The aim of this study was to give detailed information about the use of heart rate variability (HRV) and measurement and evaluation methods of the monitoring fatigue. HRV has become an increasingly used tool for monitoring fatigue in athletes. HRV is used for monitoring changes in optimize training load, and identify training adaptations. HRV monitoring provides important information about the athlete's recovery and the impact of training and competition on overall fatigue levels. Recent developments in wearable technologies and mobile applications have made it possible to measure HRV in real time and to continuously monitor fatigue levels. It is also important to consider the validity and reliability of HRV measurement tools and to report HRV results clearly and comprehensively. In athlete monitoring, it can be said that HRV measurements can be evaluated mostly at rest, with ultra-short-term (<60 sec) analysis method, and by taking into account the lnRMMSD and RMMSD metrics. However, it is clear that more research is needed to determine the validity of HRV in athletic populations. In addition, sports scientists and practitioners should consider other fatigue monitoring tools in addition to the use of HRV when making decisions about the fatigue and recovery levels of athletes.
Alvurdu, S. (2023). Measurement and evaluation of heart rate variability in monitoring fatigue: A narrative review . Journal of ROL Sport Sciences, 4(1), 336–358. https://doi.org/10.5281/zenodo.7741425
📄Allen, D. G. (2009). Fatigue in working muscles. Journal of Applied Physiology, 106(2), 358-359.
📄Altini, M., Van Hoof, C., & Amft, O. (2017, February). Relation between estimated cardiorespiratory fitness and running performance in free-living: an analysis of HRV4Training data. In 2017 IEEE EMBS International Conference on Biomedical & Health Informatics (BHI) (pp. 249-252). IEEE.
📄Anunciacao, P.G., Polito, M.D., & Casonatto, J. (2011). Blood pressure responses and heart rate variability after resistance exercise with different intensities and same workload. International SportMed Journal, 12(2), 53-67.
📄Bellenger, C.R., Miller, D.J., Halson, S.L., Roach, G.D. & Sargent, C. (2021). Wrist-based photoplethysmography assessment of heart rate and heart rate variability: Validation of WHOOP. Sensors, 21(10), 3571.
📄Blásquez, J.C.C., Font, G.R. & Ortís, L.C. (2009). Heart-rate variability and precompetitive anxiety in swimmers. Psicothema, 531-536.
📄Bogdanis, G.C. (2012). Effects of physical activity and inactivity on muscle fatigue. Frontiers in Physiology, (142).
📄Borresen, J., & Lambert, M.I. (2007). Changes in heart rate recovery in response to acute changes in training load. European Journal of Applied Physiology, (101), 503-511.
📄Borresen, J., & Lambert, M.I. (2008). Autonomic control of heart rate during and after exercise: measurements and implications for monitoring training status. Sports Medicine, (38), 633-646.
📄Bosquet, L., Merkari, S., Arvisais, D., & Aubert, A.E. (2008). Is heart rate a convenient tool to monitor over-reaching? A systematic review of the literature. British Journal of Sports Medicine, 42(9), 709-714.
📄Bricout, V.A., DeChenaud, S., & Favre-Juvin, A. (2010). Analyses of heart rate variability in young soccer players: the effects of sport activity. Autonomic Neuroscience, 154(1-2), 112-116.
📄Buchheit, M. (2014). Monitoring training status with HR measures: do all roads lead to Rome? Frontiers in Physiology, 5, 73.
📄Camm, A.J., Malik, M., Bigger, J.T., Breithardt, G., Cerutti, S., Cohen, R. J., . . . et al. (1996). Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation,, 93(5), 1043-1065.
📄Cao, R., Azimi, I., Sarhaddi, F., Niela-Vilen, H., Axelin, A., Liljeberg, P., … et al. (2022). Accuracy assessment of oura ring nocturnal heart rate and heart rate variability in comparison with electrocardiography in time and frequency domains: comprehensive analysis. Journal of Medical Internet Research, 24(1), e27487.
📄Chan, P.H., Wong, C.K., Poh, Y.C., Pun, L., Leung, W.W.C., Wong, Y.F., … et al. (2016). Diagnostic performance of a smartphone‐based photoplethysmographic application for atrial fibrillation screening in a primary care setting. Journal of the American Heart Association, 5(7), e003428.
📄Coutts, A.J., Slattery, K.M. & Wallace, L.K. (2007). Practical tests for monitoring performance, fatigue and recovery in triathletes. Journal of Science and Medicine in Sport, 10(6), 372-381.
📄Cowan, M.J. (1995). Measurement of heart rate variability. Western Journal of Nursing Research, 17(1), 32-48.
📄Dobbs, W.C., Fedewa, M.V., MacDonald, H.V., Holmes, C.J., Cicone, Z.S., Plews, D.J., … et al. (2019). The Accuracy of Acquiring Heart Rate Variability from Portable Devices: A Systematic Review and Meta-Analysis. Sports Medicine (Auckland, N.Z.), 49(3), 417-435.
📄Edwards, R.H. (1981). Human muscle function and fatigue. Human Muscle Fatigue: Physiological Mechanisms, (82), 1-18.
📄Esco, M.R., & Flatt, A.A. (2014). Ultra-short-term heart rate variability indexes at rest and post-exercise in athletes: evaluating the agreement with accepted recommendations. Journal of Sports Science ve Medicine, 13(3), 535.
📄Esco, M.R., Flatt, A.A. & Nakamura, F.Y. (2017). Agreement between a smartphone pulse sensor application and electrocardiography for determining lnRMSSD [Article]. Journal of Strength and Conditioning Research, 31(2), 380-385.
📄Figueiredo, T., Menezes, P., Kattenbraker, M., Polito, M., Reis, V., & Simão, R. (2013). Influence of exercise order on blood pressure and heart rate variability after a strength training session. Journal of Sports Medicine and Physical Fitness, 53(3), 12-17.
📄Fitzpatrick, J.F., Hicks, K.M., Russell, M., & Hayes, P.R. (2021). The reliability of potential fatigue-monitoring measures in elite youth soccer players. Journal of Strength and Conditioning Research, 35(12), 3448-3452.
📄Flatt, A.A., & Esco, M. R. (2013). Validity of the ithlete™ smart phone application for determining ultra-short-term heart rate variability. Journal of Human Kinetics, (39), 85-92.
📄Flatt, A. A. and Esco, M. R. (2016). Heart rate variability stabilization in athletes: Towards more convenient data acquisition. Clinical Physiology and Functional Imaging, 36(5), 331-336.
📄Flatt, A.A., Hornikel, B., & Esco, M. R. (2017). Heart rate variability and psychometric responses to overload and tapering in collegiate sprint-swimmers. Journal of Science and Medicine in Sport, 20(6), 606-610.
📄Flatt, A.A., & Howells, D. (2019). Effects of varying training load on heart rate variability and running performance among an Olympic rugby sevens team. Journal of Science and Medicine in Sport, 22(2), 222-226.
📄Fronchetti, L., Nakamura, F.Y., De-Oliveira, F.R., Lima-Silva, A.E., & De Lima, J. R. (2007). Effects of high-intensity interval training on heart rate variability during exercise. Journal of Exercise Physiology Online, 10(4).
📄Furlan, R., Pagani, M., & Malliani, A. (1993). Effects of exercise and training on control of heart rate. Cardiovascular Research, 27(12), 2286-2287.
📄Gabriel, H.H., Urhausen, A., Valet, G., Heidelbach, U., & Kindermann, W. (1998). Overtraining and immune system: A prospective longitudinal study in endurance athletes. Medicine and Science in Sports and Exercise, (30), 1151-1157.
📄Georgiou, K., Larentzakis, A.V., Khamis, N.N., Alsuhaibani, G.I., Alaska, Y.A., & Giallafos, E.J. (2018). Can wearable devices accurately measure heart rate variability? A systematic review. Folia Medica, 60(1), 7-20.
📄Halson, S.L. (2014). Monitoring training load to understand fatigue in athletes. Sports Medicine, 44(Suppl 2), 139-147.
📄Halson, S.L., & Jeukendrup, A.E. (2004). Does overtraining exist? An analysis of overreaching and overtraining research. Sports Medicine, (34), 967-981.
📄Hedelin, R., Kenttä, G., Wiklund, U., Bjerle, P., & Henriksson-Larsén, K. (2000). Short-term overtraining: effects on performance, circulatory responses, and heart rate variability. Medicine and Science in Sports and Exercise, 32(8), 1480-1484.
📄Henriques, T., Ribeiro, M., Teixeira, A., Castro, L., Antunes, L., & Costa-Santos, C. (2020). Nonlinear methods most applied to heart-rate time series: A review. Entropy, 22(3), 309.
📄Hon, E. (1965). Electronic evaluations of the fetal heart rate patterns preceding fetal death: further observations. American Journal of Obstetrics and Gynecology, (87), 814-826.
📄Hynynen, E., Uusitalo, A., Konttinen, N., & Rusko, H. (2008). Cardiac autonomic responses to standing up and cognitive task in overtrained athletes. International Journal of Sports Medicine, 29(07), 552-558.
📄Iellamo, F., Legramante, J.M., Pigozzi, F., Spataro, A., Norbiato, G., Lucini, D., & Pagani, M. (2002). Conversion from vagal to sympathetic predominance with strenuous training in high-performance world class athletes. Circulation, 105(23), 2719-2724.
📄Ishaque, S., Khan, N., & Krishnan, S. (2021). Trends in heart-rate variability signal analysis. Frontiers in Digital Health, (3), 639444.
📄Javorka, M., Zila, I., Balharek, T., & Javorka, K. (2002). Heart rate recovery after exercise: relations to heart rate variability and complexity. Brazilian Journal of Medical and Biological Research, (35), 991-1000.
📄Jones, C.M., Griffiths, P.C., & Mellalieu, S.D. (2017). Training load and fatigue marker associations with injury and illness: a systematic review of longitudinal studies. Sports Medicine, (47), 943-974.
📄Kaikkonen, P., Rusko, H., & Martinmäki, K. (2008). Post‐exercise heart rate variability of endurance athletes after different high‐intensity exercise interventions. Scandinavian Journal of Medicine ve Science in Sports, 18(4), 511-519.
📄Kellmann, M. (2010). Preventing overtraining in athletes in high‐intensity sports and stress/recovery monitoring. Scandinavian Journal of Medicine ve Science in Sports, (20), 95-102.
📄Kenney, W.L., Wilmore, J.H., & Costill, D.L. (2021). Physiology of sport and exercise. Human kinetics.
📄Kumar, P., Das, A.K., & Halder, S. (2020). Time-domain HRV analysis of ECG signal under different body postures. Procedia Computer Science, (167), 1705-1710.
📄Kumar, P., Das, A.K., & Halder, S. (2022). Statistical heart rate variability analysis under rest and post-exercise. International Journal of Computational Science and Engineering, 25(2), 186-197.
📄Lacey, J.I. (1956). The evaluation of autonomic responses: Toward a general solution. Annals of the New York Academy of Sciences, 67(5), 125-163.
📄Lai, E., Boyd, K., Albert, D., Ciocca, M., & Chung, E. H. (2017). Heart rate variability in concussed athletes: A case report using the smartphone electrocardiogram. HeartRhythm case reports, 3(11), 523-526.
📄Lamberts, R., Swart, J., Capostagno, B., Noakes, T., & Lambert, M. (2010). Heart rate recovery as a guide to monitor fatigue and predict changes in performance parameters. Scandinavian Journal of Medicine and Science in Sports, 20(3), 449-457.
📄Li, K., Rüdiger, H., & Ziemssen, T. (2019). Spectral analysis of heart rate variability: Time window matters. Frontiers in Neurology, (10), 545.
📄Lourenço, J., Gouveia, É.R., Sarmento, H., Ihle, A., Ribeiro, T., Henriques, R., … et al. (2023). Relationship between Objective and Subjective Fatigue Monitoring Tests in Professional Soccer. International Journal of Environmental Research and Public Health, 20(2), 1539.
📄Malik, M. (1996). Heart rate variability: Standards of measurement, physiological interpretation, and clinical use: task force of the European Society of Cardiology and the North American Society for pacing and electrophysiology. Annals of Noninvasive Electrocardiology, 1(2), 151-181.
📄Martinmäki, K., & Rusko, H. (2008). Time-frequency analysis of heart rate variability during immediate recovery from low and high intensity exercise. European Journal of Applied Physiology, (102), 353-360.
📄McCorry, L.K. (2007). Physiology of the autonomic nervous system. American Journal of Pharmaceutical Education, 71(4).
📄McGuigan, M. (2017). Monitoring training and performance in athletes. Human Kinetics.
📄McKenna, M.J., & Hargreaves, M. (2008). Resolving fatigue mechanisms determining exercise performance: integrative physiology at its finest! In (Vol. 104, pp. 286-287): American Physiological Society.
📄Meeusen, R., Duclos, M., Foster, C., Fry, A., Gleeson, M., Nieman, D., … et al. (2013). Prevention, diagnosis and treatment of the overtraining syndrome: Joint consensus statement of the European College of Sport Science (ECSS) and the American College of Sports Medicine (ACSM). European Journal of Sport Science, 13(1), 1-24.
📄Meeusen, R., Duclos, M., Gleeson, M., Rietjens, G., Steinacker, J., & Urhausen, A. (2006). Prevention, diagnosis and treatment of the overtraining syndrome. European Journal of Sport Science, 6(1), 1-14.
📄Michael, S., Graham, K.S., & Davis, G. M. (2017). Cardiac autonomic responses during exercise and post-exercise recovery using heart rate variability and systolic time intervals—a review. Frontiers in Physiology, (8), 301.
📄Morales, J., Álamo, J.M., García-Massó, X., López, J.L., Serra-Añó, P., & González, L.M. (2014). Use of heart rate variability in monitoring stress and recovery in judo athletes. The Journal of Strength ve Conditioning Research, 28(7), 1896-1905.
📄Mourot, L., Bouhaddi, M., Perrey, S., Cappelle, S., Henriet, M.T., Wolf, J.P., … et al. (2004). Decrease in heart rate variability with overtraining: assessment by the Poincare plot analysis. Clinical Physiology and Functional Imaging, 24(1), 10-18.
📄Moya-Ramon, M., Mateo-March, M., Peña-González, I., Zabala, M., & Javaloyes, A. (2022). Validity and reliability of different smartphones applications to measure HRV during short and ultra-short measurements in elite athletes. Computer Methods and Programs in Biomedicine, (217), 106696.
📄Nikhil, S., Kegan, J. M., Christle, J. W., Hadley, D., Plews, D., & Froelicher, V. (2018). Heart rate variability: An old metric with new meaning in the era of using MHealth technologies for health and Exercise training guidance. Part one: Physiology and methods. Arrhythmia ve Electrophysiology Review, 7(4), 193-198.
📄Pereira, R.d.A., Alves, J.L.d.B., Silva, J.H.d.C., Costa, M.d.S., & Silva, A.S. (2020). Validity of a smartphone application and chest strap for recording RR intervals at rest in Athletes. International Journal of Sports Physiology and Performance, 15(6), 896-899.
📄Perrotta, A.S., Jeklin, A.T., Hives, B.A., Meanwell, L.E., & Warburton, D. E. (2017). Validity of the elite HRV smartphone application for examining heart rate variability in a field-based setting. The Journal of Strength ve Conditioning Research, 31(8), 2296-2302.
📄Plews, D.J., Laursen, P.B., Stanley, J., Kilding, A.E., & Buchheit, M. (2013). Training adaptation and heart rate variability in elite endurance athletes: opening the door to effective monitoring. Sports Medicine, (43), 773-781.
📄Plews, D.J., Scott, B., Altini, M., Wood, M., Kilding, A.E., & Laursen, P.B. (2017). Comparison of Heart-Rate-Variability Recording With Smartphone Photoplethysmography, Polar H7 Chest Strap, and Electrocardiography. International Journal of Sports Physiology and Performance, 12(10), 1324-1328.
📄Quintana, D., Alvares, G.A., & Heathers, J. (2016). Guidelines for Reporting Articles on Psychiatry and Heart rate variability (GRAPH): recommendations to advance research communication. Translational Psychiatry, 6(5), e803-e803.
📄Rabbani, A., Baseri, M.K., Reisi, J., Clemente, F.M., & Kargarfard, M. (2018). Monitoring collegiate soccer players during a congested match schedule: Heart rate variability versus subjective wellness measures. Physiology and Behavior, (194), 527-531.
📄Rajalakshmi, R., Akila, B. & Tharion, E. (2015). Intra-class correlation among heart rate variability analysis softwares across different physiological postures. Indian Journal of Physiology and Pharmacology, 59(1), 2-8.
📄Ramasamy, S., & Balan, A. (2018). Wearable sensors for ECG measurement: a review. Sensor Review, 38(4), 412-419.
📄Rezk, C.C., Marrache, R.C., Tinucci, T., Mion, D., & Forjaz, C.L.M. (2006). Post-resistance exercise hypotension, hemodynamics, and heart rate variability: influence of exercise intensity. European Journal of Applied Physiology, (98), 105-112.
📄Rouast, P.V., Adam, M.T., Cornforth, D.J., Lux, E., & Weinhardt, C. (2017). Using contactless heart rate measurements for real-time assessment of affective states. Information Systems and Neuroscience: Gmunden Retreat on NeuroIS 2016,
📄Sammito, S., & Böckelmann, I. (2016). Factors influencing heart rate variability. International Cardiovascular Forum Journal, (6), 18-22.
📄Sammito, S., Thielmann, B., Seibt, R., Klussmann, A., Weippert, M., & Böckelmann, I. (2015). Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational science. ASU International, 2015(06), 1-29.
📄Schaafsma, A. E. (2015). Heart rate variability and wellness monitoring in collegiate athletes University of Illinois at Urbana-Champaign].
📄Schmitt, L., Regnard, J., Desmarets, M., Mauny, F., Mourot, L., Fouillot, J.P., … et al. (2013). Fatigue shifts and scatters heart rate variability in elite endurance athletes. PloS one, 8(8), e71588.
📄Schneider, C., Wiewelhove, T., Raeder, C., Flatt, A.A., Hoos, O., Hottenrott, L., … et al. (2019). Heart rate variability monitoring during strength and high-intensity interval training overload microcycles. Frontiers in Physiology, (10), 582.
📄Schuurmans, A.A., de Looff, P., Nijhof, K.S., Rosada, C., Scholte, R.H., Popma, A., … et al. (2020). Validity of the Empatica E4 wristband to measure heart rate variability (HRV) parameters: A comparison to electrocardiography (ECG). Journal of Medical Systems, (44), 1-11.
📄Stangl, F.J., & Riedl, R. (2022). Measurement of heart rate and heart rate variability with wearable devices: A systematic review.
📄Stauss, H.M. (2003). Heart rate variability. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 285(5), R927-R931.
📄Terziotti, P., Schena, F., Gulli, G., & Cevese, A. (2001). Post-exercise recovery of autonomic cardiovascular control: A study by spectrum and cross-spectrum analysis in humans. European Journal of Applied Physiology, (84), 187-194.
📄Thorpe, R.T., Atkinson, G., Drust, B., & Gregson, W. (2017). Monitoring fatigue status in elite team-sport athletes: implications for practice. International Journal of Sports Physiology and Performance, 12(s2), S2-27-S22-34.
📄Thorpe, R.T., Strudwick, A.J., Buchheit, M., Atkinson, G., Drust, B., & Gregson, W. (2016). Tracking morning fatigue status across in-season training weeks in elite soccer players. International Journal of Sports Physiology and Performance, 11(7), 947-952.
📄Urhausen, A., Gabriel, H., & Kindermann, W. (1995). Blood hormones as markers of training stress and overtraining. Sports Medicine, (20), 251-276.
📄Uusitalo, A., Uusitalo, A., & Rusko, H. (2000). Heart rate and blood pressure variability during heavy training and overtraining in the female athlete. International Journal of Sports Medicine, 21(01), 45-53.
📄Yan, B.P., Lai, W.H., Chan, C.K., Chan, S.C.H., Chan, L.H., Lam, K.M., … et al. (2018). Contact‐free screening of atrial fibrillation by a smartphone using facial pulsatile photoplethysmographic signals. Journal of the American Heart Association, 7(8), e008585.
📄Zając, A., Chalimoniuk, M., Maszczyk, A., Gołaś, A., & Lngfort, J. (2015). Central and peripheral fatigue during resistance exercise–a critical review. Journal of Human Kinetics, (49), 159.
