Applied Heart Rate Variability Across the Lifespan: From Clinical Rehabilitation to Digital Technologies

Heart rate variability (HRV) research provides an important framework for understanding autonomic nervous system regulation, central autonomic network function, and systemic allostatic load. Once primarily associated with exercise physiology and sports performance, HRV is now being investigated across neurological medicine, rehabilitation, preventive health, behavioural interventions, and wearable technology. Current research examines whether HRV can improve early risk detection, characterize disease progression, guide rehabilitation, and support individualized exercise and recovery strategies. However, important questions remain regarding the clinical meaning of specific HRV metrics, the influence of biological sex and life stage, and the reproducibility of measurements across protocols and populations. Recent studies suggest that HRV may reflect autonomic and inflammatory changes associated with neurological disorders, physical activity, respiratory training, and stress regulation, while methodological advances have expanded opportunities for continuous monitoring. Nevertheless, heterogeneity in acquisition procedures, preprocessing, reporting standards, and device algorithms limits comparison between studies and translation into clinical practice. A coordinated investigation integrating autonomic physiology, clinical neuroscience, exercise science, respiratory interventions, and sensor validation is therefore needed to establish robust applications and common standards.This Research Topic aims to advance the assessment and interpretation of HRV as a translational biomarker of autonomic regulation across the lifespan. It will examine the value of HRV for neurological risk stratification, disease monitoring, rehabilitation, exercise prescription, recovery, and personalized health management. It will also evaluate whether respiratory and physical activity interventions can improve vagal modulation, neuroplasticity, inflammatory regulation, and symptoms in healthy and clinical populations. Further aims are to clarify sex- and gender-related variation in autonomic responses and to determine the accuracy, reliability, and clinical utility of wearable HRV technologies compared with established electrocardiographic standards.To gather further insights in translational HRV assessment across neurological health, clinical rehabilitation, exercise and respiratory interventions, sex- and gender-informed autonomic regulation, and wearable monitoring, we welcome articles addressing, but not limited to, the following themes:HRV as a biomarker of risk, progression, prognosis, and rehabilitation outcomes in stroke, Parkinson’s disease, mild cognitive impairment, dementia, traumatic brain injury, and functional neurological disorders.Preclinical detection of autonomic dysregulation before the onset of overt neurological symptoms.Effects of physical activity, exercise training, and recovery protocols on parasympathetic modulation across diverse populations.Resonance-frequency breathing, HRV biofeedback, mindfulness, and other respiratory interventions targeting vagal modulation.Associations among HRV, neuroplasticity, systemic inflammation, the cholinergic anti-inflammatory pathway, and symptom management.Effects of menstrual-cycle phases, endogenous hormones, oral contraceptives, pregnancy, and menopause on HRV.Sex- and gender-specific responses to exercise, respiratory training, stress, and recovery.Validation of photoplethysmography sensors, smart rings, chest straps, and other wearable devices against clinical ECG.Signal fidelity, artifact correction, algorithm transparency, and HRV reporting standards.Wearable HRV assessment during movement, free-living conditions, ageing, arrhythmias, tremor, and neurological disease.Multimodal, longitudinal, and personalized approaches to autonomic monitoring across the biological lifespan.Appendix: We welcome original research articles, systematic reviews, meta-analyses, and methodological validation studies. Topic editors: María Carrasco-Poyatos, Marco Altini Source: https://www.frontiersin.org/research-topics/86008/applied-heart-rate-variability-across-the-lifespan-from-clinical-rehabilitation-to-digital-technologies