Methodologic implications for rehabilitation research: Differences in heart rate variability introduced by respiration.
Methodologic implications for rehabilitation research: Differences in heart rate variability introduced by respiration.
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DOI：
10.1002/pmrj.12770
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发表时间：
2022-12
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心率变异性是衡量自主活动的指标，作为一项研究成果越来越受欢迎。然而，尽管其使用量有所增加，但康复医学研究中很少考虑呼吸对心率变异性测量的已知影响，从而导致潜在的误解。描述在康复医学相关的脊髓损伤个体示例中，无节奏和有节奏呼吸对心率变异性测量的影响。在同一实验期间，同一个人在无节奏呼吸和有节奏呼吸（0.25Hz，每分钟 15 次呼吸）期间心率变异性的横断面比较。学术自主生理学实验室 不适用 平均低频 (LF) 和高频 (HF) 心率变异功率、源自 LF 频谱的总功率百分比、LF:HF 比率。 59 名脊髓损伤患者使用标准化方案 (NCT02139436) 完成了实验室评估。在对个体进行重复测量时，与定速呼吸相比，无定速呼吸的平均 LF 功率显着更高（1292 vs. 573 ms2，p<0.001）。在比较无节奏和节奏呼吸条件时，Bland-Altman 图显示 LF 功率存在显着的正比例偏差 (R2=0.39)。在无节奏呼吸和有节奏呼吸条件下，平均高频功率相似，但测量结果之间存在广泛的正负差异，因此在不考虑呼吸混杂因素时会导致显着的不确定性。与定速呼吸相比，无定速呼吸的 LF 频谱总功率百分比和平均 LF:HF 比率均显着更高（分别为 64% vs. 42%，p<0.001；以及 3.2% vs. 1.1，p<0.001）。呼吸对脊髓损伤后的心率变异性有重大影响，不考虑这一点会对准确解释无节奏数据产生严重后果。康复医学中心率变异性的未来研究应相应地考虑节奏呼吸。
Heart rate variability is a measure of autonomic activity which is growing in popularity as a research outcome. However, despite its increased use, the known effects of respiration on heart rate variability measures are rarely accounted for in rehabilitation medicine research, leading to potential misinterpretation. Describe the impact that unpaced and paced breathing introduces to heart rate variability measures in a rehabilitation medicine relevant example of individuals with spinal cord injury. Cross sectional comparison of heart rate variability during unpaced and paced breathing (0.25Hz, 15 breaths per minute) within the same individuals during the same lab session. Academic autonomic physiology laboratory Not applicable Mean low frequency (LF) and high frequency (HF) heart rate variability power, percentage of total power derived from the LF spectrum, LF:HF ratio. Fifty-nine individuals with spinal cord injury completed laboratory assessments using standardized protocols (NCT02139436). In repeated measures within individuals, mean LF power was significantly higher in unpaced breathing compared to paced breathing (1292 vs. 573 ms2, p<0.001). A Bland-Altman plot demonstrated significant positive proportional bias for LF power when comparing unpaced and paced breathing conditions (R2=0.39). Mean HF power was similar between unpaced and paced breathing conditions, though demonstrated wide positive and negative differences between measures, leading to notable uncertainty when respiratory confounders were not accounted for. The percentage of total power derived from the LF spectrum and the mean LF:HF ratio were both significantly higher for unpaced breathing compared to paced breathing (64 vs. 42%, p<0.001; and 3.2 vs. 1.1, p<0.001, respectively). Respiration has a significant impact on heart rate variability following spinal cord injury, and not accounting for this has serious consequences for accurate interpretation of unpaced data. Future studies of heart rate variability in rehabilitation medicine should accordingly consider paced breathing.
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