Slow-Paced Breathing and Autonomic Function in People Post-stroke

Mia Larson, Daniel P. Chantigian, Ninitha Asirvatham-jeyaraj, Ann Van De Winckel, Manda L. Keller-ross

Research output: Contribution to journalArticlepeer-review


Purpose: To determine if acute slow breathing at 6 breaths/min would improve baroreflex sensitivity (BRS) and heart rate variability (HRV), and lower blood pressure (BP) in adults after stroke. Methods: Twelve individuals completed two randomized study visits where they performed a 15-min bout of breathing exercises at 6 breaths/min (slow) and at 12 breaths/min (control). Continuous BP and heart rate (HR) were measured throughout, and BRS, BRS response to elevations in blood pressure (BRSup), BRS response to depressions in blood pressure (BRSdown), and HRV were calculated and analyzed before (pre), during, and after (post) breathing exercises. Results: BRS increased from pre to post slow breathing by 10% (p = 0.012), whereas BRSup increased from pre to during slow breathing by 30% (p = 0.04). BRSdown increased from pre to post breathing for both breathing conditions (p < 0.05). HR (control: Δ − 4 ± 4; slow: Δ − 3 ± 4 beats/min, time, p < 0.01) and systolic BP (control: Δ − 0.5 ± 5; slow: Δ − 6.3 ± 8 mmHg, time, p < 0.01) decreased after both breathing conditions. Total power, low frequency power, and standard deviation of normal inter-beat intervals (SDNN) increased during the 6-breaths/min condition (condition × time, p < 0.001), whereas high frequency increased during both breathing conditions (time effect, p = 0.009). Conclusions: This study demonstrated that in people post-stroke, slow breathing may increase BRS, particularly BRSup, more than a typical breathing space; however, paced breathing at either a slow or typical breathing rate appears to be beneficial for acutely decreasing systolic BP and HR and increasing HRV.

Original languageEnglish (US)
Article number573325
JournalFrontiers in Physiology
StatePublished - Oct 30 2020

Bibliographical note

Funding Information:
This work was in part supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (Award Number UL1TR000114) and an American Physiological Society (APS) Research Enhancement Award (MK-R). NA-J acknowledges support from the DST-Inspire faculty award, India (DST/INSPIRE/04/2017/003227). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health APS, or DST-Inspire. These granting organizations played no role in the design, execution, analysis, data interpretation, or writing of the manuscript.

Publisher Copyright:
© Copyright © 2020 Larson, Chantigian, Asirvatham-Jeyaraj, Van de Winckel and Keller-Ross.


  • autonomic function
  • baroreflex
  • heart rate variability
  • slow breathing
  • stroke

PubMed: MeSH publication types

  • Journal Article


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