Symptom Management Among Cancer Survivors: Randomized Pilot Intervention Trial of Heart Rate Variability Biofeedback

Burch, James B.; Ginsberg, J. P.; McLain, Alexander C.; Franco, Regina; Stokes, Sherry; Susko, Kerri; Hendry, W. Garden; Crowley, Elizabeth; Christ, Alex; Hanna, John; Anderson, Annie; Hébert, James R.; O’Rourke, Mark Allen

doi:10.1007/s10484-020-09462-3

Cited by 25 publications

(25 citation statements)

References 36 publications

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“…A total of 14 RCTs were analysed on a total of 794 patients divided into experimental ( M age = 46.17 SD = 7.72, 42.72% female) and control ( M age = 46.81, SD = 7.17, 44.5% female) groups. Among the studies, two were conducted in Taiwan 35 , 43 , two in Netherlands 44 , 47 , three in the USA 26 , 46 , 54 , three in Germany 45 , 49 , one in the UK, one in Austria, one Iran and one in Sweden 48 , 50 , 51 , 53 . Nine studies were conducted on patients with cardiovascular disease, stress symptoms, cancer or alcohol disorder, while the remaining five studies focused on non-clinical samples 26 , 44 , 47 , 48 , 52 .…”

Section: Resultsmentioning

confidence: 99%

“…Considering the previous recent meta-analysis, which found a significant yet small effect size of HRV on depression, we found a slightly higher effect. Such a difference might be due to the fact that Lehrer et al 40 assessed the efficacy of both HRVB and paced-breathing and that we included five recent studies 43 , 51 – 54 , which were not included in the previous meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

“…The year of publication moderated the effect of the intervention, in the direction of larger effect sizes for recent studies. The most recent studies we included had usual care and active control groups and conducted the interventions on participants with heterogeneous features (cardiovascular disease, psychiatric illnesses and no medical condition) 43 , 51 – 54 , thus it is unlikely that those specific features had an influence in moderating the effects.…”

Section: Discussionmentioning

confidence: 99%

“…2 studies reported incomplete data 41 , 42 ; corresponding authors were contacted, none provided the requested data, and those studies were therefore excluded. The remaining 14 studies were included in the present meta-analysis 26 , 35 , 43 – 54 .…”

Section: Methodsmentioning

confidence: 99%

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A meta-analysis on heart rate variability biofeedback and depressive symptoms

Pizzoli

Marzorati

Gatti

et al. 2021

Sci Rep

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Heart rate variability biofeedback (HRVB) has been used for a number of years to treat depressive symptoms, a common mental health issue, which is often comorbid with other psychopathological and medical conditions. The aim of the present meta-analysis is to test whether and to what extent HRVB is effective in reducing depressive symptoms in adult patients. We conducted a literature search on Pubmed, ProQuest, Ovid PsycInfo, and Embase up to October 2020, and identified 721 studies. Fourteen studies were included in the meta-analysis. Three meta-regressions were also performed to further test whether publication year, the questionnaire used to assess depressive symptoms, or the interval of time between T0 and T1 moderated the effect of HRVB. Overall, we analysed 14 RCTs with a total of 794 participants. The random effect analysis yielded a medium mean effect size g = 0.38 [95% CI = 0.16, 0.60; 95% PI = − 0.19, 0.96], z = 3.44, p = 0.0006. The total heterogeneity was significant, QT = 23.49, p = 0.03, I2 = 45%, which suggested a moderate variance among the included studies. The year of publication (χ2(1) = 4.08, p = 0.04) and the questionnaire used to assess symptoms (χ2(4) = 12.65, p = 0.01) significantly moderated the effect of the interventions and reduced heterogeneity. Overall, results showed that HRVB improves depressive symptoms in several psychophysiological conditions in adult samples and should be considered as a valid technique to increase psychological well-being.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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A meta-analysis on heart rate variability biofeedback and depressive symptoms

Pizzoli

Marzorati

Gatti

et al. 2021

Sci Rep

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“…[ 16 ] A study with correction officers revealed significant improvements in resilience, cholesterol, glucose, heart rate, and blood pressure at a projected annual healthcare cost savings of $1,179 per employee. [ 17 ] Chronic diseases often have a psychological component, and numerous studies have also demonstrated reduced stress and improved psychological functioning in these patients when using self-regulation with HRV biofeedback[ 18 19 20 21 22 23 ] and without it. [ 24 ] Thus, there is a need to assess whether using a daily self-regulation practice with HRV biofeedback is a practical way to improve stress and job satisfaction amongst primary care clinicians and nurses.…”

Section: Discussionmentioning

confidence: 99%

Daily self-regulation with biofeedback to improve stress and job satisfaction in a primary care clinic

Orlando

Rahmanian

Byrd

et al. 2021

Journal of Family Medicine and Primary Care

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Background: Burnout in healthcare professions is higher than other careers. An undesirable work-life balance has resulted in declining job satisfaction among primary care physicians. Biofeedback devices teach self-regulation techniques, which reduce stress and increase resilience. Objectives: We assessed whether self-regulation with biofeedback is effective at decreasing stress and improving job satisfaction among primary care clinicians and nurses. Methods: Two naturally occurring cohorts of clinicians and nurses were followed over 12 weeks. The treatment group (N = 9) completed 12 weeks of self-regulation with optional clinic-based biofeedback and received peer support for the first half. The control group (N = 9) started a delayed intervention after 6 weeks without peer support. Descriptive and bivariate analyses were conducted. Results: The treatment group averaged one biofeedback session weekly for 6 min and the control group two sessions for 11 min. Adherence differed by age. Subjects also reported using self-regulation techniques without biofeedback. Perceived stress initially increased in both groups with intervention implementation, more so in the treatment group ( P = 0.03) whose stress then decreased but was not significant. Overall and extrinsic job satisfaction similarly increased but were not significance. Conclusion: The initial increase in perceived stress was related to daily biofeedback adherence and clinic responsibilities. Treatment group stress then decreased with self-regulation but was difficult to quantify in a small cohort. Larger studies could increase daily self-regulation adherence by improving biofeedback accessibility for leisurely use. Using self-regulation with biofeedback may be an innovative approach to reduce stress and improve job satisfaction in primary care.

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Pilot Study on Reducing Symptoms of Anxiety with a Heart Rate Variability Biofeedback Wearable and Remote Stress Management Coach

Chung¹,

Gevirtz

Gharbo

et al. 2021

Appl Psychophysiol Biofeedback

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We assessed the feasibility of using a consumer friendly, heart rate variability biofeedback (HRVB) wearable device in conjunction with a remote stress management coach to reduce symptoms of anxiety. We utilized a discreet, continuously wearable electrocardiogram device, the Lief Smart Patch, which measures and records heart rate and HRV in real time, and guides HRVB exercises using vibrations and visual cues. During the 8-week study, participants ( N = 14) wore the Lief Smart Patch, participated in HRVB with the device, utilized the mobile app, and communicated with a remote stress management coach. We collected self-report survey responses to measure symptoms of anxiety (GAD-2) and depression (PHQ-2) every 2 weeks, as well as HRV data throughout the study. Participants’ mean GAD-2 score began at 4.6 out of 6. By the trial’s completion, the group’s mean GAD-2 score dropped to 1.7 (t (13) = 11.0, p < .001) with only 2 of the 14 subjects remaining over the clinical threshold of high anxiety. Similarly, the group’s mean PHQ-2 score dropped from 2.93 to 1.29 (t (13) = 3.54, p < .01). In addition, participants increased their HRV (RMSSD) by an average of + 11.4 ms after participating in a low dose biofeedback exercise. These findings suggest that engaging in HRVB through a discreet wearable device in conjunction with a remote stress management program may be effective for reducing symptoms of anxiety and depression.

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Symptom Management Among Cancer Survivors: Randomized Pilot Intervention Trial of Heart Rate Variability Biofeedback

Cited by 25 publications

References 36 publications

A meta-analysis on heart rate variability biofeedback and depressive symptoms

A meta-analysis on heart rate variability biofeedback and depressive symptoms

Daily self-regulation with biofeedback to improve stress and job satisfaction in a primary care clinic

Pilot Study on Reducing Symptoms of Anxiety with a Heart Rate Variability Biofeedback Wearable and Remote Stress Management Coach

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