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


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-05-01

AUTHORS

James B. Burch, J. P. Ginsberg, Alexander C. McLain, Regina Franco, Sherry Stokes, Kerri Susko, William Hendry, Elizabeth Crowley, Alex Christ, John Hanna, Annie Anderson, James R. Hébert, Mark A. O’Rourke

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: NCT 03692624 www.clinicaltrials.gov More... »

PAGES

99-108

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10484-020-09462-3

DOI

http://dx.doi.org/10.1007/s10484-020-09462-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1127314530

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32358782


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23 schema:description 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: NCT 03692624 www.clinicaltrials.gov
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30 schema:keywords HRV coherence
31 HRV recordings
32 HRVB
33 HRVB training
34 acquisition
35 activation
36 autonomic dysregulation
37 autonomic imbalance
38 baseline
39 biofeedback
40 biofeedback training
41 cancer survivors
42 cancer-related symptoms
43 cardiorespiratory homeostasis
44 care
45 coherence
46 coherence ratio
47 control
48 daytime impairment
49 depression
50 differences
51 disorders
52 distress
53 disturbances
54 dysregulation
55 fatigue
56 follow
57 group
58 group differences
59 heart rate variability
60 heart rate variability biofeedback
61 homeostasis
62 hypothesis
63 imbalance
64 impairment
65 improvement
66 indicators
67 interaction
68 intervention
69 intervention group
70 intervention trials
71 intervention validity
72 large-scale interventions
73 linear mixed models
74 management
75 mean symptom score
76 measures
77 mixed models
78 model
79 nervous system
80 outcomes
81 pain
82 participants
83 pilot intervention
84 pilot intervention trial
85 population
86 post-traumatic stress disorder
87 post-treatment differences
88 rate variability
89 ratio
90 recordings
91 role
92 scores
93 sessions
94 significant group
95 skill acquisition
96 sleep disturbances
97 sleep symptoms
98 sleep-related daytime impairment
99 stress
100 stress disorder
101 survivors
102 sympathetic nervous system
103 symptom management
104 symptom scores
105 symptoms
106 system
107 time interaction
108 training
109 training sessions
110 treatment-related improvement
111 trends
112 trials
113 usual care
114 validity
115 variability
116 www
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