Effects of Aerobic training on Time-domain and Frequency-domain Parameters of Heart Rate Variability (HRV) in Diabetic Neuropathy Patients
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Introduction: One the symptoms of diabetes mellitus (DM) is cardiac autonomic dysfunction. Cardiac autonomic dysfunction occurs when, as a result of chronic hyperglycemia, the sympathetic and parasympathetic nervous systems become hyperactive and hypoactive respectively, hence the dominance of sympathetic nervous system which can be detected by decrease in heart rate variability (HRV). In fact, Heart rate variability (HRV) is a noninvasive, practical and reproducible measure of cardiac autonomic nervous system function. Studies have shown that aerobic training is an efficient and practical way to improve HRV and restore autonomic balance in diabetics through increasing the vagal tone and decreasing deadly cardiac arrhythmia, such improvements play a protective role for heart. The purpose of this study was to examine whether regular aerobic training can improve HRV in diabetic neuropathy patients?
Methodology: In this quasi-experimental clinical trial study, 20 middle-aged (40-60 years old) men with diabetic neuropathy were randomly placed at two groups: aerobic training (n=10) and control group (n=10). Aerobic training was accomplished for 8 weeks (3 sessions per week, intensity 70% of the maximum heart rate, duration of each session 25-40 min). Heart rate variability of patients was recorded by Holter Monitoring VX3+ for 20 min at rest and in the supine position before and after 12 weeks of aerobic training, using time- domain (SDNN and rMSSD) and frequency-domain (HF Power, LF Power and LF/HF Ratio) parameters. Repeated measures ANOVA and Paired-Samples T Test were used for intra-group comparisons, while intergroup comparisons were done by Independent-Samples T Test.
Results: The results of intra-group showed in aerobic training group there were significant difference between pre and posttest in the HF Power, SDNN and rMSSD parameters. However, there were no significant differences in LF Power and LF/HF Ratio. The results of intergroup changes indicated that SDNN, rMSSD and HF Power parameters in aerobic training group were significantly different from those in the control group.
Discussion: The findings showed that the eight-week aerobic training had positive and significant effect on time-domain and frequency-domain parameters of HRV in diabetic neuropathy patients. It seems that moderate intensity aerobic training improve the cardiac rhythms and consequently the function of the cardiac autonomic system, through the increase of vagal tone and HRV.