Sensorimotor rhythm (SMR)/Theta neurofeedback is an intervention protocol to enhance attention performance in children with attention deficit hyperactivity disorder, predominantly inattentive (ADHD-I). However, the effects of this attention modulation intervention on reading fluency in these children are not well documented. This study examined the efficacy of SMR/Theta neurofeedback in auditory and visual attention and reading fluency in children with ADHD-I. A cohort of 34 children aged 9-10 years underwent three-month neurofeedback training sessions. Attention was assessed with the Integrative Visual and Auditory Continuous Performance Test (IVA +), and reading ability was assessed by applying the Test of Word Reading Efficiency (TOWRE) and oral/silent reading measures. Repeated-measures ANOVA was conducted to analyze pre- and post-intervention performance. The results revealed significant improvements in components of visual attention, including visual focus and sustained visual vigilance (p < 0.005). Auditory attention also increases in auditory vigilance and sustained auditory attention significantly (p < 0.05). Reading fluency tasks yielded significant increases in sight word efficiency and oral/silent reading (p < 0.001). These findings demonstrate that SMR/Theta neurofeedback significantly enhances auditory and visual attention components, as well as reading fluency, in children with ADHD-I. The last effect of this intervention should be explored in future research, as well as its impact on higher-order reading comprehension processes.

Heart rate variability biofeedback (HRV-B) is a technique that has been shown to have benefits for both physical and mental health conditions. The aim of the present systematic review and meta-analysis is to describe the methodological approach and examine the efficacy of remote HRV-B interventions for mental health symptoms, including depression, stress, anxiety, and sleep as well as heart rate variability (HRV), a measure of autonomic function. A systematic literature search was conducted from five databases and eighteen studies with a total of 1352 subjects from different populations were included in this systematic review and meta-analysis based on the inclusion criteria. Meta-analysis showed a medium effect size of HRV-B for improving both depression (g = - 0.41 [- 0.049, - 0.772], p = 0.026, I = 72.623%, k = 10) and HRV (g = 0.443, [0.718, 0.167], p = 0.002, I = 56.81%, k = 10) compared to control conditions. These results remained significant after sensitivity analyses excluding high-risk, non-randomized, and outlier studies. Effect for stress was not significant (p = 0.152, k = 8). Meta-regressions identified study and protocol characteristics as significant moderators of the effect on HRV, stress, and anxiety. Specifically, maximizing resonance, screen on the device, less lab visits, less than twenty minutes of practice time per day, and female gender were beneficial for the intervention effectiveness. Overall, this study indicates that HRV-B is an effective intervention for decreasing depressive symptoms and increasing HRV across populations, and some intervention variables may influence the intervention outcomes.

Postoperative cognitive impairment is common among patients undergoing brain tumor resection. Neurofeedback (NF) represents a promising adjunctive intervention for cognitive rehabilitation, though its clinical application in neuro-oncology remains largely unexplored. This prospective case series enrolled seven inpatients (5 women, 2 men; aged 46-76 years) with cognitive deficits following brain tumor surgery. Each underwent 15 sessions of EEG-based NF (35 min/session, five times per week for three weeks) in parallel with daily motor rehabilitation. Baseline and post-intervention assessments included quantitative EEG (qEEG), a comprehensive neuropsychological battery, and functional measures. All patients completed the NF protocol without adverse events. qEEG analyses revealed heterogeneous but measurable modulations in absolute power and spectral ratios, with several patients showing normalization of pathological delta/beta activity. Reliable Change Index analyses indicated cognitive improvements in all patients, particularly in domains of memory, executive function, and language. Secondary benefits were also observed in mood, motor performance, and activities of daily living, though these varied across individuals. Intensive NF training combined with motor rehabilitation was feasible and well tolerated in this heterogeneous cohort. Preliminary results suggest that NF may promote postoperative cognitive recovery, with additional gains in functional and affective domains. Larger controlled studies are required to validate these exploratory findings.

With the heavy academic demands for medical students, this research aimed to find the potential benefits of short-term mindfulness meditation in improving working memory among medical students, which may potentially have positive effects on their academics. Several previous studies have also shown the positive effects of mindfulness meditation in improving different cognitive functions, however, most of those studies studied the effects of long-term meditation. This study is unique because it studies the effectiveness of short-term meditation. To see the effects of a short-term mindfulness meditation practice on working memory among medical students at Khyber Medical College, Peshawar. In a quasi-experimental study, 55 medical students provided written consent to participate. The participants' working memory was assessed using the forward digit span test before a brief mindfulness meditation session. Following listening to a 10 min mindfulness audiotape, the forward digit span test was administered again. The pre- and post-meditation test scores were compared using SPSS software for statistical analysis. This study explored the pre- and post-meditation Forward Digit Span test scores. The improvements were extremely significant as per the T-test analysis (p = 0.00). On separate T-tests for each gender, it was found that females (p = 0.013) had a comparatively lesser increase in digit-span test scores than males (p = 0.003). However, both males and females showed improvements of significance. These findings imply the cognitive benefits of meditation practices for both genders. This research indicates that short-term mindfulness meditation improves the working memory of medical students. Evidence was obtained to suggest that mindfulness practice can improve working memory, which may have implications for enhancing the academic performance of medical students.

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor impairments. While pharmacological treatments offer symptom alleviation, their long-term effectiveness is insufficient. Deep Brain Stimulation (DBS) is a neurosurgical treatment that targets brain pathways to alleviate motor symptoms in PD. It is a highly invasive procedure and carries associated risks. This prompts investigation of non-invasive alternatives, such as real-time functional Magnetic Resonance Imaging (rt-fMRI) neurofeedback (NF). This work investigates the feasibility of using the basal ganglia, more specifically the putamen, a key structure in the motor network, as a potential NF target region. Two rt-fMRI studies were conducted: (i) Twelve healthy individuals participated in a single-blind, crossover study involving one MRI session targeting the putamen and the supplementary motor area (SMA) in separate runs. (ii) Twelve PD patients followed the same protocol but with three MRI sessions. We investigated whether participants could learn to voluntarily control brain activity through NF training. The PD patients successfully recruited the putamen during NF-reinforced motor imagery, which was also found at trend level in the healthy participants. We found no learning effect and no difference in putamen activation when it was directly targeted versus when the target signals came from the SMA. Overall, widespread cortical and subcortical areas involved in motor control were activated during neurofeedback. This study demonstrates for the first time that PD patients can modulate putamen activity through NF training, supporting its potential as a non-invasive neuromodulation target. This opens opportunities for integrating invasive and non-invasive neuromodulation for PD treatment.

Although biofeedback (BFB) treatment has been well researched for different outpatient settings, relatively little information exists on the implementation process or the difficulties of applying this form of therapy in an inpatient setting. This study, therefore, focuses on the implementation of BFB in the inpatient setting and the potential barriers to its implementation and use. A mixed methods approach was chosen. Medical professionals in hospitals for inpatient mental health care, specializing in psychosomatic medicine and psychotherapy in Germany, were surveyed on the use of BFB via an online questionnaire. Hospitals that use BFB were then invited to take part in a semistructured interview. Participants were asked about the BFB treatment process and difficulties faced during implementation and application. Twenty-four hospitals participated in the quantitative part, and seven hospitals participated in the qualitative part of the study. The analysis of the data revealed that BFB implementation varied from hospital to hospital. The greatest differences were found primarily in the parameters surveyed, session frequency, and duration. Common features included the use of an introductory session, an evaluation, and a discussion of the benefits for patients. The obstacles included staff shortages, technical problems, and the high organizational effort required for BFB use. The data obtained confirm the benefits of BFB treatment in the inpatient setting and reveal which criteria are necessary for successful implementation. Sufficient resources (staff, time, equipment) must be provided for successful BFB implementation. Consistent integration into patients' timetables could minimize organizational effort, and therapist training could improve handling and implementation.

This study aimed to reduce alpha and beta brainwave power through external audio-visual stimulation (AVS) and to evaluate its clinical effect on anxiety levels, as measured by the State-Trait Anxiety Inventory (STAI), alongside electroencephalography (EEG) data. Thirty participants received AVS, while 12 received audio-visual white noise as a control. EEG recordings were obtained before, during, and after the stimulation. A digital FFT-based power spectrum analysis was performed, and raw sum values (sum of spectral line values) within defined frequency ranges were extracted. The STAI was administered to assess both trait and state anxiety. Statistical analysis was conducted using SPSS. In the AVS group, significant reductions in alpha and beta power were observed between the pre-, during-, and post-stimulation phases (p < 0.05). Comparison of pre- and post-STAI scores revealed a statistically significant decrease in anxiety levels within the AVS group (p < 0.001), with no similar effect observed in the control group. Audio-visual stimulation significantly reduced alpha and beta EEG power during exposure and led to a marked decrease in self-reported anxiety. These findings provide both neurophysiological and clinical support for the use of AVS as a nonpharmacological method to alleviate anxiety symptoms.

Cardiovascular diseases (CVD) are leading causes of premature mortality, disability, and reduced quality of life worldwide. While extensive literature has addressed cardiovascular risk and treatment, the role of noninvasive interventions in rehabilitation and secondary prevention remains less well defined. Among these, heart rate variability biofeedback (HRVBF) and cardioprotective dietary approaches have shown preventive benefits, yet their effectiveness in patients with established CVD or those undergoing cardiac rehabilitation is not fully established. This review systematically evaluates the evidence for HRVBF and heart-healthy dietary patterns in relapse prevention and rehabilitation, with particular attention to hospital-based contexts. Following PRISMA guidelines, systematic searches were conducted in Scopus and PubMed. Results suggest that HRVBF may enhance autonomic regulation, alleviate psychological distress, and shorten hospital stays. Dietary interventions, particularly those emphasizing omega-3 polyunsaturated fatty acids and Mediterranean-style patterns, demonstrate potential to reduce inflammation and modulate cardiovascular risk markers. Nevertheless, evidence supporting their integration into postoperative rehabilitation or treatment of established CVD remains limited. Heterogeneity in study designs and lack of standardization further constrain generalizability. Overall, the findings underscore the promise of early, noninvasive, and integrative rehabilitation strategies, highlighting the need for structured protocols in clinical settings, particularly during the immediate postoperative phase or after acute cardiac events.

Normal gastric functioning (normogastria) is characterized by rhythmic gastric myoelectric activity, while dysrhythmic gastric activity (bradygastria and tachygastria) is associated with symptoms such as nausea, epigastric discomfort and fullness. Gastric biofeedback using electrogastrography (EGG) has emerged as a promising tool to regulate gastric rhythm, but research remains limited with few experimental studies. The current study (N = 94) tested a novel gastric biofeedback training in virtual reality (VR). We used a randomized controlled study design with three groups: (1) VR gastric biofeedback training, (2) the same training on a 2D screen and (3) a relaxation control group. We examined (1) the trajectory of gastric activity before, during, and after training (2) participants' ability to increase normogastria and reduce dysrhythmic activity and (3) self-reported experiences (motivation, attention, mood, presence, user acceptance, etc.). Results showed the expected peak in normogastria and a nadir in dysrhythmic activity during training, with a significant reduction in dysrhythmic gastric activity across sessions. Participants reported an improved ability to handle physical discomfort over time. VR and 2D groups reported faster time perception and better concentration than controls. Spatial presence (i.e., the feeling of "being there") was higher in the VR group than in the 2D group. Enjoyment, concentration, and alertness were initially high but declined over time in all groups. The results demonstrate the general technical feasibility of the paradigm and positive evaluations. Further research is needed to better understand the underlying mechanisms and to determine whether and how training success may relate to beneficial outcomes in clinical populations.

Despite a wide variety of research and clinical utilization over the past 50 years, neurofeedback has failed to gain recognition comparable to other well-researched mental health interventions. The goal of this study was to explore neurofeedback practitioners' perspectives on what would help make the intervention more accessible to mental health providers and to the public. Despite a wide variety of research and clinical utilization over the past 50 years, neurofeedback has failed to gain recognition comparable to other well-researched mental health interventions. The goal of this study was to explore neurofeedback practitioners' perspectives on what would help make the intervention more accessible to mental health providers and to the public. As part of a larger implementation study using mixed methods to identify determinants of neurofeedback implementation, this qualitative study involved semi-structured interviews conducted online with 17 neurofeedback practitioners in outpatient settings, analyzed using inductive thematic analysis to identify themes related to accessibility. This study focused on the interview question: "What would help increase the accessibility of neurofeedback to the public?" Interview data were analyzed by two independent coders using inductive thematic analysis. The sample was mostly White (n = 15, 88%) and female (n = 13, 76%) with an average age of 53 years (range: 34-73 years). They averaged 17.8 years in practice (range: 3-36 years) and 8 years practicing neurofeedback (range: 1-20 years). Three major themes to help increase accessibility were identified: (a) financial support, including increased insurance coverage; (b) better provider education, including introduction of neurofeedback into graduate school curriculum; and (c) more research/research funding contributing to the scientific credibility of the neurofeedback field. This study was the first to qualitatively explore the accessibility changes of neurofeedback from an implementation science lens. Study participants described tangible ways to address these challenges through actionable avenues that could ultimately lead to increasing the update of neurofeedback in routine mental healthcare.

This retrospective study analyzes the effects of Mind Meter-a session of group-delivered pain neuroscience education (PNE) paired with temperature biofeedback-on peripheral temperature and pain outcomes in chronic pain participants. A retrospective review assessed physiological and subjective responses to this novel group intervention. Before and immediately after the intervention, peripheral skin temperature and pain related symptom scores were collected using an adapted Edmonton Symptom Assessment Scale (ESAS). Participants (n = 35) with chronic pain participated in a single 2-h Mind Meter group. Significant pre-post changes were seen in both physiological and subjective symptom severity. Peripheral temperature increased 2.30°F (95% CI 1.05, 3.54; p < 0.001) on average. Participants reported a mean reduction in pain intensity of -1.14 points (95% CI -1.61, -0.068; p < 0.001). Sadness, anxiety, and well-being on the ESAS also improved significantly (highest p = 0.001). In this study we observed that after a single group-session of Mind Meter, participants generated immediate, measurable physiological changes attributable to alterations in the autonomic nervous system, modest pain relief, and overall symptom improvement. This brief, group format provides a novel option that makes PNE and biofeedback a potentially accessible complementary modality.

Painful menstrual cramps (dysmenorrhea) affect the physical and mental well-being of millions of women, generally interfering with workplace productivity, educational learning experiences, and overall quality of life. This report describes the relationship between diaphragmatic breathing and the reduction of dysmenorrhea symptoms among students enrolled in a university stress-management program. Forty-nine women participated in an intervention group while 26 women participated in a comparison group. The intervention group spent 30 min practicing daily breathing and relaxation exercises over five weeks. The comparison group had no exposure to specific interventions. Analysis suggests significant improvements in menstrual symptoms in the intervention group compared to the comparison group (p = 0.0008, after age adjustment). There was no difference in outcomes between in-person and online instruction. The observations suggest that practicing 30 min per day of specific breathing and relaxation techniques are scalable for groups beyond students. Despite limitations, such as the lack of direct comparisons with pharmacological interventions (e.g. pain medications), the observations support diaphragmatic breathing as a non-pharmacological self-care method for dysmenorrhea, with recommendations for incorporating self-care practices that foster effective menstrual management and reduce stigma into everyday health education for girls and young women everywhere.

Physiological measures, most commonly heart rate, are widely used in applied police research to assess the relationships between situational stress and officer performance under pressure. However, measurements of the neurocognitive mechanisms underlying these critical skills remain limited, especially throughout police academy training. This study investigates the potential of electroencephalography (EEG) and its relationship to situational performance outcomes in police cadets (n = 58) at Kuwait's National Police Academy. EEG and electrocardiogram (ECG) activity were recorded as cadets from three different cohorts participated in a video simulation of a stressful critical incident, featuring seven decision prompts that called for procedural action. Cadets' decision-making, reasoning, and memory recall were rated during a post-task debriefing interview. Preliminary pairwise analyses identified significant correlations between performance metrics and neural activation in both beta and theta bands, particularly in the frontal cortex. Comprehensive multivariate analysis revealed frontal cortex beta-band activity to be a significant correlate of performance, particularly during decision-making and memory recall, underscoring its role in executive functions crucial to situational performance in policing. Contrary to studies that find higher activation leads to better outcomes, lower beta-band activation correlated to better performance. Additionally, ECG showed minimal predictive value during multivariate testing. This marks the first time EEG and ECG measures have been integrated into a single model predicting performance in policing. These findings contribute novel insights into the psychophysiological study of police performance, highlighting important implications for enhancing training, evaluation, and research methodologies in applied law enforcement settings.

The ability to seamlessly integrate sensory information from the environment (exteroception) and physiological states (interoception) is a key aspect of our awareness and well-being. Alterations in these processes often result in uncertainty about bodily states and dysregulation of physiological and emotional processes, as observed in clinical conditions. In this study, we employed an interactive music system as a novel method to improve interoceptive, cardiac, and emotional functioning, combining cardiac biofeedback, mindfulness, and music listening approaches. A sample of 24 healthy participants was divided into three groups, each performing a single-session attention task: heartbeat mindful attention (interoceptive), non-interactive music listening (exteroceptive), and interactive music listening (intero-exteroceptive). Significant differences in interoceptive accuracy after the session were found only in the interactive music listening task. Additionally, all groups exhibited decreased heart rate (HR), enhanced heart rate variability (HRV), and reduced negative affect after the session. Moderation analysis also revealed the role of self-reported interoception, cardiac dynamics, and anxiety and depression symptomatology on the observed effects. Together, our results demonstrated the effectiveness of interactive music systems, suggesting that this approach may facilitate intero-exteroceptive synchronization and one's certainty about bodily states, while also promoting mindful attention and calm emotional and physiological states.

High-altitude electrical work is a high-risk and physically demanding occupation that has received limited empirical investigation, particularly regarding the physiological and psychological fatigue experienced during operations. This study provides an initial empirical exploration into fatigue among high-altitude electrical workers by examining the relationship between subjective fatigue perception and multiple physiological indicators in realistic working environments. Thirty professional high-altitude electrical workers participated in field-based measurements conducted during routine summer operations. A combination of subjective (Fatigue Severity Scale) and objective indicators-such as LF/HF, grip strength, reaction time, and critical flicker frequency-was used to assess fatigue. The experimental protocol was designed to closely mirror actual work conditions, and over 1,200 valid data points were collected across repeated measures. Spearman correlation and multiple regression analyses were employed to evaluate the association between physiological indicators and subjective fatigue ratings. Significant correlations were observed between subjective fatigue levels and several physiological indicators, particularly LF/HF (β = -0.523, p < 0.001), grip strength (β = -1.076, p < 0.001), CFF (β = -4.138, p < 0.001), and RT (β = 2.984, p < 0.001). These findings suggest these indicators may be sensitive to short-term fatigue fluctuations under operational stress. In contrast, ETCO did not show a significant relationship with subjective fatigue, likely due to its physiological stability and limited responsiveness in non-clinical field conditions. This study offers preliminary evidence supporting the feasibility of combining multiple physiological and psychological indicators for fatigue monitoring in high-altitude electrical work. The results underscore the multifaceted nature of fatigue and highlight the importance of context-specific evaluation frameworks. Future studies should further refine these indicators and expand the sample scope to enhance generalizability and practical applicability in occupational health management.

Social, emotional, and academic adjustments are critical for students' personal and academic success. Difficulties in these domains can impede overall development, necessitating effective interventions to promote psychological well-being and adaptability. Neurofeedback and mindfulness-based cognitive therapy (MBCT) have shown promise in addressing these challenges. Neurofeedback facilitates self-regulation of brain activity to improve attention and emotional control, while MBCT integrates mindfulness practices with cognitive-behavioral strategies to alleviate anxiety and depression. This study aimed to compare the effectiveness of neurofeedback and MBCT in enhancing social, emotional, and academic adjustment among students. The statistical population comprised 910 pre-university students from Zhengzhou during the 2022-2023 academic year. Based on inclusion and exclusion criteria, 90 students were selected through convenience sampling and randomly assigned to three groups: 30 in the control group, 30 in the neurofeedback group (experimental group 1), and 30 in the MBCT group (experimental group 2). Data were collected using the Adjustment Inventory for School Students (AISS) and a standardized Mindfulness Protocol. Statistical analyses revealed that neurofeedback and MBCT significantly improved students' emotional, social, and academic adjustments compared to the control group. However, no significant difference in effectiveness was observed between the two interventions. These findings suggest that neurofeedback and MBCT are equally effective in fostering students' psychological resilience and adaptability, highlighting their potential as valuable tools for promoting well-being and academic success in educational contexts.

The explanation for how acutely stressful experiences could result in proximal health outcomes has been lacking in occupational health research. Although scholars have argued that individual personality and affect could worsen health behaviors, we believe that these qualities also could intensify the experience of acute stressors, potentially explaining why acutely stress encounters result in poor health outcomes for some people, but not others. Our study examines three individual differences - worry, negative affect, and positive affect - that are relevant to differential stress anticipation, reactivity, and recovery. Study participants, who were full-time professional or managerial employees, attended a clinic where we gathered data on their trait worry, and state negative and positive affect. Then, they took part in an experimental exercise that should reflect stressful experiences at work (i.e., cognitive stressor with social pressure). The clinician collected measures of participant facial muscle tension, skin temperature, blood pressure, respiratory breathing, and heart rate, before, during, and after the stressful exercise. Results suggest that only positive affect magnified stress during the anticipation of the experiment, both worry and negative affect intensified the negative physiological effects of the stressor in two of the three experimental stages, and only negative affect delayed physiological recovery and relaxation. Our findings augment our understanding of how individual differences affect physiological responses to acute stress.

The current trial aimed to assess the effectiveness of Mindfulness-Based Stress Reduction training on salivary cortisol and α-amylase levels, anxiety and depression of students. This research was an experimental trial with a pre-test-post-test design and a control group. The statistical population of the research included all students studying in the universities of Khoy, Iran in 2021. The sample consisted of 30 people who were assigned to two experimental and control groups equally. Stress, anxiety and depression scale (DASS-21), General Health Questionnaire (GHQ-28) and saliva samples were passively taken by ELISA laboratory method with special kits. Data analysis was done using an independent t-test and analysis of covariance using IBM-SPSS version 26 software. The results showed that MBSR training on general health, alpha-amylase level and alpha-amylase/cortisol ratio of experimental group participants was more effective than the control group (P < 0.05). However, it was not effective on students' cortisol levels (P > 0.05). According to the findings, it can be argued that MBSR training has been able to promote the psychological (DASS and general health) and hormonal (alpha amylase level and alpha-amylase/cortisol ratio) mental health indicators of the experimental group participants compared to the control group.

Traumatic brain injury (TBI) is often associated with autonomic nervous system (ANS) dysregulation and reduced heart rate variability (HRV), potentially affecting cognition. This study tested whether HRV biofeedback (HRV-B) improved resting HRV and stress recovery in individuals with TBI compared to sham control. We also examined whether HRV changes related to physical symptoms, emotional well-being, cognitive performance, and adherence. Fifty-eight participants with TBI enrolled; 49 completed the study (HRV-B: 25, mean age 27.1; sham: 24, mean age 26.6). Participants attended five weekly sessions. Assessments included cognitive, emotional, and physical outcomes. HRV metrics (HF, LF, LF/HF, SDNN, RMSSD) were collected via electrocardiogram. The HRV-B group showed a higher LF/HF ratio at rest (F(1, 43) = 9.38, p = 0.004) and during stress recovery (F(1, 172) = 4.27, p = 0.040) than sham. A group-by-session interaction (F(1, 172) = 4.18, p = 0.04) indicated an LF/HF increase over time for HRV-B. Condition effects for HF (log), RMSSD, and SDNN at rest favored sham but disappeared after adjusting for pre-assessment values. LF (log) showed no significant effects. Both groups improved in Fluid Cognition and Total Composite scores, with no between-group differences. Anxiety and depression decreased over sessions, with greater depression improvement in HRV-B. No group effects emerged for stress or life satisfaction. HRV-B increased LF/HF ratio at rest and during stressor recovery, possibly reflecting baroreflex engagement. However, other HRV condition effects attenuated after adjusting for baseline values. Cognitive and emotional gains were observed in both groups.

Building on prior psychophysiological stress regulation and adaptation literature (e.g., Allostatic load (AL) and Neurovisceral Integration (NVI) models), the current study explores the emerging nonlinear heart rate variability (HRV) metric-heart rate fragmentation (HRF)-and it's efficacy as a potential AL biomarker to distinguish psychosocial stress reactivity conditions and predicting subclinical mental health symptomology in healthy adults. One hundred and fifty-six (n = 156) undergraduate student participants were fitted with a chest band to monitor cardiovascular activity and completed online demographic and psychosocial surveys. Participants were grouped as healthy or displaying probable mental health symptoms (pMH; n = 94, 60.25% of sample) based on scoring above associated inventory thresholds for depression, anxiety, and posttraumatic stress disorder. Subsequently, cardiovascular activity was measured to capture HRF under the established "RRR" experimental stress paradigm: a resting baseline, reactivity to an acute stressor task, and a paced breathing recovery. Results support the global study aim in which HRF significantly differentiated between each RRR condition (p < 0.001). While healthy and pMH individuals did not significantly differ within individual conditions, exploratory analyses revealed that healthy individuals displayed significantly greater HRF reactivity between conditions (p's < 0.001) in comparison to the pMH sample, which displayed a more blunted pattern. Overall, this study establishes associations between HRF and mental health, serving as a promising biomarker that contributes towards the AL and NVI models of stress regulation and adaptation. HRF may also identify early signs of adverse dysregulation in samples otherwise considered "healthy", while addressing the limitations of frequently used HRV biomarkers in non-clinical studies.

Measuring pilot mental workload during flights without Precision Approach Path Indicator (PAPI) lights is crucial for enhancing flight safety. This study aimed to investigate the impact of the absence of PAPI lights on pilot mental workload during approach and landing. Sixteen cadet pilots with real flight experience participated in simulated flight scenarios with and without PAPI lights, using a Polar Verity Sense to monitor cardiac activity. The statistical analysis results indicated that the absence of PAPI lights significantly increased pilot mental workload. Instructor ratings confirmed that the absence of PAPI lights adversely affected the accuracy of the descent trajectory, leading to greater deviations. Heart rate variability (HRV) analysis revealed that specific features-SDNN, CVNNI, STD_HR, MIN_HR, and SD2-were particularly sensitive to changes in pilot mental workload. Increased mental workload was associated with a significant increase in MIN_HR and a significant decrease in the other four HRV features. Correlation analysis further identified TOTAL_POWER and RATIO_SD2_SD1 as effective indicators of pilot mental workload. These findings underscore the impact of visual guidance cues on pilot mental workload and demonstrate the value of HRV-based monitoring for assessing pilot mental workload in challenging flight scenarios.

Investigating the validity and reliability of the Turkish version of the Breathing Self-Assessment Questionnaire (SEBQ), a tool for measuring dysfunctional breathing. Ninety-two healthy adults (mean (range) age 29.4 (19-56) years; 39 males) were analysed. The SEBQ was translated and adapted into Turkish. At baseline, data were collected using the SEBQ, Nijmegen Questionnaire (NQ), breath-holding time, and Short Form 36 (SF-36). The SEBQ was repeated within 7-14 days. SEBQ validity was assessed through content, structural, and convergent/divergent validity analyses, while reliability was evaluated for internal consistency, stability, and reproducibility. One item was removed based on exploratory factor analysis. The SEBQ has a two-factor structure and explains 50.1% of total variance, confirmed by confirmatory factor analysis. It has a positive correlation with the NQ and a negative correlation with SF-36 subscales, but not with breath-holding time and general health. The Cronbach's alpha coefficient was 0.931, and the intraclass correlation coefficient was 0.814. The Standard Error of Measurement and Smallest Real Difference were 5.06 and 15.03, respectively. The SEBQ is well-structured, valid, internally consistent, stable, and reproducible for assessing subjective unexplained respiratory symptoms in the Turkish population.

The growing popularity of application-based meditation has driven the development of new technological features in this field such as the use of cardiac biofeedback, aimed at helping users train their attention to interoceptive stimuli while meditating. However, despite the innovativeness of this approach, the effectiveness of cardiac biofeedback-assisted meditation in enhancing interoception and its specific advantages in this context remains unclear. This study aimed to investigate whether a limited number of brief meditation sessions enhanced with cardiac biofeedback improves interoceptive accuracy, sensibility, and awareness more effectively than only using a meditation application. A randomized controlled trial of a 2-week intervention was conducted with participants who had no prior meditation experience (N = 105) assigned into one of three groups: a cardiac biofeedback-assisted meditation group, an app-based meditation group and a non-meditating control group. Interoceptive accuracy, sensibility and awareness were measured using the Heartbeat Discrimination Task. The findings indicated that interoceptive awareness increased from pre- to post-test across all participants, including the control group. No changes were observed in interoceptive sensibility. However, interoceptive accuracy improved in the two meditating conditions, but only among participants with positive user experience with their meditation devices.

Drug addiction significantly impacts physical and psychological health, often resulting in challenges such as weight management issues and cardiovascular irregularities. Yoga, a holistic practice, may serve as an adjunctive therapy to address these concerns. To evaluate the effects of yoga on body mass index (BMI) and heart rate (HR) in individuals undergoing drug addiction rehabilitation. A randomized controlled trial was conducted with 60 participants from a rehabilitation center in Shimla, Himachal Pradesh. The participants were divided into four groups: Asana, Pranayama, a combination of Asana and Pranayama, and a control group. The intervention spanned 12 weeks with 30-min sessions three times a week. The Asana group (Mean-23.051) presented the most significant BMI reduction, followed by the Asana + Pranayama group (Mean-23.456) and the Pranayama group (Mean-23.851). The Pranayama group (Mean-67.950) significantly improved HR, followed by Asana + Pranayama group (Mean-68.603) and the Asana group (Mean-68.859) compared with the control group. Yoga has potential as an adjunctive therapy for improving BMI and HR in individuals recovering from drug addiction, making it a valuable component of holistic rehabilitation programs.

Developmental Coordination Disorder (DCD) is a neurodevelopmental condition affecting manual dexterity (MD) and fine motor skills (FMS). Pressure biofeedback (PB), a noninvasive tool providing real-time feedback, may enhance motor learning. This study examined the effects of PB combined with occupational therapy (OT) on MD and FMS in children with DCD. In this single-blinded, randomized controlled trial, 40 children aged 5-10 years with DCD were assigned to an intervention group (PB + OT) or a control group (OT alone). The Developmental Coordination Disorder Questionnaire (DCD-Q) provided a subjective evaluation of motor coordination, including FMS and proprioception. MD was objectively measured by the manual dexterity subtest of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2). Pressure biofeedback (PB) pattern tracking quantified fine motor precision and proprioceptive regulation using Root Mean Square Error (RMSE) and visual-motor integration using the Correlation Coefficient (CC). Post-intervention, the intervention group showed significantly more improvements than controls in DCD-Q, BOT-2, RMSE, and CC scores. DCD-Q and BOT-2 scores increased (p < 0.05), indicating enhanced manual dexterity, including proprioception and fine motor skills. RMSE decreased (p < 0.001), reflecting improved fine motor precision and proprioceptive regulation. CC scores improved post-intervention (p = 0.011) and remained higher at follow-up (p < 0.001), demonstrating sustained visuomotor coordination gains. Repeated measures ANOVA confirmed significant time and group effects (p < 0.05), supporting lasting motor improvements. PB is a practical, quantitative intervention for enhancing MD and FMS in children with DCD. Integrating PB with OT led to significant and sustained improvements in motor coordination, visuomotor integration, proprioceptive function, and handwriting performance. These findings support biofeedback as a non-invasive and engaging approach for pediatric neurorehabilitation, aligning with family-centered, non-pharmacological care models.

EEG Neurofeedback is a noninvasive therapeutic modality that can potentially modify targeted aspects of brain function, considered promising for the treatment of neuropsychiatric disorders. Nevertheless, some limitations have considerable potential to compromise its efficacy, including the requirement for a high number of sessions, the repetition of therapeutic tasks, and the challenge in sustaining the objectives of these tasks. These limitations can induce a decline in system dynamism and user motivation. However, barriers can be overcome by integrating immersive virtual reality into a neurofeedback system to increase motivation, interest, and adherence through immersion and a sense of presence. This systematic review aimed to determine whether this combined treatment is effective in relieving symptoms related to general health. To conduct this search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, six electronic databases were accessed on January 26, 2024. Inclusion and exclusion criteria were defined to select the articles, and risk of bias and methodological quality assessment was conducted using the Mixed Methods Appraisal Tool and the CRED-nf checklist. A total of 24 trials were included, and according to Template for Developing Guidelines for the Evaluation of the Clinical Efficacy of Psychophysiological Interventions, the results showed that it was considered a probably efficacious treatment for attention and a possibly efficacious treatment for emotions, mood, pain, relaxation, impulsiveness, memory, self-esteem, creativity, empathy, meditation, and tiredness. Several methodological factors of the trials restrict the generalization of these findings and require caution in their interpretation, despite the promising results in future directions.

Heart Rate Variability (HRV) is considered as an objective assessment of stress, that considerably increased the last decades. The influence of Brief Mindfulness Meditation (BMM) on HRV contains gaps in the literature. This study aims to investigate the influence of BMM on HRV. A systematic search was conducted in four databases (i.e., PubMed NCBI, Cochrane Library, Scopus, and Web of Science). To be included, these studies were required to evaluate HRV before and during or after a BMM intervention. The methodological quality of the included studies was evaluated with the revised Cochrane Risk-of-Bias and the quality of the evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation. Seven studies met the inclusion criteria. Three studies had within subject design, two studies compared BMM with other relaxation techniques, one study was a controlled trial, and one study was an uncontrolled trial. Three studies, including 120 participants, found that BMM is associated with an increase of Root Mean Square of Successive Differences (RMSSD). Two studies reported an increase of the LF/HF ratio; however, the quality of the evidence was low. Although the large amount of heterogeneity can be seen as the main limitation, the results suggest that RMSSD may increase in the short-term during or after BMM, suggesting that BMM might be a promising psychological intervention to temporally reduce the physiological stress of the population. Future randomised controlled trials, measuring long-term effects of BMM on HRV, need to be conducted.Registration and information: This systematic review was registered on the international Prospective Register of Systematic Reviews (PROSPERO) database (#CRD42022291907). The review protocol can be accessed on the following link: brief mindfulness and heart rate variability .

Working memory (WM) and visuospatial memory (VSM) are pivotal for rapid decision-making and effective teamwork in football. This study investigated the effects of a single-session alpha neurofeedback training (NFT) protocol at Pz on WM and VSM in 48 male players (aged 18-28), with a detailed analysis focusing on playing position, including both defenders and attackers, who were randomly assigned to either the NFT (n = 24) or sham (n = 24) groups. The NFT group received a 25-min eyes-closed session to boost Peak Alpha Frequency (PAF) (7.5-12.5 Hz), while the sham group received non-contingent feedback. WM was assessed using an n-back task, and VSM was measured via a Football Memory Block-Tapping Test (FMBT). The NFT group showed significantly greater improvements in NCR-L1, NCR-L2 (WM), and FRS (VSM) than the sham group (p < 0.05), whereas no significant differences were found in RTs during the WM task or in BRS during the VSM task (p > 0.05). Moreover, defenders outperformed attackers on certain WM and VSM measures, potentially reflecting the distinct demands of their positions. These findings suggest that even a brief alpha NFT session may enhance certain cognitive functions in football players, providing a practical and time-efficient approach that may contribute to improvements in memory performance, with variations observed across different positional roles.