HRV

Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis

John Chalmers, Daniel Quintana, Maree J. Abbott +1 more · Frontiers in Psychiatry · 2014 · 1,027 citations

This meta-analysis found that people diagnosed with anxiety disorders consistently have lower heart rate variability (HRV) compared to healthy individuals, suggesting that tracking and improving your HRV might be a useful strategy if you experience anxiety.

Effect of an office worksite-based yoga program on heart rate variability: outcomes of a randomized controlled trial

Birinder S. Cheema, Angelique Houridis, Lisa Busch +8 more · BMC Complementary and Alternative Medicine · 2013 · 277 citations

A 10-week office-based hatha yoga program did not improve heart rate variability (a marker of physiological stress) for most participants, but those who consistently attended sessions saw improvements in flexibility, reduced state anxiety, and better upper-body muscular endurance, suggesting that high adherence is key to realizing benefits in fitness and psychological well-being.

Psychological and Physiological Effects of Compassionate Mind Training: a Pilot Randomised Controlled Study

Marcela Matos, Cristiana Duarte, Joana Duarte +4 more · Mindfulness · 2017 · 200 citations

Heart rate variability: Standards of measurement, physiological interpretation, and clinical use

Marek Malik, J. Thomas Bigger, A. John Camm +4 more · European Heart Journal · 1996 · 15,247 citations

Exercise training and heart rate variability in older people

Albertine J. Schuit, Ludovic G. P. M. van Amelsvoort, TON C. VERHEIJ +4 more · Medicine & Science in Sports & Exercise · 1999 · 131 citations

Regular, structured exercise for six months significantly increased heart rate variability (HRV) in older adults, particularly during the day, suggesting a positive modification of a key heart health marker.

The Multidimensional Assessment of Interoceptive Awareness (MAIA)

Wolf Mehling, Cynthia Price, Jennifer Daubenmier +3 more · PLoS ONE · 2012 · 1,369 citations

This paper describes the development of a multidimensional self-report measure of interoceptive body awareness. The systematic mixed-methods process involved reviewing the current literature, specifying a multidimensional conceptual framework, evaluating prior instruments, developing items, and analyzing focus group responses to scale items by instructors and patients of body awareness-enhancing therapies. Following refinement by cognitive testing, items were field-tested in students and instructors of mind-body approaches. Final item selection was achieved by submitting the field test data to an iterative process using multiple validation methods, including exploratory cluster and confirmatory factor analyses, comparison between known groups, and correlations with established measures of related constructs. The resulting 32-item multidimensional instrument assesses eight concepts. The psychometric properties of these final scales suggest that the Multidimensional Assessment of Interoceptive Awareness (MAIA) may serve as a starting point for research and further collaborative refinement.

Enhancing mental health with Artificial Intelligence: Current trends and future prospects

David B. Olawade, Ojima Z. Wada, Aderonke Odetayo +3 more · Journal of Medicine Surgery and Public Health · 2024 · 392 citations

This narrative review synthesises evidence from dozens of studies to map how AI is being used in mental healthcare—from early detection of depression and anxiety to personalised treatment plans and virtual therapists—but finds that most applications lack rigorous clinical validation, and the field is dominated by proof-of-concept work rather than randomised controlled trials, meaning you cannot yet rely on any single AI tool for self-experimentation without careful personal testing.

Effects of Heart Rate Variability Biofeedback in Patients With Acute Ischemic Stroke: A Randomized Controlled Trial

Wan-Ling Chang, Jiunn‐Tay Lee, Chi–Rong Li +3 more · Biological Research For Nursing · 2019 · 34 citations

Heart Rate Variability (HRV) biofeedback, a technique to train control over your heart rhythm, showed promise in improving autonomic function, cognitive abilities, and psychological well-being in patients recovering from acute ischemic stroke.

Heart Rate Variability, Prefrontal Neural Function, and Cognitive Performance: The Neurovisceral Integration Perspective on Self-regulation, Adaptation, and Health

Julian F. Thayer, Anita L. Hansen, Evelyn Saus-Rose +1 more · Annals of Behavioral Medicine · 2009 · 1,818 citations

BACKGROUND: In the present paper, we describe a model of neurovisceral integration in which a set of neural structures involved in cognitive, affective, and autonomic regulation are related to heart rate variability (HRV) and cognitive performance. METHODS: We detail the pathways involved in the neural regulation of the cardiovascular system and provide pharmacological and neuroimaging data in support of the neural structures linking the central nervous system to HRV in humans. We review a number of studies from our group showing that individual differences in HRV are related to performance on tasks associated with executive function and prefrontal cortical activity. These studies include comparisons of executive- and nonexecutive-function tasks in healthy participants, in both threatening and nonthreatening conditions. In addition, we show that manipulating resting HRV levels is associated with changes in performance on executive-function tasks. We also examine the relationship between HRV and cognitive performance in ecologically valid situations using a police shooting simulation and a naval navigation simulation. Finally, we review our studies in anxiety patients, as well as studies examining psychopathy. CONCLUSION: These findings in total suggest an important relationship among cognitive performance, HRV, and prefrontal neural function that has important implications for both physical and mental health. Future studies are needed to determine exactly which executive functions are associated with individual differences in HRV in a wider range of situations and populations.

Paradoxical dissociation between heart rate and heart rate variability following different modalities of exercise in individuals with metabolic syndrome: The RESOLVE study

Gil Boudet, Guillaume Walther, Daniel Courteix +9 more · European Journal of Preventive Cardiology · 2016 · 39 citations

A 3-week intensive exercise program improved heart rate variability (HRV) in people with metabolic syndrome, with moderate-intensity training showing greater improvements in stress balance (sympathovagal balance), while high-intensity resistance training led to larger reductions in overall heart rate, suggesting that tailoring exercise intensity can optimize specific cardiovascular health markers for self-experimenters.

Effect of a Biofeedback Intervention on Heart Rate Variability in Individuals With Panic Disorder: A Randomized Controlled Trial

Benedict Herhaus, Martin Siepmann, George J. Kahaly +2 more · Psychosomatic Medicine · 2021 · 28 citations

A 4-week biofeedback intervention focused on 0.1-Hz paced breathing significantly increased heart rate variability (HRV) and reduced panic symptoms in individuals with panic disorder, suggesting it's a promising non-drug approach for improving autonomic function and anxiety.

The Effect of Music on the Human Stress Response

Myriam V. Thoma, Roberto La Marca, Rebecca Brönnimann +3 more · PLoS ONE · 2013 · 476 citations

BACKGROUND: Music listening has been suggested to beneficially impact health via stress-reducing effects. However, the existing literature presents itself with a limited number of investigations and with discrepancies in reported findings that may result from methodological shortcomings (e.g. small sample size, no valid stressor). It was the aim of the current study to address this gap in knowledge and overcome previous shortcomings by thoroughly examining music effects across endocrine, autonomic, cognitive, and emotional domains of the human stress response. METHODS: Sixty healthy female volunteers (mean age = 25 years) were exposed to a standardized psychosocial stress test after having been randomly assigned to one of three different conditions prior to the stress test: 1) relaxing music ('Miserere', Allegri) (RM), 2) sound of rippling water (SW), and 3) rest without acoustic stimulation (R). Salivary cortisol and salivary alpha-amylase (sAA), heart rate (HR), respiratory sinus arrhythmia (RSA), subjective stress perception and anxiety were repeatedly assessed in all subjects. We hypothesized that listening to RM prior to the stress test, compared to SW or R would result in a decreased stress response across all measured parameters. RESULTS: The three conditions significantly differed regarding cortisol response (p = 0.025) to the stressor, with highest concentrations in the RM and lowest in the SW condition. After the stressor, sAA (p=0.026) baseline values were reached considerably faster in the RM group than in the R group. HR and psychological measures did not significantly differ between groups. CONCLUSION: Our findings indicate that music listening impacted the psychobiological stress system. Listening to music prior to a standardized stressor predominantly affected the autonomic nervous system (in terms of a faster recovery), and to a lesser degree the endocrine and psychological stress response. These findings may help better understanding the beneficial effects of music on the human body.

Whole-Body Vibration Exercise Therapy Improves Cardiac Autonomic Function and Blood Pressure in Obese Pre- and Stage 1 Hypertensive Postmenopausal Women

Alexei Wong, Stacey Alvarez‐Alvarado, Amber W. Kinsey +1 more · The Journal of Alternative and Complementary Medicine · 2016 · 40 citations

An 8-week whole-body vibration exercise program, performed three times a week, improved blood pressure and heart rate variability (a marker of heart health) in obese postmenopausal women with pre- or stage 1 hypertension, suggesting a gentle exercise alternative for improving cardiovascular health.

Validity of the Polar V800 heart rate monitor to measure RR intervals at rest

David Giles, Nick Draper, William Neil · European Journal of Applied Physiology · 2015 · 375 citations

PURPOSE: To assess the validity of RR intervals and short-term heart rate variability (HRV) data obtained from the Polar V800 heart rate monitor, in comparison to an electrocardiograph (ECG). METHOD: Twenty participants completed an active orthostatic test using the V800 and ECG. An improved method for the identification and correction of RR intervals was employed prior to HRV analysis. Agreement of the data was assessed using intra-class correlation coefficients (ICC), Bland-Altman limits of agreement (LoA), and effect size (ES). RESULTS: A small number of errors were detected between ECG and Polar RR signal, with a combined error rate of 0.086 %. The RR intervals from ECG to V800 were significantly different, but with small ES for both supine corrected and standing corrected data (ES <0.001). The bias (LoA) were 0.06 (-4.33 to 4.45 ms) and 0.59 (-1.70 to 2.87 ms) for supine and standing intervals, respectively. The ICC was >0.999 for both supine and standing corrected intervals. When analysed with the same HRV software no significant differences were observed in any HRV parameters, for either supine or standing; the data displayed small bias and tight LoA, strong ICC (>0.99) and small ES (≤0.029). CONCLUSIONS: The V800 improves over previous Polar models, with narrower LoA, stronger ICC and smaller ES for both the RR intervals and HRV parameters. The findings support the validity of the Polar V800 and its ability to produce RR interval recordings consistent with an ECG. In addition, HRV parameters derived from these recordings are also highly comparable.

A Preliminary Study: Heart Rate Variability Biofeedback for Treatment of Postconcussion Syndrome

Leah Lagos, James W.G. Thompson, Evgeny Vaschillo · Biofeedback · 2013 · 25 citations

A single athlete with persistent postconcussion syndrome (PCS) experienced clinically significant improvements in mood, PCS symptoms, and headache severity after 10 weeks of Heart Rate Variability (HRV) biofeedback, suggesting it might be a promising approach for self-experimenters dealing with similar issues.

Effects of Heart Rate Variability Biofeedback on EEG Alpha Asymmetry and Anxiety Symptoms in Male Athletes: A Pilot Study

Inga Dziembowska, Paweł Izdebski, Anna Rasmus +3 more · Applied Psychophysiology and Biofeedback · 2015 · 184 citations

Prediction of the efficacy of group cognitive behavioral therapy using heart rate variability based smart wearable devices: a randomized controlled study.

Lin Z, Zheng J, Wang Y +6 more · BMC Psychiatry · 2024 · 10 citations

Matter Over Mind: A Randomised-Controlled Trial of Single-Session Biofeedback Training on Performance Anxiety and Heart Rate Variability in Musicians

Ruth Wells, Tim Outhred, James Heathers +2 more · PLoS ONE · 2012 · 181 citations

BACKGROUND: Musical performance is a skilled activity performed under intense pressure, thus is often a profound source of anxiety. In other contexts, anxiety and its concomitant symptoms of sympathetic nervous system arousal have been successfully ameliorated with HRV biofeedback (HRV BF), a technique involving slow breathing which augments autonomic and emotional regulatory capacity. OBJECTIVE: This randomised-controlled study explored the impact of a single 30-minute session of HRV BF on anxiety in response to a highly stressful music performance. METHODS: A total of 46 trained musicians participated in this study and were randomly allocated to a slow breathing with or without biofeedback or no-treatment control group. A 3 Group×2 Time mixed experimental design was employed to compare the effect of group before and after intervention on performance anxiety (STAI-S) and frequency domain measures of HRV. RESULTS: Slow breathing groups (n=30) showed significantly greater improvements in high frequency (HF) and LF/HF ratio measures of HRV relative to control (n=15) during 5 minute recordings of performance anticipation following the intervention (effect size: η(2) =0.122 and η(2) =0.116, respectively). The addition of biofeedback to a slow breathing protocol did not produce differential results. While intervention groups did not exhibit an overall reduction in self-reported anxiety, participants with high baseline anxiety who received the intervention (n=15) displayed greater reductions in self-reported state anxiety relative to those in the control condition (n=7) (r=0.379). CONCLUSIONS: These findings indicate that a single session of slow breathing, regardless of biofeedback, is sufficient for controlling physiological arousal in anticipation of psychosocial stress associated with music performance and that slow breathing is particularly helpful for musicians with high levels of anxiety. Future research is needed to further examine the effects of HRV BF as a low-cost, non-pharmacological treatment for music performance anxiety.

The role of heart rate variability in sports physiology

JIN-GUO DONG · Experimental and Therapeutic Medicine · 2016 · 316 citations

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

The Impact of Resonance Frequency Breathing on Measures of Heart Rate Variability, Blood Pressure, and Mood

Patrick R. Steffen, Tara Austin, Andrea DeBarros +1 more · Frontiers in Public Health · 2017 · 178 citations

< 0.05). Overall, RF breathing appears to play an important role in the positive effect HRVB has on measures of HRV.

Eight weeks of moderate-intensity exercise training increases heart rate variability in sedentary postmenopausal women

Radim Jurča, Timothy S. Church, Gina M. Morss +2 more · American Heart Journal · 2004 · 164 citations

Does exercise intensity affect blood pressure and heart rate in obese adolescents? A 6‐month multidisciplinary randomized intervention study

Breno Quintella Farah, Raphael Mendes Ritti‐Dias, Prabhakaran Balagopal +2 more · Pediatric Obesity · 2013 · 95 citations

BACKGROUND: Aerobic exercise improves cardiovascular health in general, but whether the impact varies with exercise intensity is not clear. OBJECTIVE: The aim of the current study was to compare the effects of a high-intensity aerobic exercise training (HIT) vs. a low-intensity aerobic exercise training (LIT) on blood pressure (BP), heart rate (HR) and heart rate variability (HRV) in obese adolescents. METHODS: Forty-three (13-18 years) Tanner stage (III-IV) matched obese adolescents were studied in a randomized trial of either HIT (corresponding to the ventilatory threshold I; n = 20) or LIT (corresponding to 20% below the ventilatory threshold I; n = 23) programme for a period of 6 months. All participants also received a multidisciplinary therapy that included nutritional, psychological and clinical counselling. Both HIT and LIT sessions were isocaloric, with energy expenditure set at 350 kcal. BP, HR and HRV were measured along with markers of body adiposity and insulin resistance before and after the respective interventions. RESULTS: The participants in both groups had similar physical and clinical characteristics. After the 6-month intervention, systolic, diastolic and mean BP decreased (P < 0.05, for all) similarly in both groups, whereas waist circumference, HR and HRV showed beneficial changes only in the HIT group (P < 0.05). CONCLUSION: Aerobic exercise training set at a high intensity compared with the low intensity appears to have additional benefits on abdominal obesity and cardiovascular health in that it enhances the parasympathetic and autonomic modulation of the heart in obese adolescents.

Exercise training and heart rate variability in older adult female subjects.

Kenneth Madden, Wayne C. Levy, John K Stratton · PubMed · 2006 · 64 citations

INTRODUCTION: Prior investigations in post-myocardial infarction and healthy elderly subjects have established that heart rate variability (HRV) predicts mortality. Predominantly cross-sectional studies have shown an association between endurance training and measures of HRV. In a randomized trial, this study sought to prospectively compare the effects of endurance and strength training on HRV in 45 healthy elderly females (average age 69.9 +/- 0.9 years). METHODS: All subjects were rigorously screened to be normal by history, physical, blood tests, ECG, ETT and echocardiogram. All subjects were monitored for 24 hours by a 2-channel Holter before and after training. Artifacts and arrhythmias were manually removed. Tapes were examined for standard measures of HRV. INTERVENTION: 15 subjects were randomized to endurance trained (ET), 15 subjects to strength training (ST), and 15 subjects to no training (NT) for six months. RESULTS: Training resulted in a significant increase in VO2max in the ET (+7.4%, p = 0.005) group only. There was a small but not significant decrease in HR with both the ET and ST groups. ET resulted in a significant increase in most time domain and all frequency domain measures of HRV. ST resulted in no significant change in HRV measures. CONCLUSION: Strength training, as opposed to endurance training has no significant impact on HRV. This suggests that exercise interventions designed to improve strength (such as weight-lifting) will have little to no impact on HRV, suggesting that aerobic and strength training operate through different mechanisms to reduce cardiac risk.

The Effect of Heart Rate Variability Biofeedback on Performance Psychology of Basketball Players

Maman Paul, Kanupriya Garg · Applied Psychophysiology and Biofeedback · 2012 · 155 citations

Non-pharmacological Intervention for Chronic Pain in Veterans: A Pilot Study of Heart Rate Variability Biofeedback

Melanie E. Berry, Iva Chapple, J. P. Ginsberg +3 more · Global Advances in Health and Medicine · 2014 · 80 citations

OBJECTIVE: Chronic pain is an emotionally and physically debilitating form of pain that activates the body's stress response and over time can result in lowered heart rate variability (HRV) power, which is associated with reduced resiliency and lower self-regulatory capacity. This pilot project was intended to determine the effectiveness of HRV coherence biofeedback (HRVCB) as a pain and stress management intervention for veterans with chronic pain and to estimate the effect sizes. It was hypothesized that HRVCB will increase parasympathetic activity resulting in higher HRV coherence measured as power and decrease self-reported pain symptoms in chronic pain patients. STUDY DESIGN: Fourteen veterans receiving treatment for chronic pain were enrolled in the pre-post intervention study. They were randomly assigned, with 8 subjects enrolled in the treatment group and 6 in the control group. The treatment group received biofeedback intervention plus standard care, and the other group received standard care only. The treatment group received four HRVCB training sessions as the intervention. MEASURES: Pre-post measurements of HRV amplitude, HRV power spectrum variables, cardiac coherence, and self-ratings of perceived pain, stress, negative emotions, and physical activity limitation were made for both treatment and control groups. RESULTS: The mean pain severity for all subjects at baseline, using the self-scored Brief Pain Inventory (BPI), was 26.71 (SD=4.46; range=21-35) indicating a moderate to severe perceived pain level across the study subjects. There was no significant difference between the treatment and control groups at baseline on any of the measures. Post-HRVCB, the treatment group was significantly higher on coherence (P=.01) and lower (P=.02) on pain ratings than the control group. The treatment group showed marked and statistically significant (1-tailed) increases over the baseline in coherence ratio (191%, P=.04) and marked, significant (1-tailed) reduction in pain ratings (36%, P<.001), stress perception (16%, P=.02), negative emotions (49%, P<.001), and physical activity limitation (42%, P<.001). Significant between-group effects on all measures were found when pre-training values were used as covariates. CONCLUSIONS: HRVCB intervention was effective in increasing HRV coherence measured as power in the upper range of the LF band and reduced perceived pain, stress, negative emotions, and physical activity limitation in veterans suffering from chronic pain. HRVCB shows promise as an effective non-pharmacological intervention to support standard treatments for chronic pain.

The Effects of Tai Chi on Heart Rate Variability in Older Chinese Individuals with Depression

Jing Liu, Xiaoyue Hu, Ming Liu +5 more · International Journal of Environmental Research and Public Health · 2018 · 78 citations

Background Very little research has been done to simultaneously investigate the effects of Tai Chi (TC) on depression and heart rate variability (HRV). This study, therefore, attempted to explore the effects of TC on depression and on HRV parameters. Methods Sixty older individuals with depression score of 10 or above (the Geriatric Depression Scale, GDS) were randomly assigned into two groups: TC (n = 30) and control group (n = 30). Participants in the experimental group participated in a 24-week TC training program (three 60-min sessions per week), whereas individuals in the control group maintained their unaltered lifestyle. Depression and HRV were measured using the GDS and digital electrocardiogram at baseline and after the 24-week intervention. Results The TC had produced significant positive chances in depression and some HRV parameters (mean heart rate, RMSSD, HF, LFnorm, and HFnorm) (p &lt; 0.05), whereas these positive results were not observed in the control group. Conclusions The results of this study indicated that TC may alleviate depression of the elderly through modulating autonomous nervous system or HRV parameters. This study adds to a growing body of research showing that TC may be effective in treating depression of the elderly. Tai Chi as a mild to moderate mind-body exercise is suitable for older individuals who suffer from depression.

Effect of Slow Abdominal Breathing Combined with Biofeedback on Blood Pressure and Heart Rate Variability in Prehypertension

Shuzhen Wang, Sha Li, Xiaoyang Xu +4 more · The Journal of Alternative and Complementary Medicine · 2010 · 117 citations

OBJECTIVE: Prehypertension is a new category designated by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) in 2003. Managing prehypertension with nonpharmacological intervention is possibly beneficial to the prevention of hypertension. In this study, we observed the effect of slow abdominal breathing combined with electromyographic (EMG) biofeedback training on blood pressure (BP) in prehypertensives and assessed the changes of heart rate variability (HRV) in order to find an optional intervention to prevent hypertension and acquire some experimental data to clarify the underlying neural mechanism. METHODS: Twenty-two (22) postmenopausal women with prehypertension were randomly assigned to either the experiment group or the control group. The experiment group performed 10 sessions of slow abdominal breathing (six cycles/min) combined with frontal electromyographic (EMG) biofeedback training and daily home practice, while the control group only performed slow abdominal breathing and daily home practice. BP and HRV (including R-R interval and standard deviation of the normal-normal intervals [SDNN]) were measured. RESULTS: Participants with prehypertension could lower their systolic blood pressure (SBP) 8.4 mm Hg (p < 0.001) and diastolic blood pressure (DBP) 3.9 mm Hg (p < 0.05) using slow abdominal breathing combined with EMG biofeedback. The slow abdominal breathing also significantly decreased the SBP 4.3 mm Hg (p < 0.05), while it had no effect on the DBP (p > 0.05). Repeated-measures analyses showed that the biofeedback group + abdominal respiratory group (AB+BF) training was more effective in lowering the BP than the slow breathing (p < 0.05). Compared with the control group, the R-R interval increased significantly during the training in the AB+BF group (p < 0.05). The SDNN increased remarkably in both groups during the training (p < 0.05). CONCLUSIONS: Slow abdominal breathing combined with EMG biofeedback is an effective intervention to manage prehypertension. The possible mechanism is that slow abdominal breathing combined with EMG biofeedback could reduce sympathetic activity and meanwhile could enhance vagal activity.

Electrocardiogram heart rate variability for machine learning diagnosis of obstructive sleep Apnoea: A bayesian meta-analysis.

Hao Y, Tan NKW, Gao EY +12 more · Sleep Breath · 2025 · 3 citations

Combined Heart Rate Variability and Pulse Oximetry Biofeedback for Chronic Obstructive Pulmonary Disease: Preliminary Findings

Nicholas D. Giardino, Leighton Chan, Soo Borson · Applied Psychophysiology and Biofeedback · 2004 · 133 citations

Heart rate variability biofeedback therapy and graded exercise training in management of chronic fatigue syndrome: An exploratory pilot study

Petra Windthorst, Nazar Mazurak, M. Kuske +6 more · Journal of Psychosomatic Research · 2016 · 62 citations

Do Pain and Autonomic Regulation Share a Common Central Compensatory Pathway? A Meta-Analysis of HRV Metrics in Pain Trials.

Daibes M, Almarie B, Andrade MF +7 more · NeuroSci · 2025 · 5 citations

A hypotensive protocol of inspiratory muscle strength training: Systematic review and meta-analysis with trial sequential analysis.

Li W, Zhu X, Wang X +6 more · J Clin Hypertens (Greenwich) · 2023 · 2 citations

This meta-analysis found that high-intensity inspiratory muscle strength training (IMST) significantly lowers both systolic and diastolic blood pressure in adults, suggesting it's a robust, non-pharmacological approach worth testing for blood pressure management.

Effects of Physical Training on Heart Rate Variability in Patients with Metabolic Syndrome: A Systematic Review and Meta-Analysis.

Ortiz-Guzmán JE, Sánchez-Soler M, Prieto-Mondragón L +5 more · J Clin Med · 2025 · 1 citations

The effect of exercise training on heart rate variability in patients with hypertension: A systematic review and meta-analysis.

Deng Y, Zeng X, Tang C +3 more · J Sports Sci · 2024 · 13 citations

Yoga Training Improves Quality of Life in Women with Asthma

Amy J. Bidwell, Beth Yazel, David Davin +2 more · The Journal of Alternative and Complementary Medicine · 2012 · 58 citations

OBJECTIVES: Individuals with asthma frequently suffer with a decrease in quality of life. Yoga has been shown to improve autonomic function in the healthy population and has been used as an alternative therapy to help improve symptoms associated with various diseases. PURPOSE: The purpose of this study was to assess whether 10 weeks of yoga training can improve quality of life and heart rate variability (HRV) in patients with asthma. DESIGN: Nineteen (19) females were randomly assigned to a yoga group or a control group for a 10-week intervention while still following guidelines established by their physician. All subjects answered the St. George's Respiratory Questionnaire (SGRQ) to assess quality of life and performed an isometric handgrip exercise test to assess HRV. RESULTS: Based on the SGRQ, significant improvements (45%, p < 0.05) in quality of life were observed with the yoga training, while no changes were found in the control group. Resting hemodynamic measures improved significantly in the yoga group compared to the control group (p < 0.05). The yoga group decreased parasympathetic modulation (HFnu [normalized units]) pre- to postintervention (0.45 ± 0.60 to 0.35 ± 0.06 nu, p<0.05, respectively) in response to the isometric forearm exercise (IFE), whereas the control group did not change. Additionally, the yoga group increased sympathetic (LFnu) (pre 0.47 ± 0.07 to post 0.60 ± 0.07 nu, p < 0.05) and sympathovagal modulation (logLF/HF) (pre 4.61 ± 0.39 to post 5.31 ± 0.44, p < 0.05, respectively) during IFE with no change in the control group. CONCLUSIONS: Yoga training improved quality of life in women with mild-to-moderate asthma and resulted in decreased parasympathetic and increased sympathetic modulation in response to an IFE.

Enhancing wellness: a systematic review of biofeedback interventions for healthcare professionals.

Cantone E, Urban A, Perra A +4 more · Front Psychiatry · 2026 · 0 citations

A meta-analysis investigating the outcomes and correlation between heart rate variability biofeedback training on depressive symptoms and heart rate variability outcomes versus standard treatment in comorbid adult populations.

Donnelly D, Georgiadis E, Stavrou N · Acta Biomed · 2023 · 4 citations

Inclusion of a rest period in diaphragmatic breathing increases high frequency heart rate variability: Implications for behavioral therapy

Matthew E. B. Russell, April B. Scott, Ian A. Boggero +1 more · Psychophysiology · 2016 · 61 citations

Heart rate variability (HRV) is associated with positive physiological and psychological effects. HRV is affected by breathing parameters, yet debate remains regarding the best breathing interventions for strengthening HRV. The objective of the current study was to test whether the inclusion of a postexhalation rest period was effective at increasing HRV, while controlling for breathing rate. A within-subject crossover design was used with 40 participants who were assigned randomly to a breathing pattern including a postexhalation rest period or a breathing pattern that omitted the postexhalation rest period. Participants completed training on each breathing pattern, practiced for 6 min, and sat quietly during a 5-min washout period between practices. Participants were given instructions for diaphragmatic breathing at a pace of six breaths/minute with or without a postexhalation rest period. Recordings of heart rate, breathing rate, HF-HRV, RMSSD, LF-HRV, and SDNN were collected before and during each of the breathing trials. HRV indices were derived from Lead 1 ECG recordings. Pairwise contrasts showed that inclusion of a postexhalation rest period significantly decreased heart rate (p < .001) and increased HF-HRV (p < .05). No differences were found for breathing rates (p > .05), RMSSD (p > .05), and SDNN (p > .05). Results indicated that omission of the postexhalation rest period resulted in higher LF-HRV (p < .05). A postexhalation rest period improves HF-HRV, commonly associated with self-regulatory control, yet the importance of a postexhalation rest period requires further exploration.

Heart Rate Variability-Guided Training for Enhancing Cardiac-Vagal Modulation, Aerobic Fitness, and Endurance Performance: A Methodological Systematic Review with Meta-Analysis.

Manresa-Rocamora A, Sarabia JM, Javaloyes A +2 more · Int J Environ Res Public Health · 2021 · 52 citations

Exercise Frequency Determines Heart Rate Variability Gains in Older People: A Meta-Analysis and Meta-Regression.

Raffin J, Barthélémy JC, Dupré C +11 more · Sports Med · 2019 · 62 citations

The impact of long-term exercise intervention on heart rate variability indices: a systematic meta-analysis.

Zhang W, Bi S, Luo L · Front Cardiovasc Med · 2025 · 5 citations

Long-term exercise, especially aerobic and resistance training for at least 8 weeks, can improve the balance of your autonomic nervous system by reducing your LF/HF ratio, which is a good sign for cardiovascular and psychological health.

Cardiac Coherence and the Effectiveness of Cardiovascular Biofeedback in the Nursing Team: A Randomized Clinical Trial

Liliana Antoniolli, Andréia Barcellos Teixeira Macedo, Edwing Alberto Urrea Vega +3 more · Aquichan · 2024 · 1 citations

Cardiovascular biofeedback, a technique using guided deep breathing to improve heart rhythm coherence, was found to significantly increase cardiac coherence in stressed nursing professionals over three weeks compared to a placebo, suggesting it can help restore the body's balance and promote relaxation.

Physical training and heart rate and blood pressure variability: a 5-yr randomized trial

Arja Uusitalo, Tomi Laitinen, Sari Väisänen +2 more · American Journal of Physiology-Heart and Circulatory Physiology · 2004 · 66 citations

We studied the effect of regular physical activity on cardiac and vascular autonomic modulation during a 5-yr controlled randomized training intervention in a representative sample of older Finnish men. Heart rate variability (HRV) and blood pressure variability (BPV) are markers of cardiac and vascular health, reflecting cardiac and vascular autonomic modulation. One hundred and forty randomly selected 53- to 63-yr-old men were randomized into two identical groups: an intervention (EX) group and a reference (CO) group, of which 89 men remained until the final analysis (EX: n = 47; CO: n = 42). The EX group trained for 30-60 min three to five times a week with an intensity of 40-60% of maximal oxygen consumption. The mean weekly energy expenditure of the training program for the 5-yr training period was 3.80 MJ, and 71% of the EX group exceeded the mean. The EX group had a significantly (P < 0.01) higher oxygen consumption at ventilatory aerobic threshold (VO2VT) than the CO group at the 5-yr time point. VO2VT had a tendency to increase in the EX group and decrease in the CO group (interaction P < 0.001) from the baseline to the 5-yr time point. Peak performance did not change. Low-frequency power of R-R interval variability decreased in the EX group (P < 0.01, by 6%) from the baseline to the 5-yr time point. BPV did not change. In conclusion, low-intensity regular exercise training did not prevent HRV from decreasing or change BPV in 5 yr in older Finnish men.

Effects of heart rate variability biofeedback on cardiovascular responses and autonomic sympathovagal modulation following stressor tasks in prehypertensives

Shuilong Chen, Peng Sun, Shaohua Wang +2 more · Journal of Human Hypertension · 2015 · 43 citations

Heart Rate Variability Characteristics in Sedentary Postmenopausal Women Following Six Months of Exercise Training: The DREW Study

Conrad P. Earnest, Carl J. Lavie, Steven N. Blair +1 more · PLoS ONE · 2008 · 83 citations

BACKGROUND: Decreased heart rate variability (HRV) is associated with a higher risk of mortality. Overall, postmenopausal women have lower levels of HRV than premenopausal women, which may be additionally complicated by lifestyle related behaviors such as physical inactivity and obesity. Though cardiorespiratory exercise training increases HRV, little is known regarding the exercise dose necessary to promote this improvement. METHODOLOGY/PRINCIPAL FINDINGS: Our primary aim was to measure HRV in post-menopausal women following 6-months of exercise training. We examined supine resting HRV in 373 post-menopausal women (45-75 y) after 6-months of randomly assigned and double-blinded administered exercise training exercise training at 50%, 100% and 150% of the NIH Consensus Development Panel's recommended minimal physical activity level. This corresponded to 4, 8, or 12 kcal/kg per week (KKW) of energy expenditure. At baseline, we observed no significant differences in HRV or hormone replacement use between treatment groups. However, we did observe that Caucasian women and those taking antidepressant medications had lower levels of baseline HRV. After 6-months of exercise intervention, we observed a dose dependent increase in all parasympathetically derived time and frequency domain measurements across exercise groups after adjustment for age, ethnicity, antidepressants, and baseline rMSSD (all, P<0.001). For example, the parasympathetic index rMSSD was greater than control (23.19+/-1.0) for the 4-KKW (25.98+/-0.8; P = 0.14), 8-KKW (27.66+/-1.0; P<0.05), and 12-KKW (27.40+/-0.0; P<0.05) groups at follow-up. CONCLUSIONS/SIGNIFICANCE: Moderate intensity exercise training exercise is sufficient to improve HRV in previously sedentary postmenopausal women in a dose-dependent manner, as 4-KKW is insufficient to improve parasympathetic indices of HRV, while 12-KKW conferred no greater improvement than 8-KKW. TRIAL REGISTRATION: Clinicaltrials.gov NCT 00011193.

Inspiratory muscle training improves physical performance and cardiac autonomic modulation in older women

Gabriel Dias Rodrigues, Jonas Lí­rio Gurgel, Thiago Rodrigues Gonçalves +1 more · European Journal of Applied Physiology · 2018 · 53 citations

Implementing Mobile HRV Biofeedback as Adjunctive Therapy During Inpatient Psychiatric Rehabilitation Facilitates Recovery of Depressive Symptoms and Enhances Autonomic Functioning Short-Term: A 1-Year Pre–Post-intervention Follow-Up Pilot Study

Josef M. Tatschl, Sigurd Hochfellner, Andreas Schwerdtfeger · Frontiers in Neuroscience · 2020 · 37 citations

OBJECTIVE: New treatment options for depression are warranted, due to high recurrence rates. Recent research indicates benefits of heart rate variability biofeedback (HRVBF) on symptom recovery and autonomic functioning in depressed individuals. Slow-paced breathing-induced amplification of vagus nerve activity is the main element of HRVBF. Thus, the latter represents a safe and non-invasive complementary depression treatment. However, its efficacy in patients undergoing inpatient psychiatric rehabilitation receiving highly comprehensive treatments has not been evaluated. METHODS: Ninety-two inpatients were randomly assigned to an intervention group (IG) or control group (CG). While the latter received the standard treatment only, adjunctive HRVBF was provided to the IG over 5 weeks. Depression severity and heart rate variability (HRV) were assessed before (pre) and after 5 weeks (post). Moreover, 1-year follow-up depression scores were available for 30 participants. RESULTS: = 0.48). CONCLUSION: HRVBF as adjuvant therapy during inpatient psychiatric rehabilitation facilitated depression recovery. Additionally, amplified LF-HRV as well as cardiorespiratory coherence at rest and a decrease in resting breathing frequency was observed in the HRVBF group. These findings emphasize HRVBF's value as complementary therapy regardless of concurrent treatments. Moreover, these incremental benefits could serve as resource even after the actual training period. However, the additional antidepressant gains vanish during the long-term follow-up, indicating the need for more intense training or regular practice afterward, respectively. Thus, future studies are warranted to examine how the initial benefits of HRVBF during inpatient psychiatric rehabilitation can be preserved post discharge.

Preliminary findings in the heart rate variability and haemorheology response to varied frequency and duration of walking in women 65–74 yr with type 2 diabetes

Michael J. Simmonds, Clare Minahan, Kevin R. Serre +4 more · Clinical Hemorheology and Microcirculation · 2012 · 37 citations

Heart rate variability (HRV) and haemorheology adaptations to 12 wk of varied-dose treadmill walking were investigated in women aged 65-74 yr with type 2 diabetes. Subjects were randomly allocated into two groups where exercise frequency and session duration were manipulated (Group 1: 2 × 60 min·wk(-1) or Group 2: 4 × 30 min·wk(-1)), but intensity and accumulated weekly duration of exercise were consistent between groups (100% gas-exchange threshold; 120 min·wk(-1)). Twelve weeks of exercise training significantly improved peak oxygen uptake, time to exhaustion, and gas-exchange threshold (p < 0.05), independent of exercise group. Exercise training did not significantly change glycaemic control or body mass. Red blood cell (RBC) aggregation and RBC deformability significantly decreased (p < 0.05) for both groups. No change in HRV was observed for Group 1, whereas several key indicators of HRV were significantly improved in Group 2 (p < 0.05). The present study was the first to report decreased RBC aggregation following an exercise-only intervention and that exercise training improved RBC aggregation without a concomitant improvement in glycaemic control. The accumulated weekly exercise duration may be the most important training component for the prescription of exercise in older women with type 2 diabetes.

Effects of exercise training on heart rate variability in individuals with lower extremity arterial disease and claudication: A systematic review.

Marçal IR, Abreu RM, Cornelis N +8 more · J Vasc Nurs · 2023 · 1 citations

Cold Water Immersion, Heart Rate Variability and Post-Exercise Recovery: A Systematic Review.

Galvez-Rodriguez C, Valenzuela-Reyes P, Fuentealba-Sepúlveda S +2 more · Physiother Res Int · 2025 · 3 citations