Applied Psychophysiology and Biofeedback最新文献

Periodic deep slow breathing at specific frequencies can induce baroreflex resonance through the heart rate-baroreflex pathway, referred to as resonance breathing. In recent years, the application of heart rate variability (HRV) in assessing autonomic function has been questioned, whereas the novel, noninvasive measurement of skin sympathetic nerve activity (SKNA) may fill certain gaps. This study aimed to explore the effects of resonance breathing on SKNA and HRV from the perspective of autonomic indices, evaluating its acute physiological impacts on a healthy population. A randomized crossover design was employed, recruiting 27 healthy university students (14 males, 13 females) as participants. The experimental protocol consisted of a 10-minute resting period, a 15-minute resonance breathing intervention, and a 5-minute post-intervention rest phase, during which SKNA and HRV were continuously monitored and evaluated. The results showed a significant increase in sympathetic nerve activity during the resonance breathing intervention phase, followed by notable reductions in both average sympathetic activity and burst-derived parameters post-intervention. In addition, HRV indicators, particularly RMSSD and RR interval, were markedly elevated after the intervention. These findings suggest that a single session of resonance breathing exerts positive effects on autonomic function, providing a basis for considering the combined use of resonance breathing and SKNA techniques over longer durations in pathological populations for autonomic regulation.

This paper discusses both the ‘why’ and the ‘how’ concerning a multi-modal approach to enhancing treatment outcomes with a variety of clients. First, the necessity of an approach to client care that combines treatment modalities will be discussed. Then comes discussion of the history of combining modalities along with discussion of which combinations of treatments should be considered for different disorders. Attention-Deficit/Hyperactivity Disorder (ADHD), for example, requires more than one intervention because its neurological basis means it is appropriate for the brain-based intervention of neurofeedback and its comorbidities require other interventions, such as biofeedback for improved emotional regulation if there is anxiety and/or depression, and coaching in learning strategies (metacognition) to help with academic delays and/or learning disabilities. The triad of neurofeedback, biofeedback (especially heart rate variability training) and metacognitive strategies will produce improvements in most clients, regardless of their disorder. Additionally, it can also be used with athletes and executives to optimize performance. For complex cases, further interventions can be added. Medication might be needed as part of multi-modal management in ADHD or in depression or a seizure disorder. The dose can be tapered and, usually, eliminated, once the neurofeedback training produces a reduction in symptoms. Strategies can cover a wide range of approaches that are based on clients’ needs and presenting problems; for example, psychotherapy to deal with emotional issues. The final section of the paper shares clinical examples of how treatments can be combined and mentions adding newer interventions, as appropriate, including listening therapy, transcranial direct current stimulation (tDCS) and photobiomodulation (PBM).

HRV is clinically considered to be a surrogate measure of the asymmetrical interplay of the sympathetic and parasympathetic nervous system. While HRV has become an increasingly measured variable through commercially-available wearable devices, HRV is not routinely monitored or utilized in healthcare settings at this time. The purpose of this narrative review is to discuss and evaluate the current research and potential future applications of HRV in several medical specialties, including critical care, cardiology, pulmonology, nephrology, gastroenterology, endocrinology, infectious disease, hematology and oncology, neurology and rehabilitation, sports medicine, surgery and anesthesiology, rheumatology and chronic pain, obstetrics and gynecology, pediatrics, and psychiatry/psychology. A narrative literature review was conducted with search terms including HRV and relevant terminology to the medical specialty in question. While HRV has demonstrated promise for some diagnoses as a non-invasive, easy to use, and cost-effective metric for early disease detection, prognosis and mortality prediction, disease monitoring, and biofeedback therapy, several issues plague the current literature. Substantial heterogeneity exists in the current HRV literature which limits its applicability in clinical practice. However, applications of HRV in psychiatry, critical care, and in specific chronic diseases demonstrate sufficient evidence to warrant clinical application regardless of the surmountable research issues. More data is needed to understand the exact impact of standardizing HRV monitoring and treatment protocols on patient outcomes in each of the clinical contexts discussed in this paper.

Virtual reality (VR) therapy can potentially enhance upper extremity recovery and motivation in stroke rehabilitation. The BTS Nirvana system, equipped with infrared sensors and real-time audiovisual feedback, enables objective performance recording and supports task-oriented, intensive exercises. This study evaluates the combined effect of VR therapy using BTS Nirvana and conventional rehabilitation on upper extremity functions in subacute stroke patients. This randomized, controlled, single-masked study included 22 subacute hemiplegic patients divided into a virtual reality group (n = 11) and a control group (n = 11). Both groups received conventional therapy for three weeks, with the VR group undergoing additional sessions using the BTS Nirvana system. Upper extremity functions were assessed using the Fugl-Meyer upper extremity scale, Brunnstrom stage, Functional Reach Test, Chedoke Arm and Hand Activity tests, and range of motion measurements. Both groups showed significant improvements (p < 0.05) in most outcomes, except for shoulder adduction (p = 0.222) and shoulder external rotation (p = 0.113). Intergroup analysis favored the VR group for upper extremity Brunnstrom stage (p = 0.030), shoulder external rotation (p = 0.029), and Chedoke arm test scores (p = 0.039). Time-group interaction analysis also highlighted superior improvements in the VR group for these measures (p < 0.05). The BTS Nirvana system is a safe and effective complement to conventional therapy, offering intensive and repetitive training for upper extremity rehabilitation in subacute stroke patients. Further research with larger sample sizes and extended treatment durations is needed to confirm these findings and refine treatment protocols.

The young working population experiences a high level of perceived stress. Stress distorts our sympathovagal balance which maintains homeostasis in our body and leads to stress related diseases. This stress can be reduced by practicing yoga, which has various components that can bring a sensation of calmness and increased awareness. Heart rate variability (HRV) being a non-invasive technique is a good method for assessing sympathovagal balance. The present study aimed to determine the immediate changes in HRV in young adults following Nadi Shuddhi Pranayama (NSP). The study was initiated in the Physiology Department of our medical college. 40 naive to pranayama, volunteers of both genders aged 20–40 years were recruited for the study. Their perceived stress scale (PSS) score and ECG in lead II were recorded. Before ECG recording and NSP performance, volunteers were demonstrated the NSP technique by a certified yoga trainer. A 15-minute baseline ECG recording pre-NSP, followed by a 15-minute ECG recording post-NSP for HRV analysis in recovery phase was attained using a digital polygraph. Blood pressure was noted before and at the end of ECG recording. Analysis of variability in HRV was done before and after the performance of NSP. Compared to baseline readings, a significant decrease in systolic blood pressure (SBP) and a significant increase in HRV parameters like SDNN (standard deviation of RR Intervals adjacent normal to normal intervals), and HF (high frequency), along with a significant decrease LF (low frequency), LF/HF (low/high frequency) ratio was observed post NSP practice. p < 0.05 was considered as significant. We conclude that the practice of NSP even for short period can shift the balance of the ANS toward the PNS.

This study aimed to explore the moderating role of cortisol stress reactivity in the relationship between home chaos and child conduct problems among Chinese preschoolers, and further reveal these moderating patterns in boys and girls. The researchers employed a longitudinal design, surveying 160 preschool-aged children (73 boys, 87 girls) and their parents at two separate time points annually. The findings revealed a positive correlation between home chaos and child conduct problems, with cortisol stress reactivity acting as a significant moderator. Further analysis showed that low cortisol reactivity amplified the association between home chaos and child conduct problems for both boys and girls, although the interaction between cortisol reactivity and home chaos reached statistical significance only for boys. These results highlight the importance of considering the interplay between individual physiological factors, such as cortisol reactivity, and environmental risks like home chaos, in understanding behavioral outcomes in young children and further underscore the necessity of tailored interventions that account for both biological and environmental influences on child development.

There are established evidence-based interventions for children with various medical and psychological conditions. In addition, there is evidence supporting biofeedback to treat some of these conditions. However, there remains a gap in the literature in addressing how the practicing clinical psychologist or therapist can apply principles of psychotherapy to enhance biofeedback, as well as how components of biofeedback can enhance the application of evidence-based psychotherapies for children. This article utilizes a case-based approach to highlight some notable pathways for appropriate integration between psychotherapy techniques and biofeedback. It concludes with a summary of the current gaps and opportunities for research to address, as well as opportunities for clinicians and researchers to collaborate to better understand the real-world applications of successful integration of biofeedback with psychotherapy when treating children.

Special operations forces (SOF) soldiers are elite fighters and tactical professionals who perform in high-stress environments. SOF selection processes aim to identify candidates who can sustain performance in high-stress and changing conditions. The vagal nerve is a crucial moderator of stress responses, and its activity (indexed by heart rate variability, HRV) has been shown to predict performance and psycho-physiological resilience in various settings. However, its predictive validity needs to be clarified. This study examined the relationship between HRV and success in an intensive selection procedure. In a historical prospective study, we derived an HRV parameter (root mean square of successive differences between normal heartbeats, RMSSD) from a 10-second ECG of 365 candidates for an SOF naval unit. The ECG was taken approximately two months before the selection procedure. The predictive validity of other routinely obtained measures was also considered. High RMSSD was significantly associated with success, but this relation disappeared after controlling for confounders (e.g., running score). However, after matching pairs of successful and non-successful candidates on confounders, HRV was again significantly related to course performance. The results of this study support the predictive value of HRV for tactical professionals. Given the high cost of training elite soldiers and the burden they undergo, improving accuracy of the selection processes may reduce the burden on candidates and lead to resource savings. Future studies should measure HRV at several time points with longer ECG records.