Effects of a Short-Term Resistance-Training Program on Heart Rate Variability in Children With Cystic Fibrosis-A Randomized Controlled Trial

Agustín Jesús Estévez-González, Márcio Vinícius Fagundes Donadio, Fernando Cobo-Vicente, Álvaro Fernández-Luna, Verónica Sanz-Santiago, José Ramón Villa Asensi, Tamara Iturriaga Ramirez, Maria Fernández-Del-Valle, Ignacio Diez-Vega, Eneko Larumbe-Zabala, Margarita Pérez-Ruiz, Agustín Jesús Estévez-González, Márcio Vinícius Fagundes Donadio, Fernando Cobo-Vicente, Álvaro Fernández-Luna, Verónica Sanz-Santiago, José Ramón Villa Asensi, Tamara Iturriaga Ramirez, Maria Fernández-Del-Valle, Ignacio Diez-Vega, Eneko Larumbe-Zabala, Margarita Pérez-Ruiz

Abstract

Background: Cystic fibrosis (CF) affects the autonomic nervous system (ANS) and exercise in healthy children modulates the interaction between sympathetic and parasympathetic activity. This study aimed to evaluate the effects of a short-term resistance exercise program on heart rate variability (HRV) in children and adolescents with CF. Methods: A randomized controlled trial was carried out in children diagnosed with CF aged 6-18 years. Individuals were divided into two groups: control (CON) and resistance-training (EX). Individuals in the EX group completed an individualized guided resistance program (5-RM-60-80%) for 8 weeks (3 sessions of 60 min/week). Upper and lower limbs exercises (seated bench press, seated lateral row, and leg press) were used. HRV was measured using a Suunto watch with subjects in lying position. Results: Nineteen subjects (13 boys) were included (CON = 11; and EX = 8). Mean age was 12.2 ± 3.3, FEV1 (forced expiratory volume in the first second) z-score was 1.72 ± 1.54 and peak oxygen consumption (VO2peak) 42.7 ± 7.4 mL.Kg-1.min-1. Exercise induced significant changes in the frequency-domain variables, including a decrease in LF power (p = 0.001, d = 0.98) and LF/HF ratio (p = 0.020, d = 0.92), and an increase in HF power (p = 0.001, d = -0.97), compared to the CON group. No significant changes were found for time-domain variables, although increases with a moderate effect size were seen for SDNN (p = 0.152, d = -0.41) and RMSSD (p = 0.059, d = -0.49) compared to the CON group. Conclusion: A short-term resistance exercise-training program was able to modulate HRV in children and adolescents with CF presenting mild to moderate lung function impairment and good physical condition. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT04293926.

Keywords: autonomic function; cystic fibrosis; exercise; heart rate variability; pediatrics; resistance.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Estévez-González, Donadio, Cobo-Vicente, Fernández-Luna, Sanz-Santiago, Villa Asensi, Iturriaga Ramirez, Fernández-del-Valle, Diez-Vega, Larumbe-Zabala and Pérez-Ruiz.

Figures

FIGURE 1
FIGURE 1
Flow chart of the study.
FIGURE 2
FIGURE 2
Effects of a short-term resistance-training program on heart rate variability (HRV) in children with cystic fibrosis. (A) LF, low frequency band; (B) HF, high frequency band; (C) LF/HF ratio; (D) SDNN, standard deviation of R-R intervals; (E) PNN50, percentage of successive R-R intervals that differ by more than 50 ms; and (F) RMSSD, root mean square of successive differences between normal heartbeats. ms, milliseconds; nu, normalized units; CON, control group; EX, exercise group. Data presented as mean and standard deviation. Differences were analyzed using a two-way analysis of variance (ANOVA) with repeated measures. *Indicates significant differences when p < 0.05.

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