Standing up to neurodegeneration: evaluating autonomic stress and safety in sit-to-stand using heart rate variability analysis.

OBJECTIVES

Sit-to-stand (STS) exercises are commonly incorporated in functional rehabilitation due to their simplicity, relevance to daily mobility and more recently, cardiac fitness. While generally considered safe for most clinical populations, its effect on autonomic stability remains underexplored - particularly in those with autonomic vulnerability such as individuals with amyotrophic lateral sclerosis (ALS). This study investigates the suitability of STS exercises for individuals with ALS, with specific focus on establishing baseline heart rate variability (HRV) data during rest and transient STS movement.

METHODS

Heart rate (HR) and HRV (RMSSD and HF) were assessed across three cohorts; healthy young adults (n=29), individuals living with ALS (n=8), and their age-matched controls (n=9), under resting condition and two STS protocols: Timed up and go (TUG) and five times sit-to-stand test (FTSST).

RESULTS

All groups exhibited significant increase in mean HR during STS compared to rest (p<0.05), whereas no statistically significant differences were observed in RMSSD and HF. These results indicate that STS exercises elicit measurable cardiovascular exertion without triggering acute autonomic dysfunction in ALS individuals, supporting its role in safe rehabilitation for early-mid stages ALS.

CONCLUSIONS

HRV serves as a potential tool for non-invasive monitoring and assessment of autonomic function during physical therapy.