INVESTIGATING THE RELATIONSHIP BETWEEN CARDIAC AUTONOMIC MODULATION AND RESTING HEART RATE IN YOUTH ACROSS PHYSICAL ACTIVITY LEVELS
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Apr 22, 2025
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Belkadi Adel
https://orcid.org/0000-0002-8715-2036
Houcine Asli
https://orcid.org/0000-0003-1733-1829
Lalia Cherara
https://orcid.org/0000-0002-5375-1911
Saddek Benhammou
https://orcid.org/0000-0002-2726-5493
Mokrani Djemal
https://orcid.org/0000-0001-5911-7930
Mohammed Sebbane
https://orcid.org/0000-0003-3448-5299
https://orcid.org/0000-0002-8715-2036
Houcine Asli
https://orcid.org/0000-0003-1733-1829
Lalia Cherara
https://orcid.org/0000-0002-5375-1911
Saddek Benhammou
https://orcid.org/0000-0002-2726-5493
Mokrani Djemal
https://orcid.org/0000-0001-5911-7930
Mohammed Sebbane
https://orcid.org/0000-0003-3448-5299
Abstract
Objective: This study aimed to Explore the relationship between cardiac autonomic modulation (CAM) and resting heart rate (HRR) in children and adolescents, focusing on how physical activity levels influence autonomic regulation and cardiovascular health.
Methods: A total of 134 children and adolescents participated in this study. CAM and HRR were assessed using Polar heart rate monitors, and physical activity levels were evaluated using the Rider questionnaire. The relationship between CAM and HRR, stratified by physical activity levels, was analysed using linear regression adjusted for sex, age, and somatic maturation.
Results: Insufficiently active individuals exhibited a significant inverse relationship between high HRR and lower HRV indices, including RMSSD (β = -0.125), SDNN (β = -0.142), SD1 (β = -0.176), and SD2 (β = -0.114). In contrast, physically active individuals showed a weaker relationship, with only the SD1/SD2 index (β = -0.006) significantly associated with HRR. These findings suggest that regular physical activity preserves autonomic balance and reduces cardiovascular risk.
Conclusions: High resting heart rate is associated with reduced cardiac autonomic modulation in insufficiently active children and adolescents, while physical activity mitigates this relationship. These results underscore the importance of promoting physical activity in youth to enhance autonomic regulation and prevent future cardiovascular diseases. Future research should explore longitudinal and mechanistic insights to further elucidate these relationships.
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Keywords
Cardiac, autonomic, Heart rate, Physical activity, Youth
References
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3. Adel, B., Abdelkader, B., Alia, C., Othman, B., Mohamed, S., & Houcin, A. (2019). The Effect of High-Intensity Exercise on Changes of Blood Concentration Components in Algerian National Judo Athletes. Acta Facultatis Educationis Physicae Universitatis Comenianae, 59.
4. Baker-Smith, C. M., Powell-Wiley, T. M., Tabb, L. P., Falkner, B. E., & Akins, R. E. (2022). Abstract 13976 : Trends in Cardiovascular Health Status During Early vs Late Adolescence, 2007-2018. Circulation, 146, A13976‑A13976.
5. Beboucha, W., Belkadi, A., Benchehida, A., & Bengoua, A. (2021). THE ANTHROPOMETRIC AND PHYSIOLOGICAL CHARACTERISTICS OF YOUNG ALGERIAN SOCCER PLAYERS. Acta Facultatis Educationis Physicae Universitatis Comenianae, 61.
6. Belkadi, A., Alia, C., & Mohammed, Z. (2020). Algerian Judo Competition Modality and its Impacts on Upper and Lower Limbs Strength Perseverance and Limitations. Orthopedics and Sports Medicine: Open Access Journal, 3, 293‑299.
7. Belkadi, A., Beboucha, W., Benhammou, S., Moussa, M., Bouzoualegh, M., & Dairi, A. (2025). Effects of concurrent in-season training on physiological functions required for top handball performance athletes. Scientific Journal of Sport and Performance, 4, 40‑54.
8. Belkadi, A., Othman, B., Mohamed, S., M, B. H., Gleyse, J., Adel, B., … Gleyse, J. (2015). Contribution to the Identification of the Professional Skills Profile of Coaches in the Algerian Sport Judo System. International Journal of Sports Science, 5, 145‑150.
9. Benhammou, S., Clemente, F. M., Mourot, L., & Belkadi, A. (2025). Physiological and Biomechanical Responses Induced by a Continuous Test and an Intermittent Test in Middle-Distance Runners. International Journal of Sports Physiology and Performance, 1, 1‑6.
10. Benhammou, S., Mourot, L., Clemente, F. M., Coquart, J., & Belkadi, A. (2024). Is test specificity the issue in assessing aerobic fitness and performance of runners? A systematic review. The Journal of Sports Medicine and Physical Fitness, 64, 539‑549.
11. Benhammou, S., Mourot, L., Coquart, J., Belkadi, A., Mokkedes, M. I., & Bengoua, A. (2022). The 180/20 intermittent athletic test : A new intermittent track test to assess the maximal aerobic speed in middle-distance runners. Revista andaluza de medicina del deporte, 15, 6‑11.
12. Boudehri, M. E. amine, Belkadi, A., Dahoune, O., & Atallah, A. (2023). The effects of circuit exercise training strategy on health-related physical fitness level and biomarkers in elderly people with cardiovascular diseases. Quality in Sport, 11, 16‑31.
13. Brisinda, D., Picerni, M., Fenici, P., & Fenici, R. (2024a). Automatic calculation of the parasympathetic, sympathetic and Baevsky stress indexes provides a more comprehensive assessment of cardiac autonomic modulation. European Heart Journal, 45. https://doi.org/10.1093/eurheartj/ehae666.3425
14. Brisinda, D., Picerni, M., Fenici, P., & Fenici, R. (2024b). Rapid assessment of cardiac autonomic modulation and adaptive stress responses : Automatic calculation of time-varying parasympathetic, sympathetic, and Baevsky stress indexes. Brain & Heart, 2, 3503.
15. Carnagarin, R., Lambert, G. W., Kiuchi, M. G., Nolde, J. M., Matthews, V. B., Eikelis, N., … Schlaich, M. P. (2019). Effects of sympathetic modulation in metabolic disease. Annals of the New York Academy of Sciences, 1454, 80‑89.
16. Carrillo, A. E., Akerman, A. P., Notley, S. R., Herry, C. L., Seely, A. J. E., Ruzicka, M., … Kenny, G. P. (2023). Cardiac autonomic modulation in individuals with controlled and uncomplicated hypertension during exercise-heat stress. Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition Et Metabolisme, 48, 863‑869.
17. Carson, V., Lee, E.-Y., Hewitt, L., Jennings, C., Hunter, S., Kuzik, N., … Tremblay, M. S. (2017). Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years). BMC Public Health, 17, 854.
18. Chen, H., Xu, J., Xie, H., Huang, Y., Shen, X., & Xu, F. (2022). Effects of physical activity on heart rate variability in children and adolescents : A systematic review and meta-analysis. Ciencia & Saude Coletiva, 27, 1827‑1842.
19. Chrara, L., Raoui, R. A., Belkadi, A., Hocine, A., & Benbernou, O. (2018). The impact of caloric restriction on anthropometrical and specific performance in highly-trained judo athletes. Arab Journal of Nutrition and Exercise (AJNE), 3, 105‑118.
20. Christofaro, D. G. D., Tebar, W. R., Mota, J., Delfino, L. D., Santos, A. B., Ritti-Dias, R. M., … Vanderlei, L. C. M. (2024). Association of Sports Practice in Childhood and Adolescence with Cardiac Autonomic Modulation in Adulthood : A Retrospective Epidemiological Study. Sports Medicine - Open, 10, 41.
21. de Rezende, L. F. M., Rodrigues Lopes, M., Rey-López, J. P., Matsudo, V. K. R., & Luiz, O. do C. (2014). Sedentary behavior and health outcomes : An overview of systematic reviews. PloS One, 9, e105620.
22. El-Malahi, O., Mohajeri, D., Mincu, R., Bäuerle, A., Rothenaicher, K., Knuschke, R., … Lortz, J. (2024). Beneficial impacts of physical activity on heart rate variability : A systematic review and meta-analysis. PloS One, 19, e0299793.
23. Engler, M. B., & Engler, M. M. (1995). Assessment of the cardiovascular effects of stress. The Journal of Cardiovascular Nursing, 10, 51‑63.
24. Greenfield, J. R., & Campbell, L. V. (2008). Role of the autonomic nervous system and neuropeptides in the development of obesity in humans : Targets for therapy? Current Pharmaceutical Design, 14, 1815‑1820.
25. Hejazi, K., & Ferrari, F. (2022). Effects of Physical Exercise on Cardiometabolic Biomarkers and Inflammatory Markers in Children : A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biological Research for Nursing, 24, 519‑529.
26. Ilic, M. D., Stojanovic, S., Krstic, I., Ilic, S., & Stojanovic, M. (2024). Relationship between obesity, weight change and long-term blood pressure variability in patients with hypertension. Journal of Hypertension, 42, e228.
27. Ishida, R., & Okada, M. (2001). Analysis of correlation between physical training and autonomic function by using multivariate analysis : Establishing an indicator of health. Rinsho Byori. The Japanese Journal of Clinical Pathology, 49, 1162‑1165.
28. Kim Choun. (2020). Cardiac Autonomic Responses and Adaptation to Repeated Bouts of Eccentric Exercise. Exercise Science, 29, 359‑367.
29. Kim, J., Foo, J. C., Murata, T., & Togo, F. (2024). Reduced heart rate variability is related to fluctuations in psychological stress levels in daily life. Stress and Health: Journal of the International Society for the Investigation of Stress, 40, e3447.
30. Kivimäki, M., & Steptoe, A. (2018). Effects of stress on the development and progression of cardiovascular disease. Nature Reviews. Cardiology, 15, 215‑229.
31. Lee, S.-H., Kim, M. K., & Rhee, E.-J. (2020). Effects of Cardiovascular Risk Factor Variability on Health Outcomes. Endocrinology and Metabolism (Seoul, Korea), 35, 217‑226.
32. Maki, K. A., Goodyke, M. P., Rasmussen, K., & Bronas, U. G. (2024). An Integrative Literature Review of Heart Rate Variability Measures to Determine Autonomic Nervous System Responsiveness Using Pharmacological Manipulation. The Journal of Cardiovascular Nursing, 39, 58‑78.
33. Manar, B., Adel, B., Lalia, C., & Saddak, B. (2023). Investigating the Impact of Physiological and Neuromuscular Performance in Highly Trained Judo Athletes of Different Weight Categories. Slobozhanskyi Herald of Science and Sport, 27, 118‑127.
34. Mohamed, K. S., Mohamed, K., Mohammed, S., Mokrani, D., & Belkadi, A. (2019). The Effect of Heavy Weight Training on Physiological Abilities of Soccer Players Under the Age 21 Years Old. Acta Facultatis Educationis Physicae Universitatis Comenianae, 59, 33‑43.
35. Moore, S. A., McKay, H. A., Macdonald, H., Nettlefold, L., Baxter-Jones, A. D. G., Cameron, N., & Brasher, P. M. A. (2015). Enhancing a Somatic Maturity Prediction Model. Medicine and Science in Sports and Exercise, 47, 1755‑1764.
36. Murakami, Y., Goto, D., Tsukamoto, H., Yamaura, K., & Hashimoto, T. (2025). Heart Rate Variability : A Psychophysiological Factor Related to Both Regular Physical Activity and Eudaimonic Well-Being Among Young Adults. Brain and Behavior, 15, e70284.
37. Nascimento, R. D., Viana, A., Sartori, M., Zaffalon, J. R., Dias, D. da S., Monzani, J. de O. B., … Angelis, K. D. (2019). SEDENTARY LIFESTYLE IN ADOLESCENTS IS ASSOCIATED WITH IMPAIRMENT IN AUTONOMIC CARDIOVASCULAR MODULATION. Revista Brasileira de Medicina Do Esporte, 25, 191‑195.
38. Prado, J. C. do, Guedes, D. P., Dias, P. H. G., Stabelini Neto, A., & Oliveira, R. G. de. (2024). Associations Between Cardiorespiratory Fitness and Metabolic Syndrome in Adolescents : A Systematic Review and Meta-Analysis. Metabolites, 14, 635.
39. Rahmouni, K. (2010). Leptin-Induced Sympathetic Nerve Activation : Signaling Mechanisms and Cardiovascular Consequences in Obesity. Current Hypertension Reviews, 6, 104‑209.
40. Ramamurthy, S., Mj, A., Nalliah, R., & Gollapalli, P. K. (2023). A Descriptive Research of Decreased Heart Rate Variability as a Risk Factor for CardiovascularDisease in Young, Healthy Adults with Low and High BMI Indexes. IAR Journal of Medicine and Surgery Research, 4, 7‑11.
41. Rider, C. D., Kao, J., Hewawitharana, S. C., Becker, C. M., Linares, A., & Woodward-Lopez, G. (2022). Validity and Reliability of a Site-Level Assessment Questionnaire to Assess Nutrition and Physical Activity Practices in Schools. Childhood Obesity (Print), 18, 383‑398.
42. Sandercock, G. R. H., Hardy-Shepherd, D., Nunan, D., & Brodie, D. (2008). The relationships between self-assessed habitual physical activity and non-invasive measures of cardiac autonomic modulation in young healthy volunteers. Journal of Sports Sciences, 26, 1171‑1177.
43. Santos-Magalhaes, A. F., Aires, L., Martins, C., Silva, G., Teixeira, A. M., Mota, J., & Rama, L. (2015). Heart rate variability, adiposity, and physical activity in prepubescent children. Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society, 25, 169‑178.
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Adel, B., Asli, H., Cherara, L., Benhammou, S., Djemal, M., & Sebbane, M. (2025). INVESTIGATING THE RELATIONSHIP BETWEEN CARDIAC AUTONOMIC MODULATION AND RESTING HEART RATE IN YOUTH ACROSS PHYSICAL ACTIVITY LEVELS. Physical Education and Sport Through The Centuries, 12(1), 17–31. Retrieved from https://phedss.fsfv-pr.rs/index.php/phedss/article/view/26
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