Test-retest reliability of short- and long-term heart rate variability in individuals with spinal cord injury

Spinal Cord, 2023 · DOI: https://doi.org/10.1038/s41393-023-00935-w · Published: October 2, 2023

Simple Explanation

Heart rate variability (HRV) is a physiological phenomenon characterising variation in the time interval between consecutive R waves (RR-intervals). This study investigates how consistently HRV measurements reflect actual cardiovascular health in individuals with spinal cord injury (SCI). The research examines both short-term (5-10 minutes) and long-term (24 hours) HRV measurements to determine the most reliable duration for assessment.

Study Duration

October 2019 to August 2020

Participants

45 participants (11 with tetraplegia and 34 with paraplegia)

Evidence Level

Cross-sectional study

Key Findings

1
Relative reliability of HRV was excellent for 6-h and 24-h.
2
Time-domain outcomes were more reliable than frequency domain outcomes.
3
Participants with high risk of AD, particularly those with tetraplegia, showed lower reliability, especially for HF and LF.

Research Summary

This study aimed to investigate test-retest reliability of HRV metrics in individuals with SCI with no restrictions on activity over a long duration (24-h) and with sub-analysis of shorter durations of measurement (5-min, 10-min, 1-h, 3-h and 6-h). Based on ICC value ranging from 0.77 to 0.92, excellent relative reliability was found in all HRV parameters derived from 6-h and 24-h periods. Time-domain HRV outcomes were more reliable than frequency domain outcomes.

Practical Implications

Optimal Measurement Duration

Longer duration HRV recordings (6-24 hours) are more reliable for assessing cardiovascular health in individuals with SCI.

Targeted Assessment for High-Risk Individuals

Individuals with tetraplegia or high risk of autonomic dysreflexia require careful consideration when interpreting HRV measurements due to lower reliability.

Clinical Practice

24-hour HRV can be used as a practical outcome measure in SCI.

Study Limitations

1
Reduced sample size due to rejected data sets from shifting HR chest belt sensor.
2
High percentage of invalid recordings, making 24-h recordings with wearable devices challenging.
3
No HRV data from participants with complete tetraplegia, limiting the generalization of the data.

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