activity was recorded using an Actigraph wGT3x accelerometer worn at the waist of participants over 3 consecutive days. A Polar H10 chest strap measured HRV with the HF-band and RMSSD representing cardiac vagal control. After 6 months of the AEL trial, linear mixed model analyses revealed a significant intervention effect for increased HF (p = 0.044). The control group did not demonstrate changes in cardiac vagal control after the intervention ceased. Independent of age, sex, physical activity and BMI, the AEL study elicited significant improvements in the cardiac vagal control of participants who received the intervention. Findings highlight the importance of investigating HRV for assessing the cardiometabolic health in young children. ANZCTR trial registration number: ACTRN12619000638134. Novelty: The AEL curriculum improved child HRV independent of age, sex, physical activity and BMI. Heart rate and RR intervals did not demonstrate changes for the intervention and control groups. Multivariate programs for developing physical competence, confidence, knowledge and motivation may improve child health.

Interaction between Autonomic Regulation, Adiposity Indexes and Metabolic Profile in Children and Adolescents with Overweight and Obesity

Early obesity predicts initial modifications in cardiac and vascular autonomic regulation. The aim of this study was to assess the possible interaction between non-invasive measures of autonomic cardiovascular control and peripheral endothelium regulation in children with overweight and obesity. We involved 114 young subjects (77M/37F, 12.7 ± 2.2 years) with normal weight (NW, n = 46) to overweight or obesity (OB, n = 68). Multivariate statistical techniques utilizing a collection of modern indices of autonomic regulation, adiposity indexes and metabolic profile were employed. Resting values show substantial equivalence of data. Conversely, blood pressure variance is greater in NW/OB groups. The correlation matrix between major autonomic and metabolic/hemodynamic variables shows a clustered significant correlation between homogeneous indices. A significant correlation between metabolic indices and endothelial and autonomic control, mostly in its vascular end, was recorded. Particularly, the alpha index is significantly correlated with triglycerides (r = −0.261) and endothelial indices (RHI, r = 0.276). Children with obesity show a link between indices of autonomic and endothelial function, fat distribution and metabolic profile. The optimization of autonomic control, for instance by exercise/nutrition interventions, could potentially prevent/delay the occurrence of structural vascular damage leading to reduced cardiovascular health.