The 19th meeting of the Biofeedback Federation of Europe was held April 24–29, 2017, in Aveiro, Portugal. The meeting consisted of a number of intensive 1- and 2-day invited workshops that teach in-depth knowledge and skills and a scientific program. The journal is pleased to publish the abstracts of oral and poster presentations from the scientific portion of the meeting. Scientific Program abstracts are listed in alphabetical order by the lead presenter’s name for the oral presentations.

Oral Presentations

Aisenpreis

The Improvement of the Parasympathetic Response and the O2 Intake at Rest of Stress-Exposed Patients Through a HRV Controlled Application of Intermittent Hypoxia/Hyperoxia Therapy (IHHT): A Pilot Study Out of Therapeutic Practice

Punito Michael Aisenpreis, H.P.

ACT GmbH Murnau, Germany

Email: aisenpreis@somatic.de

People in strenuous life situations with a low autonomic regulation capacity as well high performance sports athletes with a high regulation present a particular challenge in a somatic practice setting. Mostly, the low autonomic regulation correlates with a disturbed breathing function, higher breath frequency and variability, higher breathing stress as well as a diminished O2 uptake at rest (VO2 rest). Out of the methods for augmentation of autonomic regulation, the training with intermittent hypoxia/hyperoxia with specifically customized O2 concentrations stands out for great effectiveness. The steering of this process with the SPO2 saturation on a finger sensor alone represents only a very inaccurate method of IHHT control. A real-time HRV-monitoring and the possibility to intervene dynamically into the IHHT process is the method of choice and has been realized with a customized IHHT device and a special HRV real-time software. Several scientific papers in a university setting (Burtscher 2005, Serebrovskaya 2008, 2014, etc.) have shed light on the possible danger of hypoxic states for the organism as well as highlighted the positive results of well-dosed treatments of IHT/IHHT. The issue of this pilot study was to explore whether the results gained in a university setting could be transferred into a setting of a somatic practice and its patients. Within a period of about 18 months, six patients were chosen, who qualified as stress burdened, and underwent 15 one-hour sessions of specially personalized hypoxia/hyperoxia training. It was researched in which areas the IHHT training was successful in relation to the parasympathetic response, breathing parameters and O2 uptake at rest. Furthermore, 19 stress-burdened patients were chosen as a control group who practiced on and off several times a week with a HRV biofeedback device at home. Both groups have been tested and compared before and after the 10-week training phases. In this controlled study, out of practices in Munich and Murnau, Germany, six participants were included in pilot Verum group, with 19 participants in control group. Parameters: HRV 5 min measurement via ECG. Parameters average heart frequency, SD1, SD2, SDNN. Breathing measurement via HRV measurement out of envelope of ECG. O2 (rest) measurement via rest spirometry measurement 3 min with O2 and CO2 sensors. The Verum-group has significantly augmented most of the researched parameters in relation to the control group after the 10 week personalized IHHT training. In the Verum-group there was a significant change between the pre- and post-measurements in the HRV parameters SD1, SD2, SDNN, breathing parameters and O2 uptake at rest: HF: from 70.15/min to 71.49/min; p = ns; SD1 from 17.1 to 27.69 ms; p = 0.007; SDNN from 40.968 to 73.76 ms; p = 0.006; SD2 from 54.82 to 100.31 ms; p = 0.007; Breath frequency from 10.97 to 7.10 cpm; O2 rest uptake from 4.95 to 5.8%; p = 0.004. In the control group, there was no significant augmentation of HRV or O2 uptake (Wilcoxon-Test for paired samples). The used statistic was ANOVA with replication. A personalized 10 week IHHT training with individual online HRV monitoring/control augments the parasympathetic regulation measured in the 5 min. HRV rest measurement in four time domain parameters, four breathing parameters as well as the O2 uptake at rest (VO2 rest) at all subjects significantly. A bigger number of subjects would put the positive results on a broader base.

  • Keywords

    • HRV

    • Hypoxia

    • Hyperoxia

    • IHHT

Andrasik

Interdisciplinary Fascia Therapy (IFT Method) in Chronic Low Back Pain: An Effectiveness Trial with 206 Outpatients

Gordon C.-M.1,2, Birbaumer N.3, Andrasik F.4

1Center for Integrative Therapy, Stuttgart, Germany, 2Fascia Research Group, Division of Neurophysiology, University of Ulm, Ulm, Germany, 3Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany, 4Department of Psychology, University of Memphis, USA (4)

Email: christopher.gordon@fasciaresearch.de

Low back pain (acute and chronic) is difficult to treat and outcomes are quite varied, even when multicomponent approaches are utilized. This state of affairs necessitates continued exploration of ways to improve upon existing outcomes. The aim of this study was to explore the preliminary outcomes of a novel application of myofascial triggerpoint therapy, administered in a community-based (as opposed to a university-based research) setting, with a large sample of patients, all treated in a common manner. The data reported here were collected over 6 years (from 2011 until 2016). Exclusionary criteria were minimal. Thus, this study is best conceived as an effectiveness rather than an efficacy trial. 206 patients (93 men, 113 women) with chronic low back pain (average pain = 7.2 years) were recruited and treated at the Center for Integrative Therapy, Stuttgart, Germany. All patients received a standardized course of IFT, which is a manual and a tool assisted myofascial trigger point release method that is augmented with heart rate variability training. The number of sessions completed by patients ranged from 8 to 12, with an average of ten treatments. Prior to and following treatment completion all patients filled out the Brief Pain Inventory (BPI) and the Pain Disability Index (PDI). The BPI and PDI assess pain intensity and reduction of life quality, respectively. Statistical analyses included the paired t-test and Cohen’s d-test. The study was undertaken in accordance with the Declaration of Helsinki and was financed through patient donations. Scores on the BPI and PDI questionnaires indicated significant reductions (p < 0.001) in pain (momentary, strongest, minimal, and average pain of the last 24 h), as well as significant improvements (p < 0.001) in disturbances of general activity, mood, normal working, relationship to other humans, sleep, walking ability and zest for life. Paired t-tests and Wilcoxon signed rank tests sum scores of four questions concerning pain intensity (65% reduction) and of seven questions concerning pain disability (69% reduction) also revealed significant reductions (p < 0.001). Cohen’s d revealed large effect sizes for these two primary measures of outcome; 1.6 and 1.5, respectively. IFT shows promise of being an effective therapy modality for the treatment of chronic low back pain. The findings are strengthened by using standard, accepted measures of pain outcome (the BPI and PDI questionnaires) and administering treatment in a workday clinic, with no special patient selection or staff training procedures. Although promising, more controlled investigations are needed in order to document the role and value of this newer, integrative approach to management of recurrent back pain.

  • Keywords

    • Chronic low back pain

    • Interdisciplinary fascia therapy

    • Effectiveness trial

    • Brief pain inventory

    • Pain disability index

Andrasik

Mindfulness for Chronic Migraine with Medication Overuse: Clinical Results and Hematological Indexes at 12 Month Follow Up

Frank Andrasik1, Licia Grazzi, Domenico D’Amico, Elena Corsini, Emilio Ciusani, Emanuela Sansone, Matilde Leonardi, Alberto Raggi2

1University of Memphis, Memphis, TN USA, 2Neurological Institute C. Besta, Milan, Italy

Email: fndrasik@memphis.edu

Chronic migraine (CM) is a disabling condition, worsened when associated with medication overuse (MO). Mindfulness is emerging as a helpful treatment for pain, but it has yet to be explored fully for CM accompanied by MO. We report initial clinical findings from an on-going trial exploring the feasibility and utility of mindfulness as a primary treatment for this condition. We also investigated whether mindfulness (and medication treatment as well) produced meaningful changes in key hematological parameters. Forty-four patients, diagnosed as CM with MO (IHS-III-beta 2013 criteria), were enrolled. All patients completed a standardized medication withdrawal in a day-hospital setting and were then assigned to one of two conditions: Prophylactic medication alone (MED) or Mindfulness training alone (MT). MT was administered during 6 weekly sessions: 30 min of guided mindfulness, with patients instructed to engage in at-home practice 7 min/day. Daily pain diaries and measures of disability (MIDAS), quality of life (HIT-6), state-trait anxiety (STAI X1-X2), depression (BDI-II), and blood samples were collected at BL and at 3, 6, 12 months follow up. Twenty patients in each group reached the 12-month follow-up assessment. Significant decreases were reported in clinical parameters and disability from BL to 12 months: (1) headache days/month-MED: 19,6 ± 7.4 versus 9.8 ± 7.3 (50% reduction); MT: 18.5 ± 7.5 versus 12.4 ± 8.5 (33% reduction). (2) Medications intake/month-MED: 17.5 ± 6.4 versus 8.1 ± 5.08 (54% reduction); MT: 17.9 ± 6.3 versus 10.3 ± 5.3 (43% reduction). (3) MIDAS score-MED: 81.1 ± 37.5 versus 51.5 ± 50.2 (36% reduction); MT: 65.2 ± 41.3 versus 53.7 ± 52.5 (18% reduction). (4) Values of STAI Y1-STAI Y2, HIT-6 and Beck decreased, but not significantly for either groups. (5) Hematological parameters: WBC count-MED: 7549 versus 6282; MT: 7037 versus 6082. Changes that did occur were chiefly due to decreases of neutrophils. CD3/μl, CD4/μl, CD19/μl decreased slightly, but not significantly. Our results provide initial evidence of sustained similar effects for MED and MT alone with respect to key headache outcomes (but not for psychological variables). Although some improvements occurred with respect to hematological parameters, they were not sizeable enough to reach statistical significance. Whether more intensive treatment and/or larger samples would lead to greater changes is unknown, but these encouraging preliminary findings suggest further research is warranted.

  • Keywords

    • Chronic migraine

    • Mindfulness

    • Medication overuse

Barel

EEG-Neurofeedback in a Case of Adolescent Female with Epilepsy

Elena Barel, Luciana Lorenzon, Rei Gjata, Amerigo Zanella

NicoNeurofeedback, Pieve di Soligo (TV) Italy

Email: elena.barel@virgilio.it

Previous research has shown that electroencephalographic (EEG) biofeedback is an effective treatment for epilepsy. In particular, different studies report that neurofeedback normalizes or enhances EEG activity by means of operant conditioning, reinforcing sensorimotor rhythms and suppressing theta wave activity. All studies reported an overall mean decreased seizure incidence. The current research reports the results of EEG biofeedback treatment in a patient with seizure behaviours. We will describe the neurofeedback training outcomes administered to a 15 year old mentally retarded female diagnosed with epilepsy. QEEG was recorded from 19 electrodes (Fp1, Fp2, F7, F3, Fz, F4, F8, T3, C3, Cz, C4, T4, T5, P3, Pz, P4, T6, O1, O2 sites in the International 10–20 system) with 250 Hz sampling rate in 0.3–70 Hz frequency range in the following conditions: (1) eyes opened (EO)—at least 5 min, (2) eyes closed (EC)—at least 5 min. The data were stored on the hard disk in the linked ears reference montage and processed offline by means of WinEEG software and Low-resolution electromagnetic tomography (LORETA). She is doing the treatment twice a week to suppress slow activity (4 to 10 Hz) and to enhance 11- to 14-Hz activity in CZ, and to suppress 4- to 9-Hz and 18- to 25-Hz activity in FZ. Neuropsychological tests were performed before and after training and changes in EEG activity as determined by Fast Fourier spectral analyses will be presented. The results of the study are presented.

  • Keywords

    • Epilepsy

    • Seizure

    • EEG

Blase

How to Understand HRV Biofeedback in its Simplicity and Sensitivity

Kees Blase, Medical Physicist, Neuroscientist and Psychologist

National Centre Stressmanagement, Netherlands

Email: k.blase@hartfocus.nl

Heart rate variability is probably the most simple and non-invasive biofeedback system to self regulate a disregulated and hyperactive nervous system. How we can understand that breathing in the resonance frequency creates balance in our ANS? What is the most effective HRV protocol? How many weeks? What positive effects are known with RCT and what studies do we need to make steps forward in science and clinical practice? How can we read the frequency spectre (the ABC of HRV)? What big steps were made in the Netherlands last years in life style programs, cardiology, addiction treatment, mentally handicapped people?

  • Keywords

    • HRV

    • Heart rate variability

    • Breathing

    • Resonance frequency

Booiman

Better Biofeedback Outcomes Through Posture Corrections

Annette Booiman

MensendieckMoves, Wormer, the Netherlands

Email: acbooiman@gmail.com

Unknowingly, we communicate with our posture. A collapsed posture is associated with, lower subjective energy, depression and back/neck/shoulder pain, while an upright posture is associated with confidence, success and the absence of pain. Many people slouch for ergonomic factors such as looking at their cell phone, or to cross their legs whilst sitting. Other reasons for slouching include age, mood and tiredness. The influence of our posture on our physiology as it interacts with our HRV, breathing amplitude or frequency, and muscle tension is not always acknowledged. A slightly slouched sitting position may impact diaphragmatic breathing, because it inhibits the diaphragm’s descend. This changes the breathing pattern and has an impact on the physiological processes of the client. Changing your posture is a simple way to change the chemistry of your body. However, most people are unaware of their posture and how this can affect their life. Wearables and biofeedback can be useful to teach posture corrections by increasing posture awareness. This suggests that posture corrections need to be incorporated as a part of biofeedback/HRV training to improve overall well-being. The presentation focuses on how posture corrections can be combined with several biofeedback modalities. The presented examples can be brought into the everyday life of the participants and their clients.

  • Keywords

    • Posture

    • Feedback

    • Pain

Booiman/Harvey

Multi-Cultural and Diversity Training Considerations for Biofeedback Practitioners

Annette Booiman1, Richard Harvey2

1MensendieckMoves, Wormer, the Netherlands, 2San Francisco State University, San Francisco, CA USA

Email: acbooiman@gmail.com

This presentation identifies curricular considerations related to multi-cultural and diversity training. Various models of cultural diversity are discussed and how they are useful for research, education, and clinical professionals who use tools to educate clients and students in instructional settings or diagnose and/or treat patients in clinical settings. The presentation begins by describing a practical framework for discussing terms such as ‘multi-cultural’ and ‘diversity training’. It continues with describing curricular components for increasing awareness of diverse cultural perspectives encountered by practitioners in various settings and will end with practical cases and examples.

  • Keywords

    • Multicultural diversity

    • Cultural competence

    • Professional development

    • Applied psychophysiology

Bosak

Implementation of Biofeedback and Neurofeedback in Stress Management

Josipa Bosak, Ana Vodanović Kosić, Ana Havelka, Ivana Živoder, Sanja Budimir

Mens sana d.o.o., Zagreb, Croatia

Email: josipabosak.jb@gmail.com

Combining different kinds of biofeedback helps a person deal with stress more efficiently and learn how to improve their own coping mechanisms while retaining a high level of concentration. The outcome of this process is a higher work satisfaction and a more pleasant approach to the work environment. We have created a stress management program that consists of three approaches and was intended for employees that work on stressful jobs. These workshops give a person tools to be more efficient in dealing with stressors and to learn how to protect his body from negative consequences of stress. In the first workshop we have created a “stress profile” for each participant based on his physiological reactions to minor stressors like the Stroop test, mathematical stressor and a social stressor. During this measurement we have used Skin conductance, Temperature, EMG, BVP and Breathing sensors in order to determine what kind of biofeedback training would benefit the person the most and after that they have undergone a specific biofeedback training. In the second workshop the emphasis was on neurofeedback and how it can be used to enter the “zone of peak performance”. The person learned how to recognize and achieve a state of relaxed focus while using minimal energy to accomplish maximal effect. The third workshop was dealing with breathing techniques and HRV biofeedback. After a crash course on all the benefits an abdominal breathing training has on a person’s health, the participants went through HRV biofeedback training. The intention of this program is to demonstrate that having feedback about how all these techniques influence our physiology has a greater benefit on their efficiency. This way a more effective stress management program could be implemented in the work environment.

  • Keywords

    • Stress

    • Biofeedback

    • Neurofeedback

    • Psychophysiology

Fuchs

Single-Session HRV Biofeedback with Live Played Music

Dominik Fuchs, Heike Argstatter, Thomas Hillecke, Petra Friedrich, Marco Warth

Kempten University of Applied Sciences, Kempten, Germany

Email: dominik.fuchs@hs-kempten.de

Recent evidence shows that both receptive music therapy and heart rate variability (HRV) biofeedback are effective in treating stress-related symptoms and promoting relaxation. However, no study has yet explored the potential of integrating the working mechanisms into a combined approach. Therefore, we conducted two pilot studies to evaluate the psychophysiological effects of a single session of HRV biofeedback with live played relaxation music to pace respiration. In study A, a total of 60 healthy adults were randomized to either the experimental group (15 min HRV Biofeedback) or the control group (pre-recorded relaxation music). Heart rate (HR) and HRV were extracted for four 5-min segments and self-ratings of relaxation and general well-being were assessed. In study B, 23 patients with chronic tinnitus were treated with a 10-min intervention. We measured HR and HRV during baseline and intervention and we assessed self-ratings of tinnitus distress and general well-being. Study A: Besides significant main effects of time for each of the measures, significant time × group interaction effects were found for general well-being (p = 0.028), RMSSD (p < 0.001) and log LF (p < 0.001), indicative of a higher vagal tone and relaxation in the experimental group. Study B: While HRV increased significantly from baseline to intervention (p = 0.037), HR dropped only marginally (from 62.4 to 59.8; p = 0.334). Subjective ratings for general well-being increased significantly (p = 0.001). subjective tinnitus ratings (from 0 = no tinnitus at all to 10 = worst tinnitus distress) slightly decreased from 6.05 to 5.71 (p = 0.295). Although generalizability of the results is limited due to the exploratory character of our analyses, we can conclude that the combination of relaxant aspects of music therapy and HRV Biofeedback appears to be a feasible, well-received and effective way to induce relaxation and well-being.

  • Keywords

    • HRV biofeedback

    • Music therapy

    • Respiration

    • Relaxation

Gordon

Interdisciplinary Fascia Therapy (IFT Method) for Chronic Low Back Pain: An Examination of Therapy Process and Outcome at 18 Months

Gordon C.M.1,2,3, Schleip R.2, Vagedes J.3, Birbaumer N.4, Montoya P.5, Andrasik F.6

1Center for Integrative Therapy, Stuttgart, Germany, 2Fascia Research Group, Division of Neurophysiology, University of Ulm, Germany, 3ARCIM Institute, Filderklinik, Bonlanden, Germany, 4Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany, 5Research Institute on Health Sciences, University of Balearic Islands, Palma, Spain, 6Department of Psychology, University of Memphis, USA

Email: christopher.gordon@fasciaresearch.de

The interdisciplinary fascia therapy method (IFT method) is a newly developed treatment for chronic low back pain. This treatment combines instrument assisted, manual based fascia therapy with diaphragmatic stimulation for the purpose of increasing vagal tone of the parasympathetic nervous system through a specialized paced breathing technique (heart rate variability—HRV training). The aims of this study were to assess the effectiveness of IFT, compare its outcome to that obtained by the more common classic massage (CM), and to begin to understand some of the factors mediating IFT (herein referred to as therapy process). Participants (N = 50) were randomly assigned to one of two groups: CM (n = 18), IFT (n = 19); we subsequently recruited a non-intervention control group for comparison purposes (n = 13). Each patient received six 30-min standardized therapy sessions, scheduled bi-weekly. The IFT group received manual and tool assisted myofascial techniques as well as HRV training; the CM group received classical massage and relaxation training. The Brief Pain Inventory (BPI), Pain Disability Index (PDI), and spine range of movement (ROM) with the Schober and Ott test served as the primary measures of outcome. Expectations for improvement (Ferts-Placebo questionnaire), pain pressure threshold on lumbar tissues and thumbnails using the pain pressure algometer, and the biomechanical variables of stiffness and elasticity measured by the MyotonPro provided measures of therapy process. Statistical analyses included the paired t-test, Wilcoxon signed rank test, Cohen’s d-test, and ANOVAs. The study was undertaken in accordance with the Declaration of Helsinki. The IFT intervention was significantly more effective than CM (p < 0.05) and the non-intervention in improving pain and life quality, both at 3 and 18 months following treatment. ROM with the Schober test and HRV coherence baseline testing in the IFT group showed significant improvement (p < 0.05) both pre to post 3 months. Reduction of muscle stiffness and gain in elasticity were improved pre to post 6 weeks intervention in the IFT group. Cohen’s d revealed medium to large effect sizes for all primary measures of outcome and also for all measures of the therapy process. The IFT method appears to be an effective intervention for patients with non-specific low back, yielding improvements that endured for 1.5 years. Massage therapy revealed a significant increase for life quality but no pain reduction post 3 months of intervention. However, further research is warranted to better understand the physiological basis and clinical applications of this promising technique, IFT.

  • Keywords

    • Instrument assisted fascia therapy

    • Chronic low back pain

    • Myofascial trigger point Release

    • HRV training

    • Vagal tone stimulation

Graf

Interdisciplinary Fascia Therapy (IFT Method) Reduces Chronic Low Back Pain: A Pilot Study for a New Myofascial Approach

Gordon C.M.1,2, Graf C.1, Lazi A.1, Birbaumer N.3, Andrasik F.4

1Center for Integrative Therapy, Stuttgart, Germany, 2Fascia Research Group, Division of Neurophysiology, University of Ulm, Ulm, Germany, 3Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany, 4Department of Psychology, University of Memphis, USA

Email: christopher.gordon@fasciaresearch.de

This pilot study is the first in a planned series of five consecutive studies designed to evaluate the effectiveness of the interdisciplinary fascia therapy (IFT method) for chronic low back pain. The IFT method augments myofascial trigger point release (MTPR) with heart rate variability training (HRV) in order to potentiate treatment effects. This pilot study evaluated the effectiveness of a MTPR technique in combination with HRV training of patients with chronic low back pain. Nine patients (seven female, two male; mean age = 53.6 ± 12) with chronic low back pain were treated in a standard outpatient setting in a clinic specialising in acute and chronic pain therapy solutions. Nine treatments were performed by fully qualified physical therapists two times a week within an intervention period of 5 weeks. The treatment consisted of a 12 grip, standardized, manual sequence focusing on the deep paravertebral myofascial structures as well as the pelvis, hip diaphragm and cervical structures. The intervention involved MTPR in combination with HRV training (15 min twice a day). All patients filled out the Brief Pain Inventory (BPI) questionnaire before the first, 4th and after the 9th treatment. Before the first treatment and after the 9th treatment patients were measured with long term ECG for 24-h and before/after each treatment a 1-min HRV test. Statistical analysis included the t-test, Wilcoxon signed rank test and Cohen’s d-test. The study was undertaken in accordance with the Declaration of Helsinki. Responses on the BPI questionnaire indicated significant reductions (p < 0.001) for momentary pain, the strongest, the minimal and the average pain of the last 24 h. Disturbances of general activity, mood, normal working, relationship to other humans, sleep, walking ability and zest for life also increased significantly (p < 0.001). T-test and Wilcoxon signed rank tests sum scores of four questions concerning pain intensity (83% reduction) and of seven questions concerning pain disability (87% reduction) also revealed significant reductions (p < 0.001). Cohen’s d showed large effect sizes of 2.08 and 1.52 respectively. The 24-h HRV showed no significance in all standard parameters, but HRV parameters revealed a medium effect size in the PNN50 (0.63), Power HF Band (0.57), HRV-breath coherence (0.59), SD2 (0.63) and a large effect size in RMSSD (0.82). The IFT method (MTPR combined with HRV training) showed a significant reduction of pain sensation and promising results of the HRV training for regulation of the autonomic nervous system of patients with chronic low back pain. Controlled trials are planned to further document the promising findings of this initial pilot study.

  • Keywords

    • Interdisciplinary fascia therapy

    • Chronic low back pain

    • Myofascial trigger point release

    • Heart rate variability

    • Brief pain inventory

Harvey

The Foreseeable Future of Wearable Technology

Richard Harvey

San Francisco State University, San Francisco, CA USA

Email: rharvey@sfsu.edu

Wearable, miniature instruments monitoring multiple modalities and physiological functions such as heart rate, muscle tension, respiration and brain activity are becoming more readily available and affordable. The ‘Transformative Technologies’ can quantify and then make accessible to users a variety of ‘system responses’ (e.g., overall moderating strain and stress reactions) as well as a ‘symptom responses’ (e.g., specific mediating reactions to a given cause). For example, activity recognition technology has been used not only for ‘life logging’ as a part of the ‘quantified self’ movement, but also for training and feedback, which is meaningful for this audience. Biofeedback software built in to these wearable devices encompasses self-regulation techniques that help people pay attention so that they may shift their intention to change, whether the change addresses some problem or symptom or whether the change addresses some area of desired improvement or enhancement. This talk describes the state of the art in wearable physiological and sociometric sensors as well as software used for pattern recognition and classification (e.g., learning algorithms) and, suggests some directions the field of applied psychophysiology and biofeedback will take to incorporate wearable devices in various clinical and educational settings.

  • Keywords

    • Wearables

    • Quantified self

    • Self-regulation

    • Biofeedback

Kovaleva

Respiratory Sinus Arrhythmia Training for Athletes

Anastasia Kovaleva

Research Institute of Normal Physiology by name of P.K. Anokhin, Moscow, Russia

Email: anastasia_kovaleva@hotmail.com

Self-regulation techniques during training and competition could increase athletes’ performance and reduce anxiety level (Cleary and Zimmerman 2001). Biofeedback (BFB) training is one of the methods to teach athletes’ self-regulation ability. Resonant frequency training is a specific BFB strategy that is aimed to produce maximal increases in amplitude of respiratory sinus arrhythmia (RSA) (Lehrer et al. 2000). RSA is a component of HRV that reflects homeostatic activity and adaptability (Berntson et al. 1997). Breathing techniques are the most suitable way to control other autonomic functions. We hypothesized that one short-term RSA training will induce positive changes in different physiological characteristics, brain activity and will be beneficial for sport performance as well. 42 athletes (22 females, 20 males) were instructed to breathe at six times per minute according to pacer on the screen in order to increase RSA. Heart rate (photoplethysmography), abdominal breathing, EEG (Cz), skin conductance, and finger temperature were recorded simultaneously on the Thought Technology equipment before, during and after biofeedback training (5 min each). Then Biograph Infiniti software, CardioPro and SPSS software were used for data analysis. After 5 min RSA-training there was a significant increase of individual alpha peak frequency, alpha1 and alpha2 spectral power in EEG, and increase of relative power of HF component of the heart rate spectrum (only in females group). Males demonstrated increase of skin conductance, forehead muscles EMG and decrease of finger temperature. A small group of athletes (n = 15) was tested for shooting performance before and after BFB training. All of them demonstrated better, but not significant results after breathing because of great individual differences. These results suggest that short RSA-training leads to positive changes in EEG (higher alpha frequency and power), modifications in autonomic balance (parasympathetic activation in females and sympathetic activation in males) and slight increase in shooting performance in athletes.

  • Keywords

    • Biofeedback

    • Respiratory sinus arrhythmia

    • EEG

    • Athletes

Kowalski

EEG Wearables and Neurofeedback Apps—Are they good tools for the job?

Axel Kowalski

NeuroFit GmbH, Krefeld, Germany

Email: dr.kowalski@neurofit-akademie.de

There are a lot of mobile and affordable EEG devices on the market. Combined with the right app and by sticking to the EEG “rules” of preparing the skin, the ensemble should fulfil the basic needs of performing an effective neurofeedback session at work or at home (nfb-home-training). The presentation gives an overview, what can be expected from such a mobile setup, regarding especially the data quality and possible (positive) effects of training. Beside basic considerations and recommendations that should be applied, preliminary results from a large pilot project (n = 150 individuals doing nfb-home-training at least twice a week) will be reported.

  • Keywords

    • EEG wearables

    • Neurofeedback apps

    • Neurofeedback home training

    • Mobile EEG

Lindner

Self-help Treatment with a Myofascial Manipulation Tool a Randomized, Double Controlled, Standardized, Clinical Study

Christopher-Marc Gordon1,2, Sophie Manuela Lindner1, Niels Birbaumer2, Pedro Montoya3

1Center for Integrative Therapy, Ahorn Str 31, 70597 Stuttgart, Germany, 2Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany, 3Research Institute on Health Sciences (IUNICS), University of Balearic Islands, Palma, Spain

Email: christopher.gordon@fasciaresearch.de

A tool assisted tissue manipulation was performed on the quadriceps and the tensor fascia latae muscle of the thigh in form of a self-help treatment. The aim of this study was to explore the practicality of this self-help modality and to assess the effectiveness of an instrument where myofascial release is combined with a vibrational oscillation. 111 male breakdancers were cluster randomized into an intervention and a control group. The intervention group performed a self-help treatment only on the right leg with the Fascia-ReleaZer® tool for eight minutes. Both groups’ thighs were assessed before and after the intervention. The not-treated left thigh served as control. Position and posture of both intervention and control groups were standardized. The following parameters were measured: stiffness, elasticity (MyotonPRO), pain pressure threshold sensitization (pressure algometer), temperature (thermography flir camera), range of movement (modified Thomas and finger to floor distance test) and momentary mood states with the Profile of mood states (POMS) questionnaire. A follow-up questionnaire was conducted 1 month after the intervention. Statistical analysis included the paired t-test, Wilcoxon signed rank test, Cohen’s d-test and ANOVA tests. A significant decrease (p < 0.001) in stiffness was observed post-intervention for both muscles only on the treated leg. The elasticity of the treated quadriceps muscle increased significantly (p < 0.001). Algometer scores, however, indicated a significant (p < 0.001) desensitization of the treated leg. A high significant increase (p < 0.001) of the local temperature was observed. A highly significant increase (p < 0.001) of flexibility of the quadriceps muscle and a trend to more flexibility in the hamstrings was found. POMS scores showed little to no changes. The follow-up questionnaire showed a stabilization in the intervention group only. The described sensation of the treated leg was relaxed, stabile and strong. Application of self-help treatment with a muscle fascia tool resulted in clinically highly significant improvements in the objective mechanical tissue properties. Pain desensitization, thermography and range of movement improved highly significantly. The consistent mood states indicate the results are not just due to positive placebo effects in the intervention group. Tool assisted self-treatment with the Fascia ReleaZer® is possibly an effective treatment modality. This needs further basic research to understand these effects on the cellular level.

  • Keywords

    • Myofascial self-help therapy

    • Tool assisted myofascial manipulation

Lorenzon

Correlation Between Anxiety Level, Lifestyles and HRV (Heart Rate Variability) in Healthy Adult Individuals

Lorenzon Luciana, Tomasi Chiara, Bianchin Matilde, Barel Elena, Bortolotto Lisa, Brugnera Nicole, Paja Ledjusa, Lizama Eugenio, Zanella Amerigo

NicoNeurofeedback, Pieve di Soligo (TV) Italy

Email: luci.gn@libero.it

Heart rate variability (HRV) is a non-invasive marker of autonomic nervous system (ANS) activity, and HRV-based methods can be used to assess physiological recovery, characterized by parasympathetic domination of the ANS. HRV is affected by multiple factors of which some are unmodifiable (such as age and gender) but many are related to psychological distress, QoL, anxiety level and daily lifestyle choices (e.g. alcohol consumption, physical activity, sleeping times). Increased HRV at rest is frequently associated to high vagal tone, good health, physical activity, and markers of quality of life (QoL). Here we investigate how these variables affect autonomic nervous system, indexed as HRV. We recruited 104 healthy adult volunteers. The participants underwent a 300 s ECG recording in the supine and sitting position. Questionnaires were applied for evaluation stress, QoL, anxiety level and daily lifestyle choices. Standard deviation of normal R–R intervals and the root mean square of successive normal interval differences were derived from time domain HRV analysis. Frequency domain HRV measures; total power, low frequency power (LF), high frequency power (HF), and LF/HF ratio were calculated. Preliminary results of the study are presented.

  • Keywords

    • Heart rate variability

    • Anxiety

    • ANS

    • HRV

Medici

Event-Related Potentials and Attention Tests in Children with Attention Deficit/Hyperactivity Disorder (ADHD) with Language and Performance Deficits

Denise Medici, María Morales Suárez-Varela

Department of Preventive Medicine, University of Valencia, CIBER Epidemiology and Public Health (CIBERESP), Center for Public Health Research (CSISP), Valencia, Spain

Email: denise_medici@yahoo.es

Introduction: In children and adolescents with a diagnosis of attention deficit/hyperactivity disorder (ADHD) identifying and validating neurophysiological quantitative indicators are essential and provide a better understanding about the neurobiology and about his cognitive deficits in language, writing and reading. The study examined if the event-related potentials (ERP) and continuous performance tests (CPT) measure deficits in selective attention associated representing potential factors in the diagnosis of ADHD and whether difficulties in language, reading and writing development represent a risk cognitive factor in the school performance. This retrospective cohort study included 297 medical date-base of patients mean age 9 years 10 months (26.60% girls and 73.40% boys) diagnosed with ADHD (DSM-IV) meeting the clinical criteria previously established in a public hospital of the Community of Valencia. We compared and analyzed whether the deficits in language, reading and writing are risk factors in the subsequent diagnosis of ADHD and if the ERP and CPT have been clinical contributions. Children with ADHD had abnormal results in 80% of visual ERP, in 93% of auditory ERP, in 66% of visual CPT and in 79% of auditory CPT. The results in both ERPs, between normal ERP and abnormal ERP, between abnormal ERP by gender and between types of alterations were statistically significant. Also between the normal CPT and abnormal CPT, between CPT according to gender and between alteration (error in Omission and in Commission and in response time) on auditory CPT, except in the last two types of alterations in Visual CPT. The results in specific language impairment as a condition that can coexist in ADHD were not statistically significant, but in school performance, in school support classes and in therapeutic support school, in speech therapy treatments and in comparing results with other studies were statistically significant (p < 0.001). The results in ERP and CPT would allow start therapeutic and/or educational procedures and reduce their symptoms and their incomprehension. It has been proven a significant percentage in children with delays in the acquisition and/or deficits in language development, reading and writing later are diagnosed with ADHD.

  • Keywords

    • ADHD

    • ERP

    • CPT

    • Cognitive deficits

Moss

Clinical Hypnosis as an Adjunct to Biofeedback Practice

Donald Moss

College of Integrative Medicine and Health Sciences, Saybrook University, Oakland, CA

Email: dmoss@saybrook.edu

Hypnosis and Biofeedback have different histories but share a core role as pillars of k9jd-body self-regulation. Clinical hypnosis is an evidence-based intervention technique that has well documented applications to a wide range of adult and pediatric disorders. Hypnosis, self-hypnosis, and hypnotically induced relaxation are useful adjuncts in biofeedback training. When a trainee is having difficulty mastering thermal biofeedback—warming of the hands and fingers, associated with autonomic nervous relaxation—a hypnotic induction and use of imagery of a warm beach or a fireplace can provide a breakthrough and empower the child. Similarly, self-hypnosis skills can be integrated into biofeedback home practice, to augment the patient’s emerging relaxation skills. This presentation will introduce Ian Wickramasekera’s model for choosing between hypnosis and biofeedback as primary modalities, based on level of hypnotic ability, and will also present case vignettes illustrating the integrative combination of the two modalities.

  • Keywords

    • Hypnosis

    • Biofeedback

    • Self-hypnosis

    • Efficacy

Peper

Maybe Your Mother was Right When She Said, “Don’t slouch, sit up straight.” The Effect of Posture and UpRight Feedback on Health and Well-being

Erik Peper

San Francisco State University, San Francisco, CA, USA

Email: epeper@sfsu.edu

A collapsed posture is associated with neck, back and shoulder discomfort/pain, tiredness, depression, decrease in subjective energy and easier access to negative memories. Being erect increases assertiveness, subjective level of energy, access to empowering memories, and an increase in health status. This presentation (1) reviews the research findings that link posture with empowerment/helplessness and joy/depression; (2) explores experiential exercises that demonstrate how posture reduces physical strength and affects memory recall; (3) describes our research findings of the effect of posture on EEG, respiration, neck and back muscle tension, pelvic floor muscle tension, and heart rate variability, and (4) reviews our research findings with 25 students and employees who used the UpRight posture feedback device and reported a significant increase in posture awareness, energy level and health status. Posture feedback was provided with an UpRight. This feedback device consists of a small sensor placed on the spine that measures both changes in spinal curvature and angle and works as an app on a cell phone. It provides real time vibrational feedback at the moment of slouching. Overwhelmingly the participants were surprised by causes of slouching: ergonomic factors, tiredness/exhausted/sleepy, depressive/negative thoughts; stress (e.g., crossed their leg as a defensive response, looking at the computer screen, thinking about the work that has to be done, or feeling defeated or intimidated). The feedback provided the cue to correct posture (e.g., wiggling to interrupt “sitting disease”), change negative thoughts into positive thoughts, and react differently to stressors. When participants changed their posture and thoughts in response to the feedback, they reported a significant increase in energy, a positive mood and less discomfort. Discussed is the importance of posture feedback to educational and clinical neuro/biofeedback and as a strategy to improve health and performance.

  • Keywords

    • Posture

    • Depression

    • Health

    • UpRight biofeedback

    • Wearable electronics

Peper/Oded/Shaffer

Blood Volume Pulse Amplitude—Much More than Heart Rate Variability

Erik Peper1, Yuval Oded2, Frederic Shaffer3

1San Francisco State University, San Francisco, CA USA, 2Cognitive-Behavioral and Psychophysiological Clinic, Tel Aviv, Israel, 3Truman State University, Kirksville, MO USA

Email: fredricshaffer@gmail.com

Most clinicians tend to only look at the heart rate, which is a derived signal from the blood volume pulse. This is especially true if one uses small sensors attached to the finger and a smart phone; however, it overlooks a much more sensitive indicator of emotional arousal and sympathetic/parasympathetic activity—blood volume pulse amplitude (BVA). In this symposium we will discuss the clinical and research findings of BVA and give examples for the use of BVA such as:

  • Monitor and improve deep relaxation skills

  • Monitor anticipatory anxiety

  • Monitor ongoing arousal and vigilance

  • Maintain attention

  • Practice physiological desensitization

  • Explore emotions, thoughts and feelings associated with

  • hyper-vigilance

  • Use BVP amplitude as an indicator of changes in peripheral temperature (rapid BVP changes precede

  • changes in peripheral temperature)

We will also share our clinical experience in integrating BVA in psychotherapy and in inter-personal biofeedback.

  • Keywords

    • BVA

    • Blood volume biofeedback

Slepecky/Kotianova

Pulse Transit Time Measured by Biofeedback Device as a Promising Indicator of Cardiovascular Risk: Differences Between Healthy Adults and Cardiovascular Patients

Milos Slepecky, Kotianova, A., Kotian, M., Zatkova, M., Popelkova, M., Majerciak, I., Prasko, J., Chupacova, M., Gyorgyova, E.

University of Constantine Philosopher, Nitra, Slovakia

Email: milos.slepecky@gmail.com

Blood vessels health status is considered as an important indicator of cardiovascular risk. The first aim of the study was to find the correlation between pulse transit time data measured by Procomp Infiniti device and data obtained by Med expert artheriograph device. Second aim was to test differences in pulse transit time data between healthy adults and cardiovascular patients. The sample was composed of 99 probands, 63.6% females and 36.4% males with mean age 40.5 (SD + 14.0). There were 45 cardiovascular patients and 54 healthy adults. We used biofeedback device to measure Pulse transit time by Electrocardiograph and photoplethysmography sensors. The data from cardiological examination were Aortic pulse wave velocity, systolic (central) aortic pressure and augmentation index using artheriograph device. Anthropometric characteristics (body mass index, waist-height ratio, waist-hip ratio) were also included to the study. Results showed significant correlations between arteriography measures and pulse transit time. Also, healthy group demonstrated lower pulse transit time than cardiovascular patients at rest and under mental stress. Biofeedback device Procomp Infiniti seems to be promising sensitive tool to evaluation of blood vessels health status and that is why it is a possible indicator of cardiovascular risk.

  • Keywords

    • Pulse transit time

    • Arteriography

    • Body mass index

    • Mental stress

Soer

Influence of Different Breathing Frequencies on HRV Parameters

Remko Soer, Anne Wilbring, Annika Kemper, Marianne Six Dijkstra, Fredrick Shaffer, Andre Bieleman, Arjan van der Salm, Frits G. J. Oosterveld

Saxion University of Applied Sciences, Enschede, The Netherlands

Email: r.soer@saxion.nl

Worldwide, relaxation exercises differ in methods and breathing frequencies. From a theoretical perspective, it is of importance to gain more knowledge on the influence of differing breathing frequencies on heart rate variability (HRV) parameters to advise therapists in their choice of relaxation practice. At the AAPB 2016 conference (Seattle Washington), Dr. Fred Shaffer presented outcomes on the relation of differing breathing frequencies and HRV parameters. No significant findings were identified, but the included group was relatively small and required replication. The aim of the current study is to replicate this study and test differences in HRV parameters in differing breathing frequencies. A cross sectional study was performed with healthy subjects (employees and students of a university). HRV time and frequency domains were collected with emWave PPG clinical assessment tool with 2 min of measurement per breathing frequency. Breathing cycles of 4, 5, 6, 7, 8 breaths per minute were delivered in randomized order (leading to 120 possible sequences). Prior to the measurements, the Mindfulness Attention and Awareness Scale, the brief resilience scale and the Baecke for physical activity were administered to identify relevant covariates. Repeated Measures ANOVA’s were performed to analyze differences between breathing frequencies. 91 subjects were included in the study (32 male, 59 female; mean age; 23 ± 6.9 years). SDNN values were negatively linear related to breathing frequency (p < 0.01), with 120.9 ms at 4 breaths per minute to 98.6 ms at 8 breaths per minute. RMSSD values did not significantly differ between breathing frequencies. Significant decrease of low frequency (LF) and high frequency power was related to higher breathing cycles (p < 0.01). LF/HF ratio significantly increased with higher breathing frequencies, but not at 4 breaths per minute, because of a high HF power. Self-report measures of mindfulness, resilience and physical activity did not significantly covariate on the outcomes. Breathing at a slower pace increases SDNN, LF and HF and decreases LF/HF ratio, but not RMSSD. Clinicians may use this data to determine ideal breathing frequencies from a HRV stand of view.

  • Keywords

    • Heart rate variability

    • Breathing

    • Relaxation

Swingle

It’s Not Artifact: Valuable Information Found in Atypical EEG Readings

Mari K. Swingle

Swingle Clinic, Vancouver, Canada

Email: mariswingle@hotmail.com

Using computer artifacting (as opposed to visual artifacting) of brain maps can often obscure and delete potentially valuable information for a Neurofeedback practitioner. This presentation will explore a series of case studies wherein unartifacted raw signals show a wealth of information that may provide central insight for effective treatment: including how low blood sugar in diabetics can look like movement artifact, dementia, closed head injury and/or extreme ADHD. How marijuana use, absent seizures, regular EMF exposure, excessive usage of screen based devices (phones, iPads/Pods etc.), early stage mourning and Botox can produce atypical signals that standard artifacting programs can delete or otherwise clean as artifact. Recognizing such atypical signals, and their various emotional-biological causation, may be central to identifying and therefore treating the right problem—hence leading to more efficacious treatment.

  • Keywords

    • Atypical EEG readings

    • Interference

    • Programmed artifacting

    • Biological causation

Vodanovic Kosic

Implementation of Neurofeedback in Rehabilitation of Children with Malignant Diseases

Ana Vodanović Kosić

Children’s Hospital Zagreb, Love in Action, NGO, Zagreb, Croatia

Email: anavodanovickosic@gmail.com

Implementing neurofeedback in rehabilitation of children with malignant diseases, especially ones with tumors of the central nervous system, can enhance recovery and restoration of deteriorated functions such as attention, processing speed, memory, emotional stability. Radiotherapy, chemotherapy, brain injury (after excision of tumor) can significantly worsen neurocognitive functioning (De Ruiter et al. 2012). These impairments can cause the decline in ability to acquire new skills and information and the gap in the development between rehabilitated children and their peers is likely to occur. Educational results, social competence and even quality of life can be seriously compromised (Carey et al. 2002). Neurofeedback is proven to be efficient in treatment of ADHD and traumatic brain injury, and our goal is to investigate benefits of implementing neurofeedback in rehabilitation process of children with malignant diseases. Croatian NGO “Love in Action”, with the support of Children’s Hospital Zagreb, started the project of providing free neurofeedback training for children with malignant diseases, treated in Children’s Hospital Zagreb, in November 2016. We are going to present the preliminary results of this project in form of case studies, which will include pre and post neurocognitive assessment, and social/emotional functioning assessment.

  • Keywords

    • Malignant diseases

    • Neurocognitive functioning

    • Neurofeedback

    • Children

Wagner

Self-help Treatment for Low Back Pain and Stress: A Pilot Study Employing a Myofascial Manipulation Tool

Gordon C.M.1,2, Graf C.1, Lindner S.M.1, Wagner M.1, Birbaumer N.2, Andrasik F.3

1Center for Integrative Therapy, Stuttgart, Germany, 2Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany, 3Department of Psychology, University of Memphis, USA

Email: malte@malte-wagner.de

A tool-assisted tissue manipulation was performed on the lower back, hip, upper leg and abdomen muscles as a form of a self-help treatment we term the interdisciplinary fascia therapy (IFT method). The aim of this study was to explore the practicality of this self-help modality and to assess the effectiveness of an instrument-based myofascial self-treatment technique, combined with a vibrational breath pacemaker training (heart rate variability HRV) on the solar plexus (diaphragm) to stimulate vagal tone. 15 participants were recruited in order to field test this novel tissue manipulation self-help device for treatment of the multifidi, quadriceps, iliotibial band bilaterally, and the abdominal muscles. The tool under investigation, the Fascia-ReleaZer, is designed to perform a myofascial release that is combined with a vibrational oscillator and a soft-tipped nosed tool. It is augmented by HRV deep breathing training induced with a vibrational pace-maker (Fascia-ReleaZer) on the solar plexus twice per day. The self-help treatment was performed for a period of 3 weeks three times per week. The following parameters were measured, with lumbar position and posture held constant to ensure standardization, prior to treatment, immediately following treatment completion (3 weeks), and at a 3-month follow-up: stiffness, elasticity (MyotonPRO), indentometer-stiffness (modified indentometer algometer), range of movement ROM of the thoracic and lumbar spine (extension/flexion, lateral flexion, rotation measured with Mobee Med, an objective measurement based on the neutral zero method), pain intensity (Brief Pain Inventory BPI questionnaire), pain disability (Pain Disability Index PDI questionnaire), HRV vagal tone analysis (HRV Scanner Biosign) and a modified stress questionnaire MSQ (with ratings performed for 24 h, 1 week, and 1 month sensitization of stress). Statistical analysis included paired t-tests and Cohen’s d to gauge strength of effect. Analysis of the data shows improvements for nearly all parameters pre to post: A significant decrease in pain intensity (p < 0.001) (BPI), pain disability (p = 0.0013) (BPI), stress sensitization (p = 0.0287) (MSQ), with a trend for pain reduction in the pain disability index (PDI). ROM of the thoracic and lumbar spine (Mobee Med) showed a significant increase for extension (p = 0.001), flexion (p = 0.0125), lateral flexion to left (p = 0.004), lateral flexion to right (p = 0.0136) and a trend to more left and right hand rotation. A HRV coherence baseline test (vagal tone, HRV Scanner Biosign) showed a trend to improvement, with a similar trend appearing for general pulse lowering. Cohen’s d revealed medium to large effect sizes for nearly all significant primary measures of outcome. T-test has shown a significant change in the 3- month follow-up for pain intensity (BPI), pain disability (BPI), pain disability index (PDI) and stress sensitization (MSQ). Cohen’s d for the 3-month follow-up revealed medium effect size for pain intensity, pain disability, stress sensitization, flexion, lateral flexion for both sides and large effect size for extension. Application of self-help treatment with a muscle fascia tool resulted in clinically relevant improvements on all objective mechanical tissue properties. Pain reduction and range of movement improved significantly. Stress scores were also reduced significantly. Tool-assisted self-treatment with the IFT method is possibly an effective self-treatment modality for chronic low back pain. Our preliminary findings support the need for further research (more well-controlled trials, inclusion of larger sample sizes, more extended follow-up periods, among other aspects).

  • Keywords

    • Myofascial self-help therapy

    • Tool-assisted myofascial manipulation

    • Fascia-ReleaZer

    • HRV training

    • Vagal tone stimulation

    • IFT method

Warnke

Combining Low-level Brain Training and Neurofeedback

Ralph Warnke

MediTECH, Wedemark, Germany

Email: ralph.warnke@meditech.de

Brain processing skills are essential for key tasks such as speech processing, focus and attention, complex comprehension or even motorical tasks. And while neurofeedback training by itself can already have an astonishing impact on performance levels in such skills, there yet is room for more.

Low-level functions are fundamental brain functions such as processing speed, spatial hearing, pitch discrimination, pattern recognition or choice-reaction time, to only name a few. Each of those functions closely relate to specific complex tasks each of us is facing on a daily basis. Phoneme discrimination is essential for swift and efficient speech processing; without suitable performance levels in processing speed and pitch discrimination, a fast phoneme recognition with a high hit rate is near to impossible. And while HEG and EEG neurofeedback training have shown great positive impact on attention skills, they can benefit even the more when being combined with training low-level functions. In this oral presentation you will learn about means to swiftly assess your client’s low level skill set and how to improve such capabilities in him in reasonable time frames. The effects of such trainings have been shown not only in dyslexic children or in adults with hearing problems, but also using brainmaps with fMRI. The author has 20 years of experience in this field and participated in a number of related research projects both nationally and internationally. He introduces means of expanding and enhancing the range of tools available to biofeedback and neurofeedback professionals in both analysis and treatment for clients.

  • Keywords

    • Low-level brain training

    • Treating dyslexia and ADD

    • Lateral training

    • Hemo-Encephalography (HEG)

Poster Presentations

HEG Biofeedback Training for Olympic Athletes

Silvio de Souza Aguiar Carvalho, Mariana Medeiros Assed; July Silveira Gomes

NeuroGym Brazil, Rio de Janeiro, Brazil

Email: silvioaguiar@neurogym.com.br

Preparing athletes for competition requires systematic training of technique and tactics associated to the modality, as well as physical and mental training, which are recognized as the gold key for high performance athletes. In competitive shooting, concentration and self-regulation play an important role, especially for prefrontal cortex (PFC) abilities, as executive functions, attention, inhibitory control, working memory and decision-making. Hemoencephalography biofeedback (HEG BFK) technique monitors PFC hemodynamics, allowing the intentional maximization of blood oxygenation, which, in its turn, may improve athletic performance. HEG measure is free of muscle and eye movement artifacts, being suitable for using during the movement execution in the training set of static-sports as shooting, archery and golf. Knowing the new rules of the 2016 Rio de Janeiro Olympic games, that allowed noising from the crowd, a psychophysiological protocol based on HEG self-regulation training was set to increase focus and reduce athletes’ stress. The process of developing the protocol was structured in five steps: (1) analysis of the modality: including cognitive abilities required and the critical moments; (2) analysis of the athletes characteristics, as weaknesses and strength of the individual and those associated to the modality; (3) definition of the HEG site and adapted the designing of the software for the protocol training; (4) Selection of ecologic feedback for the modality (the target image, according to each event); (5) insert the protocol into the technical periodization program of each athlete. Five Olympic athletes were trained along 6 months, ending up in the silver medal of the 10 m Air Pistol athletes, Felipe Wu. This was the first time this protocol was systematically implemented as part as the periodization program of Olympic athletes in Brazil.

  • Keywords

    • HEG biofeedback

    • Competitive shooting

    • Psychophysiological training

    • Olympic athletes

The Efficacy of Biofeedback for Eating Disorders

Dixie Brown

Saybrook University, Oakland, CA, USA

Email: dixie@willowplaceforwomen.com

There is evidence supporting Electroencephalograph (EEG), skin conductance and heart rate variability biofeedback as effective interventions for clients with eating disorders including Anorexia nervosa, Bulimia nervosa, Binge eating disorder, and obesity (Bartholdy et al. 2013; Meule et al. 2012; Scolnick et al. 2014; Schroedl et al. 2013; Teufelet al. 2013) This literature review examines the efficacy of biofeedback for eating disorders and suggests possible uses for treatment.

  • Keywords

    • HRV

    • Eating disorders

    • EEG

    • Anxiety

Is a 1:2 Inhalation-to-Exhalation Ratio Optimal in HRV Biofeedback?

Nicholas Gravett, Fredric Shaffer

Truman State University, Center for Applied Psychophysiology, Kirksville, MO, USA

Email: nwg4764@truman.edu

A controversy continues as to whether a 1:2 inhalation-to-exhalation (I/E) ratio produces greater heart rate variability (HRV) than a 1:1 I/E ratio. An I/E ratio is the proportion of the breathing cycle during which subjects inhale and exhale. This within-subjects randomized controlled trial (RCT) replicated a previous RCT that found no advantage for a 1:2 I/E ratio on time domain and frequency domain measures. Sixteen undergraduates (eight men and eight women), ages 18–22, participated in this study. A Thought Technology ProComp Infiniti™ system monitored ECG, respiration, temperature, and skin conductance. Active ECG electrodes were located on the lower torso. A respirometer was positioned over the naval in order to measure abdominal excursion and respiration rate. Skin conductance sensors were placed on the index and middle fingers, and a thermistor was placed on the web dorsum of the left hand. Investigators randomly assigned subjects to begin with one of two 5-min I/E ratio conditions (either a 1:1 or 1:2) and then cross over to the other condition. In each I/E ratio condition, participants sat upright while effortlessly breathing at 6 breaths per minute (bpm) guided by a visual pacer. A 3-min buffer period between conditions minimized carryover by instructing participants to sit quietly without breathing instructions or feedback. The investigators monitored compliance with respiration rate and I/E ratio instructions during each experimental condition. The researchers analyzed data using a general linear model. Participants successfully followed the visual pacer and breathed at 6 bpm in both I/E ratio conditions. Breathing ratio did not affect autonomic (heart rate, skin conductance, temperature), HRV time domain (HR Max—HR Min, NN50, pNN50, RMSSD), frequency domain (LFnu, HFnu), or nonlinear measurements (DFalpha1, SampEn). The authors recommend that clinicians select the I/E ratio that their clients prefer since this parameter did not affect HRV when participants breathed at 6 bpm.

  • Keywords

    • Heart rate variability

    • Biofeedback

    • Respiration

The Role of Personality Traits in Reducing Stress Among Students Using Biofeedback-Assisted Relaxation and Progressive Muscle Relaxation

Gabija Jarašiūnaitė, Ieva Pečiulienė, Aidas Perminas

Vytautas Magnus University, Kaunas, Lithuania

Email: gabija.jarasiunaite@gmail.com

Research data show that 10–50% of students undergo stress that is higher than average (Abouserie 1994; Pierceall and Keim 2007; Sohail 2013; American College Health Association 2013). Excessive stress can become one of the risk factors adding to poor mental and physical health and behaviour that is unfavourable and harmful to health. Relaxation techniques are one of the healthiest and most effective stress reduction methods (Everly and Lating 2013). There are studies showing that personality traits might be related to effectiveness of relaxation techniques (Chellew Gálvez 2014; O’Connor et al. 2016). Yet, personality traits are analysed quite fragmentarily, so the purpose of this research was to assess the role of personality traits in reducing subjectively perceived stress and increasing ability to relax in students using biofeedback-assisted relaxation and progressive muscle relaxation. 105 undergraduate students (20 male and 85 females) of Vytautas Magnus University with higher academic stress level participated in a study. Participants of the study were randomly assigned into three different groups: 35 students received 4 weekly biofeedback-assisted relaxation training sessions, 34 students received 4 weekly progressive muscle relaxation training sessions and 36 participated in comparison group. Personality characteristics of students were assessed using the NEO Five-Factor Inventory (NEO-FFI; Costa and McCrae 1992). Subjectively perceived stress was measured by two self-report measures: Perceived Stress Scale (Cohen 1983) and Student Academic Stress Scale (Busari 2011). Students’ ability to relax was evaluated by the changes of skin conductance, skin temperature and heart rate. The results of the study showed that the effectiveness of stress reduction programmes based on biofeedback-assisted relaxation and progressive muscle relaxation methods for the reduction of subjectively perceived stress and the reinforcement of relaxation skills are different for the students with differently expressed personality traits.

  • Keywords

    • Stress

    • Students

    • Biofeedback-assisted relaxation

    • Progressive muscle relaxation

Can Biofeedback-Assisted Relaxation or Progressive Muscle Relaxation Reduce Emotional and Physiological Response to Stressors in Type A Women?

Gabija Jarašiūnaitė, Aidas Perminas

Vytautas Magnus University, Kaunas, Lithuania

Email: gabija.jarasiunaite@gmail.com

Even though it has been several decades now from the beginning of studies of psychophysiological response to stress of individuals with Type A behaviour patterns and its’ risk for coronary artery disease, one important aspect related to stress response of Type A individuals, which received little attention: the impact of non-invasive psychological interventions on the change in the stress response of such individuals. So, this study assesses the change of emotional and physiological response to stressors of individuals with Type A behaviour pattern after biofeedback-assisted relaxation and progressive muscle relaxation training. 70 female students aged between 18 and 24 participated in the study. They were selected from 1656 undergraduate students of Vytautas Magnus University on the basis of their scores on Adolescent/Adult Type A Behavior Scale-3 (Forgays et al. 1993). The participants of this study were randomly assigned to 3 different groups. Two groups received four progressive muscle relaxation or biofeedback-assisted relaxation training sessions once a week between two measurements of their emotional and physiological response to stressors and the third group was a control group. A total of four stressors (three psychological and one physiological) were used to assess student’s response to stressors. Students’ emotional reactivity to stressors was measured by Emotional Assessment Scale (Carlson et al. 1989). The change of negative emotions such as anger, anxiety, fear and sadness were analysed. Physiological response to stressors was assessed by measuring reactivity during the anticipation, exposure to stressors and recovery after the stressors. Physiological response was assessed by skin conductance, skin temperature, heart rate and respiratory rate. The study assessing the effect of progressive muscle relaxation and biofeedback-assisted relaxation on the reduction of stress response of Type A women contributes to the development of successful evidence based programs for the reduction of response to stressors.

  • Keywords

    • Biofeedback-assisted relaxation

    • Progressive muscle relaxation

    • Response to stressors

    • Type A behavior

New Protocol for Insomnia Treatment Using Neurofeedback: Beta Decrease Protocol

Jeonguen Jeon, Sungwon Choi

Duksung Women’s University, Suyu, Seoul, Korea

Email: jeongeunjeon2@gmail.com

According to the “hyper-arousal” model of primary insomnia (PI), insomnia patients suffer higher 24 h physiological and cognitive arousal than normal during both sleep and wakefulness. The hyper-arousal model of primary insomnia suggests that a deficit of attenuating arousal during sleep might cause the experience of non-restorative sleep. PI is characterized by subjective feelings of insufficient and non-restorative sleep, complaints of daytime tiredness, unwellness, and impairments in cognitive functioning in emotional, social or professional fields. Particularly, EEG beta activity represents a marker of cortical arousal. Power of beta frequency associated with not only persistent cortical arousal level but also daily complaint in insomnia. This study aimed to verify the effectiveness for beta-decrease neurofeedback. Our hypothesis is that after beta decrease neurofeedback training insomnia patients show decreased insomnia symptoms. Participants were randomly assigned to an experimental or a wait-list control group. The experimental group received ten 30-min sessions of NFB; meanwhile, the wait-list control group received nothing. In this study, we compared pre-/post-training, follow-up (after 2 weeks) resting state EEG (EO, EC), SC, HRV, sleep scales, sleep diary, smart wearable device data. Results show significantly increased TST (total sleep time), SE (sleep effectiveness), sleep satisfaction and decreased beta power, SL (sleep latency), ISI score, PSQI score.

  • Keywords

    • Insomnia

    • Neurofeedback

    • Insomnia treatment

    • Beta

Using Biofeedback Devices to Increase Social Justice and Health Equity: A Wearable Device to Increase Awareness of Poor Posture and Improve Self-care

Lauren Mason, Monica Joy, Shane Colombo, Erik Peper, Richard Harvey

San Francisco State University, San Francisco, CA, USA

Email: epeper@sfsu.edu

Social justice and Health equity are abstract terms that suggest a fair and equal distribution of wealth, opportunity and or privilege. Unfortunately, some people (e.g. students, social activists) overexert themselves during their pursuit of attaining just and equitable allocation of social and health resources, sometimes forgetting self-care of eating well, exercising regularly, getting good sleep and relaxing when needed. Self-care techniques that include improving personal health habits (e.g. how we eat, sleep, exercise and relax) are familiar to all biofeedback practitioners. For example, applied psychophysiological techniques are based on raising awareness of the body (e.g. muscle tension, breathing rate, skin temperature) and systematically training greater degrees of awareness and control over those body processes. Whereas biofeedback training sessions typically occur in a classroom, laboratory or clinic, wearable devices permit users to continue their biofeedback awareness training in everyday settings. Providing access to inexpensive biofeedback devices that do not require having health insurance or require a clinic visit is arguably a matter of social justice and health equity. For example, an inexpensive wearable device such as the Upright can be used to monitor muscle activity in the back. Because back discomfort is a common complaint among students (who may also be social activists), this poster describes typical types of posture that can lead to negative health outcomes. As a case in point, a classroom activity included demonstrating for students the many ways that poor posture (e.g., slouched over) or healthy posture (e.g., erect, head over shoulders) influenced not only their muscle tension in the back, but also their mood and classroom performance. Other findings include: A collapsed posture is associated with depressive memory bias, failure-related emotions, lower subjective energy, lower confidence and back, neck, and shoulder pain. An upright posture is associated with increases in confidence, performance, self-image, subjective energy and less pain. In an erect position, abdominal movement is significantly larger, and both breathing and heart rates are significantly higher. Changing posture alters the physiology of the body as monitored when 15 participants either slouched or sat upright. Breathing rate was significantly higher (p < 0.05) during collapsed (9.9 breaths/min) than erect (9.0 breaths/min) position slouched vs erect and Heart rate was significantly higher (p < 0.01) during erect position (73.6/min) than collapsed position (70.7/min). As most individuals lack postural awareness, a wearable postural feedback device, (UpRight http://www.uprightpose.com), measures changes in the curvature and tilt of the spine beneath the sensor. The device provides vibrational feedback whenever slouching occurs. The purpose of the study was to evaluate what factors trigger slouching and how posture feedback can influence an individual’s well-being. 16 participants monitored their posture, emotional state, and symptoms. For 1 week of the study, participants were instructed to train with the device for at least 3 days, in sessions of at least 15 min per day. This demonstrated that participants predominantly slouched due to ergonomic factors such as looking at their cell phone (i-Neck), fatigue, stress, feeling depressed, negative self-talk, and other factors such as crossing one’s legs while sitting. The results demonstrated significant increases in awareness of posture, confidence, happiness, productivity, optimism, energy, appreciativeness, concentration, patience, and strength. In addition, participants also reported a reduction in irritability, negativity, laziness, sadness, back, headaches, neck, and shoulder pain, five participants also filled out the pre and post SF-36 RAND health survey from and reported a 28% increase in their health and well-being score. This pilot study suggests that a posture feedback device is a useful tool to quickly teach posture awareness and improve well-being.

  • Keywords

    • Posture

    • Feedback

    • Mood

    • Pain

    • Self-talk

Objective and Subjective Effects of Cognitive-Behavioral Therapy of Insomnia

Dajeong Kim, Seungwon Choi

Duksung Women’s University, Dobong-gu, Seoul, Republic of Korea

Email: dajjeong12@gmail.com

Cognitive behavioral therapy for insomnia (CBT-I) is complex treatment for changing negative faith in sleep, including behavioral therapy and cognitive therapy. CBT-I is a widely used evidence-based treatment for insomnia. However, until now there is little knowledge about effects of CBT-I on objective data like EEG power. Particularly, EEG beta activity represents a marker of cortical arousal. Power of beta frequency is associated with not only persistent cortical arousal level but also daily complaint in insomnia. This study aimed to verify the effectiveness and object data for CBT-I. Participants were recruited above ISI scale 15 and PSQI scale 6. And, Participants were randomly assigned to an experimental or a wait-list control group. The experimental group received ten 60-min sessions of CBT-I (n = 4–5); the wait-list control group received nothing. Participants carried out Sleep Scale, sleep diary, resting state EEG during pre to post program to evaluate the change of subjective and objective insomnia index. Compared to control group, CBT-I participants showed significant increased TST (total sleep time), SE (sleep effectiveness) and decreased sleep latency, ISI score, PSQI score, GSES score, and Beta power.

  • Keywords

    • Cognitive behavior therapy

    • Insomnia

    • QEEG

Effects of Breathing Biofeedback on Athlete’s Attention Characteristics During 3D-MOT Training

Anastasia Kovaleva, Alyona Grushko, Vladimir Kasatkin

Research Institute of Normal Physiology by name of P.K. Anokhin Sport Center of Innovative Technologies And Teams Training, Sport Psychology Dept., Moscow, Russia

Email: anastasia_kovaleva@hotmail.com

Three-dimensional multiple object tracking (3D-MOT) is a perceptual-cognitive training system based on a 3D virtual environment (Parsons et al. 2014). Slow diaphragmatic breathing can improve some cognitive functions (Frewen et al. 2013; Peper 2016). Well-developed visual attention and MOT skills are crucial for combat and team sports in order to outsmart opponent by anticipating his or her actions (Mangine et al. 2014; Romeas et al. 2016). We assumed, that five or more breathing biofeedback sessions will benefit attention during 3D multiple objects tracking (3D-MOT) task for football players and combat sports athletes compared for those who trained attention only. 43 male athletes (football players and combat sports athletes) performed 3 to 12 3D-MOT sessions on the NeuroTracker (NT) device (Faubert and Sidebottom 2012). Some athletes additionally took 5 biofeedback (BFB) sessions (paced breathing at 6 per minute rate according to the Lehrer and Vaschillo protocol 2001) on the Thought Technology equipment and Biograph Infiniti software. Athletes were divided into two groups: BFB group (n = 21) (breathing training and NT sessions) and control group (n = 22) (NT sessions only). Athletes from both groups demonstrated increase of NT scores from 1st (1.22 in BFB group and 1.08 in controls) to 12th session (1.92 in BFB group and 1.31 in controls). As it was noted previously (Parsons B. et al. 2014), athletes demonstrated progress in attention scores during even only 3D-MOT training (without any other interventions, e.g., BFB). But Wilcoxon matched pairs test showed that significant increase in NeuroTracker scores appears in BFB group earlier then in controls (between 1st and 2nd NT session in BFB and only between 1st and 4th in controls). In 3rd and 11th sessions athletes from BFB group demonstrated significantly higher NT scores then controls. Our results suggest that breathing biofeedback sessions can improve 3D-MOT skills in athletes.

  • Keywords

    • Biofeedback

    • Athletes

    • Multiple object tracking

    • Attention

The Application of Heart Rate Variability Biofeedback to Medical and Mental Health Disorders

Donald Moss1, Fredric Shaffer2

1College of Integrative Medicine and Health Sciences, Saybrook University, Oakland, CA USA, 2Department of Psychology, Truman State University, Kirksville, MO USA

Email: dmoss@saybrook.edu

Heart rate variability (HRV) is a medical index for morbidity and wellness. Lower HRV accompanies many illnesses; high HRV accompanies healthy states, resilience, and optimal functioning. Heart rate variability biofeedback (HRVB) uses real time electronic feedback of the moment-to-moment changes in HRV to train patients to produce increases in HRV. Outcome studies on HRVB have shown therapeutic benefit for a wide variety of medical and mental health disorders. Lehrer and colleagues have published evidence-based protocols for HRV assessment and HRV treatment. The authors review outcome studies here on a sampling of common disorders: asthma, chronic muscle pain, depression, heart failure, hypertension, and post-traumatic stress disorder. Heart rate variability biofeedback offers promising therapeutic benefit for any medical or mental health disorder known to be accompanied by autonomic nervous system dysregulation.

  • Keywords

    • Heart rate variability

    • Mental health

    • Autonomic nervous system dysregulation

Blood Volume Pulse Amplitude as an Indicator for the Ability to Cope With Stress: Results of a Prospective Study on Elite Unit Soldiers Exposed to Extreme Stress

Yuval Oded, Danny Koren

Center for Cognitive Behavioral and Psychophysiological Therapy (CBT-BF™), Tel Aviv, Israel

Email: mentalfit@gmail.com

Currently, very little research has been published describing the physiological and psychological responses to pressure, in the framework of preparatory training for stressful situations. The bulk of published research has focused on students faced with exams, patients undergoing medical procedures, and athletes; little attention has been given to the topic of healthy soldiers coping with military-related stress (Taylor et al. 2007). 46 Soldiers from an Elite unit performed a psychophysiological stress evaluation 1 month before and 1 week following an extremely stressful situation. 22 Soldiers were randomly assigned to a control group tested in the same way but without participating in the stressful scenario. The psychophysiological evaluation in the present study included the following parameters: maximum and minimum signal value; spontaneous increase in signal prior to a new stimulus as well as baseline signal levels and recovery patterns, collected via seven physiological channels; heart rate, skin conductivity, Temperature, two sEMG channels, breathing and blood volume pulse amplitude (BVP amplitude). Excluding the psychophysiological channel of BVP amplitude, and the vigilance parameter, which have not been widely used, all of the channels and parameters were chosen on the basis of being recognized, accepted parameters in the stress response literature. Results of this study demonstrate the importance of using BVP amplitude measure in addition to other more widely used measures as it has its own unique properties. Measuring vigilance towards stimulation adds important information regarding the flexibility of ANS functioning. The term anticipatory stress is recognized in the literature; the current study links, for the first time, this term and vigilance towards stimulus, as recognized concepts, to the phenomenon of a spontaneous increase in signal.

  • Keywords

    • Blood volume pulse amplitude

    • Psychophysiological stress profiling

    • Extremely stressful situation

Increasing Performance of Professional Soccer Players and Elite Track and Field Athletes with Peak Performance Training and Biofeedback: A Pilot Study

Remko Soer, Noortje H. Rijken, Ewold de Maar, Hilco Prins, Wouter B. Teeuw, Jan Peuscher, Frits G. J. Oosterveld

Saxion University of Applied Sciences, Enschede, The Netherlands

Email: r.soer@saxion.nl

Currently, there is insufficient knowledge about the effectiveness of combined mental coaching programs and biofeedback. Both HRV-biofeedback and neurofeedback may be promising, but are insufficiently studied combined with mental coaching. The aim of this pilot study was to investigate the effects of combined mental coaching with either electro encephalogram (EEG) alpha power feedback or heart rate variability (HRV) feedback on objective and subjective outcomes in elite athletes. A prospective pilot study was performed with two distinct cohorts. Soccer players were provided with four sessions of mental coaching combined with daily HRV-biofeedback (Group A); track and field athletes were provided with four sessions of mental coaching combined with daily neurofeedback (Group B). Measurements were performed at baseline, post intervention and at 5 weeks follow-up. Objective measures: EEG and ECG. Subjective measures: numeric rating scale for performance, Pittsburgh Sleep Quality Index, Rest and Stress Questionnaire and Sports Improvement-60. Group characteristics were too distinct to compare the interventions. Linear mixed models were used to analyze differences within groups over time. In Group A, significant changes over time were present in alpha power at five of seven EEG locations (p = 0.01–0.03). LF/HF ratio significantly increased (p = 0.02) and the concentration (p = 0.02) and emotional scale (p = 0.03) of the SIM-60 increased significantly (p = 0.04). In Group B, the HRV low frequency power and recovery scale of the REST-Q significantly increased (p = 0.02 and 0.01 resp.). Other measures remained stable or improved non-significantly. A mental coaching program combined with either HRV or EEG alpha power feedback may increase HRV and alpha power and may lead to better performance-related outcomes and stress reduction. Further research is needed to elucidate the effects of either type of feedback and to compare effects with a control group.

  • Keywords

    • Neurofeedback

    • HRV biofeedback

    • Peak performance

    • Sports

Efficacy of Neurofeedback Treatment in Taiwanese Children with Attention Deficit/Hyperactivity Disorder

Pinchen Yang1, I-ting Li2

1Department of Psychiatry, Kaohsiung Medical University & Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, 2Psychosomatic Division, Cheng Ching Hospital, Taichung, Taiwan

Email: pincheny@gmail.com

Attention-deficit/hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder in children. Stimulant drugs treatment has been one of the major therapeutic options for children with ADHD. However, roughly 34% of children are medication non-responders, many others are partial responders. Neurofeedback treatment is a promising alternative that is supported by western extensive peer-reviewed literature. However, there are limited empirical data of the effect of neurofeedback in Taiwanese population. The purpose of the present study is to examine the effects of neurofeedback on the primary core symptoms, neuropsychological and electrophysiological measures in Taiwanese children with ADHD who were partial responders to pharmacotherapy. Twenty-six children (7–12 years) with DSM-5 diagnosed ADHD were invited to join this study. Thirteen subjects joined the neurofeedback group and 13 subjects were allocated to the control group. All subjects have received ongoing stimulant treatment for more than 6 months with clinical impression as partial responder. Medication was continued and unaltered during the whole study period of 8 weeks. For the baseline and 8-week follow up assessments, all children received continuous performance test and their primary caregivers completed two behavior-rating scales. Subjects of neurofeedback group received 20 training sessions/8 weeks in total. The training paradigm targeted electroencephalogram Theta/beta brain wave ratio (TBR). Children were taught to decrease the excess theta and increase beta EEG activity at fronto-central locations. Significant improvements were noted on attention test and parental rating scales for subjects received neurofeedback training as compared with the control group. However, the spectral power analysis showed no significant change on TBR power after the neurofeedback training. The study supports effect of neurofeedback training as add-on treatment for improving the core symptoms and attention in Taiwanese children with ADHD.

  • Keywords

    • ADHD

    • Neurofeedback

    • Theta/beta wave ratio

The Comparison of Beta Decrease Protocols for Insomnia Patients

Soyoung Yoon, Sengwon Choi

Duksung Women’s University, Seoul, Republic of Korea

Email: tkadid2@gmail.com

As enhanced beta (18–30 Hz) power reflects state of the brain activation, the beta decrease neurofeedback training in insomnia patients is needed. However, since the beta and sigma (12–15 Hz; sleep spindle) frequency band is closely related, sigma power has a possibility to decrease by beta decrease neurofeedback training. For this reason, researchers should be considering beta decrease neurofeedback training that possibly diminishes the sigma power, which affected by the training. Though there is lack of neurofeedback study for insomnia patients to draw a comparison between the beta wave focused decrease against the beta-sigma dual training, we sought to find the distinction between the two. In this study, therefore, we compared the effectiveness between the beta protocols as followed. All participants were randomly assigned to one of three groups (beta, beta-sigma dual threshold and beta-sigma protocol). After 10 training sessions on each group, the beta-sigma protocol showed significantly decreased beta power, maintained sigma power and the highest improvement in TST (total sleep time), SE (sleep efficiency), ISI, and PSQI rather than the beta decrease and beta-sigma dual threshold training protocol. Reported further research needed.

  • Keywords

    • Neurofeedback

    • Insomnia

    • Beta protocol

    • Sigma power