Key result
Non-invasive parameters including HRV and respiratory rate reliably track acute physiological and psychological stress.
Why the study?
Objective evaluation of stress is challenging in rehabilitation medicine due to reciprocal interactions with musculoskeletal disorders, time constraints, multiple signal interferences, and patient compliance, prompting a review of physiological stress markers and related technological, legal, and bioethical aspects.
This narrative review synthesizes evidence demonstrating that non-invasively measured cardiovascular, respiratory, and skin parameters can serve as surrogate markers for acute physiological and psychological stress, while highlighting confounding factors in rehabilitation medicine such as musculoskeletal pain.
Answers are grounded in this paper and cite their sources.
Stress modifies measurable cardiovascular parameters; leaves open their prognostic value and clinical integration.
: Stress is an important component of current life and medical practice and also an actual research subject. It has been linked to a host of different pathologies both as a causative and as an aggravating factor. Stress affects both the hormonal and the immunological functions of the human body. Stress perception and induction were demonstrated to quantifiably modify a number of physiological parameters, which can be readily measured. These parameters evaluate the function of the cardiovascular and respiratory systems and reflect the changing skin physiology; collectively, we refer to these parameters as "stress markers". We reviewed the reliability of the heart rate, heart rate variability, pulse pressure, blood pressure, skin temperature, skin electrical conductance, electromyography, serum and saliva markers, and respiratory rate as surrogate data for stress quantification. Musculoskeletal disorders and stress often interact reciprocally, and this makes the objective evaluation of stress challenging in the context of rehabilitation therapies. Stress monitoring in rehabilitation medicine presents unique challenges due to time constraints, multiple signal interferences and specific patient compliance. We comment on the devel-opment of new technologies that might alleviate these problems in clinical settings and in research, from a technological, legal and bioethical perspective.
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Periferakis et al. (2026) conducted a review in Acute physiological and psychological stress. Acute physiological or psychological stress induction vs. Rest or non-stressed baseline state was evaluated on Alterations in non-invasively measured physiological parameters (cardiovascular parameters, skin temperature, skin conductance, and respiratory rate). Non-invasive electrophysiological parameters such as heart rate variability, skin temperature, skin conductance, and respiratory rate reliably reflect acute physiological and psychological stress.
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