Effect of aerobic training on baroreflex sensitivity, heart rate recovery, and heart rate variability in type 2 diabetes: a systematic review

Objective Dysfunction of cardiac autonomic control (CAC) in people with type 2 diabetes mellitus (T2DM) is a predictor of cardiovascular disease mortality. The purpose of this study was to systematically review the literature on the effects of aerobic exercise training on CAC in people with T2DM. Methods Electronic databases (MEDLINE, Scopus, and Web of Science) were systematically searched to retrieve relevant evidence from inception to April 2021. Studies investigating the effect of aerobic training on CAC assessed by heart rate variability, baroreflex sensitivity, and heart rate recovery were included in the review. Two authors independently assessed trial quality using the PEDro scale & extracted the following data: study design and participant characteristics, intervention protocol, outcome measures, & major findings of the study. Results Ten studies enrolling 651 subjects met the eligibility criteria. Out of the 10 studies, only 4 were randomized controlled trials (RCTs). Eight out of ten studies showed a positive change in cardiac autonomic function. PEDro was used for quality and characteristic assessment which revealed fair-quality evidence. Six studies showed a high risk of bias according to the Cochrane risk of bias tool. Conclusion Evidence from this systematic review suggests that aerobic training may positively influence CAC in people with T2DM. However, further large-scale, robust RCTs are required.