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Effects of Mind–Body Exercises (Tai Chi/Yoga) on Heart Rate Variability Parameters and Perceived Stress: A Systematic Review with Meta-Analysis of Randomized Controlled Trials
Open accessAbstract
Background: Heart rate variability (HRV) as an accurate, noninvasive measure of the Autonomous Nervous System (ANS) can reflect mental health (e.g., stress, depression, or anxiety). Tai Chi and Yoga (Tai Chi/Yoga), as the most widely practiced mind–body exercises, have shown positive outcomes of mental health. To date, no systematic review regarding the long-lasting effects of Tai Chi/Yoga on HRV parameters and perceived stress has been conducted. Objective: To critically evaluate the existing literature on this topic. Methods: Five electronic databases (Web of Science, PubMed, Scopus, SportDiscus and Cochrane Library) were searched from the start of the research project to July 2018. Study selection, data extraction, and study quality assessment were independently carried out by two reviewers. The potentially identified randomized controlled trials (RCT) reported the useful quantitative data that were included only for meta-analysis. Results: meta-analysis of 17 medium-to-high quality RCTs showed significantly beneficial effects on HRV parameters (normalized low-frequency, Hedge’s g = −0.39, 95% CI −0.39 to −0.56, p < 0.001, I2 = 11.62%; normalized high-frequency, Hedge’s g = 0.37, 95% CI 0.22 to −0.52, p < 0.001, I2 = 0%; low-frequency to high-frequency ratio, Hedge’s g = −0.58, 95% CI −0.81 to −0.35, p < 0.001, I2 = 53.78%) and stress level (Hedge’s g = −0.80, 95% CI −1.17 to −0.44, p < 0.001, I2 = 68.54%). Conclusions: Stress reduction may be attributed to sympathetic-vagal balance modulated by mind–body exercises. Tai Chi/Yoga could be an alternative method for stress reduction for people who live under high stress or negative emotions.
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“Critically, heart rate variability (or HRV) reflects an index of the functioning of the vagus nerve (Paso et al., 2013), and can be used as a target for tracking the impact of wellbeing-related interventions including for example, a healthy lifestyle (Jandackova et al., 2019), HRV biofeedback (Lehrer et al., 2020), mind-body techniques (Zou et al., 2018), compassion focused therapy (Bello et al.,”
From The Complex Construct of Wellbeing and the Role of Vagal Function (2022) · cites this paper as Zou et al., 2018
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Metadata
- Authors
- Zou, L., Sasaki, J. E., Wei, G.-X., Huang, T., Yeung, A. S., Neto, O. B., Chen, K. W., & Hui, S. S.-C.
- Affiliations
- Chinese University of Hong Kong (HK)
- Universidade Federal do Triângulo Mineiro (BR)
- Chinese Academy of Sciences (CN)
- Shanghai Jiao Tong University (CN)
- Harvard University (US)
- University of Maryland, Baltimore (US)
- Corresponding author
- Hui, Stanley Sai-chuen
- ORCID
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2018-10-31
- Volume
- 7
- Issue
- 11
- Pages
- 404
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC6262541
- OpenAlex
- W2898943828
- Cited by
- 267
- References
- 54
- Citations by year
- 2026: 43 · 2025: 39 · 2024: 41 · 2023: 40 · 2022: 35 · 2021: 26 · 2020: 17 · 2019: 22 · 2018: 3
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Institutional Repository of Institute of Psychology, Chinese Academy of Sciences (Institute of Psychology, Chinese Academy of Sciences) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Complementary and alternative medicine › Biofield Effects and Biophysics
- Keywords
- mind-body exercise, Tai Chi, yoga, heart rate variability, perceived stress, stress reduction, autonomic nervous system, sympathovagal balance, mental health, LF/HF ratio
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