The impact of breathing rate on the cardiac autonomic dynamics among children with cerebral palsy compared to typically developed controls

Abstract

The results of the current work present the immediate effect of paced breathing on HRV parameters in CP and TD children. Further studies are needed to investigate the effect of long-term treatment focusing on paced breathing for children with CP.

Heart Rate Variability in Children and Adolescents with Cerebral Palsy—A Systematic Literature Review

“…In 2014, Amichai and Katz-Leurer published a review based on the articles published between 1990 and 2013 assessing the function of the autonomic cardiac regulation among children with CP [10]. However, since that period, eight new articles in this area have been published [8,9,[11][12][13][14]54,56]. Amichai and Katz-Leurer concluded that there is a trend that children with CP suffer from impaired cardiac autonomic system regulation [10].…”

“…Results of the articles published between 2013 and 2019 confirmed this trend, but also provided new findings (see Table 3). Authors of these studies suggested that children with CP present lower cardiac autonomic system adaptation to exercise and activity [8] and lower spirometry [12] compared to typically developed children; non-optimal HR reduction after a submaximal treadmill test indicating low reactivation of the parasympathetic system [11]; decreased values of selected time-domain HRV parameters in those dependent on adult assistance for mobility compared to those who are generally independent [14]. Israeli-Mendlovic et al [9] suggested and Cohen-Holzer et al [13] and Amichai et al [12] showed that some forms of physical exercises and training improve cardiac autonomic regulation in pediatric patients with CP by reducing HR and breathing rate and increasing values of selected HRV parameters.…”

“…Impaired cardiac autonomic function in children with CP might be due to the damage of the developing brain or to the sedentary lifestyle, or both synergistically interacting [10,12]. Recently, the association between the anterior cingulate cortex (ACC), a bilateral cortical structure in the medial wall of the brain [62], and HRV has been shown [63,64].…”

“…In patients with CP, motor disorders attributed to non-progressive anomalies in the developing fetal or infant brain are often accompanied by a range of additional disturbances, e.g., epilepsy, sensory, perceptive, cognitive, communicational, and behavioral problems [1]. Recently, numerous studies have been performed to identify alterations in the autonomic nervous system (ANS) activity, which suggest that children and adolescents with CP present sympathovagal imbalance compared to peers with normal development [2][3][4][5][6][7][8][9][10][11][12][13][14]. Several possible causes are postulated to explain the cardiac ANS abnormalities in these patients.…”

“…In 2014, a review assessing the function of the autonomic HR regulation among children with CP was published [10]. Results of the studies included to the review (articles published before 2013) performed by Amichai and Katz-Leurer [10], but also findings of the articles that were not analyzed by these authors or were published later, showed that children with CP, in comparison to normally developing peers, present a decreased overall HRV profile, an increased average HR, and altered autonomic responses to selected movement maneuvers or physical exercise [4,6,[8][9][10][11][12]14,[54][55][56]. However, results of the mentioned HRV analyses in children with CP are not fully concordant, which may be partially caused by different methodologies and a lack of compliance with the recommendations of the Task Force [25].…”