Dynamics of Vagal Activity Due to Surgery and Subsequent Rehabilitation

Abstract

BackgroundVagal activity is critical for maintaining key body functions, including the stability of inflammatory control. Its weakening, such as in the aftermatch of a surgery, leaves the body vulnerable to diverse inflammatory conditions, including sepsis.MethodsVagal activity can be measured by the cardiorespiratory interaction known as respiratory sinus arrhythmia or high-frequency heart-rate variability (HRV). We examined the vagal dynamics before, during and after an orthopedic surgery. 39 patients had their HRV measured around the period of operation and during subsequent rehabilitation. Measurements were done during 24 h circadian cycles on ten specific days. For each patient, the circadian vagal activity was calculated from HRV data.ResultsOur results confirm the deteriorating effect of surgery on vagal activity. Patients with stronger pre-operative vagal activity suffer greater vagal withdrawal during the peri-operative phase, but benefit from stronger improvements during post-operative period, especially during the night. Rehabilitation seems not only to efficiently restore the vagal activity to pre-operative level, but in some cases to actually improve it.DiscussionOur findings indicate that orthopedic rehabilitation has the potential to strengthen the vagal activity and hence boost inflammatory control. We conclude that providing a patient with a vagal reinforcement procedure prior to the surgery (“pre-habilitation”) might be a beneficial strategy against post-operative complications. The study also shows the clinical usefulness of quantifying the cardiorespiratory interactions.

Cardiorespiratory Interaction and Autonomic Sleep Quality Improve during Sleep in Beds Made from Pinus cembra (Stone Pine) Solid Wood

“…The autonomic quotient (LF/HF) was computed from LF and HF results. LogRSA, a robust, time domain measure which is especially suitable for the estimation of the respiratory component of HRV and, hence, vagal activity [ 20 , 23 , 39 , 40 , 41 ], was used to calculate vagal activity every five minutes at two-minute increments.…”

Time Window Determination for Inference of Time-Varying Dynamics: Application to Cardiorespiratory Interaction

“…Such biological systems are usually not isolated, but interact between each other (Bashan et al, 2012). The cardiorespiratory interaction, as central mechanism of the cardiovascular system, has been studied extensively in relation to different states and diseases (Schäfer et al, 1998;Stefanovska et al, 2000;Stankovski et al, 2012;Iatsenko et al, 2013;Kralemann et al, 2013a;Schulz et al, 2018;Grote et al, 2019). The cardiac and the respiration signals can be acquired by non-invasive measurements, making the investigations of cardiorespiratory interaction easily accessible.…”

Observational study of an inpatient program for musculoskeletal disorders

“…However, even minor changes in lifestyle can lead to functional adaptations and normalization of physiological functions and help the patient to recover from chronic inflammatory or degenerative diseases. [ 40 , 41 ]…”