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Applied Psychophysiology and Biofeedback
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Munin - Open Research Archive
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Methods for Heart Rate Variability Biofeedback (HRVB): A Systematic Review and Guidelines

Authors: Lalanza, Jaume F; Lorente, Sonia; Bullich, Raimon; García, Carlos; Losilla, Josep-Maria; Capdevila, Lluis;

Methods for Heart Rate Variability Biofeedback (HRVB): A Systematic Review and Guidelines

Abstract

AbstractHeart Rate Variability Biofeedback (HRVB) has been widely used to improve cardiovascular health and well-being. HRVB is based on breathing at an individual’s resonance frequency, which stimulates respiratory sinus arrhythmia (RSA) and the baroreflex. There is, however, no methodological consensus on how to apply HRVB, while details about the protocol used are often not well reported. Thus, the objectives of this systematic review are to describe the different HRVB protocols and detect methodological concerns. PsycINFO, CINALH, Medline and Web of Science were searched between 2000 and April 2021. Data extraction and quality assessment were based on PRISMA guidelines. A total of 143 studies were finally included from any scientific field and any type of sample. Three protocols for HRVB were found: (i) “Optimal RF” (n = 37), each participant breathes at their previously detected RF; (ii) “Individual RF” (n = 48), each participant follows a biofeedback device that shows the optimal breathing rate based on cardiovascular data in real time, and (iii) “Preset-pace RF” (n = 51), all participants breathe at the same rate rate, usually 6 breaths/minute. In addition, we found several methodological differences for applying HRVB in terms of number of weeks, duration of breathing or combination of laboratory and home sessions. Remarkably, almost 2/3 of the studies did not report enough information to replicate the HRVB protocol in terms of breathing duration, inhalation/exhalation ratio, breathing control or body position. Methodological guidelines and a checklist are proposed to enhance the methodological quality of future HRVB studies and increase the information reported.

Keywords

TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::exploración física::signos vitales::frecuencia cardíaca, Control per retroacció (Biologia), Biofeedback, Psychology, Article, Respiratory Sinus Arrhythmia, ATENCIÓN DE SALUD::calidad, acceso y evaluación de la atención sanitaria::calidad de la atención sanitaria::mecanismos de evaluación de la atención sanitaria::características de los estudios epidemiológicos::protocolos clínicos, Cor - Batecs, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Complementary Therapies::Mind-Body Therapies::Biofeedback, Psychology, Respiratory Rate, Heart Rate, Exhalation, HEALTH CARE::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics::Clinical Protocols, Humans, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Vital Signs::Heart Rate, Protocols clínics, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::tratamientos complementarios::terapias mente-cuerpo::biorretroalimentación psicológica

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
51
Top 1%
Top 10%
Top 1%
Green
hybrid