Effectiveness of a Pulmonary Rehabilitation Program on Changes in Heart Rate Variability and Physical Performance in Chronic Obstructive Pulmonary Disease

Abstract

Changes in autonomic regulation are evaluated in COPD patients by using heart rate variability (HRV) in rehabilitation. Our aim was to evaluate the presence of autonomic dysfunction and to assess the effect of a rehabilitation program. R-R intervals were measured for 6 minutes in 36 patients (16 female; 20 male) before and after an inpatient pulmonary rehabilitation program that included 30 minutes of respiratory training, chest wall mobilization, learning controlled breathing techniques, inhalation, expectoration and personalized training. Ectopic beats were eliminated. Parameters used: minimal pulse (p.min), average pulse (p.avg), maximal pulse (p.max), maximum-minimum pulse difference (p.max-p.min). Long-term continuous RR intervals (stda), standard deviation of instantaneous beat-to-beat variability (stdb), the number of pairs of adjacent NN intervals differing by more than 50 ms divided by the total number of all NN intervals (pNN50). Spectral analysis provided the low-frequency/high-frequency ratio (LF/HF). HRV showed decreased p.max-p.min (15.78 ± 9.2 bpm), depressed dynamics (stda: 39.63 ± 33.5; stdb: 22.72 ± 35.84) with sympathetic overload (pNN50:3.17 ± 5.24, LF/HF: 169.52 ± 208.83), heavy parasympathetic modulation (pNN50:5.51 ± 5.59, LF/HF: 27.28 ± 13.12) in severe COPD patients. Rehabilitation resulted in lowered p.min-p.max (12.5 ± 9.01 bpm), overdepressed dynamics (stda: 34.56 ± 35.97; stdb: 20.88 ± 41.5) strong sympathetic overload (pNN50:3.33 ± 6.76, LF/HF: 252.01 ± 351.16). Patients showed abnormal physiological response in resting autonomic regulation. The rehabilitation resulted in improvement in overall status, autonomic balance. *Corresponding author: Janos Varga, Department of Pulmonary Rehabilitation, National Koranyi Institute for Pulmonology, Budapest, Hungary, Tel: +3613913374; Fax: +3613913285; E-mail: varga@koranyi.hu Received September 25, 2018; Accepted September 28, 2018; Published October 04, 2018 Citation: Szucs B, Petrekanits M, Varga J (2018) Effectiveness of a Pulmonary Rehabilitation Program on Changes in Heart Rate Variability and Physical Performance in Chronic Obstructive Pulmonary Disease. J Pulm Respir Med 8: 474. doi: 10.4172/2161-105X.1000474 Copyright: ©2018 Szucs B, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.