{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:11:48Z","timestamp":1792599108243,"version":"4.5.0"},"reference-count":74,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004837","name":"Ministerio de Ciencia e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["PID2019\u2010107721RB\u2010I00"],"award-info":[{"award-number":["PID2019\u2010107721RB\u2010I00"]}],"id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Med Sci Sports"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>Investigations into the sensitivity of heart rate\u2010(HR) derived indices for tracking parasympathetic nervous system (PNS) changes in functionally overreached (F\u2010OR) endurance\u2010trained athletes have produced equivocal findings. Lack of clarity may be a result of methodological inconsistencies. Therefore, the aims of this systematic review and meta\u2010analysis were (a) to determine the sensitivity of resting and post\u2010exercise vagal\u2010related HR variability (HRV) and HR recovery (HRR) indices to detect PNS modulation in F\u2010OR and non\u2010overreached (non\u2010OR) athletes, and (b) to investigate the influence of methodological factors on the sensitivity of HR\u2010based indices to detect PNS hyperactivity in F\u2010OR athletes. We searched CENTRAL, Scopus, PubMed, Embase, and Web of Science up to May 2020 for the following terms: male and female endurance\u2010trained athletes, controlled and uncontrolled studies that carried out an overload training period, and PNS modulation measured in resting and post\u2010exercise, pre\u2010 and post\u2010overload training period. A random\u2010effects model of standardized mean difference (SMD) was estimated for each outcome measure based on the training\u2010induced fatigue status (F\u2010OR vs non\u2010OR athletes), and the influence of methodological issues to detect PNS hyperactivity in F\u2010OR was assessed by subgroup analyses. Pooled analysis showed that resting vagal\u2010related HRV indices did not detect PNS hyperactivity in F\u2010OR athletes (SMD<jats:sub>+<\/jats:sub> = \u22120.01; 95% confidence interval [CI] = \u22120.51, 0.50), and no statistical difference (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.600) was found with non\u2010OR athletes (SMD<jats:sub>+<\/jats:sub> = 0.15; 95% CI = \u22120.14, 0.45). However, subgroup analysis based on HRV parameter showed a moderate statistical increase in weekly averaged HRV in F\u2010OR athletes (SMD<jats:sub>+<\/jats:sub> = 0.81; 95% CI\u00a0=\u00a00.35, 1.26), while isolated HRV values did not reach statistical significance (SMD<jats:sub>+<\/jats:sub> = \u22120.45; 95% CI = \u22120.96, 0.06). We observed a moderate and statistically significant increase in HRR indices among F\u2010OR athletes (SMD<jats:sub>+<\/jats:sub> = 0.65; 95% CI\u00a0=\u00a00.44, 0.87), no changes for non\u2010OR athletes (SMD<jats:sub>+<\/jats:sub> = 0.10; 95% CI\u00a0=\u00a0\u22120.15, 0.34), and statistically significant differences between F\u2010OR and non\u2010OR athletes (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Insufficient data prevented meta\u2010analysis for post\u2010exercise vagal\u2010related HRV indices. Our findings show that when methodological factors are considered, HR\u2010based indices are sensitive to increased PNS modulation in F\u2010OR.<\/jats:p>","DOI":"10.1111\/sms.13932","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T00:31:04Z","timestamp":1612571464000},"page":"1164-1182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Heart rate\u2010based indices to detect parasympathetic hyperactivity in functionally overreached athletes. A meta\u2010analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1399-2411","authenticated-orcid":false,"given":"Agust\u00edn","family":"Manresa\u2010Rocamora","sequence":"first","affiliation":[{"name":"Department of Sport Sciences Sports Research Centre Miguel Hern\u00e1ndez University of Elche Elche Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew A.","family":"Flatt","sequence":"additional","affiliation":[{"name":"Department of Health Sciences and Kinesiology Georgia Southern University Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Casanova\u2010Liz\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences Sports Research Centre Miguel Hern\u00e1ndez University of Elche Elche Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan A.","family":"Ballester\u2010Ferrer","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences Sports Research Centre Miguel Hern\u00e1ndez University of Elche Elche Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1917-6634","authenticated-orcid":false,"given":"Jos\u00e9 M.","family":"Sarabia","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences Sports Research Centre Miguel Hern\u00e1ndez University of Elche Elche Spain"},{"name":"Institute for Health and Biomedical Research (ISABIAL\u2010FISABIO Foundation) Miguel Hernandez University Alicante Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4792-8087","authenticated-orcid":false,"given":"Francisco J.","family":"Vera\u2010Garcia","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences Sports Research Centre Miguel Hern\u00e1ndez University of Elche Elche 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