Reliability of Postexercise Heart Rate Recovery

Abstract

Passive postexercise heart rate (HR) recovery is currently used in the assessment of endurance athletes to determine changes in performance or in the clinical setting as a predictor of all-cause mortality. The purpose of this investigation was to assess the reliability of HR recovery. Thirty healthy subjects performed two maximal and two submaximal treadmill exercises, followed by 5 minutes of passive recovery. HR signal was used to compute raw and Δ (exercise - recovery) HR after 1, 2, 3, and 5 minutes of exercise cessation. A mono-exponential function was fitted to the data using the least squares procedure. We found no significant bias between repeated measures. Relative reliability was lower for Δ HR when compared with raw HR (0.43 < ICC < 0.71 vs. 0.68 < ICC < 0.83, respectively). Absolute reliability was relatively constant over time for raw HR (SEM = ∼ 8 %), while it decreased exponentially from the 1st (SEM = ∼ 20 %) to the 5th minute of recovery (SEM = ∼ 8 %) for Δ HR. The reliability of parameter estimates from exponential curve fitting was less consistent, since both ICC (0.43 to 0.88) and SEM (5.7 to 21.4 %) differed from one parameter to the other according to the intensity of exercise. We conclude that passive postexercise HR recovery reliability is heterogeneous. Raw HR is the desired method to describe it.

Key words

intra‐class correlation coefficient - standard error of measurement - minimum difference considered real - reproducibility

References

• 1 Arai Y, Saul J P, Albrecht P, Hartley L H, Lilly L S, Cohen R J, Colucci W S. Modulation of cardiac autonomic activity during and immediately after exercise.  Am J Physiol. 1989;  256 H132-H141
• 2 Atkinson G, Nevill A M. Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine.  Sports Med. 1998;  26 217-238
• 3 Bunc V, Heller J, Leso J. Kinetics of heart rate responses to exercise.  J Sports Sci. 1988;  6 39-48
• 4 Carnethon M R, Jacobs Jr D R, Sidney S, Sternfeld B, Gidding S S, Shoushtari C, Liu K. A longitudinal study of physical activity and heart rate recovery: CARDIA, 1987 - 1993.  Med Sci Sports Exerc. 2005;  37 606-612
• 5 Cheng Y J, Lauer M S, Earnest C P, Church T S, Kampert J B, Gibbons L W, Blair S N. Heart rate recovery following maximal exercise testing as a predictor of cardiovascular disease and all-cause mortality in men with diabetes.  Diabetes Care. 2003;  26 2052-2057
• 6 Christenfeld N, Glynn L M, Gerin W. On the reliable assessment of cardiovascular recovery: an application of curve-fitting techniques.  Psychophysiology. 2000;  37 543-550
• 7 Cole C R, Blackstone E H, Pashkow F J, Snader C E, Lauer M S. Heart-rate recovery immediately after exercise as a predictor of mortality.  N Engl J Med. 1999;  341 1351-1357
• 8 Cole C R, Foody J M, Blackstone E H, Lauer M S. Heart rate recovery after submaximal exercise testing as a predictor of mortality in a cardiovascular healthy cohort.  Ann Intern Med. 2000;  132 552-555
• 9 Davies C TM, Di Prampero P E, Cerretelli P. Kinetics of cardiac output and respiratory gas exchange during exercise and recovery.  J Appl Physiol. 1972;  32 618-625
• 10 Duncan G E, Howley E T, Johnson B N. Applicability of V·O_2max criteria: discontinuous versus continuous protocols.  Med Sci Sports Exerc. 1997;  29 273-278
• 11 Fry R W, Morton A R, Keast D. Overtraining in athletes: an update.  Sports Med. 1991;  12 32-65
• 12 Glynn L M, Christenfeld N, Gerin W. The role of rumination in recovery from reactivity: cardiovascular consequences of emotional states.  Psychosom Med. 2002;  64 714-726
• 13 Hagberg J M, Hickson R C, Ehsani A A, Holloszy J O. Faster adjustment to and recovery from submaximal exercise in the trained state.  J Appl Physiol. 1980;  48 218-224
• 14 Hooper S L, McKinnon L T. Monitoring overtraining in athletes: recommendations.  Sports Med. 1995;  20 321-327
• 15 Huszczuk A, Whipp B J, Wasserman K. A respiratory gas exchange simulator for routine calibration in metabolic studies.  Eur Respir J. 1990;  3 465-468
• 16 Imai K, Sato H, Hori M, Kusuoka H, Ozaki H, Yokoyama H, Takeda H, Inoue M, Kamada T. Vagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure.  J Am Coll Cardiol. 1994;  24 1529-1535
• 17 Jouven X, Empana J P, Schwartz P J, Desnos M, Courbon D, Ducimetiere P. Heart rate profile during exercise as a predictor of sudden death.  New Engl J Med. 2005;  352 1951-1958
• 18 Kuipers H, Keizer H A. Overtraining in elite athletes: review and directions for the future.  Sports Med. 1988;  6 79-92
• 19 Monod H. The validity of heart rate measurement in ergonomics.  Ergonomics. 1967;  10 485-537
• 20 Morshedi-Meibodi A, Larson M G, Levy D, O'Donnell C J, Vasan R S. Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (The Framingham Heart Study).  Am J Cardiol. 2002;  90 848-852
• 21 Nishime E O, Cole C R, Blackstone E H, Pashkow F J, Lauer M S. Heart reate recovery and treadmill exercise scores as predictors of mortality in patients referred for exercise ECG.  JAMA. 2000;  284 1392-1398
• 22 Nunnally J, Bernstein I. Psychometric Theory. New York; MacGraw-Hill 1994
• 23 Perini R, Orizio C, Comande A, Castellano M, Beschi M, Veicsteimas A. Plasma norepinephrine and heart rate dynamics during recovery from submaximal exercise in man.  Eur J Appl Physiol. 1989;  58 879-883
• 24 Pitzalis M V, Mastropasqua F, Massari F, Forleo C, Di Maggio M, Passantino A, Colombo R, Di Biase M, Rizzon P. Short- and long-term reproducibility of time and frequency domain heart rate variability measurements in normal subjects.  Cardiovasc Res. 1996;  32 226-233
• 25 Savin W, Davidson D M, Haskell W L. Autonomic contribution to heart rate recovery from exercise in humans.  J Appl Physiol. 1982;  53 1572-1575
• 26 Shetler K, Marcus R, Froelicher V F, Vora S, Kalisetti D, Prakash M, Do D, Myers J. Heart rate recovery: validation and methodologic issues.  J Am Coll Cardiol. 2001;  38 1980-1987
• 27 Shrout P E. Measurement reliability and agreement in psychiatry.  Stat Methods Med Res. 1998;  7 301-317
• 28 Shrout P E, Fleiss J. Intraclass correlations: uses in assessing rater reliability.  Psychol Bull. 1979;  36 420-428
• 29 Sime W E, Whipple I T, Berkson D M, MacIntyre W C, Stamler J. Reproducibility of heart rate at rest and in response to submaximal treadmill and bicycle ergometer test in middle-aged men.  Med Sci Sports. 1972;  4 14-17
• 30 Sugawara J, Murakami H, Maeda S, Shinya K, Matsuda M. Change in post exercise vagal reactivation with exercise training and detraining in young men.  Eur J Appl Physiol. 2001;  85 259-263
• 31 Washburn R, Montoye H. Reliability of the heart rate response to submaximal upper and lower body exercise.  Res Quat Exerc Sport. 1985;  56 166-169
• 32 Weir J P. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM.  J Strength Cond Res. 2005;  19 231-240
• 33 Yamamoto K, Miyachi M, Saitoh T, Yioshioka A, Onodera S. Effects of endurance training on resting and post exercise cardiac autonomic control.  Med Sci Sports Exerc. 2001;  33 1496-1502