Background: Valve replacement surgery is a restores cardiac function, but many patients continue to experience persistent hypertension and autonomic imbalance during recovery. Additionally, fear of movement (kinesiophobia) may limit rehabilitation patients. Heart rate variability (HRV) guided slow breathing increase autonomic balance, and isometric handgrip reduces blood pressure. This study explores the combined effect of this intervention on physiological and psychological recovery.

Aim: Evaluate the effect of HRV-guided autonomic modulation technique combined with isometric handgrip training on blood pressure and kinesiophobia in hypertensive patients after valve replacement surgery. 

Methods: A Quasi experimental pretest and posttest study was conducted among 30 valve replacement patients, 3 to 12 weeks of post-surgery. Patients received slow breathing (6 breaths/ minutes for 15 minutes) followed by isometric handgrip training at 30% maximum voluntary contraction (MVC), calculated a: training intensity=0.30×MVC. The intervention was performed five sessions per week for six weeks. Outcome measures included systolic and diastolic blood pressure and Tampa scale of kinesiophobia (TSK). 

Results: The combination of HRV guided autonomic modulation and isometric handgrip training significant reductions were observed in systolic and diastolic blood pressure and TSK score. (p=0.05)

Conclusions: The combined effect of HRV guided autonomic modulation technique and isometric handgrip regulates blood pressure control, and reduces kinesiophobia.