A Narrative Review of Heart Rate Variability as a Good Index of Psychophysical Health in Athletes and in Biofeedback Training

Pruneti, Carlo; Ferrari, S.; Guidotti, Sara

doi:10.1123/jcsp.2022-0016

Cited by 7 publications

(2 citation statements)

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“…Despite the current limitations, our study shed light on a segment of ON assessment, proving its association with stress-related lifestyle and PA. Further studies are needed to shed light on the causality between these variables, but it is possible to hypothesize that the increase in PA represents a compulsion in response to the obsessive thoughts typical of individuals with orthorexia. Therefore, "obsessive" physical exercise may not generate the benefits generally reported by the literature [52] but, on the contrary, fuel the predisposition to develop stress-related disorders [53].…”

Section: Discussionmentioning

confidence: 97%

Comparison between Physical Activity and Stress-Related Lifestyle between Orthorexic and Non-Orthorexic University Students: A Case–Control Study

Guidotti,

Fiduccia,

Murgolo

et al. 2024

Nutrients

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(1) Background: The literature regarding orthorexia nervosa (ON) has well documented the association with other mental disorders, such as obsessive–compulsive and eating disorders. However, the research has not taken into account stress-related behavior and the conduction of physical activity (PA), both structured and unstructured. (2) Methods: In this cross-sectional study, 165 students of the University of Parma (92 females and 74 males) aged between 18 and 49 years old (mean = 24.62 ± 4.81) were consecutively recruited. The ORTO-15 questionnaire was used to divide the total sample into a group without orthorexia (score > 40) and a group with orthorexia (score < 40). All subjects completed the P Stress Questionnaire, and specific items were extrapolated from the Eating Habits Structured Interview (EHSI) to investigate lifestyle, including structured and unstructured PA. (3) Results: Subjects with orthorexia represented 83% of the total sample and reported higher levels of stress-related risk behaviors (i.e., sense of responsibility (t = −1.99, p = 0.02), precision (t = −1.99, p = 0.03), stress disorders (t = −1.38, p = 0.05), reduced spare time (t = −1.97, p = 0.03), and hyperactivity (t = −1.68, p = 0.04)) and a higher frequency of PA (i.e., hours spent training in structured PA, daily (t = −1.68, p = 0.05), weekly (t = −1.91, p = 0.03), and monthly (t = −1.91, p = 0.03), the tendency to carry out physical exercise even if tired (t = −1.97, p = 0.02), and to adhere to unstructured PA (i.e., moving on foot or by bike rather than using transport (t = 1.27, p = 0.04)). (4) Conclusions: The results confirmed the presence of hyperactivity at a motor and behavioral level in people with orthorexia. Further studies are necessary to highlight the causality between ON, stress, and physical activity but it may be possible to hypothesize that “obsessive” physical exercise may not generate the benefits generally known by the literature.

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Section: Discussionmentioning

confidence: 97%

Comparison between Physical Activity and Stress-Related Lifestyle between Orthorexic and Non-Orthorexic University Students: A Case–Control Study

Guidotti,

Fiduccia,

Murgolo

et al. 2024

Nutrients

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“…Clip-on ear sensors have been shown to provide an accurate assessment of HRV compared to ECG [71]. Through HRV calculations, it produces an index of coherence, as a percentage of time in high, medium, or low coherence, through breathing and self-generated positive emotions [72]. A flower-shaped central visual pacer is present in the app, which paces a participant's breathing.…”

Section: Heartmath Interventionmentioning

confidence: 99%

Remote Short Sessions of Heart Rate Variability Biofeedback Monitored With Wearable Technology: Open-Label Prospective Feasibility Study

Hirten,

Danieletto,

Landell

et al. 2024

JMIR Ment Health

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Background Heart rate variability (HRV) biofeedback is often performed with structured education, laboratory-based assessments, and practice sessions. It has been shown to improve psychological and physiological function across populations. However, a means to remotely use and monitor this approach would allow for wider use of this technique. Advancements in wearable and digital technology present an opportunity for the widespread application of this approach. Objective The primary aim of the study was to determine the feasibility of fully remote, self-administered short sessions of HRV-directed biofeedback in a diverse population of health care workers (HCWs). The secondary aim was to determine whether a fully remote, HRV-directed biofeedback intervention significantly alters longitudinal HRV over the intervention period, as monitored by wearable devices. The tertiary aim was to estimate the impact of this intervention on metrics of psychological well-being. Methods To determine whether remotely implemented short sessions of HRV biofeedback can improve autonomic metrics and psychological well-being, we enrolled HCWs across 7 hospitals in New York City in the United States. They downloaded our study app, watched brief educational videos about HRV biofeedback, and used a well-studied HRV biofeedback program remotely through their smartphone. HRV biofeedback sessions were used for 5 minutes per day for 5 weeks. HCWs were then followed for 12 weeks after the intervention period. Psychological measures were obtained over the study period, and they wore an Apple Watch for at least 7 weeks to monitor the circadian features of HRV. Results In total, 127 HCWs were enrolled in the study. Overall, only 21 (16.5%) were at least 50% compliant with the HRV biofeedback intervention, representing a small portion of the total sample. This demonstrates that this study design does not feasibly result in adequate rates of compliance with the intervention. Numerical improvement in psychological metrics was observed over the 17-week study period, although it did not reach statistical significance (all P>.05). Using a mixed effect cosinor model, the mean midline-estimating statistic of rhythm (MESOR) of the circadian pattern of the SD of the interbeat interval of normal sinus beats (SDNN), an HRV metric, was observed to increase over the first 4 weeks of the biofeedback intervention in HCWs who were at least 50% compliant. Conclusions In conclusion, we found that using brief remote HRV biofeedback sessions and monitoring its physiological effect using wearable devices, in the manner that the study was conducted, was not feasible. This is considering the low compliance rates with the study intervention. We found that remote short sessions of HRV biofeedback demonstrate potential promise in improving autonomic nervous function and warrant further study. Wearable devices can monitor the physiological effects of psychological interventions.

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From the latin “re-cordis, passing through the heart”: autonomic modulation differentiates migraineurs from controls when recounting a significant life event

Guidotti,

Torelli,

Ambiveri

et al. 2024

Neurol Sci

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Objective The literature on clinical psychophysiology highlights the possibility of using Heart Rate Variability (HRV) as an index of psychophysical balance and resilience to stress. This study investigates the differences in stress reactivity and subsequent recovery between a group of migraineurs and healthy controls. Methods Socio-demographic (i.e., sex, age, profession, marital status, and level of education) and psychophysiological (HR and HRV) measures of a group of thirty subjects with migraine (26 migraineurs without aura (86.7%), 2 migraineurs with aura (6.7%), and 2 migraineurs with and without aura (6.7%)) and from thirty healthy control subjects were collected. In particular, HRV was analyzed through frequency-domain parameters, including Low-Frequency (LF; 0.04–0.15 Hz) and High-Frequency (HF; 0.15–0.4 Hz) bands as well as LF/HF ratio during a Psychophysiological Stress Profile (PSP) structured in seven phases: (1) Baseline, (2) Objective stressor 1 (Stroop Test), (3) Rest 1, (4) Objective stressor 2 (Mental Arithmetic Task), (5) Rest 2, (6) Subjective stressor (recount a significant life event), and (7) Rest 3. The LF, HF, and LF/HF ratio values were transformed into a logarithmic scale (i.e., log-LF, log-HF, and log LF/HF ratio). Additionally, LF and HF were converted into normalized units (0-100) (i.e., LF% and HF%) which, in turn, were used to obtain reactivity and recovery to stress through delta values (Δ) calculation. Results Subjects with migraine reported greater ΔLF% levels of reactivity and recovery to subjective stressor, demonstrating a prevalence of sympathetic activity while recounting a personal life event. At the same time, a lowering of the same values was found in the subjects of the group control. Discussion Our results underline the importance of conducting a psychophysiological assessment in patients with headaches because reduced stress management skills could influence the clinical manifestations of the disease, considering stress as one of the most common triggers for migraine patients.

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A Narrative Review of Heart Rate Variability as a Good Index of Psychophysical Health in Athletes and in Biofeedback Training

Cited by 7 publications

References 0 publications

Comparison between Physical Activity and Stress-Related Lifestyle between Orthorexic and Non-Orthorexic University Students: A Case–Control Study

Comparison between Physical Activity and Stress-Related Lifestyle between Orthorexic and Non-Orthorexic University Students: A Case–Control Study

Remote Short Sessions of Heart Rate Variability Biofeedback Monitored With Wearable Technology: Open-Label Prospective Feasibility Study

From the latin “re-cordis, passing through the heart”: autonomic modulation differentiates migraineurs from controls when recounting a significant life event

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