The role of connection with nature in empirical studies with physiological measurements: a systematic literature review.

It is well described that exposure to nature reduces physiological stress, and connectedness to nature can have a moderating effect. However, few studies have so far examined the construction of the connection with nature in relation to physiological processes. In this systematic review, we collected studies that used a physiological measure and included a scale to measure connectedness to nature. Our aim was to assess the role of nature relatedness at the level of physiological processes and to summarize the results published so far. Our review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature search was conducted in 3 different databases (PubMed, ScienceDirect and Google Scholar). As keywords, we used all the different questionnaires that measure connectedness to nature, combined with terms related to physiological measures. After final screening, 28 articles met the inclusion criteria for the review. The studies were very diverse in terms of purpose, intervention and methods, so narrative synthesis was conducted without measures of effect. We found evidence for a mediating effect of nature connectedness on the associations between nature exposure and cognitive function, brain activity, blood pressure, cortisol level and mental health. Studies investigating nature relatedness as state-like characteristics have shown that exposure to nature increases the level of connection to nature. Eye-tracking studies have confirmed that this measurement method can be used to investigate nature relatedness at a physiological level, which could be a useful complement to self-report questionnaires in future studies.

Are there placebo or nocebo effects in balancing performance?

Placebo and nocebo effects could influence the perceived, actual, or both postural stabilities. Therefore, this experiment examined whether postural stability is susceptible to placebo and nocebo effects. Driven by expectations, these cognitions could influence the motor stability of people in physical rehabilitation and those with motion instability. We randomly assigned 78 participants to a placebo, nocebo, or control group. Then, we applied a sham sports cream with positive, negative, or neutral instructions about its impact on balance. Next, we tested postural stability with a modified version of the Modified Clinical Test of Sensory Interaction in Balance, including standard, proprioceptive, visual, and vestibular tests before and after the intervention. Further, we measured expected and perceived performance with visual analog scales and assessed trait anxiety, change in state anxiety, optimism, holistic thinking, persistence, and cooperation with questionnaires. The intervention did not affect actual test performances; similarly, trait and state variables and expectations did not have an impact. Furthermore, the experimental manipulation and trait and state variables did not significantly affect perceived performance. However, the association between expectation and perceived performance was strong (ϱ = 0.627, p < 0.001). These findings suggest that postural stability is not susceptible to placebo and nocebo influences. Still, there is a dissociation between objective and subjective performance, showing that expectations impact perceived but not actual performance, which could fuel motivation in rehabilitation settings.

Do we need to accurately perceive our heartbeats? Cardioceptive accuracy and sensibility are independent from indicators of negative affectivity, body awareness, body image dissatisfaction, and alexithymia.

Assessment of the acuity of heartbeat perception, dubbed cardioceptive accuracy, as well as its association with various psychological characteristics are hot topics of interoception research. In this study, we aimed (1) to replicate previously reported findings on the association between the mental tracking task and a novel motor tracking task that eliminates disturbing tactile sensations; and (2) to explore associations between performance in the latter task and indicators of negative affectivity (anxiety, depression, anxiety sensitivity, somatic symptom distress), alexithymia, body focus, and dissatisfaction with body image. 102 young people (age = 20.8±5.08 yrs) participated in the study. Mental tracking score was significantly higher than motor tracking scores, although they were strongly associated. Frequentist correlation analysis showed no significant associations between indicators of cardioceptive accuracy and questionnaire scores; Bayesian analysis indicated the lack of association for the majority of the cases. Similarly, detectors and non-detectors showed no differences in any of the assessed characteristics and Bayesian results typically supported the lack of associations. In conclusion, cardioceptive accuracy, as assessed with different tracking methods, is not associated with the aforementioned self-reported characteristics in young individuals.

The effects of a complex yoga-based intervention on healthy psychological functioning.

Background: Yoga based interventions were found to have a positive impact on various indicators of psychological functioning, such as perceived stress, satisfaction with life, positive and negative affectivity. Additionally, such interventions improved bodily or interoceptive awareness and spirituality. Methods: The present study assessed the effects of a 3-month long complex yoga-based intervention compared to a passive control group in a Hungarian community sample. The final sample consisted of 44 intervention (Mage = 47.5, SD = = 8.76) and 29 control participants (Mage = 47.4, SD = 9.47). The aforementioned constructs were measured 1 week before and after the intervention. Results: The intervention reduced participants' perceived stress (p = <0.001, ηp 2 = 0.153) and negative affectivity (p = 0.019, ηp 2 = 0.113), improved spirituality (p = 0.048, ηp 2 = 0.054) and various aspects of interoceptive awareness such as noticing (p = <0.001, ηp 2 = 0.169) attention regulation (p = <0.001, ηp 2 = 0.211), self-regulation (p = 0.002, ηp 2 = 0.190) body listening (p = 0.010, ηp 2 = 0.097), trusting (p = 0.026, ηp 2 = 0.070), but did not impact positive affectivity and satisfaction with life. Conclusion: A 3-months long complex yoga-based intervention has a positive impact on many aspects of healthy psychological functioning.

Complexity of heartbeat interval series in young healthy trained and untrained men.

The origin of heart rate variability (HRV) is largely in parasympathetic activity. The direct influence of sympathetic activity and other control mechanisms, especially at an increased HR, is not well understood. The objectives of the study were to investigate the influence of increasing HR on the properties of heartbeat interval (RR) series in young healthy subjects. ECG was recorded in 9 trained and 11 untrained young men during supine rest, standing, incremental running exercise and relaxation. During exercise, a breath-to-breath gas exchange was monitored. The RR time series analysis included the spectral analysis, detrended fluctuations analysis method and sample entropy (SampEn) calculation. During exercise, spectral powers were reduced dramatically in both groups. The dependence of short-term scaling exponent (alpha(1)) on the RR included a characteristic maximum, while SampEn for the same value of the RR had a minimum. The value of HR corresponding to the maximum of alpha(1) and minimum of SampEn (IHR) corresponded to the intrinsic HR obtained by an autonomic blockade. In trained subjects, the curves alpha(1) versus RR and SampEn versus RR were moved toward larger RR, compared with control. For HR values higher than IHR, alpha(1) decreased and SampEn increased. These results reveal that the complexity of the heart rhythm above intrinsic HR decreases with an increase in HR. We suggest that at the highest HR intrinsic heart control is reflected in the heart rhythm. We point out the possibility of developing a new non-invasive method for the determination of intrinsic HR from the curve alpha(1) versus RR.

Heart rate variability in mental stress aloud.

Previous investigations on arithmetic stress with verbalization showed that spectral measures of heart rate variability (HRV) did not assess changes in autonomic modulation, although the heart rate (HR) increased. In this study non-linear measures of HRV are determined and linear measures are re-examined in order to understand this apparent discrepancy between HR and HRV changes. In 23 healthy subjects 5-min electrocardiograms (ECGs) were recorded at rest and during arithmetic stress aloud. We determined non-linear (short-term scaling exponent, sensitivity to the initial condition and signal complexity) and linear (low-frequency and high-frequency spectral powers) measures. Our results showed that averaging concealed out an opposite effect of mental stress aloud on spectral measures and that this could be the main reason why the effect was not quantified. We found that increase of HR upon mental stress aloud could be achieved through the decreased as well as increased modulation in high-frequency band (HF). We also showed that non-linear measures distinguished this opposite effect of mental stress aloud on linear measures. Decreased HF power is associated with increase in short-term scaling exponent and decrease in signal complexity, while increased HF power increased sensitivity to the initial conditions. Apart from their opposite response to the mental stress, the two groups differed in baseline in sensitivity to the initial conditions. We suggest that variety of changes in HR dynamics upon different perturbation could be due to some differences in intrinsic properties of the system.

Reflection of heart rate regulation on linear and nonlinear heart rate variability measures.

The aim of this study was to examine the dependence of heart rate variability (HRV) measures on RR interval length and to find out relationships between linear and nonlinear measures. The spectral powers in very low (VLF), low (LF) and high (HF) frequency regions, short-term scaling exponent alpha(1) and sample entropy (SampEn) were determined. All spectral powers increased with increasing RR interval length until they reached a plateau. Neighbouring spectral powers were strongly correlated. The largest fraction of the spectrum consisted of VLF (from about 40 to 95%) and the smallest of HF, although HF was most sensitive to changes in RR interval length. SampEn is also increased with increasing RR interval, reaching a plateau. The dependence of alpha(1) on RR showed a deflection point at 0.5 s. Nonlinear measures can be expressed by spectral powers: alpha(1) by a linear function of ln(LF/HF) and SampEn by a quadratic function of ln HF. We concluded that during the day an increase of HR up to 120 beats min(-1) was reflected in a reduction in HF and LF and to a smaller extent in VLF and by decreased complexity and increased correlation in RR interval series. In sleep, HRV measures are at a plateau. We suggest that below intrinsic value, HR is regulated mainly by changes of parasympathetic activity, reflected in linear and nonlinear HRV measures.

Dependence of heart rate variability on heart period in disease and aging.

The aim of this study was to compare the dependence of heart rate variability (HRV) on heart period (RR interval length) under different physiological and pathological states in order to detect changes in HR modulation. The dependence of HRV on the RR interval length in healthy elderly subjects, congestive heart failure (CHF) patients and one patient with a transplanted heart (T) was compared with healthy young subjects. Spectral powers, sample entropy (SampEn) and short-term fractal scaling exponent (alpha1) were determined from 24 h free-running recordings. For the same HR, HRV measures were different in different groups. In healthy subjects HRV measures depended on RR interval length and all spectral powers were highly correlated, although reduced in elderly subjects. SampEn at high HR was the most sensitive quantity to changes induced by aging. In disease, CHF and T, an achievable HR range was decreased, all spectral powers were reduced, but correlated, and the dependence of HRV measures on RR was lost. There was an evident difference in the dependence of nonlinear on linear measures between young subjects and all the other studied groups. In disease the reduction in autonomic control was associated with the decrease in short-range correlation and regularity in RR series. We have concluded that the analysis of HRV measures as functions of RR interval length can reveal important aspects of HR control that might be lost in averaging.

Linear and non-linear heart rate variability measures in chronic and acute phase of anorexia nervosa.

Previous results on heart rate variability (HRV) analysis in anorexia nervosa (AN) include some apparently conflicting data. In order to find out the reason for different results and to improve understanding of autonomic control in AN we compare HRV in acute and chronic AN. Spectral powers, fractal scaling exponent and sample entropy were computed from 24 h RR series derived from Holter ECG recordings in 17 anorexic patients, nine chronic and eight healthy women. We found that all linear and non-linear HRV measures change in different direction in acute and chronic AN. Acute AN is characterized by decreased HR and increased HRV. In chronic AN, HR is increased, HRV reduced and the difference between awake and sleeping values is high. HRV measures are associated with body mass index only in chronic AN. As HRV measures are significantly different between acute and chronic AN, we propose that HRV analysis might provide additional data in clinical practice.

Correlation properties and regularity of heart period time series: influence of posture and heart disease.

Nonlinear measures of heart period variability (HPV) were determined in supine rest and standing posture in children and young adults with heart disease and compared to the control. The aim was to study influence of posture and heart disease on heart period dynamics. It was found that standing increases short-term scaling exponent in all subjects and decreases sample entropy in healthy and less severely ill patients. Severely ill patients compared to control have higher short-term scaling exponent in supine. Changes in nonlinear measures of HPV upon standing are more pronounced in healthy than diseased subjects due to different vagal activity.

Effect of posture on heart rate variability spectral measures in children and young adults with heart disease.

BACKGROUND: Reduction of heart rate variability as a consequence of heart disease and postural change has been well documented. However, the data on the effect of postural change in pediatric patients are incomplete and the effect is not fully understood. The aim of the study was to investigate effect of postural change on heart rate variability in relation to the extent of severity of heart disease. METHODS: The dependence of heart rate variability on posture in 41 children and young adults (8-20 years) with heart disease has been investigated and compared with control. Short-term electrocardiograms (ECGs) were assessed in supine rest and active standing, and spectral measures of heart rate variability were determined. RESULTS: Two types of response to the change of supine to standing posture were determined in both healthy and diseased subjects. In majority of subjects, the increased heart rate induced by standing was accompanied by a decrease in high-frequency power. However, in about 30% of all subjects, increased heart rate during standing was accompanied by an increased high-frequency power. Independently of posture and disease, high-frequency and low-frequency power were positively correlated. In subjects characterized by a reduction of heart rate variability in standing, the high-frequency power in both postures is reduced in diseased subjects compared to control. CONCLUSIONS: These results demonstrate that in this age range, the response to posture is not unique because of the difference in high-frequency power, which implies a variety of vagal modulations of heart rate.

Nonlinear and chaos characteristics of heart period time series: healthy aging and postural change.

In this study we investigated nonlinear and linear characteristics of heart period variability with aging in supine and standing posture. Sixty healthy subjects (8-61 years) divided in three age groups participated in the study. Heart period variability was assessed by measurement of short-term scaling exponent, sample entropy, largest Lyapunov exponent and spectral low-frequency and high-frequency power. In standing, there was significant increase in short-term scaling exponent and largest Lyapunov exponent in all subjects, and significant decrease in sample entropy in children (<15 years) and young adults (15-39 years). Increasing age is associated with reduction in sample entropy in supine posture. Mutual effect of aging and postural change was reflected on heart rate and sample entropy. Correlation between low-frequency-to-high-frequency power ratio and short-term scaling exponent was found in supine posture. In standing both low-frequency and high-frequency powers are correlated with short-term scaling exponent and sample entropy. These results show that posture, standing compared to supine, has significant effect on nonlinear properties of heart period variability in healthy subjects while the influence of healthy aging is less pronounced. The findings indicate that intrinsic properties of heart period dynamics, reflected on nonlinear measures, are altered only by robust changes of autonomic modulation of heart rate.

Quantification of the acute effect of a low dose of red wine by nonlinear measures of RR and QT interval series in healthy subjects.

The measures of nonlinear properties of RR interval and QT interval time series are sensitive to physiologically- or pathologically-induced complexity/regularity changes, but were not used to estimate the effect of alcohol intake. We wanted to examine the potential of these measures to quantify the acute effect of a low dose of red wine in healthy subjects. In separate experiments, fourteen young volunteers drank 200ml of red wine and a control drink with equal concentration of ethanol. ECG in supine position was recorded 20min before and 60min after drink intake. RR interval and QT interval series were extracted from ECG and we calculated variability, scaling exponents (α1 and α2) and sample entropy (SampEn) for both series. Systolic and diastolic blood pressures (BP) were measured every 10min. The immediate effect of both the drinks was equal: HR, BP and QT variability exhibited a sudden increase and then a decrease. However, the prolonged effect of wine and the control drink was different. Wine decreased both BP (p<0.05) and reduced complexity of RR and QT series (increased scaling exponents and decreased SampEn). The control drink prolonged QT and RR intervals (p<0.05). These results point out that the nonlinear properties of RR and QT interval series could be used to differentiate the effect of wine and ethanol. Changes in RR and QT interval series induced by a low dose of red wine are more detectable by methods that quantify the structure of the series than by methods that quantify their variability.

Contractions of the whole and longitudinally cut rat's portal vein.

To investigate the role of lateral interactions, we quantified spontaneous contractions of whole and longitudinally cut rat´s portal vein in vitro. The disruption of the wall had no effect on basic frequency determined from spectra and complexity index (CI) calculated by multiscale entropy analysis. Endothelium was disrupted and nonfunctional in all samples. Considering amplitude, frequency and CI we identified two modes of contractions. Neither mode of contractions nor the effect of aminopyridine (4-AP) depended on the integrity of the wall. We concluded that contractions in vitro originate in smooth muscle cells without involvement of the endothelium and lateral interactions.

Spontaneous contractions of isolated rat portal vein under temperature perturbations.

We studied nonlinear dynamics underlying spontaneous rhythmical contractions of isolated rat portal vein. The signals were acquired at four different temperatures important in isolated blood vessels preparations: 4, 22, 37 and 40 degrees C. To characterize the system's nonlinearity, we calculated the largest Lyapunov exponent, sample entropy and scaling exponents. Evidence for nonlinearity was provided by analysis of surrogate data generated from the phase-randomized Fourier transform of the original sequences. Positive values of the largest Lyapunov exponent were obtained for the time series recorded under applied conditions, indicating that the system preserves its chaotic deterministic nature even far from the physiological temperature range. Scaling exponents revealed three distinctive regions with different correlation properties. The calculated measures that characterize the time series obtained at 4 degrees C were significantly different from those derived from data obtained at higher temperatures. System's dynamics becomes more complex or less predictable as temperature approaches physiological value. The computation of the largest Lyapunov exponent, sample entropy and correlation measures gave an insight into the complex dynamics of the isolated blood vessels rhythmicity. We identified different modes of rhythmical contractions of isolated rat portal vein which could improve understanding of possible control mechanisms in vivo.

Correlation properties of heartbeat dynamics.

In this study, we investigate correlation properties of fluctuations in heart interbeat (RR) time series in a broad range of physiological and pathological conditions. Using detrended fluctuation analysis (DFA) method we determined short-term (alpha 1) and long-term (alpha 2) scaling exponent. In addition, we calculated standard deviation of RR intervals (SDRR) as the simplest variability measure. We found that the difference between alpha 1 and alpha 2 is related to RR interval length. At the shortest RR intervals, which correspond to extreme physiological and pathological conditions, we found the highest reduction of variability and the biggest difference between scaling exponents. In this case, DFA reveals a white noise over short scales (alpha 1 about 0.5) and strongly correlated noise over large scales (alpha 2 about 1.5). With an increase in RR interval, accompanied by increased variability (increase in parasympathetic control), the difference between alpha 1 and alpha 2 decreases. The difference between scaling exponents disappeared in a state of efficient autonomic control. We suggest that the complexity in heart rhythm is achieved through coupling between intrinsically controlled heart rhythm and autonomic control, and that the model of stochastic resonance mechanism could be applied to this system.

[Analysis of heart rhythm variability by linear and non-linear dynamics methods].

INTRODUCTION: Spectral analysis of heart rhythm variability is a noninvasive method to study cardiovascular autonomic control. Nonlinear methods of analysis of heart rhythm variability may provide an additional information on properties of RR interval dynamics, which cannot be revealed by linear methods. The aim of this study was to investigate and to compare some parameters of deterministic chaos, tractal and spectral properties of heart rhythm variability in healthy subjects. METHODS: Sixty healthy subjects, who participated in this study, were divided in four different age groups: children (< 15 years old), young (15-24 years), adults (25-39 years) and middle-aged (40-61 years). We analyzed the heart period variability extracted from a 5-minute electrocardiograms recordings in supine rest. Short-term fractal scaling exponent, sample entropy, minimum embedding dimension and the largest Lyapunov exponent along with the spectral measures (low-frequency and high-frequency power) were determined. RESULTS: Heart frequency, short-term fractal scaling exponent, and the largest Lyapunov exponent did not differ between the tested groups (p > 0.05). Middle-aged subjects had the lower low-frequency power as compared to the children (p < 0.001) and the young (p < 0.05), and the lower high-frequency power as compared to the other three groups (p < 0.001). Middle-aged also had a significantly lower power of high frequency and sample entropy as compared to the other three groups (p < 0.001). Children had lower values of minimum embedding dimension compared to the middle aged (p < 0.001). Significant negative correlation between the age of the tested subjects, and the low-and, high-frequency power and sample entropy was found. CONCLUSION: The obtained results suggested that healthy aging was associated with significant alteration in heart rhythm dynamics reflected on a higher regularity and lower variability of heart rhythm time-series. Significant decrease in a high-frequency power with aging suggested that reduction in parasympathetic activity was the basic cause of these changes.

[Spectral analysis of heart period variability in anorexia nervosa]. / Spektralna analiza varijabilnosti srcanih perioda kod anoreksije nervoze.

The aim of this study was to investigate the response of autonomic cardiac control to postural change using spectral analysis, in patients with anorexia nervosa. Spectral components of total variability as well as of low and high frequencies were analyzed for 17 anorexic patients with mean body mass index (14.9 +/- 1.9) kg/m2 and for 9 healthy age-matched women with body mass index (20.3 +/- 1.7) kg/m2 , in supine and standing postures. During standing posture, increased heart rate in all subjects was accompanied by the decrease in total variability and high frequency spectral powers. In supine posture, anorexic patients demonstrated the reduced low frequency spectral power. Compared to control women, during standing posture anorexic patients showed higher heart rate, reduced total variability and high frequency spectral powers. Statistically significant correlation was noticed between body mass index and spectral power of low frequency in both supine and standing posture. Alterations in autonomic cardiac control induced by anorexia nervosa could be estimated by spectral analysis of heart period variability.