HRV as an Assessment Tool

BrainTap HRV as an Assessment Tool
In our office, we believe that when working with clients – if you can’t measure it, you can’t manage it. We use many objective measures to make sure our treatment plan is producing the response we need and to allow the patient to have continuous, objective feedback to their progress.
We use the BrainTap HRV scan every 4 -6 weeks as an assessment of their progress.

Regularly assessing our clients’ HRV values helps our office in three main ways:
1. To promote accountability for the client to be a part of the recovery process
2. To gain an objective understanding of the lifestyle factors affecting the client’s
condition the other 99% of the time that they are not with us
3. To ensure that intervention is having a positive impact on overall health via an
increase in HRV values.

What HRV Can and Can’t Tell You
As an assessment tool, the BrainTap HRV can determine if there are any “red
flags” that need to be addressed such as:
o High Stress Index
o Autonomic Nervous System in “Flight or Fight” Mode
o Autonomic Nervous System Exhausted – Back-up System Running
o Low to No Energy – Potential Adrenal Exhaustion
o Brain – Over Fatigued and Stressed
o Lack of Deep, Restful and Uninterrupted Sleep
o Prematurely Aging

The scan can be used to gain a deeper understanding as to what is limiting
someone’s potential or to help isolate what seems to be keeping an individual
from making progress. This can be the middle-aged woman who has done
everything to lose weight but:
o High Stress Index = High Insulin Levels which = Lock out of Stored Fat
o Low Energy Resources + Energy Imbalance = Fat Storage Mode

 Heart Rate Variability is a measure of Autonomic Nervous System balance and
strength and consequently your systemic health and resilience. Despite the
powerful and individualized information that the scan can provide about the
body’s health, it does not give you specific information as to exactly what to focus

For example, a low baseline HRV value could be due to:
o External Stress – Work, Relationship, Children,
o Pain and Inflammation
o Lack of Sleep
o Medical Issue - Diabetes, High Blood Pressure, Depression, ect…

Which is it? In each case, Heart Rate Variability will likely give a strong indication that something is wrong, but it will not identify the culprit for you. To effectively determine what is producing the abnormal HRV values, we must add meaningfulcontext. We must take into account the full picture of an individual’s situation as we discuss below in the “how” section.

How to Assess With the BrainTap HRV


Before collecting any objective data and starting an assessment, you need to
establish subjective and qualitative markers to add context to any quantitative
data. The combination of qualitative and quantitative data helps establish a much more meaningful baseline, and helps with tracking progress and defining the end goal.

Some examples of contextual data gathered prior to treatment would include:
o Wellness Questionnaires
o Family History
o Lifestyle Habits and Patterns
o Subjective Perception of the Condition
o End Goal
Get a Baseline

 Just like many assessment tools, it is important to establish true baseline values prior to a treatment. This gives you hard data to compare progress throughout the treatment plan and prevents you from blindly guessing the level of progress attained.

 Ideally, you would like to get a scan on the first visit before they receive any

 Things to do before the HRV Scan:
o Drink plenty of water – stay hydrated
o Get a good night’s sleep
o If you drink coffee – don’t avoid it – we want a true baseline

 Things to avoid before the scan:
o Do not exercise 4 hours before the scan.
o Do not eat a meal 2 hours before the scan.

 This is also the ideal time to refine which contextual information will be the most helpful for tracking progress. Useful metrics that add context to Heart Rate
Variability values include:
o Perceived energy levels
o Sleep quality and perceived quality
o Exercise quantity, type and perceived exertion
o Mood and perceived stress levels

 Additionally, you will be able to track other metrics from the HRV Scan:
o Stress Index (is Stress High or Low)
o Autonomic Nervous System Balance (Fight or Flight / or Balanced)
o Neuro-Hormonal Regulation (Energy & Metabolism)
o Psycho-Emotional State (Brain – Stressed or Brain – Balanced)
o Prematurely Aging or Reversing the Aging Process Treatment

 In this phase, you implement a plan for your client that addresses the overall
health goals and will measurably impact the chosen relevant metrics.

 Depending on the starting point and goals, you should expect to see noticeable changes in HRV within 1-3 months for most health related goals and in as little as two weeks for fitness and training related goals.

 Determine an appropriate timeframe for which you would like to see progress.
Most practitioners rescan every 4-6 weeks or 10-12 visits.

 It is ideal if you are able to take consistent HRV measurements throughout the
entire treatment. If you scan in the morning – rescan in the morning.

Determining Progress

 To assess your progress, compare your HRV values to your starting baseline as
well as your contextual markers.
 The first things to check are goal oriented and subjective markers.
o Has the situation, or the perception of the situation, improved?
o Is the client making progress towards their goals?
 Combining this information with Heart Rate Variability data generally produces
the following conclusions (the following assumes that reasonable goals were
defined and adequate time/effort has been given):
Progress towards your goals is stagnant or backsliding.
 In this case, if the HRV numbers remain the same, then your treatment plan is
either not effective, and needs altering or not enough time has passed to see
 This could also indicate that there is potentially some underlying aspect
preventing progress and some additional data might need to be gathered at this
point to determine if something like:
o hormone imbalance
o food sensitivities
o psychological stress,
o etc. are diverting the body’s resources and preventing progress
 If the HRV numbers have decreased, this could be a warning sign that either new
stressors are present or the plan is causing more harm than good.
 If HRV has increased and your goals are health oriented, you may be making
underlying progress. Using additional contextual information will help you
determine whether to continue or to alter the plan..
Progress has been achieved.
 If HRV has increased and your goals are health oriented, you may be making
underlying progress. Using additional contextual information will help you
determine whether to continue or to alter the plan.
 If HRV has decreased – this is a tricky situation. Certain goals such as:
o fat loss
o new exercise training programs
o increased exercise
o doing a detox

All of these can cause HRV to temporarily decrease while making progress. The
body may be experiencing temporarily elevated stress levels in the pursuit of
your goals. The decline in HRV should be monitored to make sure it is a
temporary condition and not an early warning sign for a developing issue.

 Contextual information such as perceived energy levels, motivation and mood
help assess whether the stress is still in acceptable ranges for positive
adaptation. If HRV has decreased and other contextual information have also
trended negatively, then you must consider the potential that you may be
sacrificing health to attain your goals.

 Depending on circumstances information such as:
o Perceived energy levels
o Motivation
o Mood
These can help assess whether the stress is still in acceptable ranges for
positive adaptation. If HRV has decreased and these above circumstances have
also trended negatively, then you must consider the potential that you may be
sacrificing health to attain your goals.

Example Uses of Heart Rate Variability
The concept of using HRV as an assessment tool can and has been applied to many situations. The following are a few examples of how HRV can play a role in assessing various scenarios:

 Health Conditions such as:
o weight loss
o pain management,
o diabetes and
o immune system dysfunction have all been linked w/changes in HRV

 HRV has been determined to be an effective assessment of inflammation
through the vagus nerve.

 Heart Rate Variability is a powerful assessment of the system-wide condition, but needs context to determine the specifics of the situation.
 It is ideal to have at least 4-6 weeks between HRV measurements to establish a confident baseline and to compare future values to the original baseline.
 Assessing HRV can help determine if progress is being made on a given plan.
 In the case of health, increases in HRV are generally desirable.
 In the case of fitness and training, temporary decreases in HRV should be
expected – and the use of context can help determine whether the changes in
HRV are acceptable.


Goldkorn, Ronen, Alexey Naimushin, Nir Shlomo, Ariella Dan, Dan Oieru, Israel
Moalem, Eli Rozen, Ilan Gur, Jacob Levitan, David Rosenmann, Yakov Mogilewsky,
Robert Klempfner, and Ilan Goldenberg. “Comparison of the Usefulness of Heart Rate
Variability Versus Exercise Stress Testing for the Detection of Myocardial Ischemia in
Patients Without Known Coronary Artery Disease.” The American Journal of
Cardiology 115.11 (2015): 1518-522. Web.
Huston, J. M., and K. J. Tracey. “The Pulse of Inflammation: Heart Rate Variability, the
Cholinergic Anti-inflammatory Pathway and Implications for Therapy.” Journal of Internal
Medicine 269.1 (2010): 45-53. Web.
Liao, D., R. P. Sloan, W. E. Cascio, A. R. Folsom, A. D. Liese, G. W. Evans, J. Cai, and
A. R. Sharrett. “Multiple Metabolic Syndrome Is Associated With Lower Heart Rate
Variability: The Atherosclerosis Risk in Communities Study.” Diabetes Care 21.12
(1998): 2116-122. Web.
Plews, Daniel J., Paul B. Laursen, Andrew E. Kilding, and Martin Buchheit. “Heart Rate
Variability in Elite Triathletes, Is Variation in Variability the Key to Effective Training? A
Case Comparison.” European Journal of Applied Physiology Eur J Appl Physiol 112.11
(2012): 3729-741. Web.
Plews, Daniel J., Paul B. Laursen, Andrew E. Kilding, and Martin Buchheit. “Heart-Rate
Variability and Training-Intensity Distribution in Elite Rowers.” International Journal of
Sports Physiology and Performance IJSPP 9.6 (2014): 1026-032. Web.