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A systematic Review on nature´s impact on the Autonomic Nervous System measured by Heart Rate Variability
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Background: Urbanization accelerates, meantime little is known about the importance for humans to live in natural environments. The relation between nature and mental health has been studied and documented. Theories derive from environmental psychology, now researchers seek a physiological explanation; evidence documenting why and how nature impact human health, prerequisite nature-interventions being implemented efficiently in public health work and policies. The autonomic nervous system (ANS) has been suggested as the physiological explanation, specifically the Parasympathetic nervous system (PNS).
Objective: To explore if ANS can explain the relationship between nature and human health by mapping the knowledge obtained in studies using Heart Rate Variability (HRV) to measure human reaction to nature.
Methods : A systematic review of articles published in the last 5 years, using PsycINFO, Global health, Embase, PubMed Medline, Amed, CINAHL and Web of science. Additionally, a search though most cited key articles, followed by snowballing and contact to experts and lastly alerts on databases. The PICO method was used to select studies; Healthy adults, nature, control and HRV-parameters. Eight RCT studies (n=3125) were eligible for inclusion, a Narrative Synthesis was conducted.
Results: All studies found at least one significant outcome, documenting the association between nature and ANS by reactions from PNS or the Sympathetic Nervous System (SNS) or both. Real nature could be superseded by virtual nature environments. Several moderators of different categories were indentified: Duration of exposure, exercise, and ANS activity prior to exposure, stress induction, type of nature, senses exposed, personality, preferences and believes. Impact from respiration was unclear.
Discussion: The results were based on RCT´s, as cross-over trails. Limitations were; incorrect analyses, lack of blinding of outcome assessments, heterogeneity in the use of HRV-parameters, uncertainties in the interpretation of ANS activity based on HRV. Furthermore lack of possibilities to evaluate practical significance and determine cross-over effects. However enough strong evidence to state; ANS could explain nature’s impact on human health, without mutually excluding other explanations. Substantiating further research to reveal the precise influence from the moderators, develop ideal analyze methods and valid HRV-parameters. Meantime the researcher must be aware if they steer to develop an artificial substitute for nature or creation of the most efficiently real nature to initiate health benefits.
Conclusion: A convincing conclusion was the increase in the PNS initiated by viewing nature compared to build environment, documenting the suggested physiological explanation. ANS and nature challenge science to cooperate across disciplines, as more knowledge on ANS is essential, sophisticated analyze methods required and insights to environmental possibilities. This thesis gave documentation to use nature to improve health, prevent disease and identifies the complexity of investigating nature and ANS, meantime the potential to develop nature as evidence based medicine.
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... HRV har vaeret brugt til måling af naturens påvirkning af ANS, hvorved det kan dokumenteres, at naturen påvirker menneskets ANS i en sundhedsfremmende retning, fordi kroppens restitution øges (38)(39)(40). HRV er i de fleste studier et statusmål (41). ...
Der er brug for ny viden fra feltet mellem de naturvidenskabelige og de humanistiske videns felter i arbejdet med unges sundhed og trivsel. Den viden skal skabes i samarbejde med de aktører der udmønter indsatsen. Derfor har UC Syd samarbejdet med en kommune, som er pioner i opstart af naturinterventioner for unge uden beskæftigelse. Og undersøgt anvendelsen af borgernær teknologi.
Den anvendte borgernære teknologi var kropsbårne smartband til monitorering af hjerterytmevariabilitet (HRV), samtidig blev der målt på subjektiv oplevet resiliens. Der blev registreret data fra én deltager, svarerende til 7810 HRV-målinger og to interviews. Derudover er der mangelfulde data, samt observationer fra to perioder med naturinterventioner, fra i alt 10 deltagere.
Data viste at naturinterventionen resulterede i forbedret HRV og øgede deltagerens resiliens.
Anvendelse af kropsbåret monitoreringsudstyr, igangsat gennem et samarbejde mellem professionshøjskolerne og de aktører der udmønter indsatsen, f.eks. kommunen, bidrager til udvikling af evidensbaseret praksis, idet borgerens perspektiv og tværprofessionel professionsudøvelse implementeres i forskningen. Professionshøjskolerne skal bidrage med analyse af datakilderne og sikre, at data er anvendeligt til det formål, som aktørerne har planlagt og professionsudøverene skal vurdere, hvilke borgere, der kan få gavn af indsatsen. Borgernær teknologi giver mulighed for at undersøge, hvilke pædagogiske indsatser, der gennem skabelse af ressourcer og handlekompetencer, resulterer i målbare fysiologiske ændringer, som øger sundhed og trivsel, samt minimere risici for sygdom.
Fremtidig forskning skal afklare om kropsbåret monitoreringsudstyr til indsamling af HRV-data også er anvendeligt som biofeedback og borgerinddragelse. Samt undersøge, hvordan data skal analyseres i forhold til individ, døgnrytme og dynamiske ændringer.
... Nature intervention studies using HRV as an outcome documented that views, smell, physical activity or longer stays in nature increases HRV (Lee et al., 2011;Neuberg, 2014). ...
Background: There is a need to investigate the potentials of wearables as data collectors. Wearables make it possible to monitor a study population in their 24-hour rhythm outside the laboratory and wearables can monitor the autonomic nervous system (ANS). As scientific arguments target ANS to provide new explanations to the ethology behind Noncommunicable diseases (NCDs), research seeking new knowledge on the dynamics of ANS, could give new perspectives on solving the burden of NCDs. Heart rate variability (HRV) reflects ANS, but little is known about continuously HRV data collection.
Purpose: Making scientific argumentation for the relevance of measuring the dynamics of ANS. And performing a pioneer pilot study, to investigate if it is possible to collect robust data from the SONY SMART BAND SWR12 (a wearable smart band connected to the Lifelog app) in an amount large enough to analyze the dynamics of ANS
Result: It is possible to gather enough robust data. Correct use and setting of the cellphone connected to the smart band is crucial. There are several cautions to take, for future researchers, in terms of data registration relevant for the analyzes of the HRV data. Also, activity logbook is relevant.
Conclusion: Even with robust data ready to analyze the dynamics of ANS, there are many decisions to be made for the researcher, as there is no agreed definition on improved dynamics of ANS or knowledge on normal dynamics of ANS measured by HRV in healthy people.
... El Sistema Nervioso Simpático (SNS) interviene en la movilización de recursos del organismo, y garantiza la adaptación a diferentes niveles de estrés. Por su parte, el Sistema Nervioso Parasimpático (SNP) regula la relajación y recuperación de las fuentes de energía consumidas, y predomina en condiciones de reposo fisiológico (Neuberg, 2014). ...
Heart Rate Variability (HRV) analysis is a bloodless method to study the regulation of the heartbeats. However, although it has potential for various clinical and research applications, the physiological meaning of many indices that characterize variations in heart rhythm remains unclear. The aim of this research is the HRV analysis in different physiological conditions, to achieve an approach to the interpretation of its indices. Five-minute electrocardiographic recordings were made to healthy individuals in four physiological conditions: supine position, seated position, during the isometric grip maneuver and standing position. The relationship between heart rate (HR) and HRV indices was explored. In addition, the differences between the physiological conditions for traditional and novel global, medium-term and beat-to-beat HRV indices were analyzed. Short-term HRV indices confirm that parasympathetic activity does not vary significantly between study conditions. Global HRV indices increased significantly with the increase in sympathetic activity, being SD and CV the best markers of cardiac sympathetic modulation. CV was the only HRV index that is not affected by HR. The novel indices were grouped according to the HRV temporal dimension showed by them.
... (DONG, 2016) It has been clearly shown that HRV provides reliable information on the ANS function also in healthy people, believed to be a reliable tool capable of investigating SNS and PNS modulation (Gibbins, 2013). HRV has been used as biomarker for natures impact on the human body, showing a positive effect on the human body, when exposed to nature (Neuberg, 2014;van den Berg et al., 2015;Yu et al., 2017). ...
The causal physiological explanation between nature and health is not yet successfully documented but explored in numerous studies. There could be inspiration to find in the scientific pathway going from epidemiology correlating sedentary lifestyles and health, to fundamental research discovering myokines, classifying muscles as secretory organs, renewing our understanding of the bodily functions and explaining why physical activity is essential for humans and why lack of activity rises the risk of developing Non-Communicable Diseases (NCD)(Pedersen, 2013). Following the scientific pathway going from epidemiology correlating sedentary lifestyles and health, the correlation to investigate here is urbanization and health. Exploring the physiological mechanism, essential to health maintenance in the human body, eliminated by development (urbanization).
... (DONG, 2016) It has been clearly shown that HRV provides reliable information on the ANS function also in healthy people, believed to be a reliable tool capable of investigating SNS and PNS modulation (Gibbins, 2013). HRV has been used as biomarker for natures impact on the human body, showing a positive effect on the human body, when exposed to nature (Neuberg, 2014;van den Berg et al., 2015;Yu et al., 2017). ...
The causal physiological explanation between nature and health is not yet successfully documented but explored in numerous studies. When comparing to the scientific pathway going from epidemiology correlating sedentary lifestyles and health, to fundamental research discovering myokines, classifying muscles as secretory organs, renewing our understanding of the bodily functions and explaining why physical activity is essential for humans and why lack of activity rises the risk of developing Non-Communicable Diseases (NCD)(Pedersen, 2013). Following the scientific pathway going from epidemiology correlating sedentary lifestyles and health, the correlation to investigate here is urbanization and health. Exploring the physiological mechanism, essential to health maintenance in the human body, eliminated by development (urbanization). Again, comparing to elimination of physical activity, we Seek knowledge on how the bodily functions are connected to nature exposure, as nature is the determinant eliminated.
The studies of human and environment interactions usually consider the extremes of environment on individuals or how humans affect the environment. It is well known that physical activity improves both physiological and psychological well-being, but further evidence is required to ascertain how different environments influence and shape health. This review considers the declining levels of physical activity, particularly in the Western world, and how the environment may help motivate and facilitate physical activity. It also addresses the additional physiological and mental health benefits that appear to occur when exercise is performed in an outdoor environment. However, people's connectedness to nature appears to be changing and this has important implications as to how humans are now interacting with nature. Barriers exist, and it is important that these are considered when discussing how to make exercise in the outdoors accessible and beneficial for all. The synergistic combination of exercise and exposure to nature and thus the 'great outdoors' could be used as a powerful tool to help fight the growing incidence of both physical inactivity and non-communicable disease.
Traffic-related air pollution and noise are associated with cardiovascular diseases, and alternation of heart rate variability (HRV), which reflects cardiac autonomic function, is one of the mechanisms. However, few studies considered the impacts of noise when exploring associations between air pollution and HRV. We explored whether noise modifies associations between short-term exposure to traffic-related air pollution and HRV in young healthy adults. In this randomized, crossover study, 40 young healthy adults stayed for 2 h in a traffic center and, on a separate occasion, in a park. Personal exposure to traffic-related air pollutants and noise were measured and ambulatory electrocardiogram was performed. Effects were estimated using mixed-effects regression models. Traffic-related air pollution and noise were both associated with HRV, and effects of air pollutants were amplified at high noise level (>65.6 A-weighted decibels (dB[A])) compared with low noise level (≤65.6 dB[A]). High frequency (HF) decreased by -4.61% (95% confidence interval, -6.75% to-2.42%) per 10 μg/m(3) increment in fine particle (PM2.5) at 5-min moving average, but effects became insignificant at low noise level (P>0.05). Similar effects modification was observed for black carbon (BC) and carbon monoxide (CO). We conclude that noise is an important factor influencing the effects of air pollution on HRV.Journal of Exposure Science and Environmental Epidemiology advance online publication, 17 April 2013; doi:10.1038/jes.2013.21.
The neural regulation of cardiac function is mainly determined, on its efferent side, by the interaction of sympathetic and vagal mechanisms. In most physiological conditions, the activation of either the sympathetic or vagal outflow is accompanied by the inhibition of the other suggesting the concept of sympatho-vagal balance as a horizontal beam pivoted at its center. This reciprocal organization, alluding to a synergistic design, seems instrumental to the fact that sympathetic excitation and simultaneous vagal inhibition, or vice versa, are both presumed to contribute to the increase or decrease in cardiac performance required for the various behaviors. The balance oscillates from states of quiescence, when homeostatic negative feedback reflexes predominate, to states of excitation, such as those due to emotion or physical exercise. However, this neural activity is not limited to peripheral regulation but it is able to deeply modify cortical circuitry related to stress responses and sleep homeostasis, as well as the immune system. As described in this chapter, the assessment of sympatho-vagal balance is a useful noninvasive tool to infer information about the state of the autonomic nervous system modulating the viscera and stress coping systems. © 2012 Springer-Verlag Berlin Heidelberg. All rights are reserved.
The heart is dually innervated by both the sympathetic and parasympathetic nervous systems. However, parasympathetic influences dominate control of heart rate. Heart rate variability is associated with mortality and morbidity as well as physiological, affective, and cognitive regulation. A model of neurovisceral integration is described that summarizes the relationship between the central nervous system and cardiac activity as indexed by heart rate variability. Forebrain structures are important in the regulation of cardiac function and its relationship to self-regulation. This article is intended to introduce neuroscientists to this important relationship between the brain and the heart.
Over the last few decades, considerable evolutions were made in the diagnosis of cardiovascular diseases. Interpretive electrocardiography is one of the areas where the progress has been significant. This involves digital recording of cardiac signals at the body surface and subsequentcomputerized analysis. An important outcome of such analysis is heart rate variability (HRV), which is widely accepted to have prognostic significance in patients with cardiovascular diseases especially after acute myocardial infarction. This is because HRV represents one of the most helpfulmarkers of autonomic balance and hence can predict the tendency to develop fatal arrhythmias. Recently, interest has grown in relating some diseases to abnormal autonomic nervous system (ANS) activity based on HRV studies, for example: hypertension, bronchial asthma, diabetes mellitus, irritable bowel syndrome, anxiety and so many other diseases. This actually reflects the vital role of the autonomic nervous system in maintaining health. Unfortunately, HRV is of little practice, if ever, by Sudanese doctors. Therefore, this review is intended to update the physiological basis, determinants, common ways of measurements and some important clinical uses of HRV.
Kubios HRV is an advanced and easy to use software for heart rate variability (HRV) analysis. The software supports several input data formats for electrocardiogram (ECG) data and beat-to-beat RR interval data. It includes an adaptive QRS detection algorithm and tools for artifact correction, trend removal and analysis sample selection. The software computes all the commonly used time-domain and frequency-domain HRV parameters and several nonlinear parameters. There are several adjustable analysis settings through which the analysis methods can be optimized for different data. The ECG derived respiratory frequency is also computed, which is important for reliable interpretation of the analysis results. The analysis results can be saved as an ASCII text file (easy to import into MS Excel or SPSS), Matlab MAT-file, or as a PDF report. The software is easy to use through its compact graphical user interface. The software is available free of charge for Windows and Linux operating systems at http://kubios.uef.fi.