背景:心率变异性(HRV)生物反馈通常通过结构化教育进行,基于实验室的评估,和练习会议。它已被证明可以改善人群的心理和生理功能。然而,远程使用和监控这种方法的方法将允许更广泛地使用这种技术。可穿戴和数字技术的进步为这种方法的广泛应用提供了机会。
目的:研究的主要目的是确定完全远程,在不同的卫生保健工作者(HCWs)人群中自我管理的HRV定向生物反馈短期会议。次要目的是确定是否完全远程,HRV指导的生物反馈干预在干预期间显著改变纵向HRV,由可穿戴设备监控。第三目的是评估这种干预措施对心理健康指标的影响。
方法:为了确定远程实施的HRV生物反馈短会话是否可以改善自主神经指标和心理健康,我们纳入了美国纽约市7家医院的HCWs.他们下载了我们的学习应用,观看了关于HRV生物反馈的简短教育视频,并通过智能手机远程使用经过充分研究的HRV生物反馈程序。HRV生物反馈会话每天使用5分钟,持续5周。然后在干预期后随访12周。在研究期间获得了心理测量,他们佩戴AppleWatch至少7周,以监测HRV的昼夜节律特征。
结果:总计,127名HCWs被纳入研究。总的来说,只有21例(16.5%)至少50%符合HRV生物反馈干预,代表总样本的一小部分。这表明该研究设计并不可行地导致足够的干预依从性。在17周的研究期间,观察到心理指标的数值改善,虽然没有达到统计学意义(均P>.05)。使用混合效应余弦模型,正常窦性搏动间隔(SDNN)的昼夜节律模式SD的平均中线估计统计量,HRV度量,在至少50%合规的HCW中,观察到在生物反馈干预的前4周内增加。
结论:结论:我们发现,使用简短的远程HRV生物反馈会话,并使用可穿戴设备监测其生理效应,以研究的方式,是不可行的。这是考虑到研究干预的低依从率。我们发现,HRV生物反馈的远程短期会话显示出改善自主神经功能的潜在希望,值得进一步研究。可穿戴设备可以监测心理干预的生理影响。
BACKGROUND: Heart rate variability (HRV) biofeedback is often performed with structured education, laboratory-based assessments, and practice sessions. It has been shown to improve psychological and physiological function across populations. However, a means to remotely use and monitor this approach would allow for wider use of this technique. Advancements in wearable and digital technology present an opportunity for the widespread application of this approach.
OBJECTIVE: The primary aim of the
study was to determine the feasibility of fully remote, self-administered short sessions of HRV-directed biofeedback in a diverse population of health care workers (HCWs). The secondary aim was to determine whether a fully remote, HRV-directed biofeedback intervention significantly alters longitudinal HRV over the intervention period, as monitored by wearable devices. The tertiary aim was to estimate the impact of this intervention on metrics of psychological well-being.
METHODS: To determine whether remotely implemented short sessions of HRV biofeedback can improve autonomic metrics and psychological well-being, we enrolled HCWs across 7 hospitals in New York City in the United States. They downloaded our study app, watched brief educational videos about HRV biofeedback, and used a well-studied HRV biofeedback program remotely through their smartphone. HRV biofeedback sessions were used for 5 minutes per day for 5 weeks. HCWs were then followed for 12 weeks after the intervention period. Psychological measures were obtained over the
study period, and they wore an Apple Watch for at least 7 weeks to monitor the circadian features of HRV.
RESULTS: In total, 127 HCWs were enrolled in the
study. Overall, only 21 (16.5%) were at least 50% compliant with the HRV biofeedback intervention, representing a small portion of the total sample. This demonstrates that this
study design does not feasibly result in adequate rates of compliance with the intervention. Numerical improvement in psychological metrics was observed over the 17-week study period, although it did not reach statistical significance (all P>.05). Using a mixed effect cosinor model, the mean midline-estimating statistic of rhythm (MESOR) of the circadian pattern of the SD of the interbeat interval of normal sinus beats (SDNN), an HRV metric, was observed to increase over the first 4 weeks of the biofeedback intervention in HCWs who were at least 50% compliant.
CONCLUSIONS: In conclusion, we found that using brief remote HRV biofeedback sessions and monitoring its physiological effect using wearable devices, in the manner that the study was conducted, was not feasible. This is considering the low compliance rates with the
study intervention. We found that remote short sessions of HRV biofeedback demonstrate potential promise in improving autonomic nervous function and warrant further study. Wearable devices can monitor the physiological effects of psychological interventions.