Effects of physical training on heart rate variability in diabetic patients with various degrees of cardiovascular autonomic neuropathy
Abstract
OBJECTIVE: To investigate the effects of regularly performed endurance training on heart rate variability in diabetic patients with different degrees of cardiovascular autonomic neuropathy (CAN). METHODS: Bicycle ergometer training (12 weeks, 2 x 30 min/week, with 65% of maximal performance) was performed by 22 insulin-requiring diabetic patients (age 49.5 +/- 8.7 years; diabetes duration 18.6 +/- 10.6 years; BMI 25.1 +/- 3.4 kg/m2): i.e., by 8 subjects with no CAN, 8 with early CAN and by 6 patients with definite/severe CAN. A standard battery of cardiovascular reflex tests was used for grading of CAN, a short-term spectral analysis of heart rate variability for follow-up monitoring of training-induced effects. RESULTS: While the training-free interval induced no changes in spectral indices, the 12-week training period increased the cumulative spectral power of the total frequency band (P = 0.04) but to a different extent (P = 0.039) in different degrees of neuropathy. In patients with no CAN the spectral power in the high-frequency (HF) band (0.15-0.50 Hz) increased from 6.2 +/- 0.3 to 6.6 +/- 0.4 In [ms2]; P = 0.016, and in the low-frequency (LF) band (0.06-0.13 Hz) from 7.1 +/- 0.1 to 7.6 +/- 0.3 in [ms2]; P = 0.08 which resulted in an increase of total spectral power (0.06-0.50 Hz) from 7.5 +/- 0.1 to 8.0 +/- 0.3 in [ms2] (P = 0.05). Patients with the early form of CAN showed an increase of spectral power in HF (5.1 +/- 0.2 to 5.8 +/- 0.1 in [ms2], P = 0.05) and LF bands (5.6 +/- 0.1 to 6.3 +/- 0.1 in [ms2], P = 0.008), resulting in an increase of total power from 6.1 +/- 0.1 to 6.6 +/- 0.1 in [ms2] (P = 0.04), whereas those with definite/severe CAN showed no changes after the training period. Training improved fitness in the whole patient cohort. The increased autonomic tone as assessed by spectral indices disappeared after a training withdrawal period of 6 weeks. CONCLUSIONS: In diabetic patients with no or early CAN, regularly performed endurance training increased heart rate variability due to improved sympathetic and parasympathetic supply, whereas in subjects with definite/severe CAN no effect on heart rate variability could be demonstrated after this kind of training.
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Moderate-intensity aerobic training can improve autonomic function in individuals with and without CV autonomic neuropathy (CAN); however, improvements may only be evident after an acute submaximal exercise.
“Moderate-intensity aerobic training can improve autonomic function in individuals with and without CV autonomic neuropathy (CAN) ( 112 , 176 , 208 ); however, improvements may only be evident after an acute submaximal exercise ( 78 ).”
From Exercise and Type 2 Diabetes (2010) · cites this paper as [112]
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References 47 · Cited by 133
- Authors
- Howorka, K.
- Affiliations
- University of Vienna (AT)
- Corresponding author
- Howorka, K
- Venue
- Cardiovascular Research
- Publisher
- Oxford University Press (OUP)
- Published
- 1997-04
- Volume
- 34
- Issue
- 1
- Pages
- 206-214
- ISSN
- 0008-6363 (ISSN-L)
- OpenAlex
- W2128888502
- Cited by
- 133
- References
- 47
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 7 · 2018: 6 · 2017: 7 · 2016: 4 · 2015: 4 · 2014: 7 · 2013: 8 · 2012: 7
- FWCI
- 1.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cardiovascular Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Universität Wien
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- cardiac autonomic neuropathy, diabetes mellitus, endurance training, heart rate variability, spectral power, high-frequency band, low-frequency band, type 1 diabetes, cardiovascular reflex tests, autonomic function, exercise training intervention, diabetes complications prevention, diabetes education, diabetes self-management education, diabetes self-management support, diabetes self-management
- MeSH terms
- Autonomic Nervous System Diseases, Cardiovascular Diseases, Diabetes Mellitus, Type 1, Female, Heart Rate, Humans, Male, Middle Aged, Physical Endurance, Signal Processing, Computer-Assisted
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