Efecto del ejercicio en la variabilidad de la frecuencia cardíaca
Palabras clave:
variabilidad de la frecuencia cardiaca, ejercicio, rehabilitación, enfermedad cardiovascular, insuficiencia cardiaca congestivaResumen
La disfunción autonómica juega un papel primordial en la fisiopatología de la enfermedad isquémica coronaria, y el análisis de la variabilidad de la frecuencia cardíaca es un método no invasivo y reproducible para realizar una evaluación cuantitativa de la regulación autonómica cardíaca. El ejercicio regular logra mejorar la actividad vagal tanto en sujetos sanos como en pacientes con infarto agudo del miocardio y en diferentes estadios de la insuficiencia cardíaca congestiva. El papel esencial del entrenamiento físico no solo está en un mejor balance autonómico sino también en el gasto cardíaco durante la realización de la actividad física así como en la disminución de la mortalidad y la presencia de muerte súbita.
Referencias bibliográficas
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2. Huikuri HV, Makikallio TH. Heart rate variability in ischemic heart disease. Auton Neurosci. 2001;90:95–101.
3. Quintana M, Storck N, Lindblad LE, et al. Heart rate variability as a means of assessing prognosis after acute myocardial infarction: a 3-year follow-up study. Eur Heart J. 1997;18:789 –797.
4. Forslund L, Bjo¨rkander I, Ericson M, et al. Prognostic implications of autonomic function assessed by analyses of catecholamines and heart rate variability in stable angina pectoris. Heart. 2002;87:415–422.
5. Iellamo F, Legramante JM, Massaro M, et al. Effects of a residential exercise training on baroreflex sensitivity and heart rate variability in patients with coronary artery disease: a randomized, controlled study. Circulation 2000;102:2588–2592.
6. Kanadasi M, Kudaiberdieva G, Birand A. Effect of the final coronary arterial diameter after coronary angioplasty on heart rate variability responses. Ann Noninvasive Electrocardiol. 2002;7:106 –113.
7. Wennerblom B, Lurje L, Solem J, et al. Reduced heart rate variability in ischemic heart disease is only partially caused by ischemia: an HRV study before and after PTCA. Cardiology 2000;94:146 –151.
8. Tygesen H, Wettervik C, Wennerblom B. Intensive home-based exercise training in cardiac rehabilitation increases exercise capacity and heart rate variability. Int J Cardiol. 2001;79:175–182.
9. Hull SS Jr, Vanoli E, Adamson PB, et al. Exercise training confers anticipatory acute myocardial ischemia. Circulation. 1994;89:548 –552. Okazaki K, Iwasaki
10. K, Prasad A, Palmer MD, Martini ER, Fu Q, Arbab-Zadeh A, Zhang R, Levine BD. Dose-response relationship of endurance training for autonomic circulatory control in healthy seniors. J Appl Physiol 2005; 99: 1041–1049.
11. Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises. I. Aging arteries: a “set up” for vascular disease. Circulation, 2003; 107: 139–146.
12. Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, and Ray CA. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc 2004; 36: 533–553.
13. Monahan KD, Tanaka H, Dinenno FA, and Seals DR. Central arterial compliance is associated with age- and habitual exerciserelated differences in cardiovagal baroreflex sensitivity. Circulation 2001; 104: 1627–1632.
14. Lehrer P, Vaschillo E. The future of Heart Rate Variability Biofeedback. Biofeedback. 2008;36: 11-17.
15. Gademan MG, Swence CA, Verwey HF, van der laarse A, Mann AC, van de Vooren H, van Pelt J, van Exel HJ, Lucas CM, Cleuren GV, Somer S, Schalij MJ, van der Wall EE. Effect of exercise training on automatic deragement and Neurohumoral activation in chronic heart failure. J Card Fail. 2007;13(4):294-303.
16. Lee CM, Ellis D, Daprile DM. Cardiac autonomic modulation following highintensity static muscle contractions. Am J Med Sci. 2006;332(1):6-12.
17. Ebben WP, Leigh DH. The effects of resistance training on cardiovascular patients. Strength Cond J 2006; 28: 54–58.
18. Simos R, Mendes R, Castello V, Machado H, Almeida L, Baldissera V, Catai A, Arena R, Borghi-Silva A. Heart-rate variability and blood-lactate threshold interaction during progressive resistance exercise in healthy older men. Strength Cond J 2010 ; 24 (5): 1313-1320
19. Ehlke, K and Greenwood, M. Resistance exercise for postmyocardial infarction patients: current guidelines and future considerations. Strength Cond J 2007;28: 56–62.
20. Jeremy, L and Spencer,MS. Resistance training in outpatient cardiac rehabilitation. Strength Cond J 2007; 29: 18–23.
21. Turker Y, Ozaydin M, Yucel H. Heart rate variability and heart rate recovery in patients with coronary artery ectasia. Coron Artery Dis 2010;21: 8-12.
22. Pahlavan PS, Niroomand F. Coronary artery aneurysm: a review. Clin Cardiol 2006; 29:439–443.
23. Manginas A, Cokkinos DV. Coronary artery ectasias: imaging, functional assessment and clinical implications. Eur Heart J 2006;27:1026–1031.
24. Kahraman H, Ozaydin M, Varol E, Aslan SM, Dogan A, Altinbas A, et al. The diameters of the aorta and its major branches in patients with isolated coronary artery ectasia. Tex Heart Inst J 2006; 33:463–468.
25. Soares-Miranda L, Sandercock G, Valente H, Vale S, Santos R, Mota J.Vigorous physical activity and vagal modulation in young adults. Eur J Cardiovasc Prev Rehabil 2009;16:705-711.
26. Saffitz JE. Sympathetic neural activity and the pathogenesis of sudden cardiac death. Heart Rhythm 2008; 5:140–141.
27. Carter JB, Banister EW, Blaber AP. The effect of age and gender on heart rate variability after endurance training. Med Sci Sports Exerc 2003;35:1333–1340.
28. Dougherty CM, Glenny R, Kudenchuk PJ. Aerobic Exercise Improves Fitness and Heart Rate Variability After an Implantable Cardioverter Defibrillator. J Cardiopulm Rehabil Prev. 2008;28 (5): 307-311.
29. Analysis of heart rate variability at rest and during aerobic exercise: a study in healthy people and cardiac patients. B de la Cruz Torres, C López López, J Naranjo Orellana. Br J Sports Med 2008 42: 715-720.
30. Hedelin R, Winklund U, Bjerle P, et al. Cardiac autonomic imbalance in an overtrained athlete. Med Sci Sports Exerc 2000;32:1531–3.
31. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability standards of measurement, physiological interpretation, and clinical use. Circulation. 1996;93:1043–1065.
32. Dietrich D, Ackermann-Liebrich U, Schindler C, Barthélémy JC, Brandli O, Gold D, Knopfli B, Probst-Hensch N, Roche F, Tschopp JM, von Eckardstein A, Gaspoz JM, Sapaldia team. Effect of physical activity on heart rate variability in normal weight, overweight and obese subjects: results from the SAPALDIA study. Eur J Appl Physiol 2008; 104:557–565.
33. Fraley MA, Birchem JA, Senkottaiyan N, Alpert MA. Obesity and the electrocardiogram. Obes Rev 2005; 6(4):275–281.
34. Hepburn H, Fletcher J, Rosengarten Th, Coote JH. Cardiac vagal tone, exercise performance and the effect of respiratory training. Eur J Appl Physiol 2005; 94: 681–689.
35. Karavirta L, Tulppo MK, Nyman K, Laaksonen DE, Pullinen T, Laukkanen RT, Kinnunen H, Hakkinen A, Hakkinen K. Estimation of maximal heart rate using the relationship between heart rate variability and exercise intensity in 40–67 years old men. Eur J Appl Physiol 2008; 103:25–32.
36. Cottin F, Lepretre PM, Lopes P, Papelier Y, Medigue C, Billat V. Assessment of ventilator thresholds from heart rate variability in well-trained subjects during cycling. Int J Sports Med 2006; 27:959–967.
37. Tacoy G, Acikgoz K, Kocaman SA, Ozdemir M, Cengel A. Is there a relationship between obesity, heart rate variability and inflammatory parameters in heart failure? J Cardiovasc Med 2010; 11:118–124.
38. Kenchaiah S, Pocock SJ, Wang D, Finn PV, Zornoff LA, Skali H, et al., CHARM Investigators. Body mass index and prognosis in patients with chronic heart failure: insights from the Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) program. Circulation 2007; 116:627–636.
39. Grassi G, Seravelle G, Quarti-Trevano F, Scopelliti F, Dell’Oro R, Bolla G, Mancia G. Excessive sympathetic activation in heart failure with obesity and metabolic syndrome: characteristics and mechanisms. Hypertension 2007; 49:535–541.
40. Stein PK, Barzilay JI, Chaves PH, Traber J, Domitrovich PP, Heckbert SR, Gottdiener JS. Higher levels of inflammation factors and greater insulin resistance are independently associated with higher heart rate and lower heart rate variability in normoglycemic older individuals: the Cardiovascular Health Study. J Am Geriatr Soc 2008; 56:315–321.
41. Selig SE, Carey MF, Menzies DG, Patterson J, Geerling RH, Williams AD, Bamroongsuk V, Toia D, Krum H, Hare DL. Moderate-intensity resistance exercise training in patients with chronic heart failure improves strength, endurance, heart rate variability, and forearm blood flow. J Card Fail. 2004;10(1):21-30.
42. Sadock Benjamin J., Sadock Virginia A., Ruiz Pedro. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry (9th Edition). Lippincott Williams & Wilkins, 2009.
43. Sui X, LaMonte MJ, Laditka JN, Hardin JW, Chase N, Hooker SP et al. Cardiorespiratory fitness and adiposity as mortality predictors in older adults. JAMA 2007;298(21):2507– 2516.
44. Cottin F, Medigue C, Lopes P, Lepretre PM, Heubert R, Billat V. Ventilatory thresholds assessment from heart rate variability during an incremental exhaustive running test. Int J Sports Med 2007; 28:287–294.
45. Raczak G, Pinna GD, La Rovere MT, Maestri R, Danilowicz-Szymanowicz L, Ratkowski W, Figura-Chmielewska M, Szwoch M, Ambroch-Dorniak K. Cardiovagal response to acute mild exercise in young healthy subjects. Circ J. 2005;69(8):976-80. Ng J, Sundaram S, Kadish
46. AH, Goldberger JJ. Autonomic effects on the spectral analysis of heart rate variability after exercise. Am J Physiol Heart Circ Physiol 2009;297: H1421–H1428.
47. Goldberger JJ, Le FK, Lahiri M, Kannankeril PJ, Ng J, Kadish AH. Assessment of parasympathetic reactivation after exercise. Am J Physiol Heart Circ Physiol 2006;290: H2446–H2452.
48. Hu M, Finni T, Zoul L, Perhonen M, Sedliak M, Alen M, Cheng S. Effects of Strength Training on Work Capacity and Parasympathetic Heart Rate Modulation during Exercise in Physically Inactive Men. Int J Sports Med 2009;30:719–724.
49. Martinmaki K , Hakkinen K , Mikkola J , Rusko H. Effect of low-dose endurance training on heart rate variability at rest and during an incremental maximal exercise test . Eur J Appl Physiol 2008;104:541–548.
50. Mourot L, Bouhaddi M, Perrey S, Rouillon JD, Regnard J. Quantitative Poincare plot analysis of heart rate variability: effect of endurance training. Eur J Appl Physiol 2004;91:79–87.
51. Madden KM, Levy WC, Stratton JK. Exercise training and heart rate variability in older adult female subjects. Clin Invest Med 2006 ;29:20–28.
52. Nolan RP, Jong RP, Barry-Bianchi SM, Tanaka TM, Floras JS. Effects of drug, biobehavioral and exercise therapies on heart rate variability in coronary artery disease: a systematic review. Eur J Cardiovasc Prev Rehabil 2008; 15:386–396.
53. Bailey JJ, Berson AS, Handelsman H, Hodges M. Utility of current risk stratification tests for predicting major arrhythmic events after myocardial infarction. J Am Coll Cardiol 2001;38:1902–1911.
54. Lamotte M, Fleury F, Pirard M, Jamon A, van de Borne P. Acute cardiovascular response to resistance training during cardiac rehabilitation: effect of repetition speed and rest periods. Eur J Cardiovasc Prev Rehabil 2010.
55. De Vos NJ, Singh NA, Ross DA, Stavrinos TM, Orr R, Fiatarone MA. Optimal load for increasing muscle power during explosive resistance training in older adults. J Gerontol 2005;60A:638–645.
56. Braith RW, Beck DT. Resistance exercise: training adaptations and developing a safe exercise prescription. Heart Fail Rev 2008; 13:69–79.
2. Huikuri HV, Makikallio TH. Heart rate variability in ischemic heart disease. Auton Neurosci. 2001;90:95–101.
3. Quintana M, Storck N, Lindblad LE, et al. Heart rate variability as a means of assessing prognosis after acute myocardial infarction: a 3-year follow-up study. Eur Heart J. 1997;18:789 –797.
4. Forslund L, Bjo¨rkander I, Ericson M, et al. Prognostic implications of autonomic function assessed by analyses of catecholamines and heart rate variability in stable angina pectoris. Heart. 2002;87:415–422.
5. Iellamo F, Legramante JM, Massaro M, et al. Effects of a residential exercise training on baroreflex sensitivity and heart rate variability in patients with coronary artery disease: a randomized, controlled study. Circulation 2000;102:2588–2592.
6. Kanadasi M, Kudaiberdieva G, Birand A. Effect of the final coronary arterial diameter after coronary angioplasty on heart rate variability responses. Ann Noninvasive Electrocardiol. 2002;7:106 –113.
7. Wennerblom B, Lurje L, Solem J, et al. Reduced heart rate variability in ischemic heart disease is only partially caused by ischemia: an HRV study before and after PTCA. Cardiology 2000;94:146 –151.
8. Tygesen H, Wettervik C, Wennerblom B. Intensive home-based exercise training in cardiac rehabilitation increases exercise capacity and heart rate variability. Int J Cardiol. 2001;79:175–182.
9. Hull SS Jr, Vanoli E, Adamson PB, et al. Exercise training confers anticipatory acute myocardial ischemia. Circulation. 1994;89:548 –552. Okazaki K, Iwasaki
10. K, Prasad A, Palmer MD, Martini ER, Fu Q, Arbab-Zadeh A, Zhang R, Levine BD. Dose-response relationship of endurance training for autonomic circulatory control in healthy seniors. J Appl Physiol 2005; 99: 1041–1049.
11. Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises. I. Aging arteries: a “set up” for vascular disease. Circulation, 2003; 107: 139–146.
12. Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, and Ray CA. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc 2004; 36: 533–553.
13. Monahan KD, Tanaka H, Dinenno FA, and Seals DR. Central arterial compliance is associated with age- and habitual exerciserelated differences in cardiovagal baroreflex sensitivity. Circulation 2001; 104: 1627–1632.
14. Lehrer P, Vaschillo E. The future of Heart Rate Variability Biofeedback. Biofeedback. 2008;36: 11-17.
15. Gademan MG, Swence CA, Verwey HF, van der laarse A, Mann AC, van de Vooren H, van Pelt J, van Exel HJ, Lucas CM, Cleuren GV, Somer S, Schalij MJ, van der Wall EE. Effect of exercise training on automatic deragement and Neurohumoral activation in chronic heart failure. J Card Fail. 2007;13(4):294-303.
16. Lee CM, Ellis D, Daprile DM. Cardiac autonomic modulation following highintensity static muscle contractions. Am J Med Sci. 2006;332(1):6-12.
17. Ebben WP, Leigh DH. The effects of resistance training on cardiovascular patients. Strength Cond J 2006; 28: 54–58.
18. Simos R, Mendes R, Castello V, Machado H, Almeida L, Baldissera V, Catai A, Arena R, Borghi-Silva A. Heart-rate variability and blood-lactate threshold interaction during progressive resistance exercise in healthy older men. Strength Cond J 2010 ; 24 (5): 1313-1320
19. Ehlke, K and Greenwood, M. Resistance exercise for postmyocardial infarction patients: current guidelines and future considerations. Strength Cond J 2007;28: 56–62.
20. Jeremy, L and Spencer,MS. Resistance training in outpatient cardiac rehabilitation. Strength Cond J 2007; 29: 18–23.
21. Turker Y, Ozaydin M, Yucel H. Heart rate variability and heart rate recovery in patients with coronary artery ectasia. Coron Artery Dis 2010;21: 8-12.
22. Pahlavan PS, Niroomand F. Coronary artery aneurysm: a review. Clin Cardiol 2006; 29:439–443.
23. Manginas A, Cokkinos DV. Coronary artery ectasias: imaging, functional assessment and clinical implications. Eur Heart J 2006;27:1026–1031.
24. Kahraman H, Ozaydin M, Varol E, Aslan SM, Dogan A, Altinbas A, et al. The diameters of the aorta and its major branches in patients with isolated coronary artery ectasia. Tex Heart Inst J 2006; 33:463–468.
25. Soares-Miranda L, Sandercock G, Valente H, Vale S, Santos R, Mota J.Vigorous physical activity and vagal modulation in young adults. Eur J Cardiovasc Prev Rehabil 2009;16:705-711.
26. Saffitz JE. Sympathetic neural activity and the pathogenesis of sudden cardiac death. Heart Rhythm 2008; 5:140–141.
27. Carter JB, Banister EW, Blaber AP. The effect of age and gender on heart rate variability after endurance training. Med Sci Sports Exerc 2003;35:1333–1340.
28. Dougherty CM, Glenny R, Kudenchuk PJ. Aerobic Exercise Improves Fitness and Heart Rate Variability After an Implantable Cardioverter Defibrillator. J Cardiopulm Rehabil Prev. 2008;28 (5): 307-311.
29. Analysis of heart rate variability at rest and during aerobic exercise: a study in healthy people and cardiac patients. B de la Cruz Torres, C López López, J Naranjo Orellana. Br J Sports Med 2008 42: 715-720.
30. Hedelin R, Winklund U, Bjerle P, et al. Cardiac autonomic imbalance in an overtrained athlete. Med Sci Sports Exerc 2000;32:1531–3.
31. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability standards of measurement, physiological interpretation, and clinical use. Circulation. 1996;93:1043–1065.
32. Dietrich D, Ackermann-Liebrich U, Schindler C, Barthélémy JC, Brandli O, Gold D, Knopfli B, Probst-Hensch N, Roche F, Tschopp JM, von Eckardstein A, Gaspoz JM, Sapaldia team. Effect of physical activity on heart rate variability in normal weight, overweight and obese subjects: results from the SAPALDIA study. Eur J Appl Physiol 2008; 104:557–565.
33. Fraley MA, Birchem JA, Senkottaiyan N, Alpert MA. Obesity and the electrocardiogram. Obes Rev 2005; 6(4):275–281.
34. Hepburn H, Fletcher J, Rosengarten Th, Coote JH. Cardiac vagal tone, exercise performance and the effect of respiratory training. Eur J Appl Physiol 2005; 94: 681–689.
35. Karavirta L, Tulppo MK, Nyman K, Laaksonen DE, Pullinen T, Laukkanen RT, Kinnunen H, Hakkinen A, Hakkinen K. Estimation of maximal heart rate using the relationship between heart rate variability and exercise intensity in 40–67 years old men. Eur J Appl Physiol 2008; 103:25–32.
36. Cottin F, Lepretre PM, Lopes P, Papelier Y, Medigue C, Billat V. Assessment of ventilator thresholds from heart rate variability in well-trained subjects during cycling. Int J Sports Med 2006; 27:959–967.
37. Tacoy G, Acikgoz K, Kocaman SA, Ozdemir M, Cengel A. Is there a relationship between obesity, heart rate variability and inflammatory parameters in heart failure? J Cardiovasc Med 2010; 11:118–124.
38. Kenchaiah S, Pocock SJ, Wang D, Finn PV, Zornoff LA, Skali H, et al., CHARM Investigators. Body mass index and prognosis in patients with chronic heart failure: insights from the Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) program. Circulation 2007; 116:627–636.
39. Grassi G, Seravelle G, Quarti-Trevano F, Scopelliti F, Dell’Oro R, Bolla G, Mancia G. Excessive sympathetic activation in heart failure with obesity and metabolic syndrome: characteristics and mechanisms. Hypertension 2007; 49:535–541.
40. Stein PK, Barzilay JI, Chaves PH, Traber J, Domitrovich PP, Heckbert SR, Gottdiener JS. Higher levels of inflammation factors and greater insulin resistance are independently associated with higher heart rate and lower heart rate variability in normoglycemic older individuals: the Cardiovascular Health Study. J Am Geriatr Soc 2008; 56:315–321.
41. Selig SE, Carey MF, Menzies DG, Patterson J, Geerling RH, Williams AD, Bamroongsuk V, Toia D, Krum H, Hare DL. Moderate-intensity resistance exercise training in patients with chronic heart failure improves strength, endurance, heart rate variability, and forearm blood flow. J Card Fail. 2004;10(1):21-30.
42. Sadock Benjamin J., Sadock Virginia A., Ruiz Pedro. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry (9th Edition). Lippincott Williams & Wilkins, 2009.
43. Sui X, LaMonte MJ, Laditka JN, Hardin JW, Chase N, Hooker SP et al. Cardiorespiratory fitness and adiposity as mortality predictors in older adults. JAMA 2007;298(21):2507– 2516.
44. Cottin F, Medigue C, Lopes P, Lepretre PM, Heubert R, Billat V. Ventilatory thresholds assessment from heart rate variability during an incremental exhaustive running test. Int J Sports Med 2007; 28:287–294.
45. Raczak G, Pinna GD, La Rovere MT, Maestri R, Danilowicz-Szymanowicz L, Ratkowski W, Figura-Chmielewska M, Szwoch M, Ambroch-Dorniak K. Cardiovagal response to acute mild exercise in young healthy subjects. Circ J. 2005;69(8):976-80. Ng J, Sundaram S, Kadish
46. AH, Goldberger JJ. Autonomic effects on the spectral analysis of heart rate variability after exercise. Am J Physiol Heart Circ Physiol 2009;297: H1421–H1428.
47. Goldberger JJ, Le FK, Lahiri M, Kannankeril PJ, Ng J, Kadish AH. Assessment of parasympathetic reactivation after exercise. Am J Physiol Heart Circ Physiol 2006;290: H2446–H2452.
48. Hu M, Finni T, Zoul L, Perhonen M, Sedliak M, Alen M, Cheng S. Effects of Strength Training on Work Capacity and Parasympathetic Heart Rate Modulation during Exercise in Physically Inactive Men. Int J Sports Med 2009;30:719–724.
49. Martinmaki K , Hakkinen K , Mikkola J , Rusko H. Effect of low-dose endurance training on heart rate variability at rest and during an incremental maximal exercise test . Eur J Appl Physiol 2008;104:541–548.
50. Mourot L, Bouhaddi M, Perrey S, Rouillon JD, Regnard J. Quantitative Poincare plot analysis of heart rate variability: effect of endurance training. Eur J Appl Physiol 2004;91:79–87.
51. Madden KM, Levy WC, Stratton JK. Exercise training and heart rate variability in older adult female subjects. Clin Invest Med 2006 ;29:20–28.
52. Nolan RP, Jong RP, Barry-Bianchi SM, Tanaka TM, Floras JS. Effects of drug, biobehavioral and exercise therapies on heart rate variability in coronary artery disease: a systematic review. Eur J Cardiovasc Prev Rehabil 2008; 15:386–396.
53. Bailey JJ, Berson AS, Handelsman H, Hodges M. Utility of current risk stratification tests for predicting major arrhythmic events after myocardial infarction. J Am Coll Cardiol 2001;38:1902–1911.
54. Lamotte M, Fleury F, Pirard M, Jamon A, van de Borne P. Acute cardiovascular response to resistance training during cardiac rehabilitation: effect of repetition speed and rest periods. Eur J Cardiovasc Prev Rehabil 2010.
55. De Vos NJ, Singh NA, Ross DA, Stavrinos TM, Orr R, Fiatarone MA. Optimal load for increasing muscle power during explosive resistance training in older adults. J Gerontol 2005;60A:638–645.
56. Braith RW, Beck DT. Resistance exercise: training adaptations and developing a safe exercise prescription. Heart Fail Rev 2008; 13:69–79.
Cómo citar
1.
Rincón Roncancio M. Efecto del ejercicio en la variabilidad de la frecuencia cardíaca. Rev. Colomb. Med. Fis. Rehabil. [Internet]. 19 de abril de 2012 [citado 18 de abril de 2024];20(1):24-32. Disponible en: https://revistacmfr.org/index.php/rcmfr/article/view/29
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