RU2585237C2 - Method of determining overtraining and/or high level of sports stress in athletes based on assessment of colour spectrum for vegetative regulation of heart rate during night sleep during holter monitoring - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: examination is performed during night sleep. Recording and analysing spectrum of heart rate variability (HRV). At that, trend of high-frequency waves and low-frequency spectrum with HRV is determined, reflecting level of sympathetic and parasympathetic effects on cardiac rhythm. If observing smooth circadian profile, reduction of high-frequency wave spectrum range of less than 0.15 Hz sportsman's state is considered to be overtraining and/or as sports stress. Predominance in spectrum of HRV waves of high-frequency range of more than 0.20 Hz state is considered to be normal.

EFFECT: method enables instant diagnosis and assessing functional state of sportsman under conditions of training process that is ensured by analysing spectrum of HRV at night.

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Description

The invention relates to the field of sports medicine and functional diagnostics, where when conducting Holter monitoring using the Medilog DARWIN 1.11.5, SCHILLER apparatus for young elite athletes, an analysis of the color spectrogram of heart rate variability (HRV) is performed to evaluate the functional state of young athletes, to identify early signs of overtraining and timely adjust the training process.

Studies on the assessment, effectiveness of use and interpretation of the obtained HRV color spectrogram data on the apparatus of Medilog DARWIN 1.11.5, SCHILLER have not been previously conducted in young athletes. The analogues of the invention include the use of this automatic option in Europe among office workers to determine the level of stress resistance, in particular when applying for a job [D. Eller-Berndl. 24 Heart Rate Variability in Clinical Practice. Book of Abstracts 14th Congress of the International Society for Holter and Noninvasive Electrocardiology (ISHNE 2011), 12th Congress of the Russian Society for Holter Monitoring and Noninvasive Electrocardiology (ROHMINE), 26-28 april 2011, page 3; D. Eller-Berndl "Herzratenvariabilität", erschienen im Verlagshaus der Ärzte, Juni 2010]. In the work of V. Makivić et al. [B. Makivić, M. Djordjević Nikić, S. Willis. Heart Rate Variability (HRV) as a Tool for Diagnostic and Monitoring Performance in Sport and Physical Activities. Journal of Exercise Physiology; 2013; 3 (16): 103-131] presents an analysis of 4 biomedical databases (PubMed, MEDLINE, NSCA, ACSM) for assessing HRV in athletes. In this case, the analysis of HRV was carried out during exercise tests (bicycle ergometry, treadmill test) before the load, during exercise and during rest using time (time domain) and spectral (freguence domain) analysis of HRV. These methods are based on the application of statistical processing of RR intervals (time domain) or separation of the processed sample of RR intervals using fast Fourier transform into frequency spectra of different densities (freguence domain), high-frequency extraction from 0.15 to 0.40 Hz (HF - high freguence ) and low-frequency from 0.04 to 0.15 Hz (LH - low freguence) components with subsequent interpretation of the data. Assessment of the functional state of athletes based on analysis of HRV during stress tests requires the athlete to stay at the medical center for a certain time, separation from training and does not exclude the influence of external factors (early awakening, late defective breakfast, etc.), while HRV assessment at Holter monitoring provides complete information about the state of the athlete’s autonomic nervous system, which confirms WL in his work Kenney [W.L. Kenney, R.H. Humphrey, S.X. Bryant et al. ACSM′s guidelines for exercise testing and prescription American College of Sports Medicine. Baltimore, Md Williams & Wilkins 1995]. The authors recommend using HRV assessment precisely during the night's sleep (at least 4 hours from falling asleep) to obtain the most accurate and reliable information about the functional state of athletes. In addition, the use of color spectrograms of HRV during XM allows the team doctor to quickly and clearly assess the functional state of athletes directly in the conditions of the training cycle (at sports bases), identify signs of overtraining in the early stages, and adjust the training process.

The main task to be solved by the claimed invention is directed is the assessment of HRV during Holter monitoring in young athletes based on visual analysis of the color spectrogram of HRV in various phases of the training cycle, the interpretation of the obtained color spectrogram patterns of HRV, for the timely detection of signs of overtraining, correction of the training process and achieving high athletic performance. When conducting 24-hour Holter monitoring (XM) on a Medilog DARWIN 1.11.5, SCHILLER apparatus, along with the standard parameters assessed for XM, a visual analysis of the color trend of the spectral range of heart rate variability was performed, which is a specific original option for this system. On the color spectrogram of heart rate variability (Fig. 1), each individual “color-coded” spectrum is located vertically, the time of registration is indicated on the X axis, and the oscillation frequency on the Y axis. The amplitude of the heart rate variability is “color coded” so that high-frequency waves from 0.15 to 0.40 Hz (HF - high freguence) have a yellow-red color range and reflect the level of parasympathetic effects on the heart rhythm, and low-frequency waves from 0, 04 to 0.15 Hz (LH - low freguence) have a blue color range and reflect the level of sympathetic influences on the heart rhythm. The data of the color spectrogram of HRV were compared with generally accepted indicators of the temporary analysis of HRV. The color spectrogram of a healthy teenager of 16 years is shown in FIG. 2.

Athletes with clinical signs of overtraining (complaints of fatigue, decreased performance), low exercise tolerance (TFN) during exercise tests were performed 24-hour Holter monitoring with HRV analysis.

Based on the analysis of color spectrograms of HRV of young athletes (n = 36) 15-17 years old, 3 patterns of color spectrogram of HRV were identified:

1. Balanced autonomic circadian regulation of the body (increased parasympathetic influences at night with a predominance of high-frequency waves of a yellow-red spectrum of more than 0.20 Hz).

2. Dysfunction of the autonomic nervous system with reduction of parasympathetic effects on the heart rhythm (reduction of high-frequency waves of the yellow-red spectrum less than 0.15 Hz).

3. The smoothness of the circadian profile of the color spectrogram of heart rate variability in the daytime and at night with the absence of high-frequency waves of the yellow-red spectrum is a manifestation of sports vegetopathy due to overtraining and / or sports stress, somatic diseases.

EXAMPLE 1

Ivan, 15 years old. Member of the youth Olympic team of the Russian Federation in swimming. The experience of classes is 7 years, the duration of training is 10-12 hours per week. Over the past 3 weeks he participated in two major competitions, without a rest period, he estimates the results as good (3 and 4 places). Subjective assessment of physical fitness (on a 5-point scale) by 4.0 points. Complaints of fatigue, rapid fatigue, according to bicycle ergometry - low TFN. When assessing the color spectrogram of HRV during XM (Medilog DARWIN apparatus 1.11.5, SCHILLER), a decrease in the high-frequency waves of the yellow-red spectrum (less than 0.15 Hz) was observed during night sleep, indicating a reduction of parasympathetic effects on heart rhythm (Fig. 3A ) The results were compared with generally accepted HRV indices, reflecting the level of parasympathetic effects on the heart rhythm (parameters pNN50). According to a temporary analysis of HRV, a decrease in parasympathetic effects on the heart rhythm was also noted: pNN50 = 9.2% with a norm of 28.7 ± 6.3% [Makarov L.M. Holter monitoring (3rd edition) // M .: Medpraktika-M, 2011 - 456 p.].

The athlete was withdrawn from sports for 1 week, after which Holter monitoring was repeated and the HRV color spectrogram was evaluated (Fig. 3B), while normalization of the autonomic regulation of sleep was noted: high-frequency waves of the yellow-red spectrum prevailed (more than 0.20 Hz) , which indicates an increase in parasympathetic influences on the rhythm of the heart during sleep (marked by a red arrow). According to a temporary analysis of HRV, an increase in parasympathetic effects on the heart rhythm during sleep was also noted: pNN50 = 43% (normal 28.7 ± 6.3%) [Makarov L.M. Holter monitoring (3rd edition) // M .: Medpraktika-M, 2011 - 456 p.].

EXAMPLE 2

Maxim, 16 years old. Member of the youth Olympic team of the Russian Federation on football. The experience of classes is 9 years, the duration of training is 12-14 hours a week. Subjective assessment of physical fitness (on a 5-point scale) by 3.0 points. He was stressed after the team lost an important game. Complaints of decreased performance, according to bicycle ergometry - low TFN. When conducting XM (apparatus Medilog DARWIN 1.11.5, SCHILLER), a decrease in parasympathetic effects on the heart rhythm was noted both according to the color spectrogram of HRV (reduction of high-frequency vibrations of the yellow-red spectrum less than 0.15 Hz, Fig. 4A), and according to temporary analysis of HRV: pNN50 = 11.8% with a norm of 29.7 ± 6.3% [Makarov L.M. Holter monitoring (3rd edition) // M .: Medpraktika-M, 2011 - 456 p.].

The correction of the training process (reduction of loads), work with a psychologist was carried out. After 2 weeks, Holter monitoring was carried out again, when assessing HRV, balanced circadian regulation of the body was recorded with an increase in parasympathetic effects on heart rhythm during sleep according to the color spectrogram of HRV (increase in high-frequency vibrations of the yellow-red spectrum over 0.20 Hz, Fig. 4B) and temporary analysis of HRV: pNN50 = 51.2% (norm 29.7 ± 6.3%) [Makarov L.M. Holter monitoring (3rd edition) // M .: Medpraktika-M, 2011 - 456 s].

EXAMPLE 3

Denis, 17 years old. Member of the youth Olympic team of the Russian Federation in rowing. The experience of classes is 10 years, the duration of training is 10-12 hours per week. Subjective assessment of physical fitness (on a 5-point scale) by 3.5 points. Complaints of rapid fatigability under exertion. Marks the early start of training (a week later) after an acute respiratory viral infection (ARVI). According to bicycle ergometry - low TFN. When assessing the color spectrogram of HRV (Fig. 5A), there was a smoothing of the circadian differences of HRV with a reduction of parasympathetic effects on the heart rhythm (the absence of high-frequency waves of the yellow-red spectrum during night sleep), the temporal analysis of HRV was also reduced: pNN50 = 5.3% at a rate of 29.7 ± 6.3% [Makarov L.M. Holter monitoring (3rd edition) // M .: Medpraktika-M, 2011 - 456 s].

The athlete was released from sports for 2 weeks. When Holter monitoring was repeated, normalization of the autonomic regulation of sleep was observed with an increase in parasympathetic effects on the heart rhythm according to the color spectrogram of HRV (Fig. 5B) and temporary analysis of HRV: pNN50 = 47.8% (norm 29.7 ± 6.3%) [Makarov L.M. Holter monitoring (3rd edition) // M .: Medpraktika-M, 2011 - 456 p.].

Positive results (early detection of signs of overtraining of pre- and post-competitive stress using color spectrograms of HRV with subsequent correction of the training process and normalization of the state of the autonomic nervous system) were achieved in 100% of young athletes.

Brief Description of the Drawings

In the color spectrogram of heart rate variability (Fig. 1), the amplitude of the heart rate variability is “color coded” so that high-frequency waves from 0.15 to 0.40 Hz (HF - high freguence) have a yellow-red color range and reflect the level of parasympathetic effects on the heart rhythm, and low-frequency waves from 0.04 to 0.15 Hz (LH - low freguence) have a blue color range and reflect the level of sympathetic effects on the heart rhythm. On the spectrogram of a healthy teenager (Fig. 2), the sleep period is marked by an arrow. An increase in high-frequency oscillations (more than 0.20 Hz) of the yellow-red spectrum during sleep is noted, which indicates an increase in parasympathetic effects on the heart rhythm. Color spectrogram of heart rate variability of an athlete - a member of the youth Olympic swimming team (Ivan, 15 years old) after two competitions without a rest period (Fig. 3), the sleep period is marked by an arrow. Autonomic dysfunction of the autonomic nervous system is noted with a reduction of parasympathetic effects on the heart rhythm during sleep (a decrease in the high-frequency waves of the yellow-red spectrum (less than 0.15 Hz)) during night sleep, indicating a reduction in parasympathetic effects on the heart rhythm. Color spectrogram of heart rate variability of an athlete - a member of the youth Olympic swimming team (Ivan, 15 years old) after correction of the training process (weekly rest), FIG. 4, the sleep period is marked by an arrow. There is a balanced circadian regulation of the body with a predominance of high-frequency waves of the yellow-red spectrum (more than 0.20 Hz) during sleep, which indicates an increase in parasympathetic effects on the heart rhythm. Color spectrogram of heart rate variability of an athlete - a member of the youth Olympic football team (Maxim, 16 years old) after the team lost an important game (Fig. 5), the sleep period is marked by an arrow. Autonomic dysfunction of the autonomic nervous system is noted with reduction of parasympathetic effects on the heart rhythm during sleep (a decrease in the high-frequency waves of the yellow-red spectrum of less than 0.15 Hz during night sleep), indicating a reduction in parasympathetic effects on the heart rhythm. Color spectrogram of heart rate variability of an athlete - a member of the youth Olympic football team (Maxim, 16 years old) after the correction of the training process (Fig. 6), the sleep period is marked by an arrow. There is a balanced circadian regulation of the body with a predominance of high-frequency waves of a yellow-red spectrum of more than 0.20 Hz during sleep, which indicates an increase in parasympathetic effects on heart rhythm. Color spectrogram of heart rate variability of an athlete - a member of the youth Olympic team in rowing (Denis, 17 years old) 7 days after the acute respiratory viral infection (Fig. 7). Smoothness of the circadian profile of the HRV color spectrogram in the daytime and at night with the absence of high-frequency waves is noted. The period of sleep (according to the diary of the patient) is indicated by an arrow. Color spectrogram of heart rate variability of an athlete - a member of the youth Olympic team in rowing (Denis, 17 years old) after a period of rest (Fig. 8), the sleep period is marked by an arrow. Balanced circadian regulation of the body with a predominance of high-frequency waves (more than 0.20 Hz) of the yellow-red spectrum during sleep, indicating an increase in parasympathetic effects on heart rhythm.

Claims (1)

A method for assessing the overtraining of athletes and / or sports stress, including analysis of the spectrum of heart rate variability (HRV), characterized in that the study is carried out during the night's sleep, determine the wave trend of the high-frequency and low-frequency range of the HRV spectrum, reflecting the level of sympathetic and parasympathetic effects on heart rhythm , and when the smoothness of the circadian profile is detected, the wave spectrum of the high-frequency range is reduced to less than 0.15 Hz, the athlete’s condition is assessed as overtraining and / or spores active stress, and if the high-frequency range of more than 0.20 Hz prevails in the HRV spectrum, the state is assessed as normal.

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