title: Heart rate autonomic responses during deep breathing and walking in hospitalised patients with chronic heart failure.
abstract: OBJECTIVE
  To evaluate the acute effect of physiotherapy (deep breathing exercises and walking) on heart rate variability in patients hospitalised with chronic heart failure (CHF).
  
  
  METHODS
  Ten males with CHF (57 ± 7 years) and 10 healthy controls (59 ± 9 years) were included. Heart rate and RR intervals were recorded in the following conditions: supine, seated, during deep breathing exercises and during and after walking. Heart rate variability was analysed by linear and non-linear methods (α2, Mean HR, rMSSD, SDNN and ApEn).
  
  
  RESULTS
  Patients presented significantly lower SDNN (12.4 ± 4 versus 26 ± 8 ms), rMSSD (18.2 ± 16.2 versus 25 ± 19.5 ms) and ApEn (9.9 ± 10 versus 16.68 ± 22.6) during the walking compared to controls (p < 0.05). In addition, mean HR was significantly higher during and after walking for patients with CHF compared to controls (103 ± 8 versus 80 ± 2 bpm and 90 ± 9 versus 68 ± 2 bpm, respectively). Patients with CHF demonstrated a significant reduction of α2 during deep breathing (0.78 ± 0.1) when compared to the seated position (1.08 ± 0.1) and walking (1.15 ± 0.2, p < 0.05). Additionally, rMSSD index increased during deep breathing when compared to walking in both groups.
  
  
  CONCLUSIONS
  Deep breathing exercises and walking are safe and promote beneficial effects on heart rate variability in patients hospitalised for CHF.
authors: Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of Sao Carlos, Sao Paulo, Brazil.
authors: Flávia C
authors: FC
authors: Rossi Caruso
authors: Ross
authors: R
authors: Arena
authors: Renata Gonçalves
authors: RG
authors: Mendes
authors: Michel Silva
authors: MS
authors: Reis
authors: Valéria
authors: V
authors: Papa
authors: Audrey
authors: A
authors: Borghi-Silva
mesh_terms: D000368:Aged; D000886:Anthropometry; D001341:Autonomic Nervous System / Q000502:physiology; D001795:Blood Pressure Determination; D016022:Case-Control Studies; D002908:Chronic Disease; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000534:rehabilitation*; D006339:Heart Rate / Q000502:physiology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D012016:Reference Values; D012119:Respiration; D015656:Respiratory Mechanics; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016138:Walking