Effect of slow breathing exercise intension-type headache female patients: a Poincaré analysis of heart rate variability

Abstract

Introduction: Tension-type headache (TTH) is the most commonly experienced headache associated with impaired cardiac autonomic function. Poincaré plot analysis is a popular geometric method of heart rate variability(HRV) used to explore relationship between RR interval delivering  information on cardiac behavioral status. Slow breathing exercise (SBE) can significantly improve HRV in patients with various disease conditions. Objective: To observe the effect of slow breathing exercise on HRV by Poincaré plot analysis in female TTH patients. Methods: This study of quasi-experimental design was carried out from March 2021 to February 2022.Sixty  female(Age 20-45 years) TTH patients participated in this study. Thirty patients were under SBE performed  morning and evening for 30 minutes for 90 days and 30 patients were without SBE continued only conventional treatment for 90 days. Thirty age, sex and BMI matched apparently healthy control were enrolled who did not perform SBE. All subjects were followed up at baseline and also after 90 days. HRV parameters were recorded by Power Lab 8/35  and Poincare analysis was done with Lab chart soft ware AD Instruments, Australia. Data was analysed statistically by One way ANOVA followed by post-hoq Bonferroni test. Result: Poin care parameters SD1, SD2 and SD1/SD2 ratio were found significantly lower (p<0.001, p<0.01) in both group of patients compared to controls at baseline. After 90 days of performing SBE, significantly increased SD1 SD2 and SD1/SD2 ratio was observed in patients whereas these parameters were further decreased in patients without SBE after 90 days. this group of patients. Conclusion: SBE may effectively improve deranged autonomic function by increasing both sympathetic and parasympathetic limb of ANS and enhancing sympatho-vagal balance in TTH patients. J Bangladesh Soc Physiol 2026;21(1): 66-72