Heart rate variability, ECG minor changes, and HRV-ECG coupling associated with an adjunctive structured breathing-meditation protocol in combat-exposed military personnel.
Viktor S Matsyshyn, Anatolii M Kravchenko, Nataliia M Ovodiuk, Dmytro Y Zharkov, Kostiantyn O Apykhtin, Oleksandr P Romanchuk, Illya A Chaikovsky
Frontiers in Network Physiology 2026 DOI: 10.3389/fnetp.2026.1912231 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Controlled, non-randomized study Peer reviewed |
|---|---|
| Sample size | 74 |
| Population | Male Ukrainian servicemen undergoing rehabilitation (TMR group n=35, control n=39); civilian reference group (n=89) for baseline comparison |
| Intervention | Technique of Mental Relaxation (TMR) |
| Duration | 14-day rehabilitation period |
| Measures | SDNN, RMSSD, Baevsky Stress Index, heart rate, ECG repolarization intervals |
| Topics | PTSD Meditation |
| Keywords | Arterial hypertension Cardiovascular disease risk Electrocardiogram Heart rate variability Military personnel Network physiology |
| Key points | Adding TMR to standard rehabilitation improved HRV indices (SDNN, RMSSD, Baevsky Stress Index) in combat-exposed servicemen over 14 days, while controls deteriorated; between-group differences were significant for all primary outcomes, though heart-rate adjustment attenuated some effects. |
Abstract
Combat-related stress is associated with autonomic nervous system (ANS) dysregulation-sympathetic predominance, reduced vagal tone, and decreased heart rate variability (HRV)-linked to increased cardiovascular risk. Non-pharmacological interventions targeting autonomic regulation show promise, but controlled studies in combat-exposed populations remain limited. We assessed whether adding a structured breathing-meditation protocol, the Technique of Mental Relaxation (TMR), to standard rehabilitation is associated with changes in HRV and electrocardiogram (ECG)-derived indices of autonomic regulation in Ukrainian servicemen. A controlled, non-randomized study screened 84 male servicemen; 77 were allocated to a TMR group (n = 37; TMR plus standard treatment) or a control group (n = 40; standard treatment alone). Paired baseline and post-treatment 5-min supine recordings, obtained over a 14-day rehabilitation period, were available for 74 participants (TMR n = 35, control n = 39); a civilian reference group (n = 89) provided baseline comparison. Primary HRV outcomes were SDNN, RMSSD, the Baevsky Stress Index, and heart rate; ECG analysis added repolarization intervals, with Hedges' g. At baseline, both military groups showed impaired autonomic regulation versus civilians (all p < 0.0001). After intervention, the TMR group improved (SDNN 23→30 ms, p < 0.001; RMSSD 12→19 ms, p < 0.001; Stress Index 422→253, p < 0.001), whereas controls deteriorated; post-treatment between-group differences were significant for all primary outcomes (p ≤ 0.008). Heart-rate-adjusted analyses attenuated part of this difference, the Stress Index remaining most robust. Given the non-randomized design, these findings warrant caution and support randomized trials, with HRV as an objective monitoring tool.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cites 3
- HEART RATE VARIABILITY AS AN OBJECTIVE CRITERION FOR THE PSYCHO-EMOTIONAL STATE OF COMBATANTS. Wiadomosci lekarskie (Warsaw, Poland : 1960) 2023
- Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Scientific Reports January 9, 2023
- The Effects of Mindfulness and Meditation on Vagally Mediated Heart Rate Variability: A Meta-Analysis. Psychosomatic Medicine July 1, 2021