Efficacy and Methodology of Remote Heart Rate Variability Biofeedback Interventions for Mental Health: A Systematic Review and Meta-Analysis.
Sophia Vann-Adibe, Harry Kam Hung Tsui, Hui Quan Zhou et al.
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In 30 seconds
This systematic review and meta-analysis assessed remote heart rate variability biofeedback (HRV-B) for mental health symptoms and HRV across 18 studies involving 1,352 participants from different populations. Compared with control conditions, HRV-B was associated with a medium effect on depressive symptoms (g = -0.41, p = 0.026) and HRV (g = 0.443, p = 0.002); both findings remained significant in sensitivity analyses. The effect on stress was not significant. Meta-regression suggested that study and protocol characteristics moderated outcomes, although the abstract does not establish these factors as causal.
Key findings
- HRV-B improved depressive symptoms versus control conditions (g = -0.41, p = 0.026; k = 10).
- HRV-B increased HRV versus control conditions (g = 0.443, p = 0.002; k = 10).
- The effect on stress was not significant (p = 0.152; k = 8).
- Meta-regressions identified study and protocol characteristics as moderators of effects on HRV, stress, and anxiety.
Why it matters
The pooled findings suggest remote HRV-B may offer benefits for depressive symptoms and autonomic function across varied populations. The lack of a significant stress effect and the reported moderation by study and protocol characteristics indicate that outcomes may not be uniform. These results help frame the potential and uncertainty of remote delivery without establishing which protocol features should be adopted.
What to keep in mind
The review combined studies from different populations and protocols, and heterogeneity was substantial for depression (I² = 72.623%) and moderate for HRV (I² = 56.81%).