{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:51:50Z","timestamp":1793325110501,"version":"4.5.0"},"reference-count":52,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T00:00:00Z","timestamp":1712275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular diseases (CVD) are the leading causes of morbidity and mortality. Heart rate variability (HRV) represents the modulatory capacity of the autonomous nervous system and influences mortality. By surveying this meta-analysis, we investigated the impact of physical activity on HRV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Databases, online journal libraries and clinical trial registries were searched for publications of randomized controlled and non-randomized controlled trials concerning adults with coronary artery disease (CAD)\/ischemic heart disease (IHD), congestive heart failure (CHF), peripheral arterial disease (PAD) or after acute coronary syndrome (ACS) joining an intervention group with physical activity or a control group with usual care or no intervention. Extracted time-domain and frequency-domain parameter of HRV were analyzed in a meta-analysis using a random effect model. Subgroup analyses concerning intervention type, study design and type of heart disease and sensitivity analysis were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant results were obtained for RR-Interval (p = 0.05) and standard deviation of Normal-to-Normal intervals (SDNN) (p = 0.01) for short-term assessment and for the ratio of low-frequency power (LF) to high-frequency power (HF) (p = 0.05) for 24-hour assessment. Subgroup analyses also resulted significant: root-mean-square difference of successive normal R-R intervals (RMSSD) (p = 0.01), SDNN (p = 0.02) and HF (p &lt; 0.01) concerning CHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We were able to demonstrate the positive impact of physical activity on HRV, especially in patients with CHF. Cardiac rehabilitation exercise programs need to be individualized to identify the most beneficial method of training for improving the prognosis of patients with CVD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0299793","type":"journal-article","created":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T12:18:11Z","timestamp":1712319491000},"page":"e0299793","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":54,"title":["Beneficial impacts of physical activity on heart rate variability: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1554-0587","authenticated-orcid":true,"given":"Ouahiba","family":"El-Malahi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darya","family":"Mohajeri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca","family":"Mincu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"B\u00e4uerle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Korbinian","family":"Rothenaicher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramtin","family":"Knuschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Rammos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tienush","family":"Rassaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5798-3728","authenticated-orcid":true,"given":"Julia","family":"Lortz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,5]]},"reference":[{"issue":"25","key":"pone.0299793.ref001","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990\u20132019: Update From the GBD 2019 Study","volume":"76","author":"GA Roth","year":"2020","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"pone.0299793.ref002","first-page":"CD001800","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease","volume":"2016","author":"L Anderson","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"issue":"11","key":"pone.0299793.ref003","first-page":"CD001800","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease","volume":"11","author":"G Dibben","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"pone.0299793.ref004","first-page":"CD003331","article-title":"Exercise-based cardiac rehabilitation for adults with heart failure","volume":"1","author":"L Long","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"10","key":"pone.0299793.ref005","doi-asserted-by":"crossref","first-page":"e006798","DOI":"10.1161\/CIRCHEARTFAILURE.119.006798","article-title":"Multidisciplinary Cardiac Rehabilitation and Long-Term Prognosis in Patients With Heart Failure.","volume":"13","author":"K Kamiya","year":"2020","journal-title":"Circ Heart Fail"},{"issue":"18","key":"pone.0299793.ref006","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1056\/NEJM199910283411804","article-title":"Heart-rate recovery immediately after exercise as a predictor of mortality","volume":"341","author":"CR Cole","year":"1999","journal-title":"N Engl J Med"},{"issue":"9","key":"pone.0299793.ref007","doi-asserted-by":"crossref","first-page":"e0273981","DOI":"10.1371\/journal.pone.0273981","article-title":"Decrease of heart rate variability during exercise: An index of cardiorespiratory fitness","volume":"17","author":"D Mongin","year":"2022","journal-title":"PLoS One"},{"issue":"17","key":"pone.0299793.ref008","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph191710463","article-title":"Heart Rate Variability-Guided Training for Improving Mortality Predictors in Patients with Coronary Artery Disease.","volume":"19","author":"A Manresa-Rocamora","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"pone.0299793.ref009","doi-asserted-by":"crossref","first-page":"e160721189770","DOI":"10.2174\/1573403X16999201231203854","article-title":"Analysis of Heart Rate Variability and Implication of Different Factors on Heart Rate Variability.","volume":"17","author":"R Tiwari","year":"2021","journal-title":"Curr Cardiol Rev"},{"key":"pone.0299793.ref010","doi-asserted-by":"crossref","first-page":"104907","DOI":"10.1016\/j.neubiorev.2022.104907","article-title":"Heart rate variability in the prediction of mortality: A systematic review and meta-analysis of healthy and patient populations","volume":"143","author":"MN Jarczok","year":"2022","journal-title":"Neurosci Biobehav Rev"},{"issue":"8","key":"pone.0299793.ref011","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1111\/ggi.13328","article-title":"Role of autonomic nervous activity, as measured by heart rate variability, on the effect of mortality in disabled older adults with low blood pressure in long-term care.","volume":"18","author":"K Shibasaki","year":"2018","journal-title":"Geriatr Gerontol Int."},{"issue":"4","key":"pone.0299793.ref012","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/S0002-8703(98)70269-8","article-title":"Depressed heart rate variability is associated with events in patients with stable coronary artery disease and preserved left ventricular function. REGRESS Study Group","volume":"135","author":"AJ van Boven","year":"1998","journal-title":"Am Heart J"},{"issue":"2","key":"pone.0299793.ref013","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.pcad.2013.07.003","article-title":"Heart rate variability in risk stratification of cardiac patients","volume":"56","author":"HV Huikuri","year":"2013","journal-title":"Prog Cardiovasc Dis"},{"key":"pone.0299793.ref014","doi-asserted-by":"crossref","first-page":"258","DOI":"10.3389\/fpubh.2017.00258","article-title":"An Overview of Heart Rate Variability Metrics and Norms.","volume":"5","author":"F Shaffer","year":"2017","journal-title":"Front Public Health"},{"issue":"3","key":"pone.0299793.ref015","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/S0735-1097(97)00554-8","article-title":"Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades","volume":"31","author":"K Umetani","year":"1998","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"pone.0299793.ref016","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/anec.12189","article-title":"Influences of age, gender, and circadian rhythm on deceleration capacity in subjects without evident heart diseases","volume":"20","author":"R Zhao","year":"2015","journal-title":"Ann Noninvasive Electrocardiol"},{"issue":"5","key":"pone.0299793.ref017","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1111\/psyp.12027","article-title":"The utility of low frequency heart rate variability as an index of sympathetic cardiac tone: a review with emphasis on a reanalysis of previous studies","volume":"50","author":"GA Reyes del Paso","year":"2013","journal-title":"Psychophysiology"},{"key":"pone.0299793.ref018","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.3389\/fpsyg.2014.01040","article-title":"A healthy heart is not a metronome: an integrative review of the heart\u2019s anatomy and heart rate variability","volume":"5","author":"F Shaffer","year":"2014","journal-title":"Front Psychol"},{"issue":"2\u20133","key":"pone.0299793.ref019","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1159\/000355790","article-title":"Exercise and cardiovascular diseases","volume":"39","author":"M Villella","year":"2014","journal-title":"Kidney Blood Press Res"},{"issue":"4","key":"pone.0299793.ref020","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/S0025-6196(11)60548-X","article-title":"Exercise training and cardiac rehabilitation in primary and secondary prevention of coronary heart disease","volume":"84","author":"CJ Lavie","year":"2009","journal-title":"Mayo Clin Proc"},{"key":"pone.0299793.ref021","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"MJ Page","year":"2021","journal-title":"BMJ"},{"issue":"2","key":"pone.0299793.ref022","doi-asserted-by":"crossref","first-page":"195","DOI":"10.5195\/jmla.2020.834","article-title":"Improving the translation of search strategies using the Polyglot Search Translator: a randomized controlled trial.","volume":"108","author":"JM Clark","year":"2020","journal-title":"J Med Libr Assoc"},{"key":"pone.0299793.ref023","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"JAC Sterne","year":"2019","journal-title":"BMJ"},{"key":"pone.0299793.ref024","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"JA Sterne","year":"2016","journal-title":"BMJ"},{"issue":"4","key":"pone.0299793.ref025","first-page":"471","article-title":"The impact of short term supervised and home-based walking programmes on heart rate variability in patients with peripheral arterial disease","volume":"6","author":"GR Sandercock","year":"2007","journal-title":"J Sports Sci Med"},{"key":"pone.0299793.ref026","article-title":"Chapter 6: Choosing effect measures and computing estimates of effect.","author":"LT Higgins JPT","year":"2022","journal-title":"Cochrane Handbook for Systematic Reviews of Interventions version 6.3: Cochrane"},{"issue":"29","key":"pone.0299793.ref027","doi-asserted-by":"crossref","first-page":"6072","DOI":"10.1002\/sim.3427","article-title":"Meta-analysis of skewed data: combining results reported on log-transformed or raw scales.","volume":"27","author":"JP Higgins","year":"2008","journal-title":"Stat Med."},{"issue":"22","key":"pone.0299793.ref028","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1053\/euhj.1999.1715","article-title":"Aerobic group training improves exercise capacity and heart rate variability in elderly patients with a recent coronary event. A randomized controlled study","volume":"20","author":"A St\u00e2hle","year":"1999","journal-title":"European heart journal"},{"issue":"3","key":"pone.0299793.ref029","doi-asserted-by":"crossref","first-page":"e1713","DOI":"10.1002\/pri.1713","article-title":"Water exercise in coronary artery disease patients, effects on heart rate variability, and body composition: A randomized controlled trial.","volume":"23","author":"E Fiogb\u00e9","year":"2018","journal-title":"Physiotherapy research international: the journal for researchers and clinicians in physical therapy."},{"issue":"20","key":"pone.0299793.ref030","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1016\/0002-9149(92)90460-G","article-title":"Comparison of different methods for assessing sympathovagal balance in chronic congestive heart failure secondary to coronary artery disease","volume":"70","author":"S Adamopoulos","year":"1992","journal-title":"The American journal of cardiology"},{"issue":"1","key":"pone.0299793.ref031","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1067\/mhj.2000.106606","article-title":"Effect of exercise training on heart rate variability in patients with new-onset left ventricular dysfunction after myocardial infarction","volume":"140","author":"F Duru","year":"2000","journal-title":"American heart journal"},{"issue":"5","key":"pone.0299793.ref032","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.ahj.2014.02.001","article-title":"Effect of 8-week exercise-based cardiac rehabilitation on cardiac autonomic function: A randomized controlled trial in myocardial infarction patients","volume":"167","author":"NL Oliveira","year":"2014","journal-title":"Am Heart J"},{"issue":"4","key":"pone.0299793.ref033","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/j.1751-7133.2011.00282.x","article-title":"Exercise training improves heart rate variability in older patients with heart failure: a randomized, controlled, single-blinded trial.","volume":"18","author":"K Murad","year":"2012","journal-title":"Congestive heart failure (Greenwich, Conn)."},{"issue":"3","key":"pone.0299793.ref034","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.jelectrocard.2012.01.002","article-title":"Exercise training slows down heart rate and improves deceleration and acceleration capacity in patients with heart failure","volume":"45","author":"R Ricca-Mallada","year":"2012","journal-title":"Journal of electrocardiology"},{"issue":"2","key":"pone.0299793.ref035","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.rehab.2016.12.003","article-title":"Functional outcome in chronic heart failure after exercise training: Possible predictive value of heart rate variability.","volume":"60","author":"R Ricca-Mallada","year":"2016","journal-title":"Annals of physical and rehabilitation medicine"},{"issue":"2","key":"pone.0299793.ref036","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.ijcard.2009.11.015","article-title":"High-intensity interval exercise training improves heart rate variability in patients following percutaneous coronary intervention for angina pectoris","volume":"145","author":"PS Munk","year":"2010","journal-title":"International journal of cardiology"},{"issue":"1","key":"pone.0299793.ref037","doi-asserted-by":"crossref","first-page":"17","DOI":"10.5603\/CJ.2013.0004","article-title":"Influence of aerobic training on neurohormonal and hemodynamic responses to head-up tilt test and on autonomic nervous activity at rest and after exercise in patients after bypass surgery","volume":"20","author":"M Bili\u0144ska","year":"2013","journal-title":"Cardiology Journal"},{"issue":"6","key":"pone.0299793.ref038","first-page":"1205","article-title":"Influence of home-based telemonitored Nordic walking training on autonomic nervous system balance in heart failure patients Arch Med Sci.","volume":"11","author":"E Piotrowicz","year":"2014"},{"issue":"5","key":"pone.0299793.ref039","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1016\/j.jvs.2011.05.027","article-title":"Influence of peripheral arterial disease and supervised walking on heart rate variability","volume":"54","author":"AS Leicht","year":"2011","journal-title":"Journal of vascular surgery"},{"issue":"6","key":"pone.0299793.ref040","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1590\/bjpt-rbf.2014.0124","article-title":"Interval training based on ventilatory anaerobic threshold increases cardiac vagal modulation and decreases high-sensitivity c-reative protein: randomized clinical trial in coronary artery disease.","volume":"19","author":"NY Tamburus","year":"2015","journal-title":"Brazilian journal of physical therapy"},{"issue":"1","key":"pone.0299793.ref041","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S1071-9164(03)00583-9","article-title":"Moderate-intensity resistance exercise training in patients with chronic heart failure improves strength, endurance, heart rate variability, and forearm blood flow.","volume":"10","author":"SE Selig","year":"2004","journal-title":"Journal of cardiac failure."},{"issue":"4","key":"pone.0299793.ref042","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1093\/oxfordjournals.eurheartj.a060941","article-title":"Reversal of autonomic derangements by physical training in chronic heart failure assessed by heart rate variability","volume":"16","author":"K Kiilavuori","year":"1995","journal-title":"European heart journal"},{"issue":"1","key":"pone.0299793.ref043","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1177\/1099800419884642","article-title":"Low-Intensity Exercise Training Increases Heart Rate Variability in Patients With Peripheral Artery Disease.","volume":"22","author":"IKM Brenner","year":"2020","journal-title":"Biological research for nursing"},{"issue":"2","key":"pone.0299793.ref044","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/JCN.0b013e3181ed9424","article-title":"A home-based exercise program improves heart rate variability and functional capacity among postmenopausal women with coronary artery disease","volume":"26","author":"F-C Lai","year":"2011","journal-title":"The Journal of cardiovascular nursing"},{"issue":"9","key":"pone.0299793.ref045","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1089\/acm.2008.0166","article-title":"The effect of t\u2019ai chi exercise on autonomic nervous function of patients with coronary artery disease","volume":"14","author":"R-Y Chang","year":"2008","journal-title":"Journal of alternative and complementary medicine (New York, NY)."},{"key":"pone.0299793.ref046","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3389\/fphys.2014.00177","article-title":"Everything Hertz: methodological issues in short-term frequency-domain HRV.","volume":"5","author":"JA Heathers","year":"2014","journal-title":"Front Physiol."},{"issue":"7","key":"pone.0299793.ref047","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1093\/sleep\/30.7.913","article-title":"Interpretation of normalized spectral heart rate variability indices in sleep research: a critical review","volume":"30","author":"RL Burr","year":"2007","journal-title":"Sleep"},{"key":"pone.0299793.ref048","first-page":"591708","article-title":"Effects of Exercise Training on Autonomic Function in Chronic Heart Failure: Systematic Review.","volume":"2015","author":"CY Hsu","year":"2015","journal-title":"Biomed Res Int"},{"issue":"4","key":"pone.0299793.ref049","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/HJR.0b013e3283030a97","article-title":"Effects of drug, biobehavioral and exercise therapies on heart rate variability in coronary artery disease: a systematic review","volume":"15","author":"RP Nolan","year":"2008","journal-title":"Eur J Cardiovasc Prev Rehabil"},{"issue":"9","key":"pone.0299793.ref050","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.repc.2013.02.010","article-title":"Heart rate variability in myocardial infarction patients: effects of exercise training","volume":"32","author":"NL Oliveira","year":"2013","journal-title":"Rev Port Cardiol"},{"issue":"6","key":"pone.0299793.ref051","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/S0828-282X(10)70395-0","article-title":"Improvements in heart rate variability with exercise therapy","volume":"26","author":"FS Routledge","year":"2010","journal-title":"Can J Cardiol"},{"issue":"Suppl 1","key":"pone.0299793.ref052","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.4103\/sja.SJA_559_18","article-title":"The CONSORT statement.","volume":"13","author":"S. Cuschieri","year":"2019","journal-title":"Saudi J Anaesth"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0299793","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T12:18:41Z","timestamp":1712319521000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0299793"}},"subtitle":[],"editor":[{"given":"Demitri","family":"Constantinou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,5]]},"references-count":52,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0299793","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,5]]}}}