Evidence map›Paper›PMID 40111586›Full record

ReviewApplied psychophysiology and biofeedback2025

Does Vagal Nerve Activity Predict Performance in a Naval Commando Selection Test?

Yosef Kula, Zev Iversen, Adi Cohen, Ariel D Levine, Yori Gidron

Abstract readReview
In one paragraph

Review in Applied psychophysiology and biofeedback, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Heart rate variability and physician performance during airway management simulations: an exploratory pilot study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yosef KulaDepartment of Nursing, Faculty of social welfare and health sciences university of Haifa, Haifa, Israel.
Zev IversenBehavioral Science Branch, Israeli Navy, IDF, Haifa, Israel.
Adi CohenThe Israel Naval Medical Institute, Haifa, Israel.
Ariel D LevineBnai Zion Medical Center Israel, Haifa, Israel.
Yori GidronDepartment of Nursing, Faculty of social welfare and health sciences university of Haifa, Haifa, Israel. ygidron@univ.haifa.ac.il.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Special operations forces (SOF) soldiers are elite fighters and tactical professionals who perform in high-stress environments. SOF selection processes aim to identify candidates who can sustain performance in high-stress and changing conditions. The vagal nerve is a crucial moderator of stress responses, and its activity (indexed by heart rate variability, HRV) has been shown to predict performance and psycho-physiological resilience in various settings. However, its predictive validity needs to be clarified. This study examined the relationship between HRV and success in an intensive selection procedure. In a historical prospective study, we derived an HRV parameter (root mean square of successive differences between normal heartbeats, RMSSD) from a 10-second ECG of 365 candidates for an SOF naval unit. The ECG was taken approximately two months before the selection procedure. The predictive validity of other routinely obtained measures was also considered. High RMSSD was significantly associated with success, but this relation disappeared after controlling for confounders (e.g., running score). However, after matching pairs of successful and non-successful candidates on confounders, HRV was again significantly related to course performance. The results of this study support the predictive value of HRV for tactical professionals. Given the high cost of training elite soldiers and the burden they undergo, improving accuracy of the selection processes may reduce the burden on candidates and lead to resource savings. Future studies should measure HRV at several time points with longer ECG records.

Indexed as

Heart RateMilitary PersonnelPersonnel SelectionVagus NerveAdultElectrocardiographyFemaleHumansMaleProspective StudiesYoung AdultHeart rate variabilityMilitary performanceSelection proceduresStressful environmentVagal nerve

Identifiers

PMID40111586
PMCPMC12331781

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Registered trials

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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.