Physiological Markers of Autonomic Regulation During Exercise & Recovery in Young Adults: A Scoping Review

Background Exercise acts as a potent physiological stressor that places substantial demands on the autonomic nervous system to maintain hemodynamic homeostasis. While autonomic dysfunction may be subtle at rest, abnormalities may become apparent when the system is challenged by exercise and the subsequent recovery period. Although various physiological measures have been studied, response patterns associated with exercise-related autonomic regulation in young adults remain incompletely characterized. Objective To map the physiological markers and response patterns associated with exercise-related autonomic regulation in young adults, with particular consideration of responses during exercise and recovery, and to identify methodological and evidence gaps in the existing literature. Methods A scoping review was conducted in accordance with the Joanna Briggs Institute methodology and reported according to PRISMA-ScR. PubMed, Ovid MEDLINE, Scopus, CINAHL Ultimate via EBSCO, Google Scholar, and ProQuest Dissertations & Theses Global were searched. Findings were synthesized descriptively and narratively according to physiological domain, assessment phase, response pattern, and clinical relevance. Results Ten studies, comprising 198 eligible participants, were included in the scoping review. Heart rate and blood pressure were commonly assessed, heart-rate variability (HRV) in six studies, baroreflex sensitivity (BRS) in five, stroke volume, cardiac output or total peripheral resistance in four, vascular indices in four, cerebral blood-flow or autoregulatory measures in three, and neural or biochemical markers in three. Post-exercise orthostatic challenge was applied in only two studies. The evidence included direct findings related to syncope or orthostatic intolerance and mechanistic findings from apparently healthy participants. Conclusions The available findings suggests that exercise-related autonomic regulation in young adults involves dynamic interactions between cardiac autonomic regulation, cardiovascular compensation, and cerebral perfusion. Assessing physiological responses across exercise and recovery may provide complementary insights. Further research using standardized protocols and multimodal physiological assessment is needed to establish the clinical relevance and diagnostic utility of candidate markers.