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Department of Biological and Medical Sciences
Objective. To assess the acute response of cardiac autonomic modulation (ACAM) during and after a session of virtual reality-based therapy (VRBT) compared to a session of conventional cardiovascular rehabilitation (CR) and to evaluate the effects of 12 weeks of training on this response.
Methods. We assessed 28 volunteers (63.4 ± 12.5 years). The ACAM was judged by linear indexes of heart rate variability (HRV) in VRBT and CR sessions. Later, patients completed 12 weeks of VRBT+CR and the assessment was repeated at the 12th week.
Results. Throughout the 1st VRBT session vagal withdrawal occurred (RMSSD/HFnu); sympathetic nervous system stimulation (LFnu) and progressive decrease of global HRV (SDNN). During the recovery, the SDNN, HFnu, and LFnu improved from the 5thminute on both therapies. After 12 weeks, the LFnu, HFnu, and the LF/HF-ratio revealed no significant changes in Ex3-Ex4 equated to Rep during VRBT. In recovery, the HFnu and LFnu improved before the 5thminute on both therapies.
Conclusions. ACAM during and after the VRBT was comparable to CR, yet, the extents were greater in the VRBT. After 12 weeks of VRBT training, the subjects adapted to the exercises from the 15thminute and exhibited faster recovery of HFnu and LFnu indexes compared to the 1st week.
Introduction.Considering that heart rate (HR) autonomic control is impaired in cancer and subsequent respiratory effort may overload the heart, we aimed to evaluate the effect of a respiratory physical therapy session on HR autonomic regulation in children with leukemia so as to confirm its safety.
Methods.We selected children with leukemia (n = 10) and healthy children (n = 11), which were submitted to a session of respiratory physical therapy. We used Spiron Kids (NCS, Brazil), Children’s Voldyne (HUDSON RCI, USA), and Shaker (NCS, Brazil) as respiratory devices. The respiratory exercise protocols were founded on three standardized protocols. HR variability (HRV) was analyzed before, in the first minute and 5 to 10 min after intervention.
Results.We recognized no change between rest and recovery from intervention in HRV (rMSSD—square root mean square of the differences between adjacent normal R-R intervals)—Control: p = 0.8111, Leukemia: p = 0.1197, among groups: p = 0.6574; SD1—standard deviation from instantaneous beat-to-beat variability—Control: p = 0.8111, Leukemia: p = 0.131, among groups: p = 0.6556; 0V—with no variation (3 equal symbols, for example (2,2,2)—Control: p = 0.3679, Leukemia: p = 0.3553, among groups: p = 0.7421); 2UV—with two variations to the contrary (the three symbols form a peak or a valley, for instance (3,5,3)—Control: p = 0.3679, Leukemia: p = 0.2359, among groups: p = 0.4007). HF—high frequency component, range 0.15 to 0.4 Hz—decreased 0 to 1 min after intervention in the leukemia group (p = 0.0303) and no change was observed in the control group between rest versus recovery from intervention (p = 0.9761). No significant change was reported in HF between groups (p = 0.8700). Two leukemia subjects treated with vincristine presented different HRV responses to the intervention group.
Conclusion.A respiratory physical therapy session did not significantly change autonomic control of HR in children with leukemia. Yet, clinicians should be mindful of subjects undergoing treatment with vincristine.
Introduction: Approximate Entropy (ApEn) is a widely enforced metric to evaluate the chaotic response and irregularities of RR intervals from an electrocardiogram. We applied the metric to estimate these responses in subjects with type 1 diabetes mellitus (DM1). So far, as a technique it has one key problem - the accurate choices of the tolerance (r) and embedding dimension (M). So, we attempted to overcome this drawback by applying different groupings to detect the optimum.
Methods: We studied 46 subjects split into two equal groups: DM1 and control. To evaluate autonomic modulation the heart rate was measured for 30 min in a supine position without any physical, sensory, or pharmacological stimuli. For the time-series, the ApEn was applied with set values for r (0.1→0.5 in intervals of 0.1) and M (1→5 in intervals of 1) and the differences between the two groups and their effect size by two measures (Cohen’s ds and Hedges’s gs) were computed.
Results: The highest value of statistical significance accomplished for the effect sizes (ES) for any of the combinations performed was -0.7137 for Cohen’s ds and -0.7015 for Hedges’s gs with M = 2 and r = 0.08.
Conclusion: ApEn was able to identify the reduction in chaotic response in DM1 subjects. Still, ApEn is relatively unreliable as a mathematical marker to determine this.
Judging to make a decision amidst several possibilities that rise to risks, losses, gains and uncertainties is not a simple matter. In this process, the subject needs to verify the situation considering the alternatives that are made up of several elements, among them, the analysis of how much this decision will cost and what benefit it will have in response, and what the consequences will be in the long, medium and short term. In this sense, decision-making is associated with the deliberative and affective process that relates to multiple variables that are interconnected with the flow of information assimilated by the agent who is responsible for the judgment and the decision. This process is interdependent on the subject’s structure with external stimuli. Thus, the individual’s forces and social pressure are important elements to be considered for decision making. For the adolescent, this issue becomes even more important, as it is a phase of human development in which the person exhibits behaviors of risk and during this stage of life there is a process of maturation of the central nervous system, which are related to decision-making and motivational processes. Therefore, decision making among adolescents is a complex issue that in addition to biological factors are directly related to social and psychological elements, depends on a maturity in development, but can be impaired if stressful situations are constant stimuli in the lives of adolescents. =
O distanciamento social foi planejado como uma medida preventiva para controlar a disseminação extensiva da COVID-19. Nós analisamos as mortes relacionadas à COVID-19 no Brasil durante o período de medidas de distanciamento social. Os dados de mortalidade do COVID-19 foram obtidos no site da Worldometer (www.worldometer.info). As mortes foram estimadas até o 31º dia após a 5ª morte. O distanciamento social foi medido por meio dos relatórios de mobilidade comunitária COVID-19; Google (https://www.google.com/covid19/mobility/). As curvas epidêmicas brasileiras foram interligadas e os modelos matemáticos foram avaliados para se ajustarem às curvas de estimativa de mortalidade. O modelo otimista foi fundado no período de abertura da distância social e, portanto, na menor mobilidade (40-60%). O modelo realista foi calculado de acordo com medidas de distanciamento social relaxado (<40%) e o modelo pessimista foi calculado com base em R0 entre 2-3. Sob essa situação, o modelo matemático realista estimou 40.623 mortes em 9 de junho de 2020, enquanto o modelo pessimista antecipou 64.310 mortes e o modelo otimista projetou 31.384. Até hoje (24 de maio de 2020), um total de 22.965 foram relatadas, enquanto nosso modelo projetou 17.452 para o modelo otimista, 22.623 para o modelo realista e 32.825 para o modelo pessimista. Observamos movimento reduzido ao longo deste período. Em resumo, o modelo matemático sugere que a mobilidade reduzida da comunidade diminuiu o total estimado de mortes relacionadas à COVID-19 no Brasil. Enfatizamos que mais procedimentos metodológicos serão necessários para confirmar esta teoria.
Objective: We assessed the acute effect of beetroot extract intake on cardiovascular and autonomic recovery subsequent to strength exercise.Methods: This is a crossover, randomized, double-blind and placebo-controlled trial. We assessed 16 subjects but only 12 healthy male adults completed the two protocols in two randomized days: Beetroot extract (600 mg in capsule) and placebo (600 mg starch in capsule). Beetroot extract or placebo was ingested, the subjects endured 120 minutes seated at rest, followed by a 75% 1RM strength exercise and then remained seated for 60 minutes at rest. Cardiorespiratory parameters, heart rate (HR) variability (HRV) (SDNN, rMSSD, pNN50, SD1, SD2 HF [ms(2)]) were estimated before, during exercise and during recovery from exercise.Results: ingestion of beetroot extract before exercise: accelerates the recovery of SBP following physical effort; improves HR recovery to baseline resting levels (beetroot protocol: change in ∼62% vs. placebo protocol: change in ∼80%), and intensifies the return of vagal HR control during recovery after exercise.Conclusions: Beetroot extract acutely improved cardiovascular and autonomic recovery after exercise.
Metabolic syndrome (MetS) is a growing epidemic related with higher values of blood pressure (BP) and autonomic dysfunction. Scientific evidence has been indicating that functional resistance training (FRT) is superior over conventional (CRT) for muscle fatigue and pain, yet its effects on autonomic modulation (AM), BP and heart rate in MetS are unclear. We theorized that FRT can be superior to CRT in MetS patients because of larger muscle activation. This study compares FRT and CRT on AM, blood pressure, heart rate and muscle strength. Thirty-eight sex and age matched individuals (40 to 60 years) were randomized for FRT or CRT, with training intensity varying gradually from 30%?100% of one maximal repetition test (1MR), 3 times/week for 30 sessions. All outcomes were evaluated at baseline and post training. AM was assessed by heart rate variability (mean RR, RMSSD, SDNN, LF, HF, TINN, RRtri, SD1 and SD2). BP (mmHg) was obtained by cuff measures. Muscle strength was assessed by 1MR. An increase in cardiac parasympathetic activity was observed in individuals allocated to FRT in comparison to CRT group (RMSSD ?40%; SD1 ?39%; and HF ms2 ?80%). Moreover, just FRT was capable of reducing BP post intervention (SBP from 129.21 ± 19.02 to 118.94 ± 14.14 mmHg, p < .009,/d/ = 0.49; DBP from 85.26 ± 11.48 to 77.76 ± 8.93 mmHg, p < .01,/d/ = 0.51). Both groups had a similar increase in muscle strength and no changes between HR. Progressive FRT was more beneficial to CRT regarding AM, increasing vagal activity, and reducing blood pressure in MetS individuals.
Aim. Previous studies have described the substantial impact of different types of noise on the linear behaviour of heart rate variability (HRV). Yet, there are limited studies about the complexity or nonlinear dynamics of HRV during exposure to traffic noise. Here, we evaluated the complexity of HRV during traffic noise exposure via six power spectra and, when adjusted by the parameters of the Multi-Taper Method (MTM).
Material and methods. We analysed 31 healthy female students between 18 and 30 years old. Subjects remained at rest, seated under spontaneous breathing for 20 minutes with an earphone turned off and then the volunteers were exposed to traffic noise through an earphone for a period of 20 minutes. The traffic noise was recorded from a busy urban street and the sound involved car, bus, trucks engineers and horn sounds (71-104 dB).
Results. The results stipulate that CFP3 and CFP6 are the best metrics to distinguish the two groups. The most appropriate power spectra were, Welch and MTM. Increasing the DPSS parameter of MTM increased the performance of both CFP3 and CFP6 as mathematical markers. Adaptive was the preferred type for Thomson’s nonlinear combination method.
Conclusion. CFP3 with the adaptive option for MTM, and increased DPSS is designated as the best mathematical marker on the basis of five statistical tests.
Evaluating different doses of caffeine (CAF) on heart rate (HR) variability (HRV) during and following exercise in order to assess its impact on autonomic control. We intended to evaluate the influence of CAF as a supplement before exercise on HRV through a systematic review. Manuscripts were selected based on electronic searches of MEDLINE, EMBASE and CINAHL databases from 2010 to 2019 and followed the protocol Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). Blind randomized designs and controlled trials that reported the influence of CAF on HRV during exercise and during recovery from exercise, with strength of evidence assessed using the GRADE system; the search for the studies was organized using the PICOS strategy. A total of 1797 articles were recognized, following the screening and eligibility stages, 9 studies continued to the final sample. Six studies reported that the combination of CAF supplementation with physical exercise exhibited higher HR when compared to the placebo group during post-exercise recovery; additionally, prolonged activation of sympathetic cardiac control and delayed parasympathetic reactivation following exercise was observed. However, three studies demonstrated no CAF influence when using similar doses. This review observed equivocal results in HR and HRV recovery following exercise with the presence of CAF consumption. These findings cannot confirm the cardiac autonomic changes observed where entirely due to the influence of CAF, and further studies should be performed to better understand this relationship.KEY TEACHING POINTSCAF increased HR during exercise and throughout the recovery period.CAF prolonged post exercise sympathetic activity.CAF delayed vagal reactivation.Deviations in HRV and HR are dependent on the combination of three main factors: CAF dosage, type of exercise, and cardiorespiratory fitness.
The hospital anxiety depression scale (HADS) is a benchmark used to investigate possible and probable cases of psychosomatic illness. Its affiliation with autonomic recovery after exercise is unclear and, as a technique applied to evaluate cardiovascular risk. We assessed a possible link between HADS and autonomic recovery after exercise. We studied healthy subjects split into two groups: Low HADS (n = 20) and High HADS (n = 21). Subjects consented to moderate aerobic exercise on a treadmill at 60% to 65% of the maximum heart rate (HR) for 30 min. We studied HR variability (HRV) before and during 30 min after exercise. Subjects with higher HADS values presented delayed recovery of HR and root-mean square of differences between adjacent normal RR intervals (RMSSD) after submaximal exercise. RMSSD during recovery from exercise had a significant association with HADS. In summary, subjects with higher HADS presented slower vagal recovery following exercise.
Backgound and aims. In this study we analyzed heart rate variability (HRV) via chaotic global techniques so as to discriminate diabetics from control subjects. Matherial and method. Chaotic global analysis of the RR-intervals from the electrocardiogram and preprocessing adjustments were undertaken. The effect of varying two parameters to adjust the Multi-Taper Method (MTM) power spectrum were evaluated. Then, cubic splineinterpolations from 1Hz to 13Hz were applied whilst the spectral parameters were fixed. Precisely 1000 RR-intervals of data were recorded. Results. CFP1 and CFP3 are the only significant combinations of chaotic globals when the default standard conditions are enforced. MTM spectral adjustments and cubic spline interpolation are trivial at effecting the outcome between the two datasets. The most influencial constraint on the outcome is data length. Conclusion. Chaotic global analysis was offered as a reliable, low-cost and robust technique to detect autonomic dysfunction in subjects with diabetes mellitus.
Stress induced by driving has been revealed to increase the chances of cardiovascular complications and is involved or related to traffic accidents. In order to develop strategies to avoid health problems during driving we aimed to evaluate the acute effects of auditory stimulation with music on heart rate variability (HRV) during driving in congested urban traffic. This is a prospective cross-sectional randomized controlled pilot study conducted with five healthy women. Subjects were evaluated on two different random days, whose order of execution was established through a randomization process. In the music protocol the volunteers were exposed to music for the entire 20 min of traffic while in the control protocol the subjects performed the same procedures but were not exposed to any music. We noted that all Higuchi fractal dimension parameters except Kmax 10, Kmax 130 and Kmax 140 were reduced between pre-driving in the control protocol vs. driving in the control protocol. The same changes were noted between pre-driving in the music protocol vs. driving in the control protocol. In conclusion, musical auditory stimulation improved nonlinear HRV changes induced by driving.
Cortical auditory evoked potentials (CAEP) throughout a language task is beneficial during psychophysiological evaluation to advance identification of language disorders. So as to better comprehend human communication and to provide additional elements for neuropsychological examinations we aimed to (1) examine the influence of language tasks on cortical auditory processing and vagal control of heart rate and (2) to verify a possible association between the parasympathetic cardiac regulation and cortical auditory processing in language tasks. This study was completed with 49 women. The subjects were separated into two groups: (1) phonological language tasks (N = 21) and (2) semantic (N = 21) language tasks. Heart rate variability (HRV) and CAEP were evaluated before and after the tests. HRV reduced (small effect size) and P3 wave latency increased after the phonological task. Identical variables were significantly correlated after the phonological task and linear regression indicated significant interaction between pNN50 (percentage of adjacent RR intervals with a difference of duration greater than 50 milliseconds) and P3 latency (16.9%). In conclusion, phonological language tasks slightly reduced parasympathetic control of HR and increased cognitive effort. The association between HRV and CAEP are anticipated to be involved in this mechanism.
Numerous studies have investigated the connection between autonomic control of heart rate (HR) and auditory stimulus. Yet, the literature lacks evidence of a close association between auditory brainstem processing and HR autonomic control. We aimed to evaluate and verify the relationship between auditory brainstem response (ABR) and HR variability (HRV) in healthy women. Forty‑six healthy female subjects, between the ages of 18 and 30 years old participated in the study. They were subjected to an audiometry examination, followed by rest for 10 minutes for HR recording. Next, ABR evaluation was completed discretely in both ears, with I, III and V wave components. Linear regression revealed that the root‑mean square of differences between adjacent normal RR intervals (RMSSD) and the triangular interpolation of RR interval (TINN) exhibited a significant association with Wave I in the right ear. These variables contributed to 28.2% (R²) of Wave I. In conclusion, there was a significant interaction between the autonomic control of HR and auditory processing in the right ear, suggesting that vagal tone interacts with the cochlear nerve.
Introduction. Heart rate variability (HRV) can be assessed from RR-intervals. These are derived from an electrocardiographic PQRST-signature and can deviate in a chaotic or irregular manner. In the past, techniques from statistical physics have allowed researchers to study such systems.Objective. This study planned to assess the heart rate dynamics in young obese subjects by nonlinear metrics to heart rate variability. Method. 86 subjects were split equally according to status. Heart rate was recorded with the subjects resting in a dorsal (prone) position for 30 minutes. The complexity of the RR-intervals was assessed by five Entropies, Detrended Fluctuation Analysis, Higuchi and Katz’s fractal dimensions Following inconclusive tests of normality we calculated the One-Way Analysis of Variance, Kruskal-Wallis, and the Effect Sizes by Cohen’s d significances. Results. It was established that Shannon, Renyi and Tsallis Entropies and the Higuchi and Katz’s fractal dimensions could significantly discriminate the two groups. The three entropies were higher in obese youths, suggesting less predictable sets of RR intervals (p<0.0001; d≈1.0). Whilst the Higuchi (p<0.003; d≈0.76) and Katz’s (p≈0.02; d≈0.57) fractal dimensions were lower in obese youths. Conclusion. As with chaotic globals an increase in response was detected by three measures of entropy in young obese. This is counter to the decreasing response detected by fractal dimensions. Chaotic globals and entropies are more dependable than fractal dimensions when assessing the responses to obesity.
Background and aims. Statistical markers are valuable when assessing physiological status over periods of time and in certain disease states. We assess if type 1 diabetes mellitus promote modification in the autonomic nervous system using the main two types of algorithms to estimate a Fractal Dimension: Higuchi and Katz. Material and methods. 46 adults were divided into two equal groups. The autonomic evaluation consisted of recording heart rate variability (HRV) for 30 minutes in supine position in absence of any other stimuli. Fractal dimensions ought then able to determine which series of interbeat intervals are derived from diabetics’ or not. We then equated results to observe which assessment gave the greatest significance by One-way analysis of variance (ANOVA1), Kruskal-Wallis technique and Cohen’s d effect sizes. Results. Katz’s fractal dimension is the most robust algorithm when assisted by a cubic spline interpolation (6 Hz) to increase the number of samples in the dataset. This was categorical after two tests for normality; then, ANOVA1, Kruskal-Wallis and Cohen’s d effect sizes (p≈0.01 and Cohen’s d=0.814143–medium effect size). Conclusion. Diabetes significantly reduced the chaotic response as measured by Katz’s fractal dimension. Katz’s fractal dimension is a viable statistical marker for subjectswith type 1 diabetes mellitus.
Background: The priniciple objective here is to analyze cardiovascular dynamics in diabetic subjects by actions related to heart rate variability (HRV). The correlation of chaotic globals is vital to evaluate the probability of dynamical diseases. Methods: Fortysix adults were split equally. The autonomic evaluation consisted of recording HRV for 30 minutes in supine position without any additional stimuli. “Chaotic globals” are then able to statistically determine which series of interbeat intervals are diabetic and which are not. Two of these chaotic globals, spectral Entropy and spectral Detrended fluctuation analysis were derived from six alternative power spectra: Welch, Multi-Taper Method, Covariance, Burg, Yule-Walker and the Periodogram. We then compared results to observe which power spectra provided the greatest significance by three statistical tests: One-way analysis of variance (ANOVA1); Kruskal-Wallis technique and the multivariate technique, principal component analysis (PCA). Results: The Chaotic Forward Parameter One (CFP1) applying all three parameters is proven the most robust algorithm with Welch and MTM spectra enforced. This was proven following two tests for normality where ANOVA1 (p=0.09) and Kruskal-Wallis (p=0.03). Multivariate analysis revealed that two principal components represented 99.8% of total variance, a steep scree plot, with CFP1 the most influential parameter. Conclusion: Diabetes reduced the chaotic response.
Introduction: Fetal heart rate and its variability during the course of gestation have been extensively re-searched. The overall reduction in heart rate and increase in fetal HRV is associated with fetal growth and the increase in neural integration. The increased complexity of the demands on the cardiovascular system leads to more variation in the temporal course of the heart rate which has been shown to be refl ected in measures of complexity. The aim of this work was to investigate novel complexity measures with respect to their ability to quantify changes over gestational age in individual fetuses consistently and in a stable manner.
Methods: We examined 215 fetal magnetocardiograms (FMCG), each of 5 min duration, in 11 fetuses during the second and third trimesters (at least 10 data sets per fetus). From the FMCG we determined the fetal RR beat durations. For each 5 min time-series of RR intervals we then calculated Shannon entropy, high spectral entropy, high spectral Detrended Fluctuation Analysis, spectral Multi-Taper Method as well as the standard deviation and two commonly used complexity measures: Approximate Entropy and Sample Entropy. For each subject and HRV measure, we performed regression analysis with respect to ges tational age. The coeffi cient of determination R2 was used to es timate ‘goodness-of-fi t’, the slope of the regression indicated the strength of the individual dependency on gestational age.
Results: We found that the new complexity measures do not outperform ApEn.
Conclusion: This study has now rejected the hypothesis that the spectral complexity measures outperform those applied previously