{
  "abstract": "Rheumatologic diseases (RDs) are chronic autoimmune and inflammatory conditions associated with increased cardiovascular risk and autonomic nervous system dysfunction, typically characterized by sympathetic predominance, reduced vagal tone, and persistent inflammation. This narrative review synthesizes current evidence on exercise-based and mind-body rehabilitation strategies aimed at improving cardiovascular autonomic control in RDs, including rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, systemic sclerosis, and fibromyalgia. We examine the physiological mechanisms linking these interventions to autonomic regulation and inflammatory modulation, drawing upon the inflammatory reflex framework. Aerobic exercise training demonstrates consistent benefits for cardiovascular autonomic control, including enhanced heart rate variability, improved heart rate recovery, and reduced inflammation, though effects are reversible upon cessation. Resistance training improves pain and physical function but shows equivocal effects on autonomic outcomes. Balneotherapy and aquatic exercise may enhance parasympathetic activity, though responses are temperature-dependent and highly individualized. Mind-body interventions, including yoga, mindfulness, and breathing exercises, show promise for improving symptom burden and cardiac vagal modulation, with slow-paced breathing demonstrating particularly consistent acute and chronic autonomic benefits. Emerging evidence supports transcutaneous auricular vagus nerve stimulation as a non-invasive modality capable of modulating inflammation and reducing pain, though effects on cardiac autonomic control remain inconsistent across RDs populations. Key challenges include high inter-individual variability in treatment responses, poor long-term adherence, and frequent dissociation between subjective clinical improvement and objective autonomic measures. This review identifies critical knowledge gaps and proposes future research directions to optimize rehabilitation protocols for cardiovascular protection in RDs.",
  "abstract_shown": true,
  "affiliations": [
    "4Health Lab: Physiology, Research & Innovation for Precision Health, Department of Physiology and Pharmacology, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil",
    "Section of Rehabilitation, Department of Neuroscience-DNS, University of Padova, Padova, Italy",
    "University of Poitiers, Laboratory « Mobilité, Vieillissement, Exercice » (MOVE)-UR 20296, Faculty of Sports Sciences, Poitiers, France",
    "Department of Applied Sciences and Mechatronics, University of Applied Science Munich, München, Germany",
    "Klinikum Bad Gastein, Bad Gastein, Austria",
    "Department of Medical Psychology, Psychosomatics and Psychotherapy, Medical University of Graz, Graz, Austria",
    "Center of Rehabilitation, Physical and Sport Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania",
    "Department of Internal Medicine I, Division of Rheumatology and Clinical Immunology, University Medical Center, Johannes Gutenberg University, Mainz, Germany",
    "Department of Psychology, Luther College, Decorah, IA, United States",
    "0Department of Psychiatry and Behavioral Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States",
    "1Institute of Biomedical Electronics, Vienna University of Technology (TU Wien), Vienna, Austria",
    "2Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria",
    "3Institut für Physikalische Medizin und Rehabilitation, Landeskrankenhaus-Universitätsklinikum, Innsbruck, Austria",
    "4Klinikum am Kurpark, Baden, Austria"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Gabriel Dias Rodrigues"
    },
    {
      "affs": [
        1
      ],
      "name": "Maria Chiara Maccarone"
    },
    {
      "affs": [
        2
      ],
      "name": "Benoit Dugué"
    },
    {
      "affs": [
        3
      ],
      "name": "Chirstian Hanshans"
    },
    {
      "affs": [
        4
      ],
      "name": "Renata Cop"
    },
    {
      "affs": [
        5
      ],
      "name": "Sabrina Mörkl"
    },
    {
      "affs": [
        6
      ],
      "name": "Goda Camille Mickeviciute"
    },
    {
      "affs": [
        7
      ],
      "name": "Konstantinos Triantafyllias"
    },
    {
      "affs": [
        8
      ],
      "name": "Loren Toussaint"
    },
    {
      "affs": [
        9
      ],
      "name": "Jameson Hirsch"
    },
    {
      "affs": [
        10
      ],
      "name": "Eugenijus Kaniusas"
    },
    {
      "affs": [
        11
      ],
      "name": "Richard Crevenna"
    },
    {
      "affs": [
        12
      ],
      "name": "Erich Mur"
    },
    {
      "affs": [
        13
      ],
      "name": "Christian Wiederer"
    },
    {
      "affs": [
        4
      ],
      "name": "Martin Offenbächer"
    },
    {
      "affs": [
        5
      ],
      "name": "Martin Offenbächer"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7fxtpsnj78ccw.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1846075",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fmed.2026.1846075/full",
  "id": "7fxtpsnj78ccw",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://doi.org/10.3389/fmed.2026.1846075",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R5-920"
    ],
    [
      "openalex",
      "2705|Heart Rate Variability and Autonomic Control"
    ]
  ],
  "openalex": "W7225264871",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-04",
  "publisher": "Frontiers Media S.A.",
  "ris": "https://research.draconitic.com/paper/7fxtpsnj78ccw.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T14:21:03Z",
      "native_id": "136804b8a3df4c17b8173942efcce4ca",
      "source": "doaj",
      "url": "https://doi.org/10.3389/fmed.2026.1846075"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Heart Rate Variability and Autonomic Control",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Exercise-based and mind-body rehabilitation strategies to improve cardiovascular autonomic control in rheumatologic diseases",
  "title_text": "Exercise-based and mind-body rehabilitation strategies to improve cardiovascular autonomic control in rheumatologic diseases",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T14:21:03Z",
  "url": "https://research.draconitic.com/paper/7fxtpsnj78ccw",
  "venue": "Frontiers in Medicine",
  "versions": []
}