Heart Rate Variability-Guided Training for Enhancing Cardiac-Vagal Modulation, Aerobic Fitness, and Endurance Performance: A Methodological Systematic Review with Meta-Analysis

Abstract

Purpose: This systematic review with meta-analysis was conducted to establish whether heart rate variability (HRV)-guided training enhances cardiac-vagal modulation, aerobic fitness, or endurance performance to a greater extent than predefined training while accounting for methodological factors. Methods: We searched Web of Science Core Collection, Pubmed, and Embase databases up to October 2020. A random-effects model of standardized mean difference (SMD) was estimated for each outcome measure. Chi-square and the I2 index were used to evaluate the degree of homogeneity. Results: Accounting for methodological factors, HRV-guided training was superior for enhancing vagal-related HRV indices (SMD+ = 0.50 (95% confidence interval (CI) = 0.09, 0.91)), but not resting HR (SMD+ = 0.04 (95% CI = −0.34, 0.43)). Consistently small but non-significant (p > 0.05) SMDs in favor of HRV-guided training were observed for enhancing maximal aerobic capacity (SMD+ = 0.20 (95% CI = −0.07, 0.47)), aerobic capacity at second ventilatory threshold (SMD+ = 0.26 (95% CI = −0.05, 0.57)), and endurance performance (SMD+ = 0.20 (95% CI = −0.09, 0.48)), versus predefined training. No heterogeneity was found for any of the analyzed aerobic fitness and endurance performance outcomes. Conclusion: Best methodological practices pertaining to HRV index selection, recording position, and approaches for establishing baseline reference values and daily changes (i.e., fixed or rolling HRV averages) require further study. HRV-guided training may be more effective than predefined training for maintaining and improving vagal-mediated HRV, with less likelihood of negative responses. However, if HRV-guided training is superior to predefined training for producing group-level improvements in fitness and performance, current data suggest it is only by a small margin.

mHealth system (ATOPE+) to support exercise prescription in breast cancer survivors: a reliability and validity, cross-sectional observational study (ATOPE study)

“…Comparison with prior work. The majority of previous work is not oriented to the clinical population but to athletes 39 to avoid overtraining 14 and increase performance 40 . In the clinical population, to our knowledge, a similar tool has not been developed, although there is an ongoing one on post myocardial infarction (Clini-calTrials.gov Identifier: NCT03745742), with less demanding purpose but more oriented to improve functional capacities and reduce fatigue.…”

Does Wearable-Measured Heart Rate Variability During Sleep Predict Perceived Morning Mental and Physical Fitness?

“…Resting HRV during sleep should therefore not be seen as a potential replacement of perceived physical fitness, but as a complement to it. Prior studies showed that utilizing resting HRV measurements to guide training-related decision making can lead to positive outcomes in comparison to predefined training (Düking et al, 2021;Manresa-Rocamora et al, 2021). Therefore, resting HRV during sleep may be useful as a complement to the perceived physical fitness to guide decision-making on the physical readiness of the respective individual on the following day.…”

“…Finally, resting HRV has also been linked to viral infections on a withinsubject level (Conroy et al, 2022). These associations are the basis for HRV guided training, in which daily resting HRV is being used in comparison to the personal baselines of athletes to determine their physiological recovery from prior physical or mental stress and adjust training plans when necessary (Düking et al, 2021;Manresa-Rocamora et al, 2021). In this setting, the objective resting HRV data are often combined with subjective questionnaire data in order to get a more complete view of the athlete's current status.…”

Differences between Elite Male and Female Badminton Athletes Regarding Heart Rate Variability, Arterial Stiffness, and Aerobic Capacity

“…A recent study indicated that the HRV-guided training was superior for enhancing vagal-related HRV indices, which could be related to greater endurance performance. When resting HRV was within or above baseline ranges, high-intensity exercise training was prescribed; otherwise, low-intensity exercise training was prescribed when HRV values were suppressed [ 16 ]. Gaining more understanding of HRV profiles in male and female athletes could provide appropriate training prescription and effective assessment of cardiovascular adaptation.…”