Heart rate autonomic responses during deep breathing and walking in hospitalised patients with chronic heart failure.
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.
Rossi Caruso
Flávia C
FC
Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of Sao Carlos, Sao Paulo, Brazil.
Arena
Ross
R
Mendes
Renata Gonçalves
RG
Reis
Michel Silva
MS
Papa
Valéria
V
Borghi-Silva
Audrey
A
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