title: Testing an association between baseline resting pulse rate averages and short-term changes in resting pulse rates: A pilot study.
abstract: BACKGROUND
  Resting heart (pulse) rate (RPR) monitoring may be a useful neurological assessment tool in chiropractic practice. Lower RPR generally reflects a better level of fitness and health status than higher RPR. However, the clinical significance of short-term changes in RPR remains unknown. The purpose of this study was to take an initial step towards understanding the clinical significance of short-term RPR changes, first, by describing short-term RPR changes between duplicated measurements, and second, by comparing RPR changes between groups with lower and higher baseline RPR.
  
  
  METHODS
  Seventy-three healthy adult volunteers received an RPR measurement on two days within a 1-week period. The mean difference between the two measurements (RPR change) in patients with lower versus higher baseline RPR was compared.
  
  
  RESULTS
  Mean RPR change in the low baseline group was -0.3 BPM (95% confidence interval [CI] = -2.7 to 2.1 BPM) whereas in the high baseline group, it was +4.4 BPM (95% CI = 1.2 to 7.6). This difference between groups was statistically significant (P = 0.02) Testing an association between baseline resting pulse rate averages and short-term changes in resting pulse rates: A pilot study with a large effect size (Cohen's d = 0.57).
  
  
  CONCLUSIONS
  In this pilot study, a higher RPR at baseline was associated with increased RPR change, whereas a lower baseline RPR was associated with a stable or reduced RPR change. A future main study with a larger sample size and longer follow-up period is needed to better characterize both the natural variation of RPR over multiple repeated measurements, and the clinical significance of short-term RPR changes in terms of predicting longer-term health outcomes.
authors.affiliation: Assistant Director of Research.
authors.forename: John
authors.initials: J
authors.lastname: Hart
keywords: chiropractic; heart rate; pulse; reproducibility of results; risk assessment