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.
| Identifer | oai:union.ndltd.org:BGMYU2/oai:scholarsarchive.byu.edu:etd-10875 |
| Date | 08 April 2022 |
| Creators | Talbert, Leah D. |
| Publisher | BYU ScholarsArchive |
| Source Sets | Brigham Young University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Theses and Dissertations |
| Rights | https://lib.byu.edu/about/copyright/ |
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