scholarly journals Feasibility of Using a Single Heart Rate–Based Measure for Real-time Feedback in a Voluntary Deep Breathing App for Children: Data Collection and Algorithm Development

10.2196/16639 ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. e16639
Author(s):  
Christian L Petersen ◽  
Matthias Görges ◽  
Evgenia Todorova ◽  
Nicholas C West ◽  
Theresa Newlove ◽  
...  
Keyword(s):  
Heart Rate ◽  
Breathing Pattern ◽  
Self Regulation ◽  
Smartphone App ◽  
Medical Procedures ◽  
Deep Breathing ◽  
Sinus Arrhythmia ◽  
Two Measures ◽  
Mobile Smartphone ◽  
Improve Patient

Background Deep diaphragmatic breathing, also called belly breathing, is a popular behavioral intervention that helps children cope with anxiety, stress, and their experience of pain. Combining physiological monitoring with accessible mobile technology can motivate children to comply with this intervention through biofeedback and gaming. These innovative technologies have the potential to improve patient experience and compliance with strategies that reduce anxiety, change the experience of pain, and enhance self-regulation during distressing medical procedures. Objective The aim of this paper was to describe a simple biofeedback method for quantifying breathing compliance in a mobile smartphone app. Methods A smartphone app was developed that combined pulse oximetry with an animated protocol for paced deep breathing. We collected photoplethysmogram data during spontaneous and subsequently paced deep breathing in children. Two measures, synchronized respiratory sinus arrhythmia (RSAsync) and the corresponding relative synchronized inspiration/expiration heart rate ratio (HR-I:Esync), were extracted from the photoplethysmogram. Results Data collected from 80 children aged 5-17 years showed a positive RSAsync effect in all participants during paced deep breathing, with a median (IQR; range) HR-I:Esync ratio of 1.26 (1.16-1.35; 1.01-1.60) during paced deep breathing compared to 0.98 (0.96-1.02; 0.82-1.18) during spontaneous breathing (median difference 0.25, 95% CI 0.23-0.30; P<.001). The measured HR-I:Esync values appeared to be independent of age. Conclusions An HR-I:Esync level of 1.1 was identified as an age-independent threshold for programming the breathing pattern for optimal compliance in biofeedback.

scholarly journals Feasibility of Using a Single Heart Rate–Based Measure for Real-time Feedback in a Voluntary Deep Breathing App for Children: Data Collection and Algorithm Development (Preprint)

2019 ◽  
Author(s):  
Christian L Petersen ◽  
Matthias Görges ◽  
Evgenia Todorova ◽  
Nicholas C West ◽  
Theresa Newlove ◽  
...  
Keyword(s):  
Heart Rate ◽  
Breathing Pattern ◽  
Self Regulation ◽  
Smartphone App ◽  
Medical Procedures ◽  
Deep Breathing ◽  
Sinus Arrhythmia ◽  
Two Measures ◽  
Mobile Smartphone ◽  
Improve Patient

BACKGROUND Deep diaphragmatic breathing, also called belly breathing, is a popular behavioral intervention that helps children cope with anxiety, stress, and their experience of pain. Combining physiological monitoring with accessible mobile technology can motivate children to comply with this intervention through biofeedback and gaming. These innovative technologies have the potential to improve patient experience and compliance with strategies that reduce anxiety, change the experience of pain, and enhance self-regulation during distressing medical procedures. OBJECTIVE The aim of this paper was to describe a simple biofeedback method for quantifying breathing compliance in a mobile smartphone app. METHODS A smartphone app was developed that combined pulse oximetry with an animated protocol for paced deep breathing. We collected photoplethysmogram data during spontaneous and subsequently paced deep breathing in children. Two measures, synchronized respiratory sinus arrhythmia (RSA<sub>sync</sub>) and the corresponding relative synchronized inspiration/expiration heart rate ratio (HR-I:E<sub>sync</sub>), were extracted from the photoplethysmogram. RESULTS Data collected from 80 children aged 5-17 years showed a positive RSA<sub>sync</sub> effect in all participants during paced deep breathing, with a median (IQR; range) HR-I:E<sub>sync</sub> ratio of 1.26 (1.16-1.35; 1.01-1.60) during paced deep breathing compared to 0.98 (0.96-1.02; 0.82-1.18) during spontaneous breathing (median difference 0.25, 95% CI 0.23-0.30; <i>P</i>&lt;.001). The measured HR-I:E<sub>sync</sub> values appeared to be independent of age. CONCLUSIONS An HR-I:E<sub>sync</sub> level of 1.1 was identified as an age-independent threshold for programming the breathing pattern for optimal compliance in biofeedback.

Cardiorespiratory interactions during resistive load breathing

2000 ◽  
Vol 279 (6) ◽  
pp. R2208-R2213 ◽  
Author(s):  
Pascale Calabrese ◽  
Helene Perrault ◽  
Tuan Pham Dinh ◽  
Andre Eberhard ◽  
Gila Benchetrit
Keyword(s):  
Heart Rate ◽  
Breathing Pattern ◽  
Spectral Power ◽  
Intrathoracic Pressure ◽  
Random Order ◽  
Cycle Duration ◽  
Resistive Load ◽  
Sinus Arrhythmia ◽  
Period 2 ◽  
Resistive Loads

The addition to the respiratory system of a resistive load results in breathing pattern changes and in negative intrathoracic pressure increases. The aim of this study was to use resistive load breathing as a stimulus to the cardiorespiratory interaction and to examine the extent of the changes in heart rate variability (HRV) and respiratory sinus arrhythmia (RSA) in relation to the breathing pattern changes. HRV and RSA were studied in seven healthy subjects where four resistive loads were applied in a random order during the breath and 8-min recording made in each condition. The HRV spectral power components were computed from the R-R interval sequences, and the RSA amplitude and phase were computed from the sinusoid fitting the instantaneous heart rate within each breath. Adding resistive loads resulted in 1) increasing respiratory period, 2) unchanging heart rate, and 3) increasing HRV and changing RSA characteristics. HRV and RSA characteristics are linearly correlated to the respiratory period. These modifications appear to be linked to load-induced changes in the respiratory period in each individual, because HRV and RSA characteristics are similar at a respiratory period obtained either by loading or by imposed frequency breathing. The present results are discussed with regard to the importance of the breathing cycle duration in these cardiorespiratory interactions, suggesting that these interactions may depend on the time necessary for activation and dissipation of neurotransmitters involved in RSA.

Vagally Mediated Heart Rate Variability Promotes the Perception of Paradoxical Pain

2017 ◽  
Vol 31 (3) ◽  
pp. 134-144
Author(s):  
Raymonde Scheuren ◽  
Stefan Sütterlin ◽  
Fernand Anton
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Pain Sensitivity ◽  
Self Regulation ◽  
Noxious Stimulation ◽  
Dominant Hand ◽  
Resting Heart Rate ◽  
Sinus Arrhythmia ◽  
Thermal Grill Illusion ◽  
Resting Heart Rate Variability

Abstract. Self-regulation mechanisms are governed by prefrontal inhibitory processes and play a crucial role in the modulation of pain. In the present study the thermal grill paradigm was used to investigate the association of vagally mediated resting heart rate variability, a psychophysiological marker of trait self-regulatory capacity, with paradoxical pain sensations induced by non-noxious stimulation. This thermal grill illusion is only perceived by part of the tested individuals. The mechanisms underlying the observed interindividual differences in paradoxical pain sensitivity are largely unknown. During the experimental task, a temperature combination of 15 °C and 41 °C was set at the glass tubes of the thermal grill. The 52 healthy participants placed their dominant hand on the grill for a duration of one min. The magnitude of sensory and affective pain sensations perceived during stimulation was assessed with numerical rating scales. Before stimulation, a short-term electrocardiogram was recorded to compute vagally mediated heart rate variability at rest. Logistic regression analyses revealed that participants with higher vagal tone were significantly more likely to perceive the thermal grill illusion than subjects displaying lower resting heart rate variability. Paradoxical pain sensations were primarily predicted by normalized respiratory sinus arrhythmia. Our results confirm that the magnitude of vagally mediated resting heart rate variability is associated with the individual disposition to illusive pain perceptions. Since the latter is considered to be a marker of trait self-regulation ability, the present findings may corroborate and complement previous evidence for an impact of psychological characteristics on paradoxical pain sensitivity.

Respiratory Sinus Arrhythmia During Sleep and Waking

2019 ◽  
Vol 33 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Elizabeth M. Stoakley ◽  
Karen J. Mathewson ◽  
Louis A. Schmidt ◽  
Kimberly A. Cote
Keyword(s):  
Individual Differences ◽  
Respiratory Sinus Arrhythmia ◽  
Slow Wave Sleep ◽  
Self Regulation ◽  
Nrem Sleep ◽  
Sinus Arrhythmia ◽  
Affective Style ◽  
Waking State ◽  
Optimal Period ◽  
The Stability

Abstract. Resting respiratory sinus arrhythmia (RSA) is related to individual differences in waking affective style and self-regulation. However, little is known about the stability of RSA between sleep/wake stages or the relations between RSA during sleep and waking affective style. We examined resting RSA in 25 healthy undergraduates during the waking state and one night of sleep. Stability of cardiac variables across sleep/wake states was highly reliable within participants. As predicted, greater approach behavior and lower impulsivity were associated with higher RSA; these relations were evident in early night Non-REM (NREM) sleep, particularly in slow wave sleep (SWS). The current research extends previous findings by establishing stability of RSA within individuals between wake and sleep states, and by identifying SWS as an optimal period of measurement for relations between waking affective style and RSA.

Parasympathetic Concomitants of Habitual, Spontaneous, and Instructed Emotional Suppression

2017 ◽  
Vol 31 (2) ◽  
pp. 78-89 ◽  
Author(s):  
Asmir Gračanin ◽  
Igor Kardum ◽  
Jasna Hudek-Knežević
Keyword(s):  
Negative Emotion ◽  
Self Regulation ◽  
Experimental Manipulation ◽  
Task Demands ◽  
Self Control ◽  
Integration Model ◽  
Sinus Arrhythmia ◽  
Emotional Suppression ◽  
Emotion Experience ◽  
Similar Relation

Abstract. The neurovisceral integration model proposes that different forms of self-regulation, including the emotional suppression, are characterized by the activation of neural network whose workings are also reflected in respiratory sinus arrhythmia (RSA). However, most of the previous studies failed to observe theoretically expected increases in RSA during emotional suppression. Even when such effects were observed, it was not clear whether they resulted from specific task demands, a decrease in muscle activity, or they were the consequence of more specific self-control processes. We investigated the relation between habitual or trait-like suppression, spontaneous, and instructed suppression with changes in RSA during negative emotion experience. A modest positive correlation between spontaneous situational and habitual suppression was observed across two experimental tasks. Furthermore, the results showed greater RSA increase among participants who experienced higher negative affect (NA) increase and reported higher spontaneous suppression than among those with higher NA increase and lower spontaneous suppression. Importantly, this effect was independent from the habitual suppression and observable facial expressions. The results of the additional task based on experimental manipulation, rather than spontaneous use of situational suppression, indicated a similar relation between suppression and RSA. Our results consistently demonstrate that emotional suppression, especially its self-regulation component, is followed by the increase in parasympathetic activity.

Measures of RSA Suppression, Attentional Control, and Negative Affect Predict Self-Ratings of Executive Functions

2011 ◽  
Vol 25 (4) ◽  
pp. 164-173 ◽  
Author(s):  
Brian Healy ◽  
Aaron Treadwell ◽  
Mandy Reagan
Keyword(s):  
College Students ◽  
Heart Rate ◽  
Regression Analysis ◽  
Individual Differences ◽  
Negative Affect ◽  
Respiratory Sinus Arrhythmia ◽  
Attentional Control ◽  
Executive Processes ◽  
Sinus Arrhythmia ◽  
Low Levels

The current study was an attempt to determine the degree to which the suppression of respiratory sinus arrhythmia (RSA) and attentional control were influential in the ability to engage various executive processes under high and low levels of negative affect. Ninety-four college students completed the Stroop Test while heart rate was being recorded. Estimates of the suppression of RSA were calculated from each participant in response to this test. The participants then completed self-ratings of attentional control, negative affect, and executive functioning. Regression analysis indicated that individual differences in estimates of the suppression of RSA, and ratings of attentional control were associated with the ability to employ executive processes but only when self-ratings of negative affect were low. An increase in negative affect compromised the ability to employ these strategies in the majority of participants. The data also suggest that high attentional control in conjunction with attenuated estimates of RSA suppression may increase the ability to use executive processes as negative affect increases.

scholarly journals Cardiopulmonary coupling indices to assess weaning readiness from mechanical ventilation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pablo Armañac-Julián ◽  
David Hernando ◽  
Jesús Lázaro ◽  
Candelaria de Haro ◽  
Rudys Magrans ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mechanical Ventilation ◽  
Spontaneous Breathing Trial ◽  
Sinus Arrhythmia ◽  
Time Frequency ◽  
Cardiopulmonary Coupling ◽  
Cardiac Pumping ◽  
Successful Weaning ◽  
Frequency Coherence ◽  
Subspace Projections

AbstractThe ideal moment to withdraw respiratory supply of patients under Mechanical Ventilation at Intensive Care Units (ICU), is not easy to be determined for clinicians. Although the Spontaneous Breathing Trial (SBT) provides a measure of the patients’ readiness, there is still around 15–20% of predictive failure rate. This work is a proof of concept focused on adding new value to the prediction of the weaning outcome. Heart Rate Variability (HRV) and Cardiopulmonary Coupling (CPC) methods are evaluated as new complementary estimates to assess weaning readiness. The CPC is related to how the mechanisms regulating respiration and cardiac pumping are working simultaneously, and it is defined from HRV in combination with respiratory information. Three different techniques are used to estimate the CPC, including Time-Frequency Coherence, Dynamic Mutual Information and Orthogonal Subspace Projections. The cohort study includes 22 patients in pressure support ventilation, ready to undergo the SBT, analysed in the 24 h previous to the SBT. Of these, 13 had a successful weaning and 9 failed the SBT or needed reintubation –being both considered as failed weaning. Results illustrate that traditional variables such as heart rate, respiratory frequency, and the parameters derived from HRV do not differ in patients with successful or failed weaning. Results revealed that HRV parameters can vary considerably depending on the time at which they are measured. This fact could be attributed to circadian rhythms, having a strong influence on HRV values. On the contrary, significant statistical differences are found in the proposed CPC parameters when comparing the values of the two groups, and throughout the whole recordings. In addition, differences are greater at night, probably because patients with failed weaning might be experiencing more respiratory episodes, e.g. apneas during the night, which is directly related to a reduced respiratory sinus arrhythmia. Therefore, results suggest that the traditional measures could be used in combination with the proposed CPC biomarkers to improve weaning readiness.

scholarly journals Features of heart rate variability in patients with takotsubo syndrome

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
D Evdokimov ◽  
SA Boldueva ◽  
VS Feoktistova ◽  
TA Baeva
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Sinus Rhythm ◽  
Autonomic Regulation ◽  
Deep Breathing ◽  
Takotsubo Syndrome ◽  
Orthostatic Test ◽  
Rate Regulation ◽  
Heart Rate Regulation ◽  
Deep Breathing Test

Abstract Funding Acknowledgements Type of funding sources: None. Main funding source(s): North-Western State Medical University named after I.I. Mechnikov Objective to study the features of autonomic regulation of sinus rhythm features of autonomic regulation of cardiac sinus rhythm in patients with Takotsubo syndrome (TTS) during inpatient stay in hospital. Materials and methods. The study included 25 female patients (the median age 57.5 ± 28.5 years) with TTS, diagnosis was based on the InterTAK criteria. On the 5-7th day after admission, the heart rate variability (HRV) was assessed both at rest and cardiac autonomic function tests: the deep breathing test (DBT) and active orthostatic test (AOT) with the usage of a computer diagnostic system «Valenta». RESULTS According to HRV data, initially at rest, the majority of the studied patients predominantly had a parasympathetic impact on the heart rate regulation: in 70% - increased parasympathetic influence, in 17% - increased sympathetic influence, in 13% - a balanced heart rate regulation. When performing a DBT, the predominance of the parasympathetic influence on the heart rate was noted both in spectral parameters and according to the data of time analysis (HF  during DBT  increased 1.8 times  up to  489.6 ± 114.2 ms2 (p &lt;0.05) ; LF  decreased 1.7 times  up to 254.1 ± 70.3 ms2 (p &lt;0.05); VLF  increased 2.8 times up to 402.3 ± 101.8 ms2 (p &lt;0, 05); TP  increased 1.4 times up to 1145.9 ± 251.3 ms2; CV increased 1.3 times up to 6.5 ± 0.7% (p &lt;0.05); SDNN increased 1.3 times up to - 58.7 ± 6.6 ms (p &lt;0.05). HRV measured during an AOT  showed a paradoxical  evaluation  in the parasympathetic impact on the heart rate (HF increased by 1.8 times and reached - 488.0 ± 104.7 ms2 (p &lt;0.05); LF decreased by 1.1 times up to  408 , 4 ± 103.6 ms2; VLF increased 1.2 times  up to  166.4 ± 52.2 ms2; TP increased 1.3 times  up to 1062.8 ± 181.1 ms2 (p &lt;0.05); CV increased 1.6 times  up to 8.0 ± 0.9% (p &lt;0.05); SDNN increased 1.4 times  up to 62.6 ± 7.5 ms (p &lt;0.05)). Conclusions During the index hospital inpatient stays the majority of patients with TTS have a vegetative imbalance due to increased parasympathetic influence on the heart rate, both at rest and  during a deep breathing test and an active orthostatic test. This fact is quite unexpected and requires further study.

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