Exercise-induced changes in compensatory reserve and heart rate complexity

Michelle B. Mulder, Sarah A. Eidelson, Mark D. Buzzelli, Kirby R. Gross, Andriy I. Batchinsky, Victor A. Convertino, Carl I. Schulman, Nicholas Namias, Kenneth G. Proctor

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


BACKGROUND: Portable noninvasive Heart Rate Complexity (HRC) and Compensatory Reserve Measurement (CRM) monitors have been developed to triage supine combat casualties. Neither monitor has been tested in upright individuals during physical exercise. This study tests the hypothesis that exercise evokes proportional changes in HRC and CRM. METHODS: Two instruments monitored volunteers (9 civilian and 11 soldiers) from the Army Trauma Training Department (ATTD) before, during, and following physical exercise. One recorded heart rate (HR, bpm), cardiac output (CO, L � min-1), heart rate variability (HRV, root mean square of successive differences, ms), and HRC (Sample Entropy, unitless). The other recorded HR, pulse oximetry (Spo2, %), and CRM (%). RESULTS: Baseline HR, CO, HRV, HRC, and CRM averaged 72 ± 1 bpm, 5.6 ± 1.2 L � min-1, 48 ± 24 ms, 1.9 ± 0.5, and 85 ± 10% in seated individuals. Exercise evoked peak HR and CO at > 200% of baseline, while HRC and CRM were simultaneously decreased to minimums that were ≤ 50% of baseline (all P < 0.001). HRV changes were variable and unreliable. Spo2 remained consistently above 95%. During a 60 min recovery, HR and CRM returned to baseline on parallel tracks (t1/2=11 ± 8 and 18 ± 14 min), whereas HRC recovery was slower than either CRM or HR (t1/2=40 ± 18 min, both P < 0.05). DISCUSSION: Exercise evoked qualitatively similar changes in CRM and HRC. CRM recovered incrementally faster than HRC, suggesting that vasodilation, muscle pump, and respiration compensate faster than cardiac autonomic control in young, healthy volunteers. Both HRC and CRM appear to provide reliable, objective, and noninvasive metrics of human performance in upright exercising individuals.

Original languageEnglish (US)
Pages (from-to)1009-1015
Number of pages7
JournalAerospace Medicine and Human Performance
Issue number12
StatePublished - 2019


  • Compensatory reserve measurement
  • Heart rate complexity
  • Heart rate variability
  • Homeostasis

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Exercise-induced changes in compensatory reserve and heart rate complexity'. Together they form a unique fingerprint.

Cite this