The Effects of Posture and the Ratio of Inhalation and Exhalation on Heart Rate Variability

Ji-Hwan Kim; Seong-Sik Park; Kim, Ji-Hwan; Park, Seong-Sik

doi:10.13048/jkm.16011

JKM > Volume 37(1); 2016 > Article

Kim and Park: The Effects of Posture and the Ratio of Inhalation and Exhalation on Heart Rate Variability

Original Article

The Journal of Korean Oriental Medicine 2016; 37(1): 114-124.

Published online: March 31, 2016

DOI: https://doi.org/10.13048/jkm.16011

The Effects of Posture and the Ratio of Inhalation and Exhalation on Heart Rate Variability

Ji-Hwan Kim, Seong-Sik Park

Department of Sasang Constitutional Medicine, Dongguk University

Correspondence to: Seong-Sik Park, Dept. of Sasang Constitutional Medicine, Bundang Korean medical hospital of Dongguk university, 268, Buljeong-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea, 13601, Rep. of Korea. Tel: +82-31-710-3723, Fax: +82-31-710-3780, E-mail: parkss@dongguk.ac.kr

Received February 23, 2016 Revised March 25, 2016 Accepted March 30, 2016

Abstract

Objectives:

The aim of this study is to find what effects both the posture of sitting and standing and the ratio of inhalation and exhalation (I/E) have on heart rate variability (HRV)

Methods:

We made two breathing sets with 4:6 or 6:4 ratios of I/E at 0.1 Hz of respiratory frequency and sitting or standing position. There was 20 minute-rest between sets. Each set include 5 minute-3 breathings as follows: 0.1Hz paced breath with sitting, usual breathing with standing and 0.1Hz paced breath with standing. Five minute-usual breathings with sitting as basal lines were exerted before and after these 3 breaths. Electrocardiogram-recording was exerted from 73 healthy participants (37 men and 36 women) who carried out two sets of breathings. Finally, HRV indices were analyzed of 62 participants (32 men and 30 women).

Results:

In 4:6 maintaining the same posture, SDNN were statistically increased, while mean heart rate(HR) were not changed. In 6:4, mean HR, SDNN were statistically increased. When changed from sitting to standing, in 4:6, SDNN were statistically decreased and mean HR was increased. However, in 6:4 during change of posture, SDNN were also statistically decreased and mean HR was statistically decreased. There was no statistical change of HF during 4:6 or 6:4 ratios of I/E moving from sitting to standing position.

Conclusions:

For increasing HRV, breathing in low respiratory rate with sitting was recommended regardless of ratio of I/E. In changing from sitting to standing, 4:6 may increase mean HR, and 6:4 may decrease mean HR.

Keywords: Heart rate Variability, Respiration, Posture, Inhalation, Exhalation

Fig. 1.

Participants’flow

Thirty seven men and 36 women were participated. Four men & 3 women were excluded due to drop out of the research schedule. The datum of 1 man & 3 women in heart rate variability (HRV) corresponded to outlier, thus, the analysis was finally performed for 62 participants (32 men and 30 women)

Fig. 2.

Protocol for the assessment of the effects of posture and the ratio of inhalation and exhalation on Heart rate variability(HRV)

All participants performed usual breathing(UB) with sitting position, and then, they did paced breathing(PB) with sitting position, UB with standing, PB with standing in order. Whenever these three breathings were finished, UB with sitting was performed for resting. All breathing phases were performed each for 5 minutes during which HRV was measured. Paced breathing was composed of 0.1Hz respiratory rate. During PB, the ratio of 4 seconds’ inspiration and 6 seconds’ expiration(4:6) was first performed(Long expiration set), and 20 minutes later, the ratio of 6 seconds’ inspiration and 4 seconds’ expiration(6:4) was performed(Long inspiration set).

Table 1.

Hear Rate and Heart Rate Variability according to the 4:6 Ratio of inhalation and Exhalation and the Posture (N=62)

Order	1	2	3	4	5	6	7	P-value between breaths
Breaths	UB-Sit1	PB-Sit	UB-Sit2	UB-Sta	UB-Sit3	PB-Sta	UB-Sit4	UB-Sit1 vs. PB-Sit	UB-Sta vs. PB-Sta	UB-Sit2 vs. UB-Sta	PB-Sit vs. PB-Sta
Mean HR (bpm)	76.35±12.40	75.79±11.82	76.95±12.41	86.93±11.99	76.4±12.10	86.08±11.74	77.85±11.33	1.00	1.00	0.0001^*	0.0001^*
STD HR (bpm)	12.32±28.83	8.23±5.11	7.32±7.80	8.75±19.91	9.96±16.45	12.01±23.37	9.14±8.89	1.00	1.00	1.00	1.00
Mean RR (ms)	814.60±128.89	819.22±128.27	806.99±133.66	707.96±97.16	813.26±125.35	718.63±99.37	795.36±118.44	1.00	0.422	0.0001^*	0.0001^*
SDNN (ms)	60.91±26.49	78.14±25.67	66.11±42.36	49.67±18.20	73.66±36.76	66.61±29.20	73.17±31.80	0.0001^*	0.0001^*	0.008^*	0.0001^*
RMSSD (ms)	42.24±25.69	47.65±24.78	38.51±24.15	21.36±11.63	41.86±36.99	33.08±20.70	35.93±20.51	1.00	0.0001^*	0.0001^*	0.0001^*
pNN50 (%)	15.39±14.31	19.20±13.35	11.89±12.23	3.27±5.17	15.83±14.71	7.91±8.48	12.40±13.31	0.024^*	0.0001^*	0.0001^*	0.0001^*
L.F (ms²)	1059.63±1093.31	4142.37±2590.97	1152.53±943.24	648.402±607.29	979.77±966.72	2247.02±1764.59	1226.59±1496.79	0.0001^*	0.0001^*	0.002^*	0.0001^*
HI (ms²)	2907.04±17584.85	641.71±871.01	585.18±699.32	153.37±144.07	614.84±877.20	395.09±1129.28	497.06±792.99	1.00	1.00	0.0001^*	1.00
n.u.LF	62.09±21.43	88.28±9.54	71.66±15.27	79.39±13.81	66.19±16.69	88.76±10.71	72.22±14.79	0.0001^*	0.001^*	0.005^*	1.00
n.u.HF	37.74±21.24	11.63±9.43	28.13±15.10	20.51±13.65	33.62±16.55	11.14±10.56	27.70±14.76	0.0001^*	0.001^*	0.004^*	1.00

UB : Usual breathing

PB : 0.1Hz Paced breathing

Sit : Sitting position

Sta : Standing position

HR : Heart rate

RR : Intervals between R–R waves in electrocardiogram

STD HR : Standard deviation of heart late

SDNN : Standard deviation of N–N(Consecutive normal sinus intervals) intervals

RMSSD : Root-mean square differences of successive R–R intervals

NN50 : Mean number of times per hour in which the change in N–N intervals exceeds 50 milliseconds.

pNN50 : (NN50 count) / (total N–N count)

LF : Low frequency

HF: High frequency

n.u. : Normalized unit {n.u.LF = LF/(LF+HF): n.u.HF=HF/(LF+HF)}

* p<0.05

Table 2.

Heart Rate and Heart Rate Variability according to the 6:4 Ratio of inhalation and Exhalation and the Posture (N=62)

Order	1	2	3	4	5	6	7	P-value between breaths
Phase	UB-Sit1	PB-Sit	UB-Sit2	UB-Sta	UB-Sit3	PB-Sta	UB-Sit7	UB-Sit1 vs. PB-Sit	UB-Sta vs. PB-Sit	UB-Sit2 vs. UB-Sta	PB-Sit vs. PB-Sta
Mean HR (bpm)	38.91±26.15	50.91±33.89	37.25±31.16	23.14±13.82	4199±24.21	33.54±2355	39.27±27.02	0.016^*	0.001^*	0.0001^*	0.0001^*
STD HR (bpm)	76.90±11.21	76.42±10.05	79.04±10.15	87.83±11.81	77.97±11.56	86.44±11.78	78.25±11.32	1.00	0.518	0.0001^*	0.0001^*
Mean RR (ms)	802.68±117.28	812.51±112.59	779.40±104.04	701.09±95.85	796.31±120.17	714.32±101.81	793.06±121.92	0.909	0.318	0.0001^*	0.0001^*
SDNN (ms)	64.39±41.17	85.32±34.07	70.78±33.74	57.50±23.63	73.89±31.91	68.50±27.64	77.67±40.07	0.003^*	0.0001^*	0.004^*	0.0001^*
RMSSD (ms)	7.22±10.77	13.44±24.65	8.11±6.47	8.24±6.65	12.29±21.56	8.50±4.47	9.44±8.90	1.00	1.00	1.00	1.00
pNN50 (%)	13.70±14.35	18.96±14.25	11.05±10.68	4.28±6.77	13.96±13.28	8.80±10.48	12.92±13.05	0.002^*	0.0001^*	0.0001^*	0.0001^*
L.F (ms²)	1156.62±1630.91	4563.77±3843.00	1654.94±833.20	869.47±901.77	1073.16±873.79	2897.88±2528.88	1739.15±3732.45	0.0001^*	0.0001^*	0.011^*	0.001^*
HI (ms²)	634.39±1263.75	2550.42±12696.22	560.2±811.18	224.22±395.59	587.56±790.63	346.44±704.49	709.34±1603.34	1.00	1.00	0.039^*	1.00
n.u.LF	68.99±15.81	86.84±17.82	77.06±13.32	83.21±11.48	64.86±16.69	91.83±8.93	74.53±11.40	0.0001^*	0.0001^*	0.108	0.923
n.u.HF	30.91±15.76	13.05±17.54	22.84±13.17	16.73±11.40	29.98±16.50	8.11±8.76	25.36±11.37	0.0001^*	0.0001^*	0.105	0.895

UB : Usual breathing

PB : 0.1Hz Paced breathing

Sit : Sitting position

Sta : Standing position

HR : Heart rate

RR : Intervals between R–R waves in electrocardiogram

STD HR : Standard deviation of heart rate

SDNN : Standard deviation of N–N(Consecutive normal sinus intervals) intervals

RMSSD : Root-mean square differences of successive R–R intervals

NN50 : Mean number of times per hour in which the change in N–N intervals exceeds 50 milliseconds.

pNN50 : (NN50 count) / (total N–N count)

LF : Low frequency

HF: High frequency

n.u. : Normalized unit {n.u.LF = LF/(LF+HF); n.u. HF=HF/(LF+HF)}

* p<0.05

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