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Heart Rate Variability and Chiropractic Care

Written by Dr. Ari Cohn DC


Heart Rate Variability (HRV) is the slight variation in intervals between heartbeats. It may seem counterintuitive, but your heartbeat should NOT beat at perfectly regular intervals. There should be little variations in the times between each beat. It would be like driving your car down a straight road and holding the steering wheel completely still. If you weren't making those slight adjustments to the steering wheel for bumps, wind, etc., eventually you would drive off the road. Your heart has to continuously have its beat adjusted to help you adapt to changes in body position, altering blood flow to different parts of the body, and for just regulating your blood pressure. These adjustments are controlled by the nervous system.

Heart Rate Variability (HRV) has been studied for almost 30 years by a many high level medical groups.1-3 It has been researched and shown to be a strong indicator of heart health, digestive health, emotional health, improved ability to handle stress, athletic training and fitness, and improved healing ability in general.4-10 The National Institutes of Health (NIH), Mayo Clinic, Stanford University Hospital and Clinics, and Mount Sinai Medical Center and School of Medicine are among the many prestigious research centers studying HRV and using it in clinical practice.11, 12 Clinical research has shown that when HRV levels are high, a person has a greater resiliency to stress.13 When HRV levels are low, the person's resiliency to stress is also low.13 This is because the more adaptable we are, the more capable we are of dealing with life's inevitable stressors. This adaptability is directly controlled by our nervous system and can be measured, using HRV as an indicator.14-19 This is why so many studies are showing that chiropractic care not only improves heart rate variability, but that it also improves a patient's overall level of health looking at a variety of health outcome measures.14-19

In our office we will now be periodically monitoring our patient's HRV to help us ensure that they are not only feeling better but growing stronger and healthier as well.

Chiropractic and heart rate variability.

  • 1. Thayer J, Et Al. A Meta-Analysis of Heart Rate Variability and Neuroimaging Studies: Implications for Heart Rate Variability as a Marker of Stress and Health. Neuroscience and Biobehavioral Reviews. 36 (2012) 747-756.
  • 2. Marek M. Heart Rate Variability. Annals of Noninvasive Electrocardiology. Volume 1, Issue 2. April 1996, Pages 151-181.
  • 3. Jiri, P., Et Al. Functional Assessment of Heart Rate Variability: Physiological Basis and Practical Applications. International Journal of Cardiology Vol. 84, Issue 1. July 2002, P. 1-14.
  • 4. Kleiger R. Et Al. Decreased Heart Rate Variability and its Association With Increased Mortality After Acute Myocardial Infarction. Am J Cardiol. 1987 Feb 1;59(4):256-62.
  • 5. Ramaekers D, Ector D. Heart Rate Variability and Heart Rate in Healthy Volunteers. Is the Female Autonomic Nervous System Cardioprotective? European Heart Journal. Vol 19. Issue 9. P. 1334-1341.
  • 6. Heitkemper M. Heart Rate Variability is Related to Pain Severity and Predominant Bowel Pattern in Women with Irritable Bowel Syndrome. Neurogastroenterology and Motility. Volume 19, Issue 2 February 2007 Pages 110-118.
  • 7. Carmilla M, Licht M, Et Al. Association Between Major Depressive Disorder and Heart Rate Variability in the Netherlands Study of Depression and Anxiety (NESDA) FREE Arch Gen Psychiatry. 2008;65(12):1358-1367.
  • 8. Thayer J, Hansen, A, Et Al. Heart Rate Variability, Prefrontal Neural Function, and Cognitive Performance: The Neurovisceral Integration Perspective on Self-regulation, Adaptation, and Health. Annals of Behavioral Medicine. April 2009, Volume 37, Issue 2. P. 141-153.
  • 9. Yamamoto Y, Hughson L, Peterson J. Autonomic Control of Heart Rate During Exercise Studied by Heart Rate Variability Spectral Analysis. Journal of Applied Physiology. September 1991 Vol. 71 no. 3, 1136-1142.
  • 10. Aubert A, Seps B, Beckers F. Heart Rate Variability in Athletes. Sports Medicine. October 2003, Volume 33, Issue 12, pp 889-919.
  • 11. Seong J.S, LeeT.M, Shin W, Kim Y, Yoon R. Yoon The Analysis of Mental Stress Using Time-Frequency Distribution of Heart Rate Variability Signal. Proceedings of the 26th Annual International conference of the IEEEEMBS, September 2004.
  • 12. Lizawati S, Jaegeol Cho M, Gi Jeong D. Ultra Short Term Analysis of Heart Rate Variability for Monitoring Mental Stress in Mobile Settings. Proceedings of the 29th Annual International Conference of the IEEE EMBS, August 2007.
  • 13. Alex, M. Muhs, G. Rationale for Assessing the Effects of Manipulative Therapy on Autonomic Tone by Analysis of Heart Rate Variability. J of Manip and Phys Ther. Vol. 22, Issue 3, April 1999, p 161-165.
  • 14. Adelaida M, Guillermo M. A Randomized Controlled Trial Investigating the Effects of Craniosacral Therapy on Pain and Heart Rate Variability in Fibromyalgia Patients. Clinical Rehabilitation. Vol 2. P. 403.
  • 15. Zhang J, Douglas D, Et Al. Effect of Chiropractic Care on Heart Rate Variability and Pain in a Multisite Clinical Study. J Manip Phys ther. Vol. 29, Issue 4. May 2006, Pages 267-274.
  • 16. Richard R, Jean B, Alain C. Heart Rate Variability Modulation after Manipulation in PainFree Patients vs. Patients in Pain. Vol. 32, Issue 4. May 2009, Pages 277-286.
  • 17. Budgell B, Fumie H. Innocuous Mechanical Stimulation of the Neck and Alterations in Heart-Rate Variability in Heathy Young Adults. Autonomic Neuroscience. Vol. 91, Issue 1-2. 13 August 2001, Pages 96-99.
  • 18. Arlene W, Boone R. Sympathetic and Parasympathetic Responses to Specific Diversified Adjustments to Chiropractic Vertebral Subluxations of the Cervical and Thoracic Spine. Journal of Chiropractic Medicine. Vol. 7, Issue 3. September 2008, Pages 86-93.
  • 19. Budgell B, Polus B. The Effects of Thoracic Manipulation on Heart Rate Variability: A Controlled Crossover Trial. J of Manip and Physiol Ther. Vol. 29. Issue 8. October 2006, Pages 603-610.


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