What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Healthy adults (n=623). Intervention: Exercise training vs. No intervention. Primary outcome: Root mean square of successive differences in heart period series (RMSSD) (SMD 0.84, 95% CI 0.36, 1.31, p=0.0005).

What does this research mean for the field?

Exercise training significantly improves heart rate variability parameters, including RMSSD and SDNN, compared to no intervention in healthy adults. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

June 16, 2024Open Access

Effects of Exercise Training on Heart Rate Variability in Healthy Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

YAYoussra AmekranAbdelmalek Essaâdi University AHAbdelkader Jalil El HangoucheAbdelmalek Essaâdi University

Key Result

Exercise training significantly improved heart rate variability parameters, including RMSSD (SMD 0.84) and SDNN (SMD 0.58), compared to no intervention in healthy adults.

Study Design

Type

Meta-Analysis (n=623)

Structured PICO

Does exercise training improve heart rate variability parameters in healthy adults?

Population

623 healthy adults (aged ≥ 18 years) pooled from 16 RCTs. Mean age ranged from 19.2 to 68 years. 7 studies recruited males, 4 females, and 5 both genders.

Intervention

Aerobic, anaerobic, or combined exercise training programs lasting 4 or more weeks (mean intervention length 10.4 weeks, ranging from 4 weeks to 8 months).

Comparator

No intervention (control group).

Outcome

Changes in autonomic nervous system activity measured by time-domain HRV indices (SDNN, RMSSD, and pNN50) and frequency-domain indices (LF, LFnu, HF, HFnu, and LF/HF ratio) from baseline to post-intervention.surrogate

Exercise training significantly enhances heart rate variability parameters associated with vagal and sympathetic activity in healthy adults.

Main Result

Effect estimate: SMD 0.84 (95% CI 0.36, 1.31)

p-value: p=0.0005

Limitations

Limited number of existing RCTs related to the subject
Substantial significant heterogeneity observed in several HRV indices (SDNN, RMSSD, HF, LF, and LF/HF)

Abstract

This meta-analysis was conducted to investigate the effects of exercise training on heart rate variability (HRV) parameters associated with the autonomic nervous system (ANS) activity. Randomized controlled trials (RCTs) involving healthy adults (aged ≥ 18 years) were included. We searched PubMed, Scopus, Web of Science, and EBSCO databases to identify relevant studies. A random-effects meta-analysis was performed using the standardized mean difference (SMD) and 95% confidence interval (CI). Sixteen RCTs with a total of 623 participants were selected for the final analysis. The analysis showed that exercise training improved the standard deviation of normal-to-normal intervals (SDNN) (SMD: 0.58 (0.16, 1.00); p = 0.007), the root mean square of successive differences in heart period series (RMSSD) (SMD: 0.84 (0.36, 1.31); p = 0.0005), and the absolute power of high-frequency band (HF) (SMD: 0.89 (0.27, 1.51); p = 0.005) parameters compared to the control group. Analysis of the moderator variables showed that the effect of exercise on HRV indices may be influenced by sex, age, and type of exercise used, specifically in HF band, absolute power of low-frequency band (LF), and LF/HF ratio parameters. Despite the limited number of existing RCTs related to the subject, the results suggest that exercise training enhances HRV parameters associated with vagal-related activity (RMSSD and HF) and both sympathetic and parasympathetic activities (SDNN). This study overcomes the lack of meta-analyses on the effects of exercise training on autonomic modulation among healthy adults and may bridge the gap in understanding the potential physiological underpinnings of the acknowledged positive health benefits of exercise.

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