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Methodologic implications for rehabilitation research: Differences in heart rate variability introduced by
Ryan Solinsky1,2,3, Grant D Schleifer4, Adina E Draghici1,2,3
1Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.
PM & R : the Journal of Injury, Function, and Rehabilitation
|January 25, 2022
Summary
Respiration significantly impacts heart rate variability (HRV) in individuals with spinal cord injury. Accounting for breathing patterns is crucial for accurate HRV interpretation in rehabilitation research.
Area of Science:
- Autonomic physiology
- Rehabilitation medicine
- Cardiovascular research
Background:
- Heart rate variability (HRV) is increasingly used to assess autonomic activity.
- Respiration's influence on HRV is often overlooked in rehabilitation research, risking misinterpretation.
Purpose of the Study:
- To investigate the effects of unpaced and paced breathing on HRV measures.
- To analyze HRV in individuals with spinal cord injury within a rehabilitation context.
Main Methods:
- Cross-sectional study comparing HRV during spontaneous and controlled breathing (15 breaths/min).
- Laboratory assessment in individuals with spinal cord injury.
- Analysis of low frequency (LF) and high frequency (HF) power, LF percentage, and LF:HF ratio.
Main Results:
- Unpaced breathing showed significantly higher LF power (1292 vs. 573 ms²), LF spectrum percentage (64% vs. 42%), and LF:HF ratio (3.2 vs. 1.1) compared to paced breathing.
- HF power showed similar means but wide variability, indicating uncertainty without controlling for respiration.
- Significant positive proportional bias was observed for LF power between breathing conditions.
Conclusions:
- Breathing significantly influences HRV in individuals with spinal cord injury.
- Failure to account for respiration can lead to misinterpretation of unpaced HRV data.
- Future rehabilitation studies should incorporate paced breathing for accurate HRV assessment.
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