The immediate effect of paced breathing פולינה גינזבורג 18-1

 The immediate effect of paced breathing with biofeedback on heart rate variability in patients at

the sub-acute post stroke phase.

 Ginsburg Polina, Bartur Gadi, Peleg Sara, Katz-Leurer Michal

Abstract:
Autonomic instability is a common phenomenon following stroke, with signs and symptoms of hyperstimulation of the sympathetic nervous system. The aim of this case serial was to assess the capability of patients post stroke to perform slow paced breathing and to evaluate any immediate impact of this manipulation on their cardiac autonomic system.

Methods: Included were 8 patients within one month post stroke. Measures: A12-lead Digital Holter ECG recorder was used; heart rate (HR), time, and frequency heart rate variability (HRV) parameters were calculated. The ECG was continuously monitored throughout 15 minutes of rest while breathing at a comfortable rate, and then during a Biofeedback breathing session, when patients were guided to breathe at as low a rate as possible, up to 6 breaths per minute. 

Results: At rest, the median breathing rate was 14.3 bpm (range: 13.5-15.8). During paced breathing, the breathing rate decreased significantly, to 8.5 bpm (range: 7.5-11.7) (p-value = .012). Median HR decreased by 11 bpm (range: 3-16 bpm) (p = .012), and the median value for the normalized high frequency HRV was marginally significant (p = .08).
Conclusion: Rhythmical breathing, which stimulates the cardiovascular system, led to heart rate oscillations, decreased heart rate, and low frequency HRV parameters among post-stroke patients.  Further research should be excecuted to assess the effect of paced breathing training on autonomic activity among these patients.

Keywords: stroke, autonomic system, heart rate variability, paced breathing