European Journal of Applied Physiology

, Volume 118, Issue 5, pp 919–926 | Cite as

Can the use of a single integrated unitary autonomic index provide early clues for eventual eligibility for olympic games?

  • Daniela Lucini
  • Roberto Sala
  • Antonio Spataro
  • Mara Malacarne
  • Manuela Benzi
  • Stefano Tamorri
  • Massimo Pagani
Original Article



Optimal autonomic regulation and stress resilience might be considered critical elements of athletic performance. We hypothesize that a novel unitary autonomic index for sports (ANSIs), together with a somatic stress related symptom score (4SQ) might help characterize athletes who were eventually selected for the Rio 2016 Olympic Games Italian team (Rio +).


In this retrospective study we examined 778 athletes (age 24.4 ± 6.7 yrs) who underwent a planned yearly pre-participation screening. All athletes underwent clinical, autonomic and exercise ECG evaluation. The combination of vagal and sympathetic indices from RR variability into ANSIs was performed by radar plot and percent ranking of index variables. We assessed (Rio +) versus (Rio −) athletes also after subdivision into three sport intensity groups (low, mid and high intensity).


Overall there were no significant differences between (Rio +) and (Rio −) athletes when considering individual spectral derived variables. Conversely, the unitary Index ANSIs was significantly higher in (Rio +) compared to (Rio −) athletes (respectively 54.5 ± 29.5 and 47.9 ± 28.4 p = 0.014). This difference was particularly evident (p = 0.017) in the group of athletes characterized by both high static and dynamic components. 4SQ was smaller in the (Rio +) group, particularly in the groups of athletes characterized by both low-medium static and dynamic components.


ANSIs, a proxy of integrated cardiac autonomic regulation and simple assessment of resilience to stress, may differentiate Italian athletes who were eventually selected for participation in the 2016 Rio Olympic Games from those who were not, suggesting the possibility of a “winning functional phenotype”.


Olympic Games Elite athletes Autonomic nervous system Stress resilience 



Somatic Stress Related Symptom Score




Arbitrary units


Autonomic nervous system


Unitary multivariate percent ranked ANS index


Unitary autonomic index for sports




Body mass index


ECG chest lead


Italian national olympic committee


Deceleration capacity


For example




High frequency


Heart rate variability


Jonckheere terpstra


Low frequency


Normalized units


Personal computer


RR Interval variability


Standard deviation


Statistical package for the social sciences





We would like to thank Dana Alon Shiffer (LA, CA, USA) for mother tongue language and English style assistance.

Compliance with ethical standards

Conflict of interest

Authors declare that they have no conflict of interest.

Supplementary material

421_2018_3822_MOESM1_ESM.doc (84 kb)
Supplementary material 1 (DOC 83 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.BIOMETRA University of MilanoRozzano (Milano)Italy
  2. 2.Exercise Medicine UnitHumanitas Clinical and Research CenterRozzano (Milano)Italy
  3. 3.Sports Medicine Institute CONI RomeRomeItaly

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