Symptom Management Among Cancer Survivors: Randomized Pilot Intervention Trial of Heart Rate Variability Biofeedback.
Appl Psychophysiol Biofeedback
; 45(2): 99-108, 2020 06.
Article
en En
| MEDLINE
| ID: mdl-32358782
ABSTRACT
Chronic cancer-related symptoms (stress, fatigue, pain, depression, insomnia) may be linked with sympathetic nervous system over-activation and autonomic imbalance. Decreased heart rate variability (HRV) is an indicator of autonomic dysregulation that is commonly observed among cancer survivors. HRV biofeedback (HRVB) training induces HRV coherence, which maximizes HRV and facilitates autonomic and cardiorespiratory homeostasis. This randomized, wait-list-controlled, pilot intervention trial tested the hypothesis that HRVB can improve HRV coherence and alleviate cancer-related symptoms. The intervention group (n = 17) received 4-6 weekly HRVB training sessions until participants demonstrated skill acquisition. Controls (n = 17) received usual care. Outcomes assessed at baseline and follow-up included 15-min HRV recordings (HRV Coherence Ratio), and symptoms of stress, distress, post-traumatic stress disorder (PTSD), pain, depression, fatigue, and sleep disturbance. Linear mixed models for repeated measures were used to assess Group-by-Time interactions, pre- versus post-treatment differences in mean symptom scores, and group differences at follow-up. Mean HRV Coherence Ratios (± standard error) improved in the HRVB group at follow-up (baseline 0.37 ± 0.05, post-intervention 0.84 ± 0.18, p = 0.01), indicating intervention validity. Statistically significant Group-by-Time interactions indicated treatment-related improvements in HRV Coherence Ratios (p = 0.03, Pre-vs. post-treatment effect size [Cohen's d] 0.98), sleep symptoms (p = 0.001, d = 1.19), and sleep-related daytime impairment (p = 0.005, d = 0.86). Relative to controls, the intervention group experienced trends toward improvements in stress, distress, fatigue, PTSD, and depression, although no other statistically significant Group-by-Time interactions were observed. This pilot intervention found that HRVB training reduced symptoms of sleep disturbance among cancer survivors. Larger-scale interventions are warranted to further evaluate the role of HRVB for managing symptoms in this population. Registration NCT03692624 www.clinicaltrials.gov.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Sistema Nervioso Autónomo
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Síntomas Conductuales
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Biorretroalimentación Psicológica
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Supervivientes de Cáncer
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Frecuencia Cardíaca
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Trastornos del Inicio y del Mantenimiento del Sueño
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Observational_studies
/
Prognostic_studies
Límite:
Humans
/
Middle aged
Idioma:
En
Revista:
Appl Psychophysiol Biofeedback
Asunto de la revista:
CIENCIAS DO COMPORTAMENTO
/
PSICOFISIOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Estados Unidos