Cardiac Autonomic Control in Women with Rheumatoid Arthritis During the Glittre Activities of Daily Living Test

Abstract

Background: Cardiovascular autonomic dysfunction is one of the most common complications in rheumatoid arthritis (RA), which can be assessed by heart rate variability (HRV) analysis. Because the autonomic nervous system plays an important role in orchestrating the cardiovascular response to stressors, assessing HRV during exercise is critical. The Glittre Activities of Daily Living test (GA-T) was recently proposed as a multitask field test that requires the performance of the upper and lower limbs, both of which are affected in individuals with RA. Objectives: This study was conducted to evaluate autonomic impairment by HRV in women with RA using the GA-T and to correlate these changes with physical functioning and muscle strength. Methods: This cross-sectional study enrolled 20 women (median [interquartile range]: age 55 [47.5 - 68.8] years) with RA (time since diagnosis: 15 [6.50 - 23.5] years) who underwent HRV assessment during GA-T. They also underwent physical functioning assessment through the Health Assessment Questionnaire Disability Index (HAQ-DI) and handgrip strength (HGS) and quadriceps strength (QS) measures. Results: The GA-T time exhibited significant correlations with the following HRV indices: root mean square of successive differences (RMSSD, rs = -0.451, P = 0.041), proportion of iRR differing by > 50 ms from previous intervals (pNN50, rs = -0.697, P = 0.0006), high frequency (HF, rs = -0.693, P = 0.0007), standard deviation of the points perpendicular to the line-of-identity (SD1, rs = -0.476, P = 0.034), and approximate entropy (ApEn, rs = 0.545, P = 0.013). In addition, the HAQ-DI exhibited significant correlations with the following HRV indices: pNN50 (rs = -0.467, P = 0.038) and HF (rs = -0.444, P = 0.049). We did not observe significant correlation between the HRV indices during the GA-T and the muscle strength measures (HGS and QS). Conclusions: In women with RA, the longer the required to perform the GA-T the worse their parasympathetic modulation, sympathetic-vagal imbalance, and complexity of the autonomic nervous system (i.e., increased index of ApEn) were. Physical functioning level was also related to vagal modulation.

Association between ventilatory efficiency, oxygen uptake, and Glittre-ADL test results in patients with chronic heart failure: a preliminary study

“…Before the beginning of the test, a metabolic gas analyser was coupled to the patient to measure the ventilatory variables through telemetry (VO2000, ErgoMET 13 software, MedGraphics, Brazil). Immediately before and after the test, the Borg Rating of Perceived Exertion (RPE) scale (fatigue and dyspnoea) was used, and pulse oximetry, blood pressure, and peripheral oxygen saturation were measured [9,10]. The VO 2peak value considered for analysis was the value at the end of the test, while the VE/ VCO 2 slope value was the mean of all values obtained during GA-T.…”

Heart Rate Variability in Adults with Sickle Cell Anemia During a Multitasking Field Test

“…The maximum force was assessed in the dominant leg after a 5-s sustained isometric contraction. QS was summarized as the highest value from three attempts with a 1-min intervals (19).…”