To evaluate the effectiveness of biofeedback interventions for pain management and rehabilitation outcomes in athletes and individuals with sports-related injuries. Systematic review of randomized controlled trials. A systematic literature search was conducted in eight electronic databases: PubMed, Google Scholar, Web of Science, Scopus, ProQuest, PEDro, SPORTDiscus, and the Cochrane Central Register of Controlled Trials. Searches were completed in September 2024 and updated in November 2025. Randomized controlled trials investigating the use of biofeedback interventions for pain management and rehabilitation in athletes or individuals with sports-related injuries were eligible for inclusion. Due to heterogeneity in participant characteristics, injury types, biofeedback modalities, and outcome measures, a narrative synthesis was performed. Methodological quality was assessed using the Cochrane Risk of Bias tool. Nine randomized controlled trials from Saudi Arabia, Taiwan, Canada, Romania, Brazil, and Iran were included. Biofeedback interventions addressed patellofemoral pain, shoulder impingement, chronic ankle instability, plantar fasciitis, post-traumatic osteoarthritis, chronic low back pain, meniscal injuries, and other musculoskeletal sports injuries. Modalities included electromyography, heart rate variability, neurofeedback, virtual reality feedback, and real-time visual gait retraining. Biofeedback was associated with reduced pain, improved muscle activation and strength, enhanced functional recovery, and better rehabilitation outcomes. Biofeedback may be a valuable adjunct to conventional rehabilitation for athletes or individuals with sports-related injuries. For clinicians, it can enhance neuromuscular control, patient engagement, and functional outcomes in multimodal programs. However, the certainty of the evidence is low, and further high-quality trials across diverse populations are needed.
Auricular neuromodulation specificity remains debated, particularly for electrical approaches in which current spread may obscure site-specific effects. We tested whether focal mechanical auricular acupressure produces site-by-pathway differences across Hot affective interference control and Cold inhibitory braking. In a single-blind, randomized, active-controlled study, 55 young adults with elevated affective symptoms received 48-h auricular acupressure at Shenmen, Subcortex, Combined (Shenmen + Subcortex), or an active Shoulder control site. Participants completed an Emotional Flanker task indexing Hot control and an Emotional Go/No-Go task indexing Cold control. Standardized change scores were analyzed using linear mixed-effects models, with hierarchical drift diffusion modeling and signal detection theory analyses used to constrain mechanistic interpretation. A significant Group × Pathway interaction was observed (p = 0.002). In the Cold pathway, Subcortex and Combined stimulation showed greater improvement than Shenmen stimulation. In the Hot pathway, Shenmen stimulation showed greater improvement than Subcortex stimulation, whereas Hot-pathway contrasts against the active control were non-significant. Focal auricular acupressure produced pathway-selective, site-dependent profiles across Hot and Cold executive-control tasks. These findings suggest relative site-by-pathway specificity, although further studies with larger samples and optimized control conditions are needed to confirm the robustness and mechanisms of this effect.
Working memory (WM) depends on dynamic cognitive control processes that adapt to task demands. Although meditation has been associated with enhanced attentional regulation, its effects on load-dependent neural dynamics remain unclear. The present study investigated the effects of one month of OM meditation on behavioral performance and electrophysiological markers of cognitive control during a visual working memory task. Thirty-four healthy adult males were randomly assigned to either an OM meditation group (n = 18) or a non-meditative control group (n = 16). Electroencephalographic activity was recorded while participants performed visual n-back task with three load conditions (0-back, 1-back, and 2-back). Behavioral performance was analyzed using linear mixed-effects models. Event-related potentials (ERPs), including the P1, N1, N2, P3, and late slow wave components, were examined using both component-based and time-resolved analyses. Behaviorally, the meditation group demonstrated greater pre–post improvements in reaction time during the 0-back and 1-back conditions, but not during the 2-back condition. Accuracy remained high across all task conditions. Electrophysiologically, a significant Group × Time × Load interaction was observed for the N2 component, primarily driven by the 1-back condition. Time-resolved permutation testing further revealed a temporally localized N2 modulation under moderate working memory demand, with no reliable effects observed in other ERP components. These findings suggest that OM meditation selectively modulates monitoring-related cognitive control processes in a demand-dependent manner. More broadly, the results support adaptive models of cognitive control and highlight the value of time-resolved electrophysiological approaches for detecting transient neural changes associated with meditation training.
The aim of this research was to examine if biofeedback nasal breathing can augment psychological and physiological recovery following exposure to mild stress. Two studies are reported. The first study (Study 1) was a feasibility study (n = 12) to examine if six minutes of biofeedback nasal breathing is relaxing and acceptable for participants. Following positive results from Study 1, Study 2 examined if biofeedback nasal breathing can enhance recovery from mild stress. In this latter study, after six minutes of free breathing (baseline), participants (n = 37) were administered the N-Back and the Go/No-Go task, to induce stress, in that order. In between each stress task, individuals practised either biofeedback nasal breathing, or free normal breathing for six minutes in a crossover design. It was found that biofeedback nasal breathing was associated with higher ratings of serenity, lower breathing rate, and an increased subjective capacity to doze, relative to baseline free breathing and post-stress free breathing. In addition, biofeedback nasal breathing was associated with higher heart rate variability (HRV) in terms of RMSSD, relative to baseline free breathing, and higher High Frequency HRV (HF), relative to baseline free breathing, and free breathing post stress. Overall, the present findings indicate that real-time auditory feedback of nasal breathing represents a feasible and potentially efficacious approach for facilitating relaxation and supporting recovery from mild psychological stress. With continued development, such methods may offer accessible and scalable strategies for enhancing emotional well-being and fostering stress resilience across both clinical and non-clinical populations.
Heart rate variability biofeedback (HRV biofeedback) is a promising treatment for improving autonomic regulation and health outcomes. Although HRV biofeedback has demonstrated benefits in younger adults, its efficacy in older adult samples remains unclear. Given age-related declines in heart rate variability (HRV) and corresponding risk for heart disease, stress-related difficulties, and cognitive decline, HRV biofeedback could be an intervention to enhance HRV and improve emotional functioning, sleep, and cognitive performance in older adults. We conducted a randomized, sham-controlled trial wherein 53 healthy older adults were randomized to active HRV biofeedback treatment or sham. Participants completed a five-week HRV biofeedback intervention with assessments measuring HRV at rest, during stress recovery, along with measures of emotional functioning, sleep, and cognitive performance and completed pre- and post-testing along with a 5-week intervention. No significant differences were detected in resting HRV between groups. However, the HRV biofeedback group showed a significant increase in LF during recovery from an acute laboratory stressor (Paced Auditory Serial Addition Test), suggesting potential modulation of HRV during recovery, particularly in low frequency oscillatory ranges. Both HRV biofeedback and sham conditions reported improved sleep quality as well as improvements in HF, RMSSD, and SDNN HRV measures, but no significant differences were present for measures of emotional functioning or cognitive performance. High adherence rates in both conditions did not moderate HRV outcomes. Findings suggest HRV biofeedback may enhance aspects of HRV during stress recovery in older adults but there were not specific improvements in resting HRV, emotional health, or cognition.
Children with autism spectrum disorder (ASD) face difficulties in expressing and recognizing emotions resulting in meltdowns and aggressive situations which is strenuous for both parents and caretakers. A device that would help parents and caretakers to identify the onset of emotional variations would not only aid in preventing undesirable situations but also help them resort to remedial therapies. Towards that, this research work focuses on identifying the positive and negative emotional state of children with ASD using electrocardiogram (ECG) signals and artificial intelligence (AI) techniques. Training AI for emotion recognition requires ECG data to reflect the emotional state. As physiological data cannot be manipulated, emotions need to be induced in children to obtain the emotional ECG data. This research analyses two emotion elicitation protocols namely audio-visual (AV) based emotion elicitation protocol and multimodal emotion elicitation protocol to identify the protocol that can be used to better elicit emotions in children with ASD. In this work, emotional ECG data was acquired from 25 children with ASD using both the protocols. Results indicate that, the ECG data elicited using multimodal emotion elicitation protocol and AV based protocol, categorize emotions at the highest average accuracy of 85.7
Recently, the applied psychophysiology community has started to investigate the effectiveness of combining neurofeedback and biofeedback interventions. The training triad of beta-theta neurofeedback, heart rate variability biofeedback, and box-breathing continuous feedback can influence participants’ electrophysiological activity and also help healthy individuals decrease reaction time. For this purpose, twenty-two students (6 male, 16 female) were randomly assigned to three experimental groups using block randomization. The first group (N = 7) received 10 sessions of beta-theta neurofeedback, heart rate variability biofeedback, and box-breathing continuous feedback simultaneously. The second group (N = 8) underwent 10 sessions of only box-breathing continuous feedback, while the third group (N = 7) participated in 10 sessions of beta-theta neurofeedback and heart rate variability biofeedback together. A multivariate analysis of covariance was used to compare reaction time scores among the three groups in a pretest-posttest design. Additionally, repeated measures analysis of variance assessed within-group changes in electrophysiological markers across three time points: pre-test, mid-test, and post-test. Results indicated that, compared to groups 2 and 3, the visual-recognition-reaction-time scores in experimental group 1 significantly decreased (P-value < 0.05). In addition, group 1 showed significant within-group changes (P-value < 0.05) in electroencephalography measures (beta/theta power ratio and high-beta relative power) and heart rate variability (root mean square of successive differences). We conclude that the combination of beta-theta neurofeedback, heart rate variability biofeedback, and box-breathing continuous feedback can effectively reduce reaction time through mind-body interaction at a self-aware level.
Posttraumatic stress disorder (PTSD) may be conceptualized as a condition of autonomic nervous system (ANS) imbalance and hyperreactivity, as multiple symptoms are indicative of ANS imbalance (e.g., hypervigilance, exaggerated startle response, etc.). Several meta-analyses found hyperreactivity of the sympathetic nervous system (SNS), reduced basal parasympathetic nervous system (PNS) activity, and exaggerated PNS withdrawal. Additionally, evidence-based psychotherapies (EBPs) for PTSD do not always improve this ANS imbalance, nor the negative health consequences associated with it (i.e., hypertension). As such, providing adjunctive interventions that target this may be beneficial, such as Heart Rate Variability Biofeedback (HRVB). Yet, there is limited research on how adding Trauma Informed HRVB (T-HRVB) may affect HRV and secondary mechanisms of change, such as interoceptive awareness (i.e., awareness of one's internal responses and their use in self-regulation). The current study aimed to fill this gap by examining the effectiveness of Trauma Informed HRVB (T-HRVB) among outpatient and residential veterans engaged in PTSD programming. Thirty-seven veterans completed T-HRVB while participating in either outpatient or residential treatment. HRV and self-report measures were collected at the beginning and end of T-HRVB. Improvements in both HRV and interoceptive awareness were hypothesized and confirmed, with several HRV variables (e.g., Standard Deviation of Normal to Normal, etc.) significantly increasing, as well as interoceptive listening, trusting, and self-regulation. Thus, these findings provide initial evidence of the impact of implementing biofeedback in active treatment for PTSD. However, future studies should compare T-HRVB to other active approaches.
The phenomenon of “choking” under pressure remains a significant challenge in elite sports, where traditional psychological skills training (PST) often yields limited efficacy and transferability due to its subjective nature. This study investigated the efficacy of “Cognitive Armor,” a novel neurofeedback protocol designed to enhance performance under pressure by training athletes to self-regulate neural activity associated with an optimal performance state. Forty-five elite athletes from precision-based sports were randomly assigned to one of three groups: a Neurofeedback Group (NG) receiving the Cognitive Armor protocol, an Active Control Group (ACG) receiving sham neurofeedback, and a traditional PST Group (PSTG). Over a 12-week intervention, participants underwent baseline and post-intervention assessments, including quantitative EEG (qEEG), sport-specific performance tests under normal and induced pressure conditions, and psychological questionnaires. A follow-up assessment was conducted after 3 months. Results indicated that the NG demonstrated a significantly greater ability to increase the sensorimotor rhythm (SMR)/high-beta ratio compared to both control groups (F(2, 42) = 21.34, p < .001, ηp2 = 0.50). Crucially, the NG showed significantly smaller performance degradation under high-pressure conditions than the ACG and PSTG (F(2, 42) = 8.91, p < .01, ηp2 = 0.30), and these gains were maintained at follow-up. These findings provide promising evidence that objective, EEG-based neurofeedback can be a superior intervention for building mental resilience and preventing performance decrements in elite athletes, offering an evidence-based tool for mental conditioning in competitive sports.
Understanding the linkage between slow paced breathing (SPB), slow cortical potentials (SCP) and the human consciousness could help to improve practicing strategies in the field of mental well-being. Providing 25 individuals performing two different breathing cycles (6 s—cycle and 10 s—cycle), which were accompanied by the sound of a humming gong, while measuring a 64-channel EEG, our study provides an insight into the relationship between SPB and SCPs. More importantly, it points out the greater impact of the 10 s—cycle on SCPs than the 6 s—cycle. Breathing with a frequency of 0.1 Hz led to an increased SCP-amplitude ratio as well as to a synchronization of SCPs with the breathing rhythm. Also, non-SCP frequencies were considered. Here, the 10 s—cycle showed the increased appearance of delta (ES_t = 3.52), theta (ES_t = 4.11), and alpha 1 (ES_t = 3.47) frequencies, especially in the occipital and central parietal regions. Moreover, subjectively, the SPB intervention has been rated to evoke an increased feeling of “integrity” and “balance” as well as a slightly increased feeling of “vitality”. Demonstrating the relation between SPB, SCPs, and subjective mental feeling, this study contributes to emphasizing the importance of SPB in mental health.
This study aimed to examine the restorative effects of aerobic exercise on mental fatigue using physiological indicators. Mental fatigue was induced in healthy adults using the Paced Auditory Serial Addition Test. Of these, 40 participants who exhibited confirmed fatigue based on flicker values were randomly assigned to either an exercise group (20 min of aerobic exercise) or a rest group (20 min of bed rest); n = 20 per group. Flicker values and electroencephalographic (EEG) parameters (mean power of theta, alpha, and beta waves) were measured before and after the intervention. Fatigue recovery was assessed through within-group comparisons of pre- and post-intervention values and between-group comparisons of change scores. In the exercise group, flicker values significantly increased post-intervention, and this change was significantly greater than that in the rest group. EEG analysis revealed a significant increase in theta power post-intervention in the exercise group. Additionally, alpha and beta power increased significantly, with changes greater than those in the rest group. Conversely, no significant changes in flicker values or EEG measures were observed in the rest group. Correlation analysis revealed that the degree of recovery in flicker values was significantly and positively correlated with increases in alpha and beta wave power. Aerobic exercise produced a significantly greater restorative effect on mental fatigue than bed rest, as evidenced by objective indicators such as flicker values and EEG measures. The findings suggest that aerobic exercise is a promising intervention for addressing mental fatigue in contemporary society. Trial registration UMIN000057499, Registered 3 April 2025 (retrospectively registered).
An investigation the effect of an Electromyography Respiratory Biofeedback (ERB) method on the anxiety level of male patients with incomplete cervuaical spinal cord injury (CSCI). 40 patients (men) were included in the study considering the inclusion criteria and randomly divided into two groups of 20 patients. The control group received 15 sessions of common respiratory physiotherapy (CRPT). In addition to 15 sessions of CRPT, the intervention group also received 15 sessions of ERB. Anxiety level was measured by the Zung questionnaire for both groups at three levels, before the beginning of the treatment, after the completion of the treatment and one month after the completion of the treatment sessions. The results were evaluated by SPSS software. The results of the repeated measure test showed that both CRPT and the addition of ERB can have statistically significant effects on the anxiety level of patients over time (p-value < 0.001). The emotional and physical subscales of the Zung questionnaire were also statistically significantly affected by the passage of time in both groups. The values related to the total score of the Zung questionnaire and its emotional and physical subscales, in the control group, increased again one month after the treatment sessions, while in the control group, these values continued to decrease. CRPT aimed at improving diaphragmatic breathing can reduce the anxiety level of patients with CSCI in the short term, and these positive effects may diminish over time. However, the addition of ERB appears to support the short-term maintenance of these therapeutic effects during the one-month follow-up.
Although flow experience has become a widely studied phenomenon in recent decades, research on its physiological manifestations is still limited. With the present study, we aimed to fill part of this research gap by approaching the flow concept from a biopsychosocial model of challenge and threat (BPS-CT) perspective. Impedance cardiography, electrocardiography and blood pressure of chess players (N = 32) were measured continuously while they completed a two-hour session of “mate in two moves” tasks on a computer under conditions of a balance of skills and task demands. Self-reported flow was assessed afterwards. On a descriptive level, results revealed the occurrence of (a) a modest cardiovascular challenge pattern during an initial phase of task engagement and (b) a cardiovascular threat pattern after one hour until the end of task performance, accompanied by cardiovascular indicators of motivational disengagement. On average, participants reported a high perceived balance of skills and demands and subjective flow experience, which was negatively associated with perceived strain but mostly unrelated to cardiovascular reactivity. The benefits, limitations and future potential of applying the BPS-CT framework to the study of the physiological implications of prolonged flow experiences are discussed.
Individuals vary in musical emotional responses, possibly due to empathising ability. But how it impacts audio-listening emotions (basic or aesthetic) remains unclear, and few prior studies measured dimensional and discrete emotion models together. This study screened 40 subjects (22 females) into high- and low-empathy groups via the Interpersonal Reactivity Index. They listened to 14 Chinese Pipa music excerpts (7 positive, 7 negative) in a naturalistic setup. Emotional reactions were measured using three-dimensional (valence, energy, tension) and discrete (6 basic, 9 aesthetic emotions) models, along with recording autonomic nervous system changes. Behavioural results showed that the high empathy group had stronger emotional arousal and produced more basic and aesthetic emotions than the low empathy group. Physiological results showed higher activation of skin conductance in the high empathy group than in the low empathy group, stronger respiratory responses in the high empathy group than in the low empathy group when listening to positive music, a more significant degree of difference in the activation of skin temperature in the high than in the low empathy group in the two music genres, and greater sensitivity to the perception of emotional valence.
This study tested whether a neurofeedback protocol targeting sensorimotor rhythm (SMR) enhancement, theta down-regulation, and alpha up-regulation improves sustained attention, spatial attentional dynamics (inhibition of return; IOR), and shooting performance under pressure in national-team shooters. This parallel-group randomized controlled pretest–posttest study enrolled 20 national-team shooters (NF, n = 10; control, n = 10) were randomly allocated to groups. The NF group completed 12 training sessions over 4 weeks, while both groups continued their regular training. Sustained attention was assessed with the Conners Continuous Performance Test (CPT), including commission errors, omission errors, and reaction time. Spatial attentional dynamics were indexed using an IOR cue–target task, with IOR calculated based on reaction time. Shooting performance under pressure was measured using SCATT optoelectronic scoring during a standardized high-pressure 60-shot task. Linear mixed-effects models tested Group × Time effects. Relative to controls, NF improved sustained attention: commission errors decreased (p =.018), omission errors decreased (p =.018), and CPT reaction time improved (p =.010). No significant between-group change was observed for IOR_time (p =.155). For pressured shooting performance, the Group × Time interaction for SCATT total score was not significant (p =.097), although trends favored NF. SMR/theta/alpha neurofeedback training may enhance components of sustained attention in national-team shooters, with limited short-term transfer to IOR dynamics or performance under pressure.
Cardiac autonomic regulation has been proposed as a critical psychophysiological linkage supporting cognitive and social cognition. While heart rate variability biofeedback (HRVB) has demonstrated robust effects on stress reduction, its potential role in supporting social cognition—particularly theory of mind (ToM)—and the underlying psychophysiological mechanisms remain unclear. This randomized controlled trial examined the effects of a six-session HRVB intervention with preset-paced breathing on social cognition and executive functions in young adults with high perceived stress, and explored whether HRVB-induced changes in cardiac autonomic activity may serve as a psychophysiological mechanism linking the intervention to improvements in social cognition beyond executive function changes. As a manipulation check, participants receiving HRVB (n = 32) showed significant reductions in heart rate, respiratory rate, and perceived stress, accompanied by increased cardiac parasympathetic activity and decreased cardiac sympathetic activity, compared with the control group (n = 32). Significant group × time interaction effects were observed for distinct ToM performances, as well as for executive functions. Importantly, exploratory parallel mediation analyses further revealed that HRVB-induced changes in cardiac autonomic activity mediated improvements in overall ToM performance, whereas changes in cardiac sympathetic activity uniquely mediated improvements in cognitive ToM, even after controlling for executive function changes. Together, these findings provide intervention-based evidence suggesting that HRVB-induced modulation of cardiac autonomic activity is associated with a psychophysiological mechanism preferentially supporting social-cognitive function—particularly ToM—beyond executive control. HRVB may therefore represent a promising psychophysiological intervention for enhancing social-cognitive function in stress-vulnerable and high-arousal populations.
Mindful Self-Compassion (MSC) programs have demonstrated benefits for psychological well-being, yet their neurophysiological mechanisms remain underexplored, particularly in naturalistic settings using portable electroencephalography (EEG). This study examined the effects of a six-week MSC program, Embracing Your Life (EYL), on stress response, brain activity, and self-compassion among Chinese university students. A quasi-experimental design was used with 62 participants (31 in the experimental group and 31 in the control group; mean age = 26.6 years). The experimental group participated in six weekly 1.5-h EYL sessions, while the control group received no intervention. EEG data were collected using a portable headband (channels AF7, AF8) during baseline and post-intervention, involving three meditation tasks: resting state, mindfulness breathing, and a self-compassion break. Power spectral density (PSD) was calculated, and self-reported measures included self-compassion (SCS-SF), perceived stress (PSS), resilience (CD-RISC), mindfulness attention (MAAS), and well-being (SWEMWBS). Generalized estimating equations were used to analyze the data, controlling for baseline differences. The experimental group showed significant improvements in self-compassion (MD = + 0.28, p = 0.003), mental well-being (+ 1.75, p < 0.001), and perceived stress (− 3.48, p < 0.001), with a marginal increase in resilience (+ 2.88, p = 0.045). EEG analyses revealed condition-specific reductions in alpha and beta power during mindfulness and self-compassion tasks, with significant Group × Time interactions (e.g., alpha: Wald χ2 = 14.55, p < 0.001; Wald χ2 = 225.34, p < 0.001). Theta activity showed nuanced patterns, with suppression during mindfulness and partial recovery during self-compassion. While during the intervention, formal practice segments exhibited the lowest power values across all frequency bands, indicating deeper meditative engagement and enhanced neural efficiency. The EYL program improved psychological outcomes and induced distinct EEG changes. These findings support the feasibility of portable EEG devices for monitoring mindfulness-based interventions and suggest that self-compassion practices engage in unique neural mechanisms beyond traditional mindfulness meditation. Future research should employ larger samples and multi-channel EEG to validate these results.
This study aimed to evaluate the effectiveness of Magic Keys AR as a tool for accelerating vocal learning through synchronized monitoring of breathing, posture, and acoustics. The findings indicate that augmented reality facilitates faster vocal mastery, allowing students to visualize three parameters simultaneously—breathing, posture, and sound. The experiment involved 120 conservatory students aged 18–25 from three Chinese cities, divided into two groups of 60 participants each: the experimental group trained using the Magic Keys AR system, while the control group followed traditional mirror-based instruction. The training lasted 16 weeks. Respiration was measured via plethysmography, body movements were tracked across 37 anatomical points, and voice was recorded in high resolution (96 kHz/24 bit). Students using AR increased phonation duration by 34.1
Heart rate variability biofeedback (HRVB) has been confirmed to enhance cardiovagal activation and alleviate depressive symptoms in patients with major depressive disorder (MDD). However, it remains unknown which dimensions of depression predict better treatment outcomes following HRVB. This study utilized a randomized controlled trial design. A total of 59 patients with depressive disorder were enrolled and randomly assigned to either the HRVB group or the relaxation training (RT) group. Both groups receive 60-min training sessions twice weekly for 10 sessions over five weeks. Psychological variables (depression and anxiety) and lead II electrocardiogram (ECG) were collected at pre-test and post-test. ECG data were converted into HRV indices. Two-way mixed-design analyses of variances were conducted to examine the Group (HRVB vs. RT) × Time (pre-test vs. post-test transfer) interaction effects on psychological outcomes and HRV indices. In addition, participants in the HRVB group were classified as responders (n = 10) or non-responders (n = 14) based on change in the root mean square of successive differences between normal heartbeats (RMSSD) following HRVB. Differences in demographic and psychological variables between these subgroups were further examined. (1) Both groups showed significant reductions in depression and anxiety over time; however, no significant differences between groups were observed. (2) At the transfer stage, the HRVB group demonstrated significant increases in HRV indices from pre-test rest stage to post-test transfer stage. (3) Within the HRVB group, responders exhibited significantly lower levels of depressive symptoms (including loss of pleasure, loss of interest, worthlessness, and loss of energy) and lower parasympathetic activity compared with non-responders. HRVB not only alleviated depression and anxiety symptoms but also enhanced autonomic nervous system activity. Moreover, patients who derived the greatest benefit from HRVB tended to exhibit more favorable psychological features at pre-test. These findings may inform the development of personalized and evidence-based psychological interventions for patients with depressive disorders.
This research project investigates the impact of virtual reality (VR) on rehabilitation through a comparative analysis of three distinct 3D environments. Developed as serious games on the Oculus Quest 2 VR platform, these environments aim to enhance breathing techniques for individuals with conditions like Chronic Obstructive Pulmonary Disease (COPD) and post-COVID symptoms, while also addressing anxiety management. The games focus on teaching and practicing specific techniques including Box Breathing, 4-7-8 Breathing, and Bhramari pranayama, known for their relaxation and stress-reduction benefits. Preliminary findings indicate that VR environments and traditional settings for guided breathing techniques without external stimuli are equally effective in reducing anxiety and inducing physiological changes. In a comprehensive study, we observed that the happy environment consistently led to the greatest reduction in STAI-S scores compared to neutral and dark environments. These results underscore VR's potential, particularly in environments fostering positive emotional responses, to augment stress reduction in therapeutic settings.
