Today I will review the research I’ve read that investigates the relationship between perceived exertion ratings of a workout session (sRPE), subjective levels of fatigue and HRV in effort to examine the usefulness of HRV in reflecting training load in athletic populations. Like all of my articles, this report is based on my interpretation of the research and perspectives from personal experience.

The Research

In a brand new study from the JSCR, Sartor and colleagues (2013) followed elite male gymnasts (n=6, age 16) over 10 weeks of training. HRV was monitored daily every other week while sRPE was collected immediately following each workout. HRV strongly correlated to previous day sRPE in both supine (HF%, HF%/LF%) and supine to seated measurements (mean RR, mean HR, HF%, SD1). Relationships were also seen between HRV, and perceived wellness (foster’s index). HRV correlated with training load (sRPE) and psychophysiological status.

Though sRPE wasn’t used in this next study, KeTien (2012) monitored HRV, blood-urine nitrogen (BUN) and profile of mood states (POMS) in 24 national level rugby players over an 8 week conditioning program. The program progressed from more aerobic based work to more anaerobic/interval based work. Spectral measures of HRV correlated with both POMS and BUN at each time point throughout the training period.

During the 2006 World Cup, Parrado and colleagues (2010) set out to determine if perceived tiredness could predict cardiac autonomic response to overload in elite field hockey players (n=8).  A strong correlation was found between per­ceived tiredness scores and HRV. Higher levels of perceived tiredness (acquired from questionnaire) were related to lower values of parasympathetic tone (RMSSD), pNN50 and higher LF/HF ratio. In order to discern changes in HRV brought on by fatigue from changes in HRV caused by pre-competitive anxiety, the researchers had the athletes complete anxiety questionnaires.

“Results show that cognitive anxiety and self-confidence sub­scales of the CSAI–2 were not related to perceived tiredness nor to heart rate variability. In the absence of a relation between cognitive anxiety and heart rate variability, it can be assumed that the relationship established between heart rate variability indexes and perceived tiredness scores are attributable to the fatigue state.”

Accounting for pre-game anxiety is very important as previous research has shown this to affect HRV (Edmonds et al. 2012, Mateo et al. 2012, Murray et al. 2008), thus making it difficult to distinguish fatigue from acute anxiety on the morning of a competition.

Edmonds et al. (2012) found that HRV (HF) correlated with sRPE in youth rugby players (n=9) during a one week microcycle of practices and a game. However, game day HRV values were lower which was attributed to the aforementioned pre-game anxiety since training loads were reduced before the competition.

Smith and Hopkins (2011) monitored performance, HRV, sRPE and subjective fatigue in elite rowers (n=10) throughout an intense 4 week training period. Interestingly, the most improved athlete and the only overtrained athlete both had statistically similar levels of perceived fatigue and changes in LF/HF ratio. However, after looking closely at the data, RMSSD showed a noticeable decline in the OT athlete compared to the most improved who had a moderate increase in RMSSD. The determining factor however in this case was performance changes.

Thiel at al. (2012) found that in 3 elite male tennis players, HRV, serum urea and psycho-physical state (assessed by EBF-52 questionnaire) each responded to overload training. As training load increased, HRV (RMSSD) decreased, perceived fatigue increased and serum urea increased. However, performance increased (V02 max, Single Leg CMJ, DJ index) and therefore performance metrics should always be considered when trying to discern functional overreaching (FOR) from non-functional overreaching (NFOR). HRV changes act as an early warning sign while performance decrements may represent the initial transition from FOR to NFOR.

Cipryan et al (2007) found that HRV correlated to performance in hockey players (age 17, n=4) but did not correlate to self-reported health status. Therefore, coaches should use caution when using perceived stress to predict ANS status and thus an objective measure (like HRV) is still recommended.

In elite female wrestlers, perceived stress (in the form of; excessive competition schedule, social, education, occupational, economical, travel, nutritional, etc) contributed to NFOR when HRV parameters were significantly increased (Tian et al. 2012). There was no mention of perceived stress/recovery in the NFOR group with significant decreases in HRV parameters. Regardless, subjective measures of stress including non-training related events require consideration when planning training. Monitoring the global stress of an athlete is more meaningful then simply training load.

Plews et al. (2012) monitored HRV and perceived measures of recovery (sleep, soreness, etc.) in two elite triathletes over a 77 day period leading up to competition. One athlete was considered NFOR. Perceived levels of recovery were not associated with HRV. However, the NFOR athlete admitted that she felt deterred from  reporting  low scores as anything below a certain score would be automatically sent to the coach. Therefore, when relying on perceptual measures from athletes, coaches must be prudent in ensuring honest reports. HRV was a better indicator of fatigue in this study.

The last study I’d like to mention only appears to be available in German at the moment. I translated the paper with google, however it was very rough to say the least. Therefore I will simply quote the pertinent information from the abstract:

“6 endurance athletes measured morning heart rate, heart rate variability (HRV) and mood state during a normal training period, a 17 day ultrarace (Deutschlandlauf) and following a recovery period. 4 out of 6 runners could not finish the race due to injury or exhaustion. 3 of them showed diagnostically relevant criteria of overreaching. All runners who quit the race showed increased morning heart rate, decreased HRV and a decreased mood state during competition. The studied parameters showed individually different adaptations but there were early changes that preceded the abortion of the run that gave diagnostically relevant information.” (Bossmann 2012)

Thoughts

Though there appears to be a strong tendency for HRV to reflect perceived training load and subjective fatigue, an objective measure of ANS status should still be considered. Subjective measures from athletes are only meaningful if honestly reported.

I’ve personally seen a strong correlation between morning HRV score and session rating of perceived exertion (sRPE) of the previous day’s workout. However, I’ve learned that this relationship isn’t perfect. I’ve experienced situations where;

–          Perceived exertion may be high but HRV response may be minimal if the workout is familiar (exercise selection, order, intensity, etc.).

–          In direct contrast to the above, perceived exertion may be moderate but HRV response may be significant if the workout is unfamiliar.

–          Non-training related factors affect HRV. Sleep, aerobic fitness, mental stress, nutrition, etc. can all impact ANS activity, possibly obscuring the relationship between training load and HRV.

–          Stress from travel, illness, occupation, etc. may have a larger impact on ANS than is perceived and reported.

–          More on other factors effecting HRV here.

In conclusion, obtaining both objective and subjective measures of fatigue along with performance indicators will provide a more accurate indication of training status. Monitoring of these variables regularly should enable the coach to better manipulate training loads to ensure progression and avoid unintentional overreaching.

References

Bossman, T. (2012) Effects of ultra-long-distance running on selected physiological and psychological parameters as a possible marker of overloading. Swiss Journal of Sports Medicine, 60(1): 21-5. Full Text

Cipryan, L., Stejskal, P., Bartakova, O., Botek, M., Cipryanova, H., Jakubec, A., Petr, M., & Řehova, I. (2007)  Autonomic nervous system observation through the use of spectral analysis of heart rate variability in ice hockey players.  Acta Universitatis Palackianae Olomucensis. Gymnica, 37(4): 17-21. Free Full-Text

Edmonds, RC., Sinclair, WH., and Leicht, AS. (2012) The effect of weekly training and a game on heart rate variability in elite youth Rugby League players. Proceedings of the 5th Exercise & Sports Science Australia Conference and 7th Sports Dietitians Australia Update. Research to Practice  Abstract

Ke-Tien, Y.(2012) Effects of Cardiovascular Endurance Training Periodization on Aerobic performance and Stress Modulation in Rugby Athletes. Life Science Journal, 9(2): 1218-25. Full-Text

Mateo, M. et al. (2012) Heart rate variability and pre-competitive anxiety in BMX discipline. European Journal of Applied Physiology, 112(1): 113-23.

Murray, N. P. et al. (2008) Heart rate variability as an indicator of pre-competitive arousal. International Journal of Sport Psychology, 39: 346-355.

Plews, DJ., Laursen, PB., Kilding & Buchheit, M. (2012) Heart rate variability in elite triathletes, is variation in variability the key to effective training? A case comparison. European Journal of Applied Physiology, 112(11): 3729-41.

Parrado, E.  et al. (2010)Perceived tiredness and HRV in relation to overload during a field hockey world cup. Perceptual and Motor Skills, 110(3): 699-713 Abstract

Sartor, F. et al. (2013) Heart rate variability reflects training load and psychophysiological status in young elite gymnasts. Journal of Strength & Conditioning Research, Published ahead of print.

Smith, T.B., & Hopkins, WG. (2011) Heart rate variability and psychological stress in an elite female rower who developed over-training syndrome. New Zealand Journal of Sports Medicine, 38(1): 18-20.

Thiel, C. et al. (2012) Functional overreaching in preparation training of elite tennis professionals. Journal of Human Kinetics, DOI: 10.2478/v10078-011-0025-x

Tian, Y., He, ZH., Zhao, JX., Tao, DL., Xu, KY., Earnest, CP. & McNaughton, LR. (2012) Heart rate variability threshold values for early-warning non-functional overreaching in elite women wrestlers. Journal of Strength & Conditioning Research, Published ahead of print