ArticleInternational journal of environmental research and public health2019
Heart Rate Variability and Performance of Commercial Airline Pilots during Flight Simulations.
Article in International journal of environmental research and public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 79 citations in OpenAlex.
- Approaches to inducing mental fatigue: A systematic review and meta-analysis of (neuro)physiologic indices.Behavior research methods · 2025Pooled it
- Psychophysiological responses to a multimodal physiotherapy program in fighter pilots with flight-related neck pain: A pilot trial.PloS one · 2024Trial
- Effects of increased recirculation air rate and aircraft cabin occupancy on passengers' health and well-being - Results from a randomized controlled trial.Environmental research · 2023Trial
- Research on Flight Training Optimization with Instrument Failure Based on Eye Movement Data.Journal of eye movement research · 2025Article
- Psychophysiological and Dual-Task Effects of Biofeedback and Neurofeedback Interventions in Airforce Pilots: A Pilot Study.Sensors (Basel, Switzerland) · 2025Article
- Pilot mental workload analysis in the A320 traffic pattern based on HRV features.Frontiers in neuroergonomics · 2025Article
- Article
- Metabolic flexibility associated with flight time among combat pilots of the Brazilian air force.Metabolomics : Official journal of the Metabolomic Society · 2024Article
- Blink-Related Oscillations Provide Naturalistic Assessments of Brain Function and Cognitive Workload within Complex Real-World Multitasking Environments.Sensors (Basel, Switzerland) · 2024Article
- Pilot turning behavior cognitive load analysis in simulated flight.Frontiers in neuroscience · 2024Article
- Stress and Workload Assessment in Aviation-A Narrative Review.Sensors (Basel, Switzerland) · 2023Review
- Exploring objective measures for assessing team performance in healthcare: an interview study.Frontiers in psychology · 2023Article
- A narrative review of the interconnection between pilot acute stress, startle, and surprise effects in the aviation context: Contribution of physiological measurements.Frontiers in neuroergonomics · 2023Review
- The Effect of Expertise during Simulated Flight Emergencies on the Autonomic Response and Operative Performance in Military Pilots.International journal of environmental research and public health · 2022Article
- Impact of Real and Simulated Flights on Psychophysiological Response of Military Pilots.International journal of environmental research and public health · 2021Article
- Is There an Optimal Autonomic State for Enhanced Flow and Executive Task Performance?Frontiers in psychology · 2019Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pilots undergo a variety of stressors that may affect their performance during all phases of flight. Heart rate variability (HRV) has been considered as a reliable indicator of the parasympathetic and sympathetic activities of human autonomic nervous system, which can be used to characterize the sympathetic stress response of pilots during flight. In this study, thirty active commercial airline pilots were recruited to fly three flight segments in a Federal Aviation Administration (FAA)-certified A320 flight simulator with each segment at a different carbon dioxide (CO₂) concentration on the flight deck. The pilots performed a series of maneuvers of varying difficulty, and their performance was evaluated by FAA designated pilot examiners. The HRV metrics (SDNN, RMSSD and LF/HF ratio) of each pilot both before and during flight simulations were measured with a Movisens EcgMove3 sensor. The average SDNN, RMSSD and LF/HF ratio of the pilots during flight simulations were 34.1 ± 12.7 ms, 23.8 ± 10.2 ms and 5.7 ± 2.8 respectively. Decreased HRV was associated with aging, obesity and performing difficult maneuvers. Both CO₂ exposure and HRV had an independent effect on the pilot performance, while their interaction was not significant. The generalized additive mixed effect model results showed that a pilot performed better on a maneuver when his stress response was lower, as indicated by higher SDNN and RMSSD and lower LF/HF ratio. An interquartile range (IQR) increase in SDNN (21.97 ms) and RMSSD (16.00 ms) and an IQR decrease in LF/HF ratio (4.69) was associated with an increase in the odds of passing a maneuver by 37%, 22% and 20%, respectively.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.