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Heart Rate Variability-Guided Training for Enhancing Cardiac-Vagal Modulation, Aerobic Fitness, and Endurance Performance: A Methodological Systematic Review with Meta-Analysis

Author

Listed:
  • Agustín Manresa-Rocamora

    (Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain
    Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain)

  • José Manuel Sarabia

    (Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain
    Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain)

  • Alejandro Javaloyes

    (Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain)

  • Andrew A. Flatt

    (Department of Health Sciences and Kinesiology, Georgia Southern University (Armstrong Campus), Savannah, GA 31419, USA)

  • Manuel Moya-Ramón

    (Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain
    Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain)

Abstract

Purpose: This systematic review with meta-analysis was conducted to establish whether heart rate variability (HRV)-guided training enhances cardiac-vagal modulation, aerobic fitness, or endurance performance to a greater extent than predefined training while accounting for methodological factors. Methods: We searched Web of Science Core Collection, Pubmed, and Embase databases up to October 2020. A random-effects model of standardized mean difference (SMD) was estimated for each outcome measure. Chi-square and the I 2 index were used to evaluate the degree of homogeneity. Results: Accounting for methodological factors, HRV-guided training was superior for enhancing vagal-related HRV indices (SMD + = 0.50 (95% confidence interval (CI) = 0.09, 0.91)), but not resting HR (SMD + = 0.04 (95% CI = −0.34, 0.43)). Consistently small but non-significant ( p > 0.05) SMDs in favor of HRV-guided training were observed for enhancing maximal aerobic capacity (SMD + = 0.20 (95% CI = −0.07, 0.47)), aerobic capacity at second ventilatory threshold (SMD + = 0.26 (95% CI = −0.05, 0.57)), and endurance performance (SMD + = 0.20 (95% CI = −0.09, 0.48)), versus predefined training. No heterogeneity was found for any of the analyzed aerobic fitness and endurance performance outcomes. Conclusion: Best methodological practices pertaining to HRV index selection, recording position, and approaches for establishing baseline reference values and daily changes (i.e., fixed or rolling HRV averages) require further study. HRV-guided training may be more effective than predefined training for maintaining and improving vagal-mediated HRV, with less likelihood of negative responses. However, if HRV-guided training is superior to predefined training for producing group-level improvements in fitness and performance, current data suggest it is only by a small margin.

Suggested Citation

  • Agustín Manresa-Rocamora & José Manuel Sarabia & Alejandro Javaloyes & Andrew A. Flatt & Manuel Moya-Ramón, 2021. "Heart Rate Variability-Guided Training for Enhancing Cardiac-Vagal Modulation, Aerobic Fitness, and Endurance Performance: A Methodological Systematic Review with Meta-Analysis," IJERPH, MDPI, vol. 18(19), pages 1-22, September.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:10299-:d:646878
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    References listed on IDEAS

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    3. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
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    1. Ke Li & Cristiano Cardoso & Angel Moctezuma-Ramirez & Abdelmotagaly Elgalad & Emerson Perin, 2023. "Heart Rate Variability Measurement through a Smart Wearable Device: Another Breakthrough for Personal Health Monitoring?," IJERPH, MDPI, vol. 20(24), pages 1-24, December.
    2. Ching-Chieh Tai & Yi-Liang Chen & Ludek Kalfirt & Kunanya Masodsai & Chia-Ting Su & Ai-Lun Yang, 2022. "Differences between Elite Male and Female Badminton Athletes Regarding Heart Rate Variability, Arterial Stiffness, and Aerobic Capacity," IJERPH, MDPI, vol. 19(6), pages 1-11, March.

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