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A primer on Heart Rate Variability Biofeedback

5/13/2020

 
Blog post by Marco Altini

Life can be demanding, from both a physical and psychological point of view. Our health and performance can be affected by how we are able to effectively cope with stressful situations and deal with anxiety, or in broader terms, our ability to emotionally self-regulate is key

Heart Rate Variability (HRV) Biofeedback can directly affect physiological and psychological factors through deep breathing exercises and is an ideal strategy to help us self-regulate and better cope with stressful situations

We are working on something new. Learn more about biofeedback at HRV4Biofeedback.com 
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HRV4Biofeedback is coming soon — Join the waiting list

Scientific rationale

Practically speaking, HRV Biofeedback consists of providing an individual with real-time feedback on instantaneous heart rate and respiration changes while being instructed to breathe at low frequencies (Lehrer and Gevirtz, 2014)

From a physiological point of view, we can consider homeostasis as a starting point to understand the rationale behind using HRV Biofeedback. As the body via the autonomic nervous system (ANS) responds to stressful stimuli in an attempt to maintain a state of balance, we can determine how effective this physiological self-regulation process is, by measuring the ANS

During HRV Biofeedback, an individual is instructed to breathe at low frequencies. Breathing at low frequencies (or deep breathing) causes large oscillations in the instantaneous heart rate, which synchronize with breathing rate. The influence of breathing on heart rate is called Respiratory Sinus Arrhythmia (RSA) and is mostly modulated by the parasympathetic branch of the ANS (Lehrer and Gevirtz, 2014). Hence, deep breathing results in training of the parasympathetic system, which might explain at least part of the positive effects of HRV Biofeedback reported in the literature in the context of reducing stress and anxiety (Goessl, Curtiss, and Hofmann, 2017)

Strengthening the parasympathetic nervous system could also motivate using HRV Biofeedback in athletes, with the potential of improving emotional self-regulation, coping mechanisms, and performance (Khazan, 2016; Pusenjak et al., 2015)

Check out these resources to learn more about  the physiological underpinnings of HRV Biofeedback:
  • HRV Biofeedback guide
  • The science of biofeedback

What's the difference between morning HRV measurements and  biofeedback?

If you are familiar with our work or the way we normally talk about HRV, that's probably the first question that comes to mind

HRV analysis can be used for various applications. What we do at HRV4Training is to quantify baseline physiological stress (what we could call "chronic" stress), and how this changes in response to training and lifestyle over periods of weeks or longer. To quantify baseline physiological stress, our measurements need to be taken in a very precise moment, which is first thing in the morning, so that we can avoid the effect of confounding factors. You can find a few examples here

By capturing changes in resting physiology, we can provide useful feedback that helps individuals to make meaningful adjustments to better balance training and lifestyle. This is particularly relevant as we all respond differently even to the same stressors depending on various aspects (how novel is the stressor, how much of that stressor we are used to take, what other stressors are present), hence only by measuring our individual response we can figure out if it's all proceeding according to our plans or not

What about HRV biofeedback then?

HRV Biofeedback is a technique that we use to improve self-regulation, and also strengthen the parasympathetic system. While our morning measurements should be done while resting and breathing naturally, during biofeedback we use deep breathing to elicit higher parasympathetic activity

You can see your biofeedback session the same way you see your other training sessions, this is something you do so that in the longer term, there can be beneficial changes in health and performance. Biofeedback is just a positive stressor

Where do regular baseline HRV measurements and biofeedback meet?

Normally we would recommend doing biofeedback exercises as an add on the regular morning measurement done with HRV4Training. Combining biofeedback with morning measurements taken with HRV4Training, you could see also potential changes in baseline chronic physiological stress as measured in a known context (first thing in the morning), as a result of your biofeedback sessions

We are building something new

In the next weeks, we'll start beta testing our new product, specifically designed for biofeedback. Visit HRV4Biofeedback.com to learn more
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HRV4Biofeedback is coming soon — Join the waiting list

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    This blog is curated by
    Marco Altini, founder of HRV4Training


    ​Blog Index
    ​
    The Ultimate Guide to HRV
    1: Measurement setup
    2: Interpreting your data
    3: Case studies and practical examples

    How To
    1. Intro to HRV
    ​2. How to use HRV, the basics
    3. HRV guided training
    ​4. HRV and training load
    ​
    5. HRV, strength & power
    6. Overview in HRV4Training Pro​
    7. HRV in team sports
    ​

    HRV Measurements
    Best Practices

    1. Context & Time of the Day
    2. Duration
    ​
    3. Paced breathing
    4. Orthostatic Test
    5. Slides HRV overview
    6. Normal values and historical data
    ​7. HRV features
    ​
    Data Analysis
    1a. Acute Changes in HRV
    (individual level)

    1b. Acute Changes in HRV (population level)
    ​
    1c. Acute Changes in HRV & measurement consistency
    1d. Acute Changes in HRV in endurance and power sports​
    2a. Interpreting HRV Trends
    2​b. HRV Baseline Trends & CV
    3. ​Tags & Correlations​
    4. Ectopic beats & motion artifacts
    5. HRV4Training Insights
    6. HRV4Training & Sports Science
    7. HRV & fitness / training load
    ​8. HRV & performance
    9. VO2max models
    10. Repeated HRV measurements
    11. VO2max and performance
    12. HR, HRV and performance
    13. Training intensity & performance​
    14. Publication: VO2max & running performance
    ​
    15. Estimating running performance
    16. Coefficient of Variation
    17. More on CV and the big picture
    ​​​​​18. Case study marathon training
    19. Case study injury and lifestyle stress
    20. HRV and menstrual cycle
    21. Cardiac decoupling
    22. FTP, lactate threshold, half and full marathon time estimates
    ​23. Training Monotony
    ​
    Camera & Sensors
    1. ECG vs Polar & Mio Alpha
    2a. Camera vs Polar
    2b. Camera vs Polar iOS10
    2c. iPhone 7+ vs Polar
    2d. Comparison of PPG sensors
    3. Camera measurement guidelines
    4. Validation paper
    ​5. Android camera vs Chest strap
    ​6. Scosche Rhythm24
    ​7. Apple Watch
    8. CorSense
    ​
    9. Samsung Galaxy
    ​
    App Features
    ​1. Features and Recovery Points
    2. Daily advice
    3. HRV4Training insights
    4. Sleep tracking
    5. Training load analysis
    ​6a. Integration with Strava
    6b. Integration with TrainingPeaks
    6c. Integration with SportTracks
    6d. Integration with Genetrainer
    ​
    6e. Integration with Apple Health
    ​
    ​6f. Integration with Todays Plan
    7. Acute HRV changes by sport
    8. Remote tags in HRV4T Coach
    9. VO2max Estimation
    ​
    10. Acute stressors analysis
    11. Training Polarization
    ​
    12. Lactate Threshold Estimation
    13. Functional Threshold Power(FTP) Estimation for cyclists
    14. Aerobic Endurance analysis
    15. Intervals Analysis
    ​​​16. Training Planning
    17. Integration with Oura
    18. Aerobic efficiency and cardiac decoupling
    ​
    Other
    1. HRV normal values​
    ​2. HRV normalization by HR
    ​
    3. HRV 101

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