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.

Background: Traumatic brain injury is a significant public health problem. Heart rate variability is a potential modality to measure physiological dysfunction following traumatic brain injury to assist in determining recovery time and the relationship between traumatic brain injury severity and recovery. To date, a summary of the evidence across injury severities and the possible role of heart rate variability biofeedback in traumatic brain injury treatment is lacking but needed to determine potential clinical utility. Participants and Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Systematic literature searches on CINAHL, Embase, PsycINFO, SPORTDiscus, and MEDLINE were conducted in August of 2020. There were two parts to this systematic review. Part I reviewed the relationship between heart rate variability and injury severity, recovery, and cognitive and emotional functioning. Part II reviewed the relationship between heart rate variability biofeedback and traumatic brain injury. Two coders coded each article and provided quality ratings with discrepancies resolved by consensus. Results: Regarding Part I, eighty-five papers met inclusion criteria. For outcome measures, eight studies (9%) focused on HRV as a predictor of mortality following moderate-to-severe traumatic brain injury; 9 studies (10%) included a measure of post-concussive symptom improvement; 7 studies (8%) included a measure of mood disturbance/change; 3 studies (3%) assessed return to consciousness. Overall, there appears to be a positive relationship between increased heart rate variability and recovery of clinical symptoms following traumatic brain injury. For Part II, seven papers met inclusion criteria. All studies included a measure of mood; 5 studies (71%) included neuropsychological functioning as an outcome measure; 1 study (14%) included a measure of life satisfaction. On average, participants completed 14 sessions of heart rate variability biofeedback (mean = 13.5, SD = 13.5, range = 1 to 40). Biofeedback was associated with improved heart rate variability following traumatic brain injury, though the methodological quality is questionable, and more controlled studies and randomized controlled trials are needed. Conclusions: Findings to date suggest a positive relationship between increased heart rate variability and recovery of clinical symptoms, including improvements in cognitive function and physical symptoms including headaches, dizziness, and sleep problems. Literature on traumatic brain injury and heart rate variability biofeedback treatment is in the early stages, and effectiveness is unclear due to poor-to-fair study quality, though early results are promising.

Background: Reduced heart rate variability is an important factor in evaluation of autonomic nervous system and diseases. Resonance frequency breathing is a non-invasive and effective training method for increasing heart rate variability. Turing this breathing exercise into a video game is an efficient way to reduce training time and vapidity. Though there has been a successful implementation in 3D game, the influence of virtue reality technology application and interaction elements still need to be explored. Objective: The main objective is to build and evaluate the virtue reality game. Applying appropriate game design and interaction elements will also be discussed. The correct and efficient training should be ensured. Also, recognizing the relationship between game elements and efficiency is also included in the task. By evaluating the impact in heart rate variability biofeedback, the understanding of breathing training game design will be broadened and deepened. Methods: A 3D virtue reality running game is designed with biofeedback framework. Development process is conducted in a user-centred way with interface test. The summative evaluation will be performed 10 participants in a controlled setting. (participant age and health state) Each participant will fill a post-test questionnaire about game experience. The sensor data will be stored on local device. Qualitative analyse of data will be done. Results: VR environment game has shown more significant effects in helping increase heart rate variability than normal game (P<0.05). Both modes have shown more than 50% increase in standard deviation of heart rate variability. A high immersion and positive effects along was reported by a Game Experience Questionnaire. Conclusion: The results have shown that the VR game has the potential to help increase HRV via the resonance breathing training. The game can also allow long-term study by increasing the motivation of participants. Evaluation with GEQ are presented, which will give insights about the usability of this game. Additionally, the new tracks for future study have been explored.

As upper-limb rehabilitation devices development continue to grow, lower limb rehabilitation devices have limited development. Thus a device that measures weight bearing of heel and forefoot during gait and also produces auditory feedback at certain thresholds were made in this project. The device was constructed based on an ARM-Core microcontroller and was supported by 5 force sensing resistor sensors for each foot. Communications between the modules and the computer as the GUI were established using an UART interface. For testing, sensors were placed beneath the foot using a stretchable cloth so each different subjects’ pressure points were correctly placed. The biofeedback used for this device was by enabling a buzzer and LED embedded to the designed board that turns on when heel strike or push off reached acertain threshold. Testing were divided into phase one and two. From phase one, it was concluded that both push off and heel strike event can have a reading exceeding 8.5% of the body weight. It was then used as a threshold for the biofeedback event. During the biofeedback tests, improvements in the subjects’ walking pattern and reading were noted. Results suggest that biofeedback can change the behavior of the subject. / I takt med att utvecklingen av rehabilitationsapparater i övre extremiteterna fortsätter att växa, har rehabiliteringsanordningar för nedre extremiteterna begränsad utveckling. Således gjordes en anordning som mäter viktbearbetning av häl och framfot under gång och också ger hörselåterkoppling vid vissa trösklar i detta projekt. Enheten var konstruerad baserad på en ARM-Core mikrokontroller och stöds av 5 kraftsavkännande motståndssensorer för varje fot. Kommunikation mellan modulerna och datorn som GUI upprättades medhjälp av ett UART-gränssnitt. För testning placerades sensorer under foten meden töjbar duk så att varje olika försöks tryckpunkter placerades korrekt. Den biofeedback som användes för den här enheten var genom att aktivera en summer och LED inbäddad i det konstruerade kortet som slås på när hälslaget eller skjutstoppet nådde en viss tröskel. Testningen delades in i fas en och två. Frånfas ett drogs slutsatsen att både push off och hälstreffhändelse kan ha en avläsningsom överstiger 8.5% av kroppsvikt. Den användes sedan som en tröskelför biofeedback-händelsen. Under biofeedback-testen noterades förbättringar i försökspersonernas gångmönster och läsning. Resultaten tyder på att biofeedback kan förändra beteendet hos ämnet.

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.

This paper is aimed at investigating whether a biofeedback device can positively increase a player's experience of thrill and suspension in a horror game. To facilitate this, two versions of the same horror game were created with a connection to a heart rate monitor. The difference between the two versions of the game was that the core elements were controlled by the heart rate which attempted to keep the player in a constant suspense state based on their heart rate. This was done to enhance the player's experience and thrill. These two versions of the game were then play-tested by users. Users had no insight into which version they were testing and afterward, a questionnaire was administered to ascertain the tester's emotional responses.The collected data was then analyzed and a pattern could be observed where testers preferred the version of the game that was controlled by the heart rate. This, backed by previous studies showed that using a biofeedback device to implement only the heart rate into a game had a marked positive effect on player experience. Still, additional research is needed with a larger control group to get more accurate results.

Background: Individuals with depression have a higher incidence of comorbidity which significantly decreases their ability to function and increases their utilization of health care. Due to the severity of the economic burden resulting with depression, research is needed to further examine the most effective treatments for depression. Biofeedback is a therapy that teaches patients how to control the physical affects that manifest during depression. Aim: The purpose of this review of literature is to discover the benefits of biofeedback for patients diagnosed with depression. Method: An electronic literature search was conducted using various databases to retrieve articles examining biofeedback as an intervention for patients with depression or depressive symptoms. Results: Studies that used biofeedback as an intervention for depression reported significant physical benefits for patients, including decreased heart rate variability and respiratory rate, as well as improved function. Conclusion: Research indicates that treatments need to have the potential to empower individuals, relieve them of their negative symptoms, relieve their financial burden, and allow them the quality of life they deserve.

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In dieser Dissertation untersuche ich das Zusammenspiel mentaler und körperlicher Prozesse, insbesondere den Einfluss von kontemplativem Mentaltraining (KMT) auf Interozeption (innerliches Spüren des Körpers) und physiologische Regulation. In einer großangelegten Trainingsstudie (n = 332, Trainingsdauer 3-9 Monate), der ReSource-Studie, zeige ich, dass KMT die interozeptive Genauigkeit in den Trainingskohorten erhöht, nicht jedoch in einer Retest-Kontrollgruppe. Die Steigerungen in interozeptiver Genauigkeit gehen mit Veränderungen im emotionalen Gewahrsein einher und sagen diese voraus. Im Einklang mit diesen Befunden berichten die Studienteilnehmenden von positiven Veränderungen in verschiedenen Dimensionen des Körpergewahrseins. Diese betreffen vor allem die Fähigkeit, Aufmerksamkeit auf Körperempfindungen aufrechtzuerhalten sowie deren Gebrauch zur Emotionserkennung und -regulation. Ich beschreibe eine neuentwickelte Biofeedback-Aufgabe, welche die Fähigkeit misst, willentlich die hochfrequente Herzratenvariabilität (HF-HRV) hochzuregulieren, wodurch die willentliche parasympathische Kontrollfähigkeit (WPK) indiziert wird. Ich zeige, dass individuelle Unterschiede in WPK mit dem Oxytocin-Rezeptorgen-Polymorphismus rs53576 zusammenhängen und mit individuellen Unterschieden im altruistisch motivierten Verhalten korrelieren. WPK wird durch KMT verbessert, wobei diese Verbesserungen durch den rs53576 Genotyp moduliert werden. In einer weiteren Untersuchung zeige ich, dass retrospektive, subjektive Berichte über eine emotional erregende Erfahrung teilweise die objektiv gemessene körperliche Erregung widerspiegeln. Das Ausmaß dieser körperlich-mentalen Kohärenz ist abhängig von der interozeptiven Genauigkeit. Zusammengenommen vertiefen diese Studien unser Verständnis des Zusammenspiels von physiologischen und mentalen Prozessen und zeigen wie KMT das innerliche Spüren des Körpers und die willentliche physiologische Regulation verbessert. / In this dissertation, I investigate interactions between mental and bodily processes, specifically by studying the influence of contemplative mental training (CMT) on interoception (inner body sensing) and physiological regulation. In a large-scale mental training study (n = 332, training durations 3–9 months), the ReSource Project, I find that CMT increases interoceptive accuracy in the training cohorts, but not in a retest control cohort. These increases in interoceptive accuracy co-occur with and predict improvements in emotional awareness. In line with these objective data on interoception, participants self-report training-related benefits on multiple dimensions of body awareness. The strongest changes occur in the ability to sustain attention to body sensations and the use of this ability to identify and regulate emotions. I also introduce a novel biofeedback task that measures the ability to voluntarily upregulate high frequency heart rate variability (HF-HRV), indicative of voluntary parasympathetic control. Cross-sectional data of the ReSource Project show that individual differences in voluntary parasympathetic control are related to the oxytocin receptor gene rs53576 polymorphism and correlate to individual differences in altruistically motivated behavior. Furthermore, CMT improves various aspects of voluntary HF-HRV regulation, with modulation of these improvements by rs53576 genotype. An additional investigation in cross-sectional data shows that subjective retrospective reports of an emotionally arousing experience partially mirror the objectively measured bodily arousal during the actual experience. Individual differences in this mind–body coherence are related to individual differences in interoceptive accuracy. Together, these studies highlight the tight interplay between physiological and mental processes and show how CMT improves inner body sensing and voluntary physiological regulation.

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