EEG biofeedback training, known as neurofeedback, has been explored as a nonpharmacologic prophylaxis for migraines. Based on the conceptual model of disregulation of central arousal function, the Othmers proposed a protocol in migraine prophylaxis by raising the sensory motor rhythm (SMR, 12- 15 Hz), accompanied by an inhibition of theta ( 4- 7 Hz) frequency. Relaxation with music, on the other hand, is another type of nonpharmacologic prophylaxis for migraines and is used to reduce perceived psychological and/or physiological stress and pain. Studies showed that an effective relaxation with music program is one that integrates certain relaxing musical characteristics and personal factors. Six female participants (29 to 57 years of age) previously diagnosed with migraines participated in this single-subject design study. This study employed two independent variables- the SMR/theta training and music therapy, and the dependent variables were the SMR and theta recording registration. Each participant first participated in the EEG Base-rate recording session, and was then randomly assigned to the following treatment conditions: SMR/Theta training only, music therapy only, and SMR/Theta training and music therapy." Counterbalancing of the treatment conditions was applied across participants, two sessions weekly for a total of 13 sessions, 30 minutes each session. In SMR/Theta training only, participants were instructed to raise their SMR while inhibiting theta. In music therapy only, participants were instructed to select their relaxation CD music to be played during the sessions. The SMR and theta data were graphed for each participant and implications were discussed. Graph analysis indicated that two participants were responsive to SMR/Theta training and music therapy and SMR/Theta training only respectively. Overall, all participants acquired relaxation skills and seemed better at adapting themselves to a stressful environment.

Two subjects exhibiting drug-induced hand tremor received EMG feedback from electrode sites above the forearm extensor muscles . EMG feedback resulted in reductions in muscle potentials for both subjects. However, self-report measures of tremor severity showed only general improvement in Subject l and little or no improvement in Subject 2. Behavioral measures of hand steadiness taken immediately after each treatment session showed slight changes across treatment conditions for both subjects. As indicated by a rapid increase in EMG measures during reversal, treatment effects appear transitory.

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This study is a qualitative analysis and a quantitative analysis of all peripheral biofeedback client data files of the University of North Texas Biofeedback Research and Training Laboratory since its establishment in 1991 and through the year of 2002. The purpose of this study is to evaluate the clinical and educational efficacy of the BRTL. Clients' electromyography and temperature measures, self-report of homework relaxation exercises and progress, and the pre- and post-Stress Signal Checklist were reviewed and analyzed. In regard to clinical efficacy, results indicate statistically significant changes in both temperature training and muscle tension training as a whole group. When divided into subtypes based on the clients' primary presenting problem, findings indicate statistical significance in chronic pain, tension headache, and temporomandibular jaw pain on temperature training, and show statistical significance in chronic pain, tension headache, hypertension, migraine headache, stress, and temporomandibular jaw pain on muscle tension training. When analyzing the Stress Signal Checklist, only 25% of clients had complete information on both pre- and post-Stress Signal Checklist. For these 25%, 87.5% reported symptoms decreased. When reviewing the clients' self-reported progress in therapist's session notes, there is no procedure for computing a treatment success to failure ratio due to the inconsistency of therapists in recording clients' statements. This study also identifies three basic biofeedback learning curves that show how people learn self-regulation skills in biofeedback therapy: 1) steady state and trainable (low variability), 2) phasic state and trainable (high variability), and 3) phasic state and low trainable (high variability).

A dissertation submitted in fulfilment of the requirements for the degree Master of Science in Engineering, in the Faculty of Engineering and the Built Environment, University of the Witwatersrand, Johannesburg. January 2017 Johannesburg / It is well known that emotional stress has a negative impact on people’s health and physical, emotional and mental performance. Previous research has investigated the effects of stress on various aspects of physiology such as respiration, heart rate, heart rate variability (HRV), skin conductance, skin temperature and electrical activity in the brain. Essentially, HRV, Electroencephalography (EEG), skin conductance and skin temperature appear to reflect a stress response or state of arousal. Whilst the relationship between respiration rate, respiration rhythm and HRV is well documented, less is known about the relationship between respiration rate, EEG, skin conductance and skin temperature, whilst HRV is maximum (when there is resonance between HRV and respiration i.e. in phase with one another). This research project aims to investigate the impact that one session of slow paced breathing has on EEG, heart rate variability (HRV), skin conductance and skin temperature. Twenty male participants were randomly assigned to either a control or intervention group. Physiological data were recorded for the intervention and control group during one breathing session, over a short initial baseline (B1), a main session of 12 minutes, and a final baseline (B2). The only difference between the control and intervention groups was that during the main session, the intervention group practiced slow paced breathing (at 6 breaths per minute), while the control group breathed spontaneously. Wavelet transformation was used to analyse EEG data while Fourier transformation was used to analyse HRV. The study shows that slow-paced breathing significantly increases the low frequency and total power of the HRV but does not change the high frequency power of HRV. Furthermore, skin temperature significantly increased for the control group from B1 to Main, and was significantly higher for the control group when compared to the intervention group during the main session. There were no significant skin temperature changes between sessions for the intervention group. Skin conductance increased significantly from Main to B2 for the control group. No significant changes were found between sessions for the intervention group and between groups. EEG theta power at Cz decreased significantly from Main to B2 for the control group only, while theta power decreased at F4 from Main to B2 for both groups. Lastly, beta power at Cz decreased from B1 to B2 for the control group only. This significant effect that slow-paced breathing has on HRV suggests the hypothesis that with frequent practice, basal HRV would increase, and with it, potential benefits such as a reduction in anxiety and improved performance in specific tasks. Slow-paced breathing biofeedback thus shows promise as a simple, cheap, measurable and effective method to reduce the impact of stress on some physiological signals, suggesting a direction for future research. / MT2017

Self-monitoring, lowered arousal training (i.e., biofeedback and relaxation training) and maintenance follow-up appeared to contribute to effective treatment of hypertension. Cognitive therapy, while effective in treatment of some stress-related disorders, has not been studied as a specific treatment component for hypertension. The present study explored the use of cognitive therapy as a treatment variable to reduce blood pressure in hypertensive persons. The effectiveness of a multi-element treatment including cognitive therapy, blood-pressure biofeedback, and relaxation training was also assessed. Self-monitoring and maintenance training were included as a part of each treatment process.

Peniston and Kulkosky (1989, 1990) demonstrated the effectiveness of alpha-theta EEG-Biofeedback (EEG-BFB) in treating inpatient alcoholics noting significant improvements in depression, psychopathology, serum β-endorphin levels, and abstinence rates. The present study is an extension of a previously unpublished replication of the Peniston EEG-BFB protocol with 20 chemically dependent outpatients (Bodenhamer-Davis, Callaway, & DeBeus, 2002). Fifteen subjects were "high risk for re-arrest" probationers. Data for the EEG-BFB group was collected from archival records. Subjects completed an average of 39 sessions (SD = 6.096), with 33 of those being EEG-BFB. Pre/post-treatment MMPI-2s™ (University of Minnesota) were collected and follow-up (4-11 years) data obtained (abstinence rates, re-arrests in some cases). Treatment effects were evaluated by comparing assessment data (pre/post) and documenting abstinence rates. Post-treatment MMPI-2 results were within normal limits, with several scales significantly reduced from baseline suggesting less psychopathology. Results were then compared to 20 subjects receiving standard addiction treatment (OT-CD group), but not EEG-BFB. OT-CD subjects completed a 2-week inpatient program followed by 18 outpatient sessions. Pre/post assessment and follow-up data was collected on the OT-CD group. The OT-CD group's post-assessment results showed three elevations (MMPI-2 scales 4/6/8), suggestive of characteriological problems. Post-MMPI-2 results of the two groups were compared via ANCOVAs. Findings indicated no significant differences between groups on targeted scales; however, there was a trend for the EEG-BFB group to have lower scores. Follow-up data was obtained on 13 EEG-BFB subjects. Results indicated 92% (n = 12) were sober, with 8% (n = 1) claiming significantly reduced alcohol intake. Probationer re-arrest and revocation rates were collected on the subset of probationers (n = 14 out of 15). The majority of the probationers (79%, n = 11) had not been re-arrested nor had their probation been revoked. Short-term follow-up information (35-131 days post-assessment), available at the time of writing, for the OT-CD group (N = 13) showed 85% (n = 11) were sober, with 15% (n = 2) relapsed. Limitations and implications of the study are discussed.

This study examined effectiveness of heart rate variability (HRV) biofeedback-assisted stress management training in reducing anxiety and stress in pregnant women and the effect of maternal stress management skills practice on fetal heart rate measures in real time. Participants were seven working pregnant women who volunteered in response to recruitment announcements and invitations from cooperating midwives. Reported state and trait anxiety and pregnancy specific stress were measured during five 45- to 50-minute training sessions. Training included bibliotherapy, instruction in the use of emotion-focused stress management techniques, and HRV biofeedback. Subjects used portable biofeedback units for home practice and were encouraged to practice the skills for 20 minutes a day and for short periods of time during stressful life events. At the end of training, fetal heart rate was monitored and concurrent maternal HRV measures were recorded. Repeated measures ANOVA and paired samples t-test analysis of study data revealed no statistically significant reductions in state or trait anxiety measures or in pregnancy specific stress measures. Partial eta squared (n²) and Cohen's d calculations found small to medium effect sizes on the various test scales. Friedman's analysis of variance of biofeedback measures showed a statistically significant decrease in low HRV coherence scores (X2 = 10.53, p = .03) and medium HRV coherence scores (X2 = 11.58, p = .02) and a statistically significant increase in high HRV coherence scores (X2 = 18.16, p = .001). This change is an indication of improved autonomic function. Results of concurrent maternal and fetal HRV recordings were generally inconclusive. A qualitative discussion of individual subject results is included. During follow-up interviews five subjects reported that they felt they were better able to cope with stress at the end of the study than at the beginning, that they used the stress management skills during labor, and that they continue to practice the skills in their daily lives.

The present study evaluated the utility of heart rhythm coherence (HRC) feedback to reduce the reported pain intensity of patients enrolled in a multimodal pain management program. Participants were recruited and assigned to a usual treatment group (UT) or a heart rhythm coherence feedback group (UT+HRC). It was hypothesized that UT+HRC participants who achieved heart rhythm coherence would report a reduction of pain intensity, as measured by the McGill Pain Inventory. For those whose pain intensity decreased, it was also expected that their self reported levels of depression as measured by the Beck Depression Inventory-Second Edition and state anger as measured by the State Trait Anger Inventory would decrease. It is also hypothesized that with a reduction in pain levels, anger, and depression, blood pressure would also decrease among those who had high blood pressure prior to the intervention. Multivariate analyses of variance (MANOVA) were used to investigate the relationship between treatment condition, coherence status and pain levels. A series of independent t-tests were utilized to investigate the change in pain, depression, and state anger from baseline to posttest, followed by Pearson product moment correlation coefficients on difference scores to understand the relationship between the outcome variables for Hypothesis 2. Standard multiple regression analyses were computed using difference scores to determine if the outcome measures were significant predictors of systolic blood pressure and diastolic blood pressure. Results indicated a failure to reject the null with regard to hypothesis one. No relationship between treatment assignment, coherence status or pain levels were found. Hypothesis 2 was partially supported. Although there was a positive significant relationship between depression and anger when utilizing difference scores, these affective measures were not related to difference scores on either pain measure. In regard to Hypothesis 3, there was also a failure to reject the null. None of the outcome measures utilized in this study emerged as being significantly related to changes in systolic or diastolic blood pressure. Limitations of the study and implications for future research are offered.

This thesis explores the use of heart rate as a biofeedback game mechanic control in combination with physical movement in a Virtual reality (VR) environment using either teleportation, or a VR treadmill. A literature review, surveys, expert interviews, semi-structured interviews and a VR prototype were created. The prototype was iterated three times, and tested using the A-B method with 57 participants. The Polar H10 was used for the heart rate monitoring of the participants. The readings of the heart rate values were received via a script in Python in order to extract raw heart rate data from the participant in real time and sent to the prototype in Unity. It includes different interaction functionalities, a teleportation system, and a grabbing system from the SteamVR asset pack, a walk function using the Omnideck from Omnifinity, and includes assets from Unity for the graphics and sound. From the results and analysis of the data from the prototype, it can be interpreted that using some sort of movement in VR enhances the participants engagement and immersiveness in the environment. While heart rate biofeedback control enhances the VR experience, adding physical walking using treadmills improves it even more.