Session Information
Session Title: AA 2022 Posters - Neurological Rehabilitation
Session Time: None. Available on demand.
Disclosures: Raouf Gharbo, DO, FAAPMR: Lief Therapeutics (Products/Services: Yes) (Consultant/Advisory Board)
Objective: Test the hypothesis that Heart Rate Variability Biofeedback (HRVB) can improve heart rate variability (HRV) coherence and alleviate pain catastrophizing among Veterans with chronic pain.
Design: Randomized, sham-controlled, intervention trial.
Setting: Columbia Veterans Affairs (VA) Health Care System.
Participants: 113 subjects randomly assigned to either the active HRV training group (n=57) or a sham condition (n=56) group.
Interventions: Patients completed 6 weekly training sessions (HRVB or sham), a booster training session (1-month post-training), and a final follow-up assessment (2 months post-training).
Main Outcome Measures: Mean HRV coherence ratios and pain catastrophizing scores (PCS).
Results: HRVB patients had a baseline mean (95% confidence interval) HRV Coherence Ratio of 0.18 (0.13, 0.25, n=56) and an elevated mean at follow-up (0.52 [0.36, 0.76], p < 0.01 vs. baseline, n=38), whereas no differences were observed among controls: baseline mean; 0.17 (0.12, 0.25, n=57); follow-up mean: 0.20 (0.13, 0.30, p=0.76, n=39). Relative to baseline, HRVB patients had reduced follow-up scores for PCS-Helplessness (pre-post difference of -3.4 [-4.6, -2.1], p < 0.01, n=37) relative to controls (-1.6 [-2.8, -0.3], p=0.01, n=39; Group by Time p=0.13). Similar results were obtained for PCS-Magnification following HRVB training difference: -1.0 [-1.7, -0.3], p < 0.01, n=37) versus controls (0.2 [-0.5, 0.9], p=0.57, n=39; Group by Time p=0.03). Results for total PCS and PCS-Rumination were similar between HRVB and controls.
Conclusions: Pain catastrophizing refers to rumination, magnification, and helplessness associated with anticipated and actual pain. HRVB offers a method to physiologically reduce pain catastrophizing, and more specifically pain helplessness and magnification, to potentially improve coping skills.
Level of Evidence: Level II
To cite this abstract in AMA style:
Gharbo R, Miller AR, Burch J, Mercadel J, Ginsberg J, Nevels T, Winstead J. The Benefit of Heart Rate Variability Biofeedback for Pain Catastrophizing [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/the-benefit-of-heart-rate-variability-biofeedback-for-pain-catastrophizing/. Accessed May 21, 2025.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-benefit-of-heart-rate-variability-biofeedback-for-pain-catastrophizing/