There are many studies in the literature on transcutaneous vagus nerve stimulation (VNS) and controlled breathing exercises (CBE), but there are limited studies examining the effects of both interventions on performance and the autonomic nervous system. The investigators aim to contribute to the literature by examining the effects of VNS and CBE on performance and the autonomic nervous system in moderately physically active individuals and their superiority over each other.
The sympathetic and parasympathetic divisions of the autonomic nervous system affect the function of many organs, glands, and involuntary muscles in the body. The sympathetic and parasympathetic nervous systems often play opposing roles in the body, one is suppressed when the other increases activity. With the beginning of exercise or sports activity, sympathetic activity in the body increases and after a certain period reaches a plateau value at maximum activity. With the end of sports activity, the suppressed parasympathetic activity increases, and the sympathetic system returns to its resting state over time. Low sympathetic activity and/or high parasympathetic activity and low heart rate before training or exercise can be considered as performance indicators. It also indicates that recovery from the previous training or exercise is adequate. Parasympathetic system activation continues for up to 48 hours after exercise. If the exercise is intense and persistent, parasympathetic system activity can last up to 72 hours. In addition, due to the increase in anaerobic respiratory rate during exercise, there may be decreases in parasympathetic reactivation. Transcutaneous vagus nerve stimulation (VNS) can affect cardiovascular parameters both at rest and during exercise. VNS improves autonomic modulation and positively reduces pain and fatigue associated with cycling exercise. On the other hand, VNS is particularly useful in reducing pain and fatigue during and after competition. Slow breathing modulates the activity of the vagus nerve. Controlled breathing exercises (CBE) directly affect the respiratory rate, which can lead to faster physiological and psychological calming effects by increasing vagal tone during slow expiration. CBE increase heart rate variability in healthy participants. The investigators aim to contribute to the literature by examining the effects of VNS and CBE on performance and the autonomic nervous system in moderately physically active individuals and their superiority over each other.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
64
In the study, CE certified vagus nerve stimulation device Vagustim will be used. Transcutaneous auricular vagus nerve stimulation will be applied bilaterally. The stimulation pulse width is 300 microseconds, frequency is 10 Hz and will be applied biphasically for 20 minutes.
A controlled breathing exercise group will continue for a total of 2 weeks and will receive 10 sessions of 20 minutes per day. The thoracic expansion exercise will be performed in 10 repetitions. In each intervention session, 2 sets of nadi shodhana pranayama consisting of 8 respiratory cycles will be applied to the patients, with a 2-minute rest period between the sets. Kapalabhati will be practised for 3 minutes, with 15 quick breaths in 10 seconds followed by a 20-second break (a total of 30 breaths per minute). In each session, 2 sets of bhramari pranayama consisting of 10 breathing cycles will be performed at a low respiratory rate, with a 1-minute rest period between sets. The physiological sigh exercise involves the first inspiration phase being 1 second, the second phase 0.25 seconds, and the exhalation 2 seconds for 3 minutes.
Bahçesehir University
Istanbul, Istanbul, Turkey (Türkiye)
Performance
Individuals will be taken to the treadmill and the distance and time taken until the maximum heart rate value reaches 80% will be recorded. The maximum heart rate value will be determined for each individual according to the formula 220-age. The participants will walk at a speed of 2 km/h for 1 minute, at a speed of 4 km/h for 1 minute and at a speed of 6 km/h, and the distance and time taken until the maximum heart rate reaches 80% will be recorded. In the termination phase of the run, a walk will be performed at a speed of 4 km/h for 1 minute and a speed of 2 km/h for 1 minute and will be completed.
Time frame: Baseline and 2 weeks.
Autonomic nervous system
Heart rate change will be evaluated for the evaluation of the autonomic nervous system. Polar H9 heart rate sensor chest strap and wristwatch will be used to measure analytical heart rate change. During the assessment, the participant will be seated in a chair and the Polar system chest strap will be placed just above the sternum, and ultrasound gel will be used to increase the sensor's conductivity. This method is valid with an electrocardiogram. Heart rate variability parameters such as RMSSD, LF, and HF will be measured.
Time frame: Baseline and 2 weeks.
International Physical Activity Questionnaire
International Physical Activity Questionnaire is used to determine the activity levels of individuals. IPAQ Short Form, consisting of seven questions, provides information on the time spent walking, moderate-intensity and vigorous-intensity activities, and the time spent sitting. The calculation of the total score of the short form includes the sum of the duration (minutes) and frequency (days) of walking, moderate-intensity and vigorous-intensity activities.
Time frame: Baseline
Modified Borg Scale
Developed by Gunnar Borg, this scale includes values from 1 to 10 and difficulty statements written next to some of these values. This scale, used to determine the intensity of exercises and training, is a subjective method in which individuals determine the difficulty level of the exercise and training themselves.
Time frame: Baseline and 2 weeks.
Perceived Stress Scale
It is used to determine the stress level of individuals. The scale consists of 10 items in total. The items of the scale are answered using a 5-point Likert scale ranging from 0 (never) to 4 (very often). The total score varies between 0-40. It is concluded that as the score obtained from the scale increases, the perceived stress increases.
Time frame: Baseline and 2 weeks.
Blood Pressure Measurement
Blood pressure measurement will be done using an Omron brand digital wrist type blood pressure monitor. Before taking the measurement, individuals will be asked to rest for at least 5 minutes to ensure that they are relaxed for accurate measurement.
Time frame: Baseline and 2 weeks.
Pulse
Pulse measurement will be done with a finger-type Pulse oximeter device.
Time frame: Baseline and 2 weeks.
Oxygen Saturation
Pulse oximetry is a noninvasive, painless and reliable method used to measure oxygen saturation (SpO2) in arterial blood. Oxygen saturation measurement will be done with a finger-type pulse oximetry device.
Time frame: Baseline and 2 weeks.
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