Guiding Breathing at the Resonance Frequency with Haptic Sensors Potentiates Cardiac Coherence.

Cardiac coherence is a state achieved when one controls their breathing rate during the so-called resonance frequency breathing. This maneuver allows respiratory-driven vagal modulations of the heart rate to superimpose with sympathetic modulations occurring at 0.1 Hz, thereby maximizing autonomous power in heart-to-brain connections. These stimulations have been shown to improve vagal regulations, which results in obvious benefits for both mental and organic health. Here, we present a device that is able to deliver visual and haptic cues, as well as HRV biofeedback information to guide the user in maintaining a 0.1 Hz breathing frequency. We explored the effectiveness of cardiac coherence in three guidance conditions: visual, haptic and visuo-haptic breathing. Thirty-two healthy students (sixteen males) were divided into three groups that experienced five minutes of either visual, haptic and visuo-haptic guided breathing at 0.1 Hz. The effects of guidance on the (adequate) breathing pattern and heart rate variability (HRV) were analyzed. The interest of introducing haptic breathing to achieve cardiac coherence was shown in the haptic and visuo-haptic groups. Especially, the P0.1 index, which indicates how the autonomous power is 'concentrated' at 0.1 Hz in the PSD spectrum, demonstrated the superiority of combining haptic with visual sensory inputs in potentiating cardiac coherence (0.55 ± 0.20 for visuo-haptic vs. 0.28 ± 0.14 for visual only guidance; p < 0.05) haptic-induced effectiveness could be an asset for a more efficient and time-saving practice, allowing improved health and well-being even under tight time constraints.

Effect of Resonance Breathing on Heart Rate Variability and Cognitive Functions in Young Adults: A Randomised Controlled Study.

INTRODUCTION: Heart rate variability (HRV) is an important physiological biomarker of wellbeing, mood, and adaptation, and hence improvements in HRV signify improved health, mood, and adaptation to stress. Resonance breathing has consistently been shown to increase HRV, mood, and adaptability. The study investigated the effects of four-week training of resonance breathing in young adults on HRV, stress, and cognition functions. METHODS: The randomized controlled study was conducted on young men (18-30 years) after obtaining Institutional Ethics Committee approval and written informed consent from the participants. Participants were randomly divided into two groups: the control group and the resonance breathing (RB) group. Baseline parameters, along with heart rate variability, trail tests for cognition, and perceived stress level, were assessed in both groups. After undergoing four weeks of training, the intervention group practiced deep breathing at the resonance frequency for 20 minutes per day for four weeks, whereas the control group did not. All parameters were recorded again after four weeks of resonance breathing. RESULTS: No difference was observed in the HRV parameters in the control group at baseline and four weeks after the baseline recording (p>0.05). In the intervention group, there was a significant improvement in the HRV parameters, the standard deviation of the normal-to-normal interval (SDNN), the proportion derived by dividing NN50 by the total number of NN intervals (pNN50), and total power, after practicing four weeks of resonance breathing (p<0.05). A significant difference in these parameters was also observed in the control and intervention groups after four weeks (p<0.05). There was a significant improvement in the Trails A and B test performance in the intervention group after practicing for four weeks of RB. Similarly, the perceived stress score decreased significantly in the RB group in comparison to its baseline value as well as the control group value.  Conclusion: Increased parasympathetic and decreased sympathetic activity were observed after practicing 20 minutes of resonance frequency breathing every day for four weeks. It also improved cognition and reduced perceived stress levels among young adults. It is recommended that young adults should practice deep breathing at the resonance frequency for a few minutes every day. This would allay anxiety and stress, improve their cognitive performance, and also reduce their cardiovascular morbidity.

A preliminary systematic review and meta-analysis on the effects of heart rate variability biofeedback on heart rate variability and respiration of athletes.

To date, there is no quantitative review examining the influence of heart rate variability biofeedback (HRV BFB) on the athlete population. Such an undertaking may provide valuable information on the autonomic and respiration responses of athletes when performing HRV BFB. Thus, purpose of this preliminary systematic review and meta-analysis on the effects of HRV BFB on HRV and respiration of athletes. Searches of Springerlink, SportDiscus, Web of Science, PROQUEST Academic Research Library, Google Scholar, and ScienceDirect were conducted for studies that met the following criteria: (1) experimental studies involving athletes that underwent randomized control trial; (2) availability of HRV BFB as a treatment compared with a control (CON)/placebo (PLA); (3) any pre and post HRV variable and/or breathing frequency as dependent variable/s; and, (4) peer-reviewed articles written in English. Four out of 660 studies involving 115 athletes (25 females and 90 males) ages 16-30 years old were assessed in this review. Preliminary findings suggest the promising ability of HRV BFB to improve respiratory mechanics in athlete population. More work is needed to determine the autonomic modulatory effect of HRV BFB in athletes.

Music Therapy for Depression Enhanced With Listening Homework and Slow Paced Breathing: A Randomised Controlled Trial.

Introduction: There is evidence from earlier trials for the efficacy of music therapy in the treatment of depression among working-age people. Starting therapy sessions with relaxation and revisiting therapeutic themes outside therapy have been deemed promising for outcome enhancement. However, previous music therapy trials have not investigated this issue. Objective: To investigate the efficacy of two enhancers, resonance frequency breathing (RFB) and listening homework (LH), when combined with an established music therapy model (trial registration number ISRCTN11618310). Methods: In a 2 × 2 factorial randomised controlled trial, working-age individuals with depression were allocated into groups based on four conditions derived from either the presence or absence of two enhancers (RFB and LH). All received music therapy over 6 weeks. Outcomes were observed at 6 weeks and 6 months. The primary outcome was the Montgomery Åsberg Depression Rating Scale (MADRS) score. Results: There was a significant overall effect of treatment for the primary outcome favouring the breathing group (d = 0.50, 95% CI 0.07 to 0.93, p = 0.02). The effect was larger after adjustment for potential confounders (d = 0.62, 95% CI 0.16 to 1.08, p = 0.009). Treatment effects for secondary outcomes, including anxiety (anxiety scale of Hospital Anxiety and Depression Scale) and quality of life (RAND-36), were also significant, favouring the breathing group. The homework enhancer did not reach significant treatment effects. Conclusion: We found that the addition of RFB to a music therapy intervention resulted in enhanced therapeutic outcome for clients with depression.

Effect of Acute Heart Rate Variability Biofeedback on H-reflex Modulation: A Pilot Study.

Heart rate variability biofeedback (HRV BFB) is paced breathing scheme that stimulates resonance in the cardiovascular system. This study aimed to investigate the effect of a single-session HRV BFB on Hoffman reflex (H-reflex) of the soleus muscle. Twelve healthy males (height: 173.7 ± 7.18 cm; weight: 72.7 ± 17.7 kg; age: 24.0 ± 5.02 yrs) completed a randomized-crossover intervention involving a 10-minute HRV BFB and normal breathing (CON) separated by 48 hours. Results revealed significantly lower 1a afferent activation after HRV BFB. Similarly, the HRV BFB also demonstrated lower proportion of activated motor neurons from 1a afferents. In conclusion, an acute HRV BFB influenced the reduction in motoneuron excitability at resting condition.

Motivational Non-directive Resonance Breathing as a Treatment for Chronic Widespread Pain.

Chronic widespread pain (CWP) is one of the most difficult pain conditions to treat due to an unknown etiology and a lack of innovative treatment design and effectiveness. Based upon preliminary findings within the fields of motivational psychology, integrative neuroscience, diaphragmatic breathing, and vagal nerve stimulation, we propose a new treatment intervention, motivational non-directive (ND) resonance breathing, as a means of reducing pain and suffering in patients with CWP. Motivational ND resonance breathing provides patients with a noninvasive means of potentially modulating five psychophysiological mechanisms imperative for endogenously treating pain and increasing overall quality of life.

Enhancing the efficacy of integrative improvisational music therapy in the treatment of depression: study protocol for a randomised controlled trial.

BACKGROUND: Depression is among the leading causes of disability worldwide. Not all people with depression respond adequately to standard treatments. An innovative therapy that has shown promising results in controlled trials is music therapy. Based on a previous trial that suggested beneficial effects of integrative improvisational music therapy (IIMT) on short and medium-term depression symptoms as well as anxiety and functioning, this trial aims to determine potential mechanisms of and improvements in its effects by examining specific variations of IIMT. METHODS/DESIGN: A 2 × 2 factorial randomised controlled trial will be carried out at a single centre in Finland involving 68 adults with a diagnosis of depression (F32 or F33 in International Statistical Classification of Diseases and Related Health Problems 10th revision). All participants will receive 6 weeks of bi-weekly IIMT, where they are invited to improvise music and reflect on those improvisations with a music therapist in a one-to-one setting. Potential enhancements to IIMT will include: home-based listening to recorded improvisations (LH) from IIMT sessions to facilitate integration of therapeutic processing into daily life; and resonance frequency breathing (RFB), a breathing exercise at the beginning of each session to facilitate emotional expression and processing. Participants will be randomised in a 1:1:1:1 ratio into each combination (IIMT alone or with one or both enhancements). The primary outcome is depressive symptoms measured by the Montgomery-Åsberg Depression Rating Scale (MADRS) at 6 weeks. Secondary outcomes are depressive symptoms at 6 months; anxiety, quality of life, and functioning at 6 weeks and 6 months; and adverse events. Secondary underlying mechanisms/process variables are self-rated momentary depression level before every IIMT session; and homework compliance in IIMT + LH. Statistical analyses involve an intention-to-treat approach, using a linear mixed-effects model examining the main effects (LH vs no LH; RFB vs no RFB) and interaction effects (LH × RFB). DISCUSSION: This trial will contribute to understanding the mechanisms of IIMT and may further enhance the effectiveness of an intervention that was previously shown to be superior to standard care alone for adults with depression. TRIAL REGISTRATION: ISRCTN11618310 . Registered on 26 January 2018.

The Impact of Resonance Frequency Breathing on Measures of Heart Rate Variability, Blood Pressure, and Mood.

Heart rate variability biofeedback (HRVB) significantly improves heart rate variability (HRV). Breathing at resonance frequency (RF, approximately 6 breaths/min) constitutes a key part of HRVB training and is hypothesized to be a pathway through which biofeedback improves HRV. No studies to date, however, have experimentally examined whether RF breathing impacts measures of HRV. The present study addressed this question by comparing three groups: the RF group breathed at their determined RF for 15 min; the RF + 1 group breathed at 1 breath/min higher than their determined RF for 15 min; and the third group sat quietly for 15 min. After this 15-min period, all groups participated in the Paced Auditory Serial Addition Task (PASAT) for 8 min, and then sat quietly during a 10-min recovery period. HRV, blood pressure, and mood were measured throughout the experiment. Groups were not significantly different on any of the measures at baseline. After the breathing exercise, the RF group reported higher positive mood than the other two groups and a significantly higher LF/HF HRV ratio relative to the control group, a key goal in HRVB training (p < 0.05). Additionally, the RF group showed lower systolic blood pressure during the PASAT and during the recovery period relative to the control group, with the RF + 1 group not being significantly different from either group (p < 0.05). Overall, RF breathing appears to play an important role in the positive effect HRVB has on measures of HRV.

Resonance Frequency Breathing Biofeedback to Reduce Symptoms of Subthreshold PTSD with an Air Force Special Tactics Operator: A Case Study.

The prevalence rates of post-traumatic stress disorder (PTSD) have been estimated to be several times higher in military populations compared to the national average. Special Tactics operators are a group that is more likely to avoid seeking psychological care due to the stigma and other consequences the diagnosis may have on their military careers. There is a need for more effective and less stigmatizing interventions to treat this population. Psychophysiological methods have been proven to be efficacious in treating PTSD, yet have received less attention as an adjunctive intervention. Resonance frequency (RF) biofeedback is a form of cardiorespiratory intervention that has shown promise as an effective treatment. The current case study examined the use of RF biofeedback in combination with other physiological and evidence-based methods as part of a comprehensive treatment approach. The client showed a significant drop from his initial scores on a screening assessment by the end of treatment, and demonstrated continued progress despite a 3-month break from the therapy. This author proposed that the synergistic effects of the multi-phased treatment approach contributed to the client's progress. Furthermore, a case was made for using multiple techniques when treating subthreshold PTSD and related symptoms within a treatment resistant population.