Hart John
Assistant Director of Research.
J Can Chiropr Assoc. 2015 Jun;59(2):165-72.
Resting heart (pulse) rate (RPR) monitoring may be a useful neurological assessment tool in chiropractic practice. Lower RPR generally reflects a better level of fitness and health status than higher RPR. However, the clinical significance of short-term changes in RPR remains unknown. The purpose of this study was to take an initial step towards understanding the clinical significance of short-term RPR changes, first, by describing short-term RPR changes between duplicated measurements, and second, by comparing RPR changes between groups with lower and higher baseline RPR.
Seventy-three healthy adult volunteers received an RPR measurement on two days within a 1-week period. The mean difference between the two measurements (RPR change) in patients with lower versus higher baseline RPR was compared.
Mean RPR change in the low baseline group was -0.3 BPM (95% confidence interval [CI] = -2.7 to 2.1 BPM) whereas in the high baseline group, it was +4.4 BPM (95% CI = 1.2 to 7.6). This difference between groups was statistically significant (P = 0.02) Testing an association between baseline resting pulse rate averages and short-term changes in resting pulse rates: A pilot study with a large effect size (Cohen's d = 0.57).
In this pilot study, a higher RPR at baseline was associated with increased RPR change, whereas a lower baseline RPR was associated with a stable or reduced RPR change. A future main study with a larger sample size and longer follow-up period is needed to better characterize both the natural variation of RPR over multiple repeated measurements, and the clinical significance of short-term RPR changes in terms of predicting longer-term health outcomes.
静息心率监测可能是脊椎按摩疗法中一种有用的神经学评估工具。较低的静息心率通常比较高的静息心率反映出更好的健康水平和身体状况。然而,静息心率的短期变化的临床意义仍然未知。本研究的目的是朝着理解静息心率短期变化的临床意义迈出第一步,首先,描述重复测量之间的静息心率短期变化,其次,比较基线静息心率较低和较高的组之间的静息心率变化。
73名健康成年志愿者在1周内的两天接受了静息心率测量。比较了基线静息心率较低和较高的患者两次测量之间的平均差异(静息心率变化)。
低基线组的平均静息心率变化为-0.3次/分钟(95%置信区间[CI]=-2.7至2.1次/分钟),而高基线组为+4.4次/分钟(95%CI=1.2至7.6)。两组之间的这种差异具有统计学意义(P=0.02)。检验基线静息心率平均值与静息心率短期变化之间的关联:一项具有较大效应量的初步研究(科恩d=0.57)。
在这项初步研究中,较高的基线静息心率与静息心率变化增加相关,而较低的基线静息心率与静息心率变化稳定或降低相关。需要进行一项样本量更大、随访期更长的未来主要研究,以更好地描述静息心率在多次重复测量中的自然变化,以及静息心率短期变化在预测长期健康结果方面的临床意义。