Research Library

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Category: Healthcare

Heart Rate Variability Biofeedback Improves Emotional and Physical Health and Performance: A Systematic Review and Meta Analysis

We performed a systematic and meta analytic review of heart rate variability biofeedback (HRVB) for various symptoms and human functioning. We analyzed all problems addressed by HRVB and all outcome measures in all studies, whether or not relevant to the studied population, among randomly controlled studies. Targets included various biological and psy-chological problems and issues with athletic, cognitive, and artistic performance. Our initial review yielded 1868 papers, from which 58 met inclusion criteria. A significant small to moderate effect size was found favoring HRVB, which does not differ from that of other effective treatments. With


Heart Rate Variability, Health and Well-Being: A Systems Perspective

The development of a new tool, analytic device, or approach frequently facilitates rapid growth in scientific understanding, although the process is seldom linear. The study of heart rate variability (HRV) defined as the extent to which beat-to-beat variation in heart rate varies, is a rapidly maturing paradigm that integrates health and wellness observations across a wide variety of biomedical and psychosocial phenomena and illustrates this nonlinear path of development. The utility of HRV as an analytic and interventive technique goes far beyond its original application as a robust predictor of sudden cardiac death. This Research Topic aims to provide a conceptual


The Impact of HeartMath Resiliency Training on HealthCare Providers

Published on: 02-12-2019

Background: Health care providers must think clearly and make critical decisionsunder stressful circumstances. Providing effective strategies for managing stress in the moment helps mitigate the physical, emotional, and psychological impacts associated with caring for others and promotes resiliency. Staff may also utilize these techniques with patients and their families to help alleviate the symptoms of stress that may be experienced as the result of illness. Aim: The purpose of this study was to measure whether HeartMath techniques reduce stress and improve resiliency in health care providers. Methods: Study participants were asked to complete the Personal and Organizational


A 6‑Week Worksite Positivity Program Leads to Greater Life Satisfaction, Decreased Inflammation, and a Greater Number of Employees with A1C Levels in Range Published: 2019

Objective: To determine whether a 6-week Positivity Program could impact employee cardiovascular inflammation, blood sugars, cortisol, dehydroepiandrosterone (DHEA), and/or life satisfaction.

Methods: Pre- and post-study blood draw and life satisfaction questionnaire tracked changes in 10 cardiovascular and inflammatory


Emotion Regulation After Acquired Brain Injury: A Study of Heart Rate Variability, Attentional Control, and Psychophysiology

Published on: 23-03-2019

Primary Objective: To examine the efficacy of heart rate variability biofeedback (HRV-BF) to treat emotional dysregulation in persons with acquired brain injury.
Design: A secondary analysis of a quasi-experimental study which enrolled 13 individuals with severe chronic acquired brain injury participating in a community-based programme. Response-to-treatment was measured with two HRV resonance indices (low frequency


Heart Rate Variability: New Perspectives on Assessment of Stress and Health Risk at the Workplace

Published on: 04-02-2019

Introduction: Cardiovascular diseases are the highest cause of death in the world. Many of these deaths may be workplace related. Long hours at work seem to be influencing the increased risks of heart diseases. Workplace stress can be defined as the “discrepancies between the physiological demands within a workplace and the inability of employees to either manage or cope with such work demands.” The varied nature and perception of stress are exemplified from literature that shows stress being either a stimulus, or a response, or a stimulus–


Combining Biofeedback with Stress Management Interventions: A Systematic Review of Physiological and Psychological Effects

Published on: 02-01-2019

Current mental healthcare systems experience difficulties meeting the challenges of a growing population with elevated stress symptoms. Outpatient stress management interventions have already proven to be effective in routine care and recent technological advances now allow to expand such interventions, for example by adding a physiological component like biofeedback. Adding biofeedback to stress management interventions appears promising, but there is a lack of insight into the general conceptualization and evaluation of the resulting


Exploring a 1-Minute Paced Deep-Breathing Measurement of Heart Rate Variability as Part of a Workers’ Health Assessment

Published on: 01-12-2018

Low heart rate variability (HRV) is related to health problems that are known reasons for sick-leave or early retirement. A 1-minute-protocol could allow large scale HRV measurement for screening of health problems and, potentially, sustained employability. Our objectives were to explore the association of HRV with measures of health. Cross-sectional design with 877 Dutch employees assessed during a Workers’ Health Assessment. Personal and job characteristics, workability, psychological and mental problems, and lifestyle were measured with questionnaires. Biometry was measured (BMI, waist circumference, blood pressure, glucose, cholesterol). HRV was assessed with a 1-minute paced deep-breathing protocol and expressed as mean heart rate range (MHRR). A low MHRR indicates a higher health risk.


Self‑Regulatory Biofeedback Training: An Intervention to Reduce School Burnout and Improve Cardiac functioning in college students

Published on: 20-10-2018

With the detrimental relationship between school burnout and physiological and cognitive functioning now well documented, interventions to ameliorate school burnout symptomology are needed. This study examined the effectiveness of a self-regulatory biofeedback intervention program (Heart RateVariability Coherence Biofeedback Training [HRVCB]) in contrast to a protocol demonstrated to produce cognitive and physiological improvements (a high intensity interval training protocol [HIIT]) as well as a wait-list control condition at decreasing school


Heart Rate Variability and Cognitive Bias Feedback Interventions to Prevent Post‑Deployment PTSD: Results from a Randomized Controlled Trial

Published on: 20-07-2018

There is a long history of pre-deployment PTSD prevention efforts in the military and effective pre-deployment strategies to prevent post-deployment PTSD are still needed. Materials and Methods: This randomized controlled trial included three arms: heart rate variability biofeedback (HRVB), cognitive bias modification for interpretation (CBM-I), and control. The hypothesis was that pre-deployment resilience training would result in lower post-deployment PTSD symptoms compared with control. Army National Guard soldiers (n =


An Overview of HRV Norms and Metrics

Published on: 28-09-2017

Healthy biological systems exhibit complex patterns of variability that can be described by mathematical chaos. Heart rate variability (HRV) consists of changes in the time intervals between consecutive heartbeats called interbeat intervals (IBIs). A healthy heart is not a metronome. The oscillations of a healthy heart are complex and constantly changing, which allow the cardiovascular system to rapidly adjust to sudden physical and psycho-logical  challenges  to  homeostasis.  This  article  briefly  reviews  current  perspectives  on  the mechanisms that generate 24 h, short-term (~5 min), and ultra-short-term (<5 min) HRV,  the  importance  of  HRV,  and  its  implications 


The effect of heart rate variability biofeedbacktraining on stress and anxiety: a meta-analysis

Published on: 22-03-2017

Background.Some evidence suggests that heart rate variability (HRV) biofeedback might be an effective way to treat anxiety and stress symptoms. To examine the effect of HRV biofeedback on symptoms of anxiety and stress, we conducted a meta-analysis of studies extracted from PubMed, PsycINFO and the Cochrane Library.Methods.The search identified 24 studies totaling 484 participants who received HRV biofeedback training for stress and anxiety. We conducted a random-effects meta-analysis. Results.The pre-post within-group effect size


Heart rate variability biofeedback therapy and graded exercise training in management of chronic fatigue syndrome

Published on: 05-12-2016

OBJECTIVE: Chronic fatigue syndrome (CFS) is characterised by persistent fatigue, exhaustion, and several physical complaints. Research has shown cognitive behavioural therapy (CBT) and graded exercise training (GET) to be the most effective treatments. In a first step we aimed to assess the efficacy of heart rate variability biofeedback therapy (HRV-BF) as a treatment method comprising cognitive and behavioural strategies and GET in the pilot trial. In a second step we aimed to compare both interventions with regard to specific


Validity of (Ultra-)Short Recordings for Heart Rate Variability Measurements

Published on: 28-09-2015

In order to investigate the applicability of routine 10s electrocardiogram (ECG) recordings for time-domain heart rate variability (HRV) calculation we explored to what extent these (ultra-)short recordings capture the “actual” HRV.

The standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences (RMSSD) were measured in 3,387 adults. SDNN and RMSSD were assessed from (ultra)short recordings of 10s(3x), 30s, and 120s and compared to 240s–300s (gold


Cardiac Coherence Training to Reduce Anxiety in Remitted Schizophrenia, a Pilot Study

Published on: 07-09-2015

Health care that addresses the emotional regulation capacity of patients with schizophrenia confronted with daily stress may contribute to a less anxious life. A psycho-physiological training [cardiac coherence training(CCT)] focusing on emotion regulation is known to decrease anxiety for healthy individuals. We performed a pilot cross sectional survey to explore the benefits of CCT for clinically stable patients with schizophrenia. Ten patients were enrolled in the program consisting of twelve weekly 1-h session programs monitored over a 2-month


Physical Activity, Mindfulness Meditation, or Heart RateVariability Biofeedback for Stress Reduction

Abstract: In contemporary western societies stress is highly prevalent, therefore the need for stress-reducingmethods is great. This randomized controlled trial compared the efficacy of self-help physical activity (PA), mindfulness meditation (MM), and heart rate variability biofeedback (HRV-BF) in reducing stress and its related symptoms. We randomly allocated 126 participants to PA, MM, or HRV-BF upon enrollment, of whom 76 agreed to participate. The interventions consisted of psycho-education and an introduction to the specific


Biofeedback Intervention for Stress, Anxiety, and Depression among Graduate Students in Public Health Nursing

Published on: 05-04-2015

Globally, graduate students have been found to have high prevalence of mental health problems. With increasing severity of mental health problems on university campuses and limited resources for mental health treatment, alternative interventions are needed.This study investigated the use of biofeedback training to help reduce symptoms of stress, anxiety, and depression. A sample of 60 graduate students in public health nursing was randomly assigned to either the biofeedback intervention or the control group. Results indicated that biofeedback


Heart Coherence: A New Tool in the Management of Stress on Professionals and Family Caregivers of Patients with Dementia

Published on: 22-03-2015

We describe a stress management intervention intended  to  reduce  the  damage  and  stress  impact  on  the heart  physiology  and  function  of  a  group  of  caregivers (professional and non-professional) who work with patients with dementia. The intervention consisted in applying heartcoherence  techniques  in  a  population  of  72  caregivers  of patients  with  dementia  (42  professional  and  29  non-pro-fessional  caregivers)  who  had  high  scores  in  heart  stress and  burden  tests.  Six  months  after  the  training  they  were able  to 


Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health Risk

Published on: 15-01-2015

Heart  rate  variability,  the  change  in the  time  intervals  between  adjacent heartbeats, is an emergent property of interdependent   regulatory   systems that  operates  on  different  time  scales to  adapt  to  environmental  and  psychological   challenges.   This   article briefly  reviews  neural  regulation  of the  heart  and  offers  some  new  perspectives on mechanisms underlying the very low frequency  rhythm  of heart rate variability. Interpretation of heart  rate  variability  rhythms  in  the context of health risk and physiological  and 


Heart Coherence Training Combined with Back School in Patients with Chronic Non-specific Low Back Pain

Published on: 02-10-2014

The aim of this study was to explore on which variables a  stress reduction program based on heartcoherence can enhance the effects of a back school (BS) inpatients with chronic non-specific low back pain and to explore possible moderators for treatment success. A ret-rospective explorative design was carried out with 170patients with chronic non-specific low back pain.  89 Patients were admitted to BS and 81 patients were selected for  BS  and  heart  coherence  training  (BS–HCT).  Six  sessions  of  heart  coherence  were  provided.  At 


Cardiac coherence, self-regulation, autonomic stability, and psychosocial well-being

Published on: 29-09-2014

The ability to alter one’s emotional responses is central to overall well-being and to effectively meeting the demands of life. One of the chief symptoms of events such as trauma, that overwhelm our capacities to successfully handle and adapt to them, is a shift in our internal baseline reference such that there ensues a repetitive activation of the traumatic event. This can result in high vigilance and over-sensitivity to environmental signals which are reflected in inappropriate emotional responses and autonomic nervoussystem dynamics. In this article


Effectiveness of emWave Biofeedback in Improving Heart RateVariability Reactivity to and Recovery from Stress

Published on: 14-02-2014

The  current  study examined  the  efficacy  of heart rate variability (HRV) biofeedback using emWave, a publicly  available  biofeedback  device,  to  determine  whether   training   affected   physiological   tone and stress responses.   Twenty-seven   individuals   aged   18–30 years were  randomized  to  a  treatment  or  no-treatment  controlgroup.  Treatment  participants  underwent  4–8  sessions  of emWave intervention,  and  all  participants  attended  pre-treatment  and  post-treatment  assessment  sessions  during which  acute  stressors  were


Stress Management Based on Trait‑Anxiety Levels and Sleep Quality in Middle‑Aged Employees Confronted with Psychosocial Chronic Stress

Published on: 15-01-2014

A  stress  management  program  using  cardiac  coherence  was  implemented  after  an  organizational  down-sizing. The study was conducted in nine voluntary workers in order to evaluate the efficiency of the program.  A  baseline  evaluation  was  conducted  on  psychological  variables  (anxiety,  perceived-stress,  well- being  and  sleep),  endocrine  assessments  (urinary  cortisol  excretion,  alpha-amylase  and  salivary  concentrations)  and  physiological  recordings  (sleep  and  heart  rate  variability).  The  low  number  of 


A pilot study of heart rate variability biofeedback therapy in the treatment of perinatal depression

Published on: 25-11-2012

Heart rate variability biofeedback (HRVB) therapy may be useful in treating the prominent anxiety features of perinatal depression. We investigated the use of this non-pharmacologic therapy among women hospitalized with severe perinatal depression. Three questionnaires, the StateTrait Anxiety Inventory (STAI), Warwick–Edinburgh Mental Well-Being Scale, and Linear Analog Self Assessment,were administered to 15 women in a specialized inpatient perinatal psychiatry unit. Participants were also contacted by telephone after discharge


Coherence: A Novel Nonpharmacological Modality for Lowering Blood Pressure in Hypertensive Patients

Published on: 17-05-2012

This  study  examined  the  efficacy  of  teaching   emotional   self-regulation   techniques     supported     by     heart     rhythm coherence training (emWave Personal Stress Reliever) as a means to quickly  lower  blood  pressure  (BP)  in  patients   diagnosed   with   hyperten-sion.  Previous  studies  have  demonstrated  systemic  reductions  in  BP  in  both   high   stress   populations   and   patients diagnosed with hypertension using this approach, but to the best of our  knowledge,  an  investigation  of  their  ability  to  produce  immediate 


Biofeedback Intervention for Stress and Anxiety among Nursing Students: A Randomized Controlled Trial

Published on: 07-05-2012

Purpose.It has been well documented that nursing students across the world experience stress and anxiety throughout their education and training. The purpose of this randomized controlled study is to investigate the impact of biofeedback intervention program on nursing students’ levels of stress and anxiety during their first clinical training. Methods.Participants consisted of 60 second-year baccalaureate nursing students. The 30 participants in the biofeedback group received training on how to use the biofeedback device to assist in stress and


The effect of a biofeedback-based stress management tool on physician stress: a randomized controlled clinical trial

Published on: 06-06-2011

Background: Physicians often experience work-related stress that may lead to personal harm and impaired profes-sional performance. Biofeedback has been used to manage stress in various populations. Objective:  To  determine  whether  a  biofeedback-based  stress  management  tool,  consisting  of  rhythmic  breathing,  actively self-generated positive emotions and a portable biofeedback device, reduces physician stress. Design: Randomized controlled trial measuring efficacy of a stress-reduction intervention over 28 days, with a


Coherence and Health Care Cost — RCA Actuarial Study: A Cost-Effectiveness Cohort Study

Published on: 15-08-2010

Chronic stress is among the most costly health problems in terms of direct health costs, absenteeism, disability, and performance standards. The Reformed Church in America (RCA) identified stress among its clergy as a major cause of higher-than-average  health  claims  and    implemented HeartMath (HM) to help its participants manage stress and increase  physiological  resilience.  The  6-week  HM  program Revitalize you! was selected for the intervention including the emWave Personal Stress Reliever technology.


Coherence training in children with attention-deficit hyperactivity disorder: cognitive functions and behavioral changes

Published on: 15-08-2010

Attention-deficit hyperactivity disorder (ADHD) is the most prevalent behavioral diagnosis in children, with an estimated 500000 children affected in the United Kingdom alone. The need for an appropriate and effective intervention for children with ADHD is a growing concern for educators and child-care  agencies.  This  randomized  controlled  clinical  trial evaluated the impact of the HeartMath self-regulation skills and  coherence  training  program  (Institute  of  HeartMath, Boulder Creek, California) on a population of 38 children with ADHD in


New Hope for Correctional Officers: An Innovative Program for Reducing Stress and Health Risks

This  study  investigated  the  impact of a new stress management program on physiological and psychological stress and health risk factors among 75 correctional officers. The experimental group received training in emotion self-regulation techniques intended to reduce stress and health risk factors. Practice of the techniques was enhanced by heart rate variability feedback, which helped participants  learn  and  sustain  use  of the  self-management tools.  Measures of physiological stress  included  cortisol, DHEA,  cholesterol, triglycerides,  fasting  glucose 


Heart Rate Variability Biofeedback for Major Depression

Published on: 15-10-2008

Heart rate variability for the treatment of major depression is  a  novel,  alternative  approach  that  can  offer  symptom reduction  with  minimal-to-no  noxious  side  effects.  The following  material  will  illustrate  some  of  the  work  being conducted  at  our  laboratory  to  demonstrate  the  efficacy of  heart  rate  variability.  Namely,  results  will  be  presented regarding our published work on an initial open-label study and  subsequent  results  of  a  small,  unfinished  randomized controlled trial. Autonomic  nervous  system  (ANS)  dysfunction 


A Controlled Pilot Study of Stress Management Training of Elderly Patients With Congestive Heart Failure

Published on: 22-11-2002

The purpose of this study was to evaluate the effect of stress management training on quality of life, functional capacity, and heart rate variability in elderly patients with New York Heart Association classI–III congestive heart failure (CHF). While substantial research exists on stress management training for patients with coronary heart disease, there are few data on the value of psychosocial training on patients with CHF. Thirty-three multi ethnic patients (mean age, 66±9 years) were assigned through incomplete randomization to one of two


The Impact of a New Emotional Self‑Management Program on Stress, Emotions, Heart Rate Variability, DHEA and Cortisol

Published on: 02-04-1998

This study examined the effects on healthy adults of a new emotional self-management program, consisting of two key techniques,"Cut-Thru" and the "Heart Lock-In." These techniques are designed to eliminate negative thought loops and promote sustained positive emotional states. The hypotheses were that training and practice in these techniques would yield lowered levels of stress and negative emotion and cortisol, while resulting in increased positive emotion and DHEA levels over a one-month period. In addition, we


The Effects of Emotions on Short‑Term Power Spectrum Analysis of Heart Rate Variability

Introduction: This study utilizes HRV analysis to examine a new method of intentionally shifting emotional states, and demonstrates that positive emotions lead to alterations in sympathovagal balance that may be beneficial in the treatment of hypertension. Anger, on the other hand, was shown to significantly increase sympathetic activation.
Summary: Salivary IgA, heart rate and mood were measured in thirty individuals before and after experiencing care or anger. Two methods