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PILOT STUDY

The Effects Of Slow Breathing Exercise On Heart

Rate Dynamics And Cardiorespiratory Coherence

In Preschool Children: A Prospective Clinical Study

Marina Zuanazzi Cruz; Moacir Fernandes de Godoy; Vitor E. Valenti, PhD;
Alfredo Pereira Jr; Roberto Antonio Dias Cardoso

ABSTRACT
Background • Slow breathing has been used to improve Results • The percentage of high coherence ratio increased
psychophysiological regulation due to positive action on (P < .0001), HRV reduced (SDNN, P = .0066; RMSSD,
the autonomic nervous system. P = .0015; pNN50, P < .0001; SD1, P = .0015; SD2, P = .0166)
Primary Study Objective • We evaluated the effects of and the complexity of HRV increased (ApEn, P = .0004;
slow breathing on heart rate autonomic control in MSE area, P < .0001; DFAαl, P = .0001; ShanEnt, P = .0106;
preschool-aged children. Lmean, P = .0066) during RSA compared to spontaneous
Methods/Design • Prospective clinical study. breathing after slow breathing training period.
Setting • Campinas, Brazil. Conclusion • Slow breathing training exercise induced
Participants • We included 42 children in the experimental increased cardiorespiratory coherence and increased
group (age 5.7 ± 0.3) and 33 children in the control group nonlinear behavior of heart rate dynamics suggesting
(age 6.2 ± 0.3). improvements in health status. Increased cardiorespiratory
Intervention • Children received a daily training of eight coherence reinforces the importance of including
weeks duration for practicing a slow breathing technique. respiratory exercises in strategies that aim to promote
Primary Outcome Measures • We analyzed heart rate physical health and self-regulation skills in educational
variability (HRV) and cardiorespiratory coherence at rest settings. (Altern Ther Health Med. 2020;26(4):14-21).
under spontaneous breathing and during respiratory sinus
arrhythmia (RSA) at the end of the 1st, 4th, and 8th weeks
of training.

Marina Zuanazzi Cruz, is at Programa de INTRODUCTION
Pós-Graduação em Saúde Coletiva, Faculdade de Medicina Psychophysiological self-regulation may be defined as
de Botucatu, Universidade Estadual Paulista, UNESP, the process in which an individual learns and employs
Botucatu, SP, Brasil. Moacir Fernandes de Godoy, is at the physical, cognitive or emotional abilities as a strategy to
Departamento de Cardiologia e Cirurgia Cardiovascular, regulate the physiological and psychological state. 1
Faculdade de Medicina de São José do Rio Preto, FAMERP, The learning of self-regulation skills is considered
São José do Rio Preto, SP, Brasil. Vitor E. Valenti, PhD, is at important for adequate neurobiological and psychosocial
Programa de Pós-Graduação em Fisioterapia, Faculdade de development in childhood. The lack of such skills impairs
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Ciências e Tecnologia, Universidade Estadual Paulista, the child’s cognitive, emotional, and social development. For
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UNESP, Presidente Prudente, SP, Brasil. Alfredo Pereira Jr, this reason, the World Health Organization has encouraged
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is at Departamento de Educação, Instituto de Biociências the implementation of programs that contribute to the
de Botucatu, Universidade Estadual Paulista, UNESP, development of life skills, social and emotional skills, with
Botucatu, SP, Brasil. Roberto Antonio Dias Cardoso, is at the objective of promoting mental health in children and
Núcleo de Medicina e Práticas Integrativas - Numepi/ adolescents. 3
Proex, Universidade Federal de São Paulo, UNIFESP, São There are several techniques that may be used to
Paulo, SP, Brasil. promote the development of self-regulation skills. Slow
breathing has been used as a technique to promote
Corresponding author: Marina Zuanazzi Cruz psychophysiological regulation mainly due to its beneficial
E-mail address: marinazc@hotmail.com action on the autonomic nervous system (ANS). Several
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14 ALTERNATIVE THERAPIES, JUL/AUG 2020 VOL. 26 NO. 4 Zuanazzi Cruz—Slow Breathing Exercise on Heart Rate