Long-term benefits of heart rate variability biofeedback training in older adults with different levels of social interaction: a pilot study

Souza, Perciliany Martins de; Souza, Miriam de Cássia; Diniz, Luiza Araújo; Araújo, Cássia Regina Vieira; López, Mariana; Volchan, Eliane; Fernandes, Orlando; Sanchez, Tiago Arruda; Souza, Gabriela Guerra Leal

doi:10.1038/s41598-022-22303-z

Cited by 6 publications

(3 citation statements)

References 35 publications

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“…In fact, the cardiac indices (RMSSD and total power, as shown in Figure 5) remained unchanged. Consequently, our findings suggest that immersion alone, without an optimization of autonomous regulation, might have only a transient effect, lacking a lasting impact over time, unlike the longer-term effects observed with cardiac coherence training (Deschodt-Arsac et al, 2018;Bögge et al, 2022;de Souza et al, 2022). Therefore, H3 is not supported in the control immersion condition.…”

Section: Discussionmentioning

confidence: 64%

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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Section: Discussionmentioning

confidence: 64%

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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“…This observation demonstrates that sustained employment of short sessions of biofeedback is required for ongoing physiological effects. This is an important finding, as there are scarce studies evaluating the long-term impact of HRV biofeedback on HRV metrics, with few studies demonstrating sustained short-term effects [85,86]. Further studies evaluating the duration of physiological effects are needed.…”

Section: Xsl • Fomentioning

confidence: 96%

Remote Short Sessions of Heart Rate Variability Biofeedback Monitored With Wearable Technology: Open-Label Prospective Feasibility Study

Hirten,

Danieletto,

Landell

et al. 2024

JMIR Ment Health

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Background Heart rate variability (HRV) biofeedback is often performed with structured education, laboratory-based assessments, and practice sessions. It has been shown to improve psychological and physiological function across populations. However, a means to remotely use and monitor this approach would allow for wider use of this technique. Advancements in wearable and digital technology present an opportunity for the widespread application of this approach. Objective The primary aim of the study was to determine the feasibility of fully remote, self-administered short sessions of HRV-directed biofeedback in a diverse population of health care workers (HCWs). The secondary aim was to determine whether a fully remote, HRV-directed biofeedback intervention significantly alters longitudinal HRV over the intervention period, as monitored by wearable devices. The tertiary aim was to estimate the impact of this intervention on metrics of psychological well-being. Methods To determine whether remotely implemented short sessions of HRV biofeedback can improve autonomic metrics and psychological well-being, we enrolled HCWs across 7 hospitals in New York City in the United States. They downloaded our study app, watched brief educational videos about HRV biofeedback, and used a well-studied HRV biofeedback program remotely through their smartphone. HRV biofeedback sessions were used for 5 minutes per day for 5 weeks. HCWs were then followed for 12 weeks after the intervention period. Psychological measures were obtained over the study period, and they wore an Apple Watch for at least 7 weeks to monitor the circadian features of HRV. Results In total, 127 HCWs were enrolled in the study. Overall, only 21 (16.5%) were at least 50% compliant with the HRV biofeedback intervention, representing a small portion of the total sample. This demonstrates that this study design does not feasibly result in adequate rates of compliance with the intervention. Numerical improvement in psychological metrics was observed over the 17-week study period, although it did not reach statistical significance (all P>.05). Using a mixed effect cosinor model, the mean midline-estimating statistic of rhythm (MESOR) of the circadian pattern of the SD of the interbeat interval of normal sinus beats (SDNN), an HRV metric, was observed to increase over the first 4 weeks of the biofeedback intervention in HCWs who were at least 50% compliant. Conclusions In conclusion, we found that using brief remote HRV biofeedback sessions and monitoring its physiological effect using wearable devices, in the manner that the study was conducted, was not feasible. This is considering the low compliance rates with the study intervention. We found that remote short sessions of HRV biofeedback demonstrate potential promise in improving autonomic nervous function and warrant further study. Wearable devices can monitor the physiological effects of psychological interventions.

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“…A preliminary three-week HRV biofeedback intervention was conducted among older adults and results indicated improvements in attentional skills ( Jester et al, 2019 ). Another study examined HRV biofeedback and loneliness in older adults and provided evidence that HRV biofeedback improved loneliness among institutionalized older adults ( de Souza et al, 2022 ).…”

Section: Treatment Targetsmentioning

confidence: 99%

Contributions of loneliness to cognitive impairment and dementia in older adults are independent of other risk factors and Alzheimer’s pathology: a narrative review

Oken,

Kaplan,

Klee

et al. 2024

Front. Hum. Neurosci.

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Loneliness significantly contributes to cognitive impairment and dementia in older adults. Loneliness is a distressing feeling resulting from a perceived lack of social connection (i.e., a discrepancy between desired and actual social relationships), while social isolation is a related term that can be defined by number and type of social relationships. Importantly, loneliness is distinct from social isolation in that it is associated with a distressing self-perception. The primary focus of this narrative review is the impact of chronic loneliness on cognitive impairment and dementia among older adults. Loneliness has a significant association with many factors that are related to worse cognition, and therefore we include discussion on health, mental health, as well as the physiological effects of loneliness, neuropathology, and potential treatments. Loneliness has been shown to be related to development of dementia with a hazard ratio (HR) risk comparable to having a single APOE4 gene. The relationship of dementia to loneliness appears to be at least partially independent of other known dementia risk factors that are possibly associated with loneliness, such as depression, educational status, social isolation, and physical activity. Episodic memory is not consistently impacted by loneliness, which would be more typically impaired if the mild cognitive impairment (MCI) or dementia was due to Alzheimer’s disease (AD) pathology. In addition, the several longitudinal studies that included neuropathology showed no evidence for a relationship between loneliness and AD neuropathology. Loneliness may decrease resilience, or produce greater cognitive change associated with the same level of AD neuropathology. Intervention strategies to decrease loneliness in older adults have been developed but need to consider key treatment targets beyond social isolation. Loneliness needs to be assessed in all studies of cognitive decline in elders, since it significantly contributes to the variance of cognitive function. It will be useful to better define the underlying mechanism of loneliness effects on cognition to determine if it is similar to other psychological factors related to excessive stress reactivity, such as neuroticism or even depression, which are also associated with cognitive decline. It is important from a health perspective to develop better strategies to decrease loneliness in older adults.

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Long-term benefits of heart rate variability biofeedback training in older adults with different levels of social interaction: a pilot study

Cited by 6 publications

References 35 publications

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

Remote Short Sessions of Heart Rate Variability Biofeedback Monitored With Wearable Technology: Open-Label Prospective Feasibility Study

Contributions of loneliness to cognitive impairment and dementia in older adults are independent of other risk factors and Alzheimer’s pathology: a narrative review

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