Virtual reality-supported biofeedback for stress management: Beneficial effects on heart rate variability and user experience

Weibel, Raphael P.; Kerr, Jasmine I.; Naegelin, Mara; Ferrario, Andrea; Schinazi, Victor R.; Marca, Roberto La; Höelscher, Christoph; Nater, Urs M.; Wangenheim, Florian von

doi:10.1016/j.chb.2022.107607

Cited by 11 publications

(29 citation statements)

References 55 publications

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“…Stress, anxiety, and depression are distinct psychological conditions, but they often coexist and share certain similarities in terms of symptoms and underlying mechanisms. In other words, biofeedback interventions can have similar effects on the autonomic nervous system (ANS) [ 39 , 40 , 18 ] and the adrenal glands in terms of both anxiety and depression due to the interconnectedness of these systems and the physiological responses associated with stress [ 41 , 42 ]. Biofeedback interventions aim to modulate the ANS response by providing real-time feedback on physiological parameters [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

A Synthesized Model for Applying Stress Management and Biofeedback Interventions in Research Utilization: A Systematic Review and Meta-analysis

Ruchiwit,

Vuthiarpa,

Ruchiwit

et al. 2024

CPEMH

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Background Stress management and biofeedback interventions have been shown to be effective in improving mental and physical health outcomes. However, previous research studies and synthesized models for applying these interventions in research utilization are insufficient. Objective This study aimed to synthesize a model for applying stress management and biofeedback interventions in research utilization. Methods A systematic review and meta-analysis were conducted according to the PRISMA guidelines. Multiple studies were used to assess the effectiveness of applying stress management and biofeedback interventions published from 2017 to 2023. The process included identifying the research questions, conducting a comprehensive literature search, assessing study quality, extracting data, synthesizing the data, analyzing and interpreting the findings, drawing conclusions, and making recommendations. Results The results indicated a significant mean effect size without evidence of publication bias. The effect sizes of the subgroups among the study variables were not significantly different [Q = 4.02, p = .26]. However, there were significant differences regarding the mean effect sizes among the studies [Q = 63.59, p < .001] and also in terms of the test of subgroups among the participants [Q = 8.49, p = .04]. Conclusion The results emphasize the importance of evidence-based practice and highlight the need for ongoing evaluation and refinement of interventions. The proposed model was supported by related theories and research studies in order to ensure the robustness and reliability to guide practice and future research in the field of biofeedback interventions. By following this model, researchers and practitioners can ensure that stress management and biofeedback interventions are evidence-based and are effective in improving mental and physical health outcomes.

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Section: Discussionmentioning

confidence: 99%

A Synthesized Model for Applying Stress Management and Biofeedback Interventions in Research Utilization: A Systematic Review and Meta-analysis

Ruchiwit,

Vuthiarpa,

Ruchiwit

et al. 2024

CPEMH

View full text Add to dashboard Cite

show abstract

“…Implementation of HMD sometimes yields better results than 2D visualization (Blum et al, 2019), improving resilience to a stressful task following HRV biofeedback. However, most studies do not nd signi cant differences in stress and anxiety reduction between virtual and 2D interventions (Rockstroh et al, 2020Weibel et al, 2023). Likewise, even if a VR system may lead to a greater concentration of autonomous power below the resonant frequency (Weibel et al, 2023), no other differences in HRV indices were found.…”

Section: -Implementations Of Hrv Biofeedback In Virtual Realitymentioning

confidence: 93%

“…However, most studies do not nd signi cant differences in stress and anxiety reduction between virtual and 2D interventions (Rockstroh et al, 2020Weibel et al, 2023). Likewise, even if a VR system may lead to a greater concentration of autonomous power below the resonant frequency (Weibel et al, 2023), no other differences in HRV indices were found. As reviewed by Lüddecke & Felnhofer (2022), VR HRV biofeedback is not more effective than traditional implementation.…”

Section: -Implementations Of Hrv Biofeedback In Virtual Realitymentioning

confidence: 93%

Immersion in a relaxing virtual reality environment is associated with similar effects on stress and anxiety as heart rate variability biofeedback

Pratviel

Bouny

Deschodt-Arsac

2023

Preprint

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Practicing guided breathing at 0.1 Hz in virtual reality yields psychological and physiological benefits. Nonetheless, it remains uncertain whether these effects surpass those induced in a real-world setting. Indeed, the potential influence of the virtual environment on perceived stress and anxiety is not yet fully understood. In this experiment, we aimed to compare the effects of heart rate variability biofeedback combining both haptic and visual cues in real and virtual reality settings within the same population. Additionally, to decipher whether psychological benefits are caused by viewing an environment in virtual reality or performing guided breathing in this setting, a “control” immersion condition was added. 36 healthy sport students (9 females) participated in this study, performing both the real and virtual reality protocols in a randomized order. At different points in each protocol, modulations of anxiety and stress were measured using the STAI-Y questionnaire and a visual analogic scale, respectively. Physiological effects were assessed with measures of heart rate variability, and the performance of cardiac coherence was compared between both real and virtual implementations of guided breathing. As expected, both real and virtual reality heart rate variability biofeedback resulted in similar physiological changes and cardiac coherence performances. A reduction in stress and anxiety was observed in both protocols, particularly for participants who were already stressed or anxious at the beginning. However, no additional changes in psychological states were observed when performing guided breathing alongside being immersed in the virtual environment.

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“…Implementation in HMD sometimes yields better results than 2D visualization (Blum et al, 2019), improving resilience to a stressful task following HRV biofeedback. However, most studies do not find significant differences in stress and anxiety reduction between virtual and 2D interventions (Rockstroh et al, 2020(Rockstroh et al, , 2019Weibel et al, 2023). Likewise, even if a VR system may lead to a greater concentration of autonomous power below the resonant frequency (Weibel et al, 2023), no other differences in HRV indices were found.…”

Section: Implementations Of Hrv Biofeedback In Virtual Realitymentioning

confidence: 93%

“…However, most studies do not find significant differences in stress and anxiety reduction between virtual and 2D interventions (Rockstroh et al, 2020(Rockstroh et al, , 2019Weibel et al, 2023). Likewise, even if a VR system may lead to a greater concentration of autonomous power below the resonant frequency (Weibel et al, 2023), no other differences in HRV indices were found. As reviewed by Lüddecke and Felnhofer (2022), VR HRV biofeedback is not more effective than traditional implementation.…”

Section: Implementations Of Hrv Biofeedback In Virtual Realitymentioning

confidence: 93%

Immersion in a relaxing virtual reality environment is associated with similar effects on stress and anxiety as heart rate variability biofeedback

Pratviel,

Bouny,

Deschodt-Arsac

2024

Front. Virtual Real.

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Practicing guided breathing at 0.1 Hz in virtual reality yields psychological and physiological benefits. Nonetheless, it remains uncertain whether these effects surpass those induced in a real-world setting. Indeed, the potential influence of the virtual environment on perceived stress and anxiety is not yet fully understood. In this experiment, we aimed to compare the effects of heart rate variability biofeedback combining both haptic and visual cues in real and virtual reality settings among the same group of participants. Additionally, to discern whether the psychological benefits arise from viewing an environment in virtual reality or from the act of performing guided breathing in this specific setting, a “control” immersion condition was introduced. 36 healthy sport students (9 females) participated in this study, performing both the real and virtual reality protocols in a randomized order. Anxiety and stress levels were assessed using the STAI-Y questionnaire and a visual analog scale, respectively. Physiological effects were assessed through measures of heart rate variability, and the performance of cardiac coherence was compared between the real and virtual implementations of guided breathing. As expected, both real and virtual reality heart rate variability biofeedback led to similar physiological modulations and cardiac coherence performances. A decrease in stress and anxiety was observed in both protocols, particularly among participants who initially reported higher stress or anxiety levels. However, no additional changes in psychological states were observed when performing guided breathing while immersed in the virtual environment.

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Virtual reality-supported biofeedback for stress management: Beneficial effects on heart rate variability and user experience

Cited by 11 publications

References 55 publications

A Synthesized Model for Applying Stress Management and Biofeedback Interventions in Research Utilization: A Systematic Review and Meta-analysis

A Synthesized Model for Applying Stress Management and Biofeedback Interventions in Research Utilization: A Systematic Review and Meta-analysis

Immersion in a relaxing virtual reality environment is associated with similar effects on stress and anxiety as heart rate variability biofeedback

Immersion in a relaxing virtual reality environment is associated with similar effects on stress and anxiety as heart rate variability biofeedback

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