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\"Examines the benefits of and the techniques for using neurofeedback to combat many childhood disorders, such as autism, ADHD, depression, and aggression\"--Provided by publisher.

In contemporary western societies stress is highly prevalent, therefore the need for stress-reducing methods 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 intervention techniques and 5 weeks of daily exercises at home. The PA exercises consisted of a vigorous-intensity activity of free choice. The MM exercises consisted of guided mindfulness meditation. The HRV-BF exercises consisted of slow breathing with a heart rate variability biofeedback device. Participants received daily reminders for their exercises and were contacted weekly to monitor their progress. They completed questionnaires prior to, directly after, and 6 weeks after the intervention. Results indicated an overall beneficial effect consisting of reduced stress, anxiety and depressive symptoms, and improved psychological well-being and sleep quality. No significant between-intervention effect was found, suggesting that PA, MM, and HRV-BF are equally effective in reducing stress and its related symptoms. These self-help interventions provide easily accessible help for people with stress complaints.

Breathing exercises with biofeedback have benefits over breathing exercises without biofeedback. However, the traditional measurement of respiratory signals that is required as part of feeding back the breath incurs high cost and effort. We propose a novel virtual reality (VR) based approach to respiratory biofeedback that utilizes the positionally tracked hand controllers integrated into modern VR systems to capture and feedback the respiration-induced abdominal movements. In a randomized controlled laboratory study, we investigated the feasibility and efficacy of the developed biofeedback algorithm. In total, 72 participants performed a short breathing exercise in VR with or without respiratory biofeedback. The feedback integration resulted in a satisfactory user experience, a heightened breath awareness, a greater focus on slow diaphragmatic breathing and an increased respiratory sinus arrhythmia. This evidences that the novel biofeedback approach is low-cost, unobtrusive, usable and effective in increasing breath awareness and promoting slow diaphragmatic breathing in the context of VR-based breathing exercises. Future studies need to investigate the broader applicability and long-term effects.

Biofeedback therapy is useful for treatment of functional defecation disorders but is not widely available and is labor intensive. We developed an Internet-of-Medical-Things (IoMT) device, enabling self-guided biofeedback therapy. This study assesses the safety and efficacy of self-guided biofeedback therapy using the IoMT device in comparison to standard operator-led therapy. Patients experiencing urge or seepage fecal incontinence (≥1 episode/week) were randomly assigned to either our IoMT system or to the conventional anorectal manometry-based therapy. Both interventions comprised six weekly sessions, focusing on enhancing anal strength, endurance, and coordination. The novel device facilitated self-guided therapy via visual instructions on a companion app. Primary outcomes included safety/tolerability, changes in Vaizey severity scores, and alterations in anorectal pressure profiles. Twenty-five patients (22 females, 3 males) participated, with 13 in the novel device group and 12 in the standard therapy group. Both groups showed significant reductions in symptom severity scores: IoMT device group -4.2 (95% CI: -4.06, -4.34, p = 0.018), and the standard therapy group -4.8 (95% CI: -4.31, -5.29, p = 0.028). Anal sphincter resting pressure and sustained squeeze time improved significantly in both groups, and the novel device group demonstrated an increase in maximum sphincter squeeze pressure. There were no significant differences between the therapy groups. Importantly, the experimental device was well-tolerated compared with standard therapy, with no serious adverse events observed. This study demonstrates the comparable efficacy of self-administered biofeedback using the IoMT device with traditional biofeedback therapy. The results demonstrates the potential of the IoMT device as a safe, self-guided method for FI therapy, offering convenience and effectiveness in fecal incontinence management.

Use of virtual reality (VR)-based biofeedback (BF) represents an emerging nonpharmacological intervention for enhancing sleep quality in individuals exhibiting depressive symptoms, anxiety symptoms, or both. However, empirical evidence regarding its efficacy in addressing sleep disturbances remains limited and inconclusive. This 3-arm randomized controlled trial aimed (1) to compare the efficacy of VR-based BF with conventional BF in improving sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), among individuals with depressive symptoms, anxiety symptoms, or both (DAS); (2) to examine the effects of VR-based BF in a demographically similar healthy control (HC) group; and (3) to evaluate between-group differences in sleep quality improvements at the 4-week follow-up. Participants scoring ≥10 on the Patient Health Questionnaire-9 or ≥9 on the Panic Disorder Severity Scale were allocated to a group with DAS while others were assigned to a HC group. The DAS group was subsequently randomized into VR-based BF or conventional BF interventions with a therapist. All participants attended sessions at weeks 0, 2, and 4, completing assessments including the Montgomery-Asberg Depression Rating Scale, State-Trait Anxiety Inventory, and Visual Analog Scale in interviews. The PSQI was administered at baseline and postintervention to evaluate alterations in sleep quality over a 4-week period. A total of 118 participants were randomized into a VR-based BF group (DAS/VR, n=40) or a conventional BF group (DAS/BF, n=38), and a control group (HC/VR, n=40) received VR-based BF. Sleep disturbance scores of both DAS/VR and DAS/BF groups had significant improvements (mean reductions of -0.58, SD 0.75 and -0.66, SD 0.75, respectively) compared to those preintervention, showing no significant difference after adjusting for age and sex (P=.49). The DAS/VR group had a greater improvement in sleep disturbance (mean -0.08, SD 0.53; P=0.0014) than the HC/VR group. Global PSQI scores in both DAS/VR and DAS/BF groups improved compared to those preintervention, showing decreases by -2.50 (SD 2.89) and -3.39 (SD 2.80), respectively. The difference between the 2 groups was not statistically significant (P=.14). The Global PSQI score in the DAS/VR group showed significant improvement (-0.95, SD 2.09; P=.01) compared to that in the HC/VR group. This study provides evidence that both VR-based BF and conventional BF with a therapist are efficacious psychological interventions for enhancing sleep quality in individuals with depressive symptoms, anxiety symptoms, or both, with no significant differences observed between these 2 approaches. Both interventions showed significant improvements compared to baseline measurements. These findings suggest potential applications of these interventions in clinical settings to improve sleep quality and mental well-being.

Previous research suggests that higher heart rate variability (HRV) is associated with better cognitive function. However, since most previous findings on the relationship between HRV and cognitive function were correlational in nature, it is unclear whether individual differences in HRV play a causal role in cognitive performance. To investigate whether there are causal relationships, we used a simple breathing manipulation that increases HRV through a 5-week HRV biofeedback intervention and examined whether this manipulation improves cognitive performance in younger and older adults (N = 165). The 5-week HRV biofeedback intervention did not significantly improve inhibitory control, working memory and processing speed across age groups. However, improvement in the Flanker score (a measure of inhibition) was associated with the amplitude of heart rate oscillations during practice sessions in the younger and older intervention groups. Our results suggest that daily practice to increase heart rate oscillations may improve inhibitory control, but future studies using longer intervention periods are warranted to replicate the present finding.

Ego-depletion describes a state of mind, where the capacity for self-control is temporarily depleted after a primary self-control action. The aim of this study was to investigate whether a brief virtual reality-based mindfulness breathing meditation with integrated biofeedback can be considered an effective strategy to counteract the detrimental effects of ego depletion on motor skill performance under pressure. The study included two experiments, each of them designed as counterbalanced cross-over trials and based on an a priori sample-size calculation. Within each experiment, participants completed two appointments in a randomly assigned order, during which they were asked to perform 20 basketball free throws ( N  = 18; Experiment 1) or 20 penalty kicks at a football goal in four target squares ( N  = 16; Experiment 2) under pressure pre and post the following conditions: Stroop-test-induced ego depletion followed by a 15 min resting break, Stroop-test-induced ego depletion followed by a 15 min virtual reality-based mindfulness breathing meditation with integrated biofeedback. Results indicate that, in comparison to a resting break, a brief virtual reality-based mindfulness meditation with integrated biofeedback can counteract the detrimental effects of ego-depletion (Experiment 2) and enhance motor skill performance under pressure (Experiment 1, 2) Implications for researchers and practitioners are derived in light of the identified methodological limitations.

This study provides a comprehensive overview of the materials and methods used to evaluate the effectiveness of the use of biofeedback in the treatment of aggressive episodes in children and adolescents. Aggressive episodes are common in various disorders and are associated with deficits in emotional processing and impulse control, primarily due to dysfunctions in the amygdala and prefrontal cortex (PFC). These brain regions also regulate physiological arousal, influencing heart rate and other autonomic functions even before aggression manifests. These early signals can be shown to the person (biofeedback) reinforcing therapeutic skills to enhance emotional regulation and reduce aggression. A total of 70 participants will be recruited for a randomized controlled trial (RCT). All participants will receive therapy, although only the intervention group will incorporate biofeedback. The experimental study will be split into three blocks: (1) Home Monitoring: Physiological signals will be recorded using a smartwatch, and aggressive episodes will be captured with a camera; (2) Laboratory Assessment: Participants will attend three sessions, where therapists will induce aggressive reactions, using the video clips recorded at home. Simultaneously, real-time physiological signals will be measured. These sessions will also include relaxation periods before and after the provoked outburst; (3) Therapeutic Intervention: Similar to the laboratory assessment block, therapists will induce aggressive responses in three sessions; however, in this block, participants will receive therapy. Additionally, participants who belong to the intervention group, will include biofeedack in the therapy. Biofeedback is focused on heart rate (HR), heart rate variability (HRV), and skin conductance level (SCL). The CACIA, the Stroop, and other pre- and post-experimental tests. will be used to assess the differences between the control and intervention groups. Emotions play a fundamental role in decision-making, social interactions, and mental health. Emotional dysregulation often leads to aggression, irritability, and anxiety. Showing physiological responses to patients, such as heart rate variability and skin conductance, may improve emotional awareness and regulation. This study aims to verify the effectiveness of including biofeedback in such therapy.

The current study compared the effects of heart rate variability biofeedback (HRV-BF) and electroencephalographic biofeedback (EEG-BF) on sleep, mood, and reaction time. Fourteen highly trained male athletes with sleep disturbances participated in this randomised crossover study. Participants took part in HRV-BF and EEG-BF training, with each condition consisting of eight sessions over 15 days. Polysomnography (PSG) and the Pittsburgh sleep quality index (PSQI) were used to assess sleep quality, the profile of mood states (POMS) questionnaire to monitor mood, and reaction time to measure performance pre and post intervention. HRV-BF training improved PSG sleep efficiency (SE) (P = 0.022, d = 0.35, 95% CI 0.01 to 0.16) and subjective sleep duration (P = 0.011, ES = 0.40) when compared to EEG-BF. Only HRV-BF reduced reaction time pre to post biofeedback training (P = 0.020, d = 0.75, 95% CI 0.006 to 0.059). The PSQI showed that both HRV-BF (P = 0.025, ES = 0.31) and EEG-BF (P = 0.003, ES = 0.32) resulted in improved global PSQI scores. Total mood disturbance was also reduced though HRV-BF (P = 0.001, ES = 0.40) and EEG-BF (P = 0.001, ES = 0.30). HRV-BF and EEG-BF enhanced some subjective parameters of sleep and mood. HRV-BF increased PSG SE and subjective sleep duration more than EEG-BF in highly trained athletes with sleep disturbances.

There is limited understanding of how well patients adhere to postoperative instructions following ankle surgery, particularly in outpatient settings regarding partial weight bearing (15–30 kg) and orthosis use. This study aims to assess orthosis compliance and load frequency over six weeks post-surgery using pressure-sensitive insoles, while also evaluating the effectiveness of continuous biofeedback. A total of 84 patients with isolated ankle fractures were enrolled. All participants were instructed to maintain partial weight bearing of 15–30 kg for six weeks with a lower leg orthosis equipped with insoles that continuously recorded daily step counts and maximum loads. In a prospective randomized design, the control group received no biofeedback, while the intervention group received audiovisual feedback whenever loads exceeded 20 kg. Adherence to the prescribed partial weight bearing and orthosis use was low in both groups, with only 10% of the control group wearing the orthosis by week three and overload occurring as early as week one. However, the implementation of biofeedback resulted in significant improvements in orthosis utilization (57.4% vs. 29.1%) and adherence to prescribed loading. The implementation of continuous biofeedback significantly enhanced adherence to prescribed loading and orthosis usage, highlighting its critical role in postoperative rehabilitation for ankle fractures.