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