Monitoring and adapting endurance training on the basis of heart rate variability monitored by wearable technologies: A systematic review with meta-analysis.

To systematically perform a meta-analysis of the scientific literature to determine whether the outcomes of endurance training based on heart rate variability (HRV) are more favorable than those of predefined training. Systematic review and meta-analysis. PubMed and Web of Science were searched systematically in March of 2020 using keywords related to endurance, the ANS, and training. To compare the outcomes of HRV-guided and predefined training, Hedges' g effect size and associated 95% confidence intervals were calculated. A total of 8 studies (198 participants) were identified comprising 9 interventions involving a variety of approaches. Compared to predefined training, most HRV-guided interventions included fewer moderate- and/or high-intensity training sessions. Fixed effects meta-analysis revealed a significant medium-sized positive effect of HRV-guided training on submaximal physiological parameters (g = 0.296, 95% CI 0.031 to 0.562, p = 0.028), but its effects on performance (g = 0.079, 95% CI -0.050 to 0.393, p = 0.597) and V̇O2peak (g = 0.171, 95% CI -0.213 to 0.371, p = 0.130) were small and not statistically significant. Moreover, with regards to performance, HRV-guided training was associated with fewer non-responders and more positive responders. In comparison to predefined training, HRV-guided endurance training had a medium-sized effect on submaximal physiological parameters, but only a small and non-significant influence on performance and V̇O

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