HEART RATE ZONE-BASED TRAINING IN THE ERA OF WEARABLE TECHNOLOGIES: CARDIOVASCULAR ADAPTATIONS AND DIGITAL HEALTH IMPLICATIONS

Szymon Świstak; Julita Papińska; Jakub Buziak; Magdalena Lengier; Małgorzata Świderska; Patrycja Małyszek; Franciszek Cezary Pastuszak; Natalia Powęska; Szymon Zych; Julia Pielacha

doi:10.31435/ijitss.3(51).2026.5773

Authors

Szymon Świstak Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Mazovia, Poland https://orcid.org/0009-0007-4382-3663
Julita Papińska Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Mazovia, Poland https://orcid.org/0009-0007-1758-1373
Jakub Buziak Franciszek Raszeja Municipal Hospital in Poznań, Poznań, Poland https://orcid.org/0009-0004-5833-975X
Magdalena Lengier Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Mazovia, Poland https://orcid.org/0009-0007-3402-6005
Małgorzata Świderska Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Mazovia, Poland https://orcid.org/0009-0005-8964-8261
Patrycja Małyszek Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Mazovia, Poland https://orcid.org/0009-0006-7324-573X
Franciszek Cezary Pastuszak Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Mazovia, Poland https://orcid.org/0009-0003-8064-5377
Natalia Powęska Medical University of Lodz, Lodz, Łódź Voivodeship, Poland https://orcid.org/0009-0005-8574-7721
Szymon Zych Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Mazovia, Poland https://orcid.org/0009-0009-7904-6047
Julia Pielacha Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Mazovia, Poland https://orcid.org/0009-0004-6822-2520

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.5773

Keywords:

Heart Rate Zones; Wearable Technologies; Digital Health; Cardiovascular Adaptations; Heart Rate Variability; Exercise Monitoring

Abstract

Purpose of research: Heart rate zone-based training is increasingly delivered through wearable technologies, mobile applications and digital health platforms. These tools make cardiovascular monitoring accessible to athletes and physically active individuals, but their interpretation requires physiological and technological understanding. The aim of this review was to evaluate cardiovascular adaptations associated with training across different heart rate zones and to discuss the role of wearable technologies in digital exercise monitoring.

Research materials and methods: A narrative review was conducted using peer-reviewed studies, systematic reviews, meta-analyses, randomized trials and scientific statements concerning heart rate zones, wearable devices, exercise intensity, VO₂max, lactate threshold, heart rate variability and endurance training.

Basic results: Low-intensity zones mainly improve aerobic efficiency, endothelial function and parasympathetic modulation. Moderate-intensity zones support sustainable cardiac output and lactate clearance. High-intensity zones stimulate VO₂max and maximal cardiac output, but excessive exposure may increase autonomic stress. Wearables improve access to real-time monitoring, although device accuracy and data interpretation remain important limitations.

Conclusions: Heart rate zone-based training is most useful when wearable-derived data are interpreted alongside physiological thresholds, perceived exertion and recovery markers.

References

Addleman, J. S., Lackey, N. S., DeBlauw, J. A., & Hajduczok, A. G. (2024). Heart rate variability applications in strength and conditioning: A narrative review. Journal of Functional Morphology and Kinesiology, 9(2), Article 93. https://doi.org/10.3390/jfmk9020093

Bassett, D. R., Jr., & Howley, E. T. (2000). Limiting factors for maximum oxygen uptake and determinants of endurance performance. Medicine & Science in Sports & Exercise, 32(1), 70–84. https://doi.org/10.1097/00005768-200001000-00012

Buchheit, M. (2014). Monitoring training status with HR measures: Do all roads lead to Rome? Frontiers in Physiology, 5, Article 73. https://doi.org/10.3389/fphys.2014.00073

Doherty, C., Keogh, A., Davenport, J., Lawlor, A., Smyth, B., & Caulfield, B. (2024). Keeping pace with wearables: A living umbrella review of systematic reviews evaluating the accuracy of consumer wearable technologies in health measurement. Sports Medicine, 54, 2459–2476. https://doi.org/10.1007/s40279-024-02039-8

Dudley, C., Johnston, R., Jones, B., Till, K., West, S. W., & Weakley, J. (2023). Methods of monitoring internal and external loads and their relationships with physical qualities, injury, or illness in adolescent athletes: A systematic review and best-evidence synthesis. Sports Medicine–Open, 9, Article 83. https://doi.org/10.1186/s40798-023-00625-y

Düking, P., Zinner, C., Trabelsi, K., Reed, J. L., Holmberg, H.-C., Kunz, P., & Sperlich, B. (2021). Monitoring and adapting endurance training on the basis of heart rate variability monitored by wearable technologies: A systematic review with meta-analysis. Journal of Science and Medicine in Sport, 24(11), 1180–1192. https://doi.org/10.1016/j.jsams.2021.04.012

Esco, M. R., Fields, A. D., Mohammadnabi, M. A., & Kliszczewicz, B. M. (2026). Monitoring training adaptation and recovery status in athletes using heart rate variability via mobile devices: A narrative review. Sensors, 26(1), Article 3. https://doi.org/10.3390/s26010003

Fuller, D., Colwell, E., Low, J., Orychock, K., Tobin, M. A., Simango, B., Buote, R., Van Heerden, D., Luan, H., Cullen, K., Slade, L., & Taylor, N. G. A. (2020). Reliability and validity of commercially available wearable devices for measuring steps, energy expenditure, and heart rate: Systematic review. JMIR mHealth and uHealth, 8(9), Article e18694. https://doi.org/10.2196/18694

Grässler, B., Thielmann, B., Böckelmann, I., & Hökelmann, A. (2021). Effects of different training interventions on heart rate variability and cardiovascular health and risk factors in young and middle-aged adults: A systematic review. Frontiers in Physiology, 12, Article 657274. https://doi.org/10.3389/fphys.2021.657274

Hellsten, Y., & Nyberg, M. (2015). Cardiovascular adaptations to exercise training. Comprehensive Physiology, 6(1), 1–32. https://doi.org/10.1002/cphy.c140080

Lima-Alves, A., Claudino, J. G., Boullosa, D., Couto, C. R., Teixeira-Coelho, F., & Pimenta, E. M. (2022). The relationship between internal and external loads as a tool to monitor physical fitness status of team sport athletes: A systematic review. Biology of Sport, 39(3), 629–638. https://doi.org/10.5114/biolsport.2022.107021

Ma, X., Cao, Z., Zhu, Z., Chen, X., Wen, D., & Cao, Z. (2023). VO₂max (VO₂peak) in elite athletes under high-intensity interval training: A meta-analysis. Heliyon, 9(6), Article e16663. https://doi.org/10.1016/j.heliyon.2023.e16663

Manresa-Rocamora, A., Sarabia, J. M., Javaloyes, A., Flatt, A. A., & Moya-Ramón, M. (2021). Heart rate variability-guided training for enhancing cardiac-vagal modulation, aerobic fitness, and endurance performance: A methodological systematic review with meta-analysis. International Journal of Environmental Research and Public Health, 18(19), Article 10299. https://doi.org/10.3390/ijerph181910299

Mezzani, A., Hamm, L. F., Jones, A. M., McBride, P. E., Moholdt, T., Stone, J. A., Urhausen, A., & Williams, M. A. (2013). Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: A joint position statement. European Journal of Preventive Cardiology, 20(3), 442–467. https://doi.org/10.1177/2047487312460484

Oliveira, P. S., Abad, C. C. C., Loturco, I., Nakamura, F. Y., Oliveira, R. S., & Stanganelli, L. C. R. (2024). Comparison of polarized versus other types of endurance training intensity distribution on endurance performance: A systematic review and meta-analysis. Sports Medicine, 54, 1433–1450. https://doi.org/10.1007/s40279-024-02034-z

Pelliccia, A., Sharma, S., Gati, S., Bäck, M., Börjesson, M., Caselli, S., Collet, J.-P., Corrado, D., Drezner, J. A., Halle, M., Hansen, D., Heidbuchel, H., Myers, J., Niebauer, J., Papadakis, M., Piepoli, M. F., Prescott, E., Roos-Hesselink, J. W., Graham Stuart, A., Taylor, R. S., Thompson, P. D., Tiberi, M., Vanhees, L., Wilhelm, M., & ESC Scientific Document Group. (2021). 2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease. European Heart Journal, 42(1), 17–96. https://doi.org/10.1093/eurheartj/ehaa605

Quinn, R., Leader, N., Lebovic, G., Chow, C.-M., & Dorian, P. (2024). Accuracy of wearable heart rate monitors during exercise in sinus rhythm and atrial fibrillation. Journal of the American College of Cardiology, 83(12), 1177–1179. https://doi.org/10.1016/j.jacc.2024.01.024

Rosenblat, M. A., Perrotta, A. S., & Thomas, S. G. (2020). Effect of high-intensity interval training versus sprint interval training on time-trial performance: A systematic review and meta-analysis. Sports Medicine, 50(6), 1145–1161. https://doi.org/10.1007/s40279-020-01264-1

Rosenblat, M. A., Granata, C., & Thomas, S. G. (2022). Effect of interval training on the factors influencing maximal oxygen consumption: A systematic review and meta-analysis. Sports Medicine, 52(6), 1329–1352. https://doi.org/10.1007/s40279-021-01624-5

Seiler, S. (2010). What is best practice for training intensity and duration distribution in endurance athletes? International Journal of Sports Physiology and Performance, 5(3), 276–291.

Terada, T., Hausen, M. R., Hirata, K., Reed, J. L., & Niebauer, J. (2025). Wearable devices for exercise prescription and physical activity monitoring in patients with various cardiovascular conditions. CJC Open, 7(5), 695–711. https://doi.org/10.1016/j.cjco.2025.02.017