Symptom Management Among Cancer Survivors: Randomized Pilot Intervention Trial of Heart Rate Variability Biofeedback

Autor:	Annie Anderson, James R. Hébert, James B. Burch, Jay P. Ginsberg, Sherry Stokes, Alex Christ, William Hendry, Kerri Susko, John Hanna, Elizabeth Crowley, Mark Allen O'Rourke, Alexander C. McLain, Regina A. Franco
Rok vydání:	2020
Předmět:	medicine.medical_specialty medicine.medical_treatment Population Pilot Projects Behavioral Symptoms Autonomic Nervous System Biofeedback 050105 experimental psychology 03 medical and health sciences 0302 clinical medicine Cancer Survivors Heart Rate Sleep Initiation and Maintenance Disorders Outcome Assessment Health Care Insomnia medicine Humans Heart rate variability 0501 psychology and cognitive sciences education Applied Psychology education.field_of_study Sleep disorder business.industry 05 social sciences Repeated measures design Biofeedback Psychology Cardiorespiratory fitness Middle Aged medicine.disease Distress Neuropsychology and Physiological Psychology Physical therapy medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies
Zdroj:	Applied Psychophysiology and Biofeedback. 45:99-108
ISSN:	1573-3270 1090-0586
DOI:	10.1007/s10484-020-09462-3
Popis:	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.
Databáze:	OpenAIRE
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