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The what and how of orthostatic test

What is the orthostatic test?

Orthostatic test is a generally used tool for monitoring the balance between training and recovery. It is based on the training-induced changes in the function of your autonomic nervous system. Orthostatic test results are affected by several external factors, such as mental stress, sleep, latent illness, environmental changes (temperature, altitude), and others. Long term follow-up helps you to optimize your training and prevent overtraining.

Orthostatic test is based on the measurement of heart rate and heart rate variability. Changes in heart rate and heart rate variability reflect the changes in autonomic regulation of the cardiovascular system. The test measures beat to beat heart rate, in other words RR intervals.

Why should I do an orthostatic test?

It helps you to avoid overtraining. Heart rate and heart rate variability measured during orthostatic test are good indicators of disturbances in the autonomic nervous system, which often occur due to fatigue or overtraining. However, heart rate responses to fatigue and overtraining are always individual. They require long term follow-up, and first of all you need to make the test six times to build a reliable baseline.

As soon as you’ve made your six baseline tests, you can start following your test results regularly. Orthostatic test is meant to be used continuously, so you can include it in your morning schedule. Note that with orthostatic test you can’t compare your results to your friends’ results: they are individual and apply for you only.

How do I do an orthostatic test?

When you start using the orthostatic test, six baseline tests should be conducted over a period of two weeks to determine your personal baseline value. These baseline tests should be made during two typical basic training weeks, not during heavy training weeks. The baseline tests should include tests taken both after training days and after recovery days.

After the baseline tests, you should continue to perform the test 2-3 times a week. Test yourself weekly in the morning following both a recovery day and a heavy training day (or a series of heavy training days). An optional third test can be performed after a normal training day. The test may not provide reliable information during detraining or in a very irregular training period. If you take a break from exercise for 14 days or longer, you should consider resetting your long-term averages and perform the baseline tests again

The test should always be taken in standardized/similar conditions in order to get the most reliable results. It is recommended that you take the test in the morning before breakfast. The following basic requirements apply:

  • Wear the heart rate sensor.
  • You should be relaxed and calm.
  • You can be seated in a relaxed position or lying in bed. The position should always be the same when you do the test.
  • There should be no disturbing noises (for example, television, radio or telephone) or other people talking to you.
  • It is recommended to perform the test regularly and at the same time of day in the morning after waking up to get comparable test results.

What are the values in the orthostatic test result?

From every orthostatic test that you perform, you get heart rate results and heart rate variability results. HR REST and RMSSD REST are your heart rate and heart rate variability when lying down. HR STAND and RMSSD STAND are your heart rate and heart rate variability when standing still. HR PEAK is the one highest heartbeat that occurs after you stand up. After your first test you start building your heart rate averages, on the lower part of the result view in Flow web service, that are automatically updated after each test.

Note that in heart rate results HR REST and HR STAND are average values. That’s why you may find lower transient values on the curve.

 

How can I use the orthostatic test results in planning my training?

As your training season progresses, you can follow the effect of an increased training load on your heart rate results by monitoring the difference between your averages and results. In the result you can see your newest peak, stand and rest values and how much they differ from your average values. If one or more of your results persistently falls below or rises above your averages and doesn’t normalize during your recovery weeks when your training load is lower, it’s possible that you are developing an overtraining syndrome. Don’t forget that your heart rate is only one indicator of overtraining. You should always monitor other changes as well, such as changes in performance and general feelings of fatigue.

It may also be a good idea to occasionally have an expert look at your values, especially in case you think you might be overtrained.

Scientific background

Even in scientific literature there is debate and continuous investigation about the best indicators of overtraining. There are different stages in training-induced fatigue that are generally classified based on how long it takes to recover. The challenge of interpreting your orthostatic test results is that your heart rate and heart rate variability responses to training may change according to the stage of fatigue, be due to other factors such as stress or illness, and be different from those of your friends. This is why you'll need to learn how your training affects your own orthostatic test results. It may also be a good idea to occasionally have an expert look at your values.

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