uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Effects of Heart Rate Variability Biofeedback in Subjects with Stress-Related Chronic Neck Pain: A Pilot Study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Psychosocial oncology and supportive care.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Show others and affiliations
2011 (English)In: Applied Psychophysiology and Biofeedback, ISSN 1090-0586, E-ISSN 1573-3270, Vol. 36, no 2, 71-80 p.Article in journal (Refereed) Published
Abstract [en]

Recent studies focusing on autonomic nervous system (ANS) dysfunctions, together with theoretical pathophysiological models of musculoskeletal disorders, indicate the involvement of ANS regulation in development and maintenance of chronic muscle pain. Research has demonstrated the effectiveness of heart rate variability (HRV) biofeedback (BF) in increasing HRV and reducing the symptoms of different disorders characterized by ANS aberration. The study investigated the effects of resonance frequency HRV BF on autonomic regulation and perceived health, pain, stress and disability in 24 subjects with stress-related chronic neck-shoulder pain. Twelve subjects participated in 10 weekly sessions of resonant HRV BF and were compared to a control group. Subjective reports and HRV measures during relaxation and in response to a standardized stress protocol were assessed for both groups pre- and post-intervention. Group × time interactions revealed a significantly stronger increase over time in perceived health (SF-36) for the treatment group, including vitality, bodily pain and social functioning. Interactions were also seen for HRV during relaxation and reactivity to stress. The present pilot study indicates improvement in perceived health over a 10 week intervention with HRV-biofeedback in subjects with chronic neck-pain. Increased resting HRV as well as enhanced reactivity to hand grip and cold pressor tests might reflect beneficial effects on ANS regulation, and suggest that this intervention protocol is suitable for a larger controlled trial.

Place, publisher, year, edition, pages
2011. Vol. 36, no 2, 71-80 p.
Keyword [en]
Heart rate variability, Biofeedback, ANS, Neck pain, Stress tests
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-148579DOI: 10.1007/s10484-011-9147-0ISI: 000290026100002PubMedID: 21365308OAI: oai:DiVA.org:uu-148579DiVA: diva2:402411
Available from: 2011-03-08 Created: 2011-03-08 Last updated: 2014-02-21Bibliographically approved
In thesis
1. Autonomic nervous system regulation in chronic neck-shoulder pain: Relations to physical activity and perceived stress
Open this publication in new window or tab >>Autonomic nervous system regulation in chronic neck-shoulder pain: Relations to physical activity and perceived stress
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Neck-shoulder pain (NSP) is a highly prevalent musculoskeletal disorder with unclear causes, and effective prevention and treatment require a further understanding of the underlying mechanisms. Aberrant autonomic nervous system (ANS) regulation is a hypothesized causal element in the development and maintenance of chronic muscle pain.

The overall aim of this thesis was to investigate possible differences in ANS regulation between chronic NSP and healthy control (CON) groups using both laboratory assessment and ambulatory monitoring in daily life.

Four papers are included in this thesis, based on data from three groups with chronic NSP. Autonomic responses to laboratory stressors were assessed using heart rate variability (HRV), blood pressure, trapezius muscle activity and blood flow measurements (Study І) in NSP and CON. Long-term ambulatory monitoring of HRV, physical activity and perceived symptoms were assessed in Studies ІІ and IV to investigate group differences in real-life conditions. Finally, the effects of a ten-week intervention (using individually adjusted HRV biofeedback) to reinstating ANS balance in subjects with chronic NSP were evaluated using self-reported symptoms and health ratings, as well as autonomic regulation testing (i.e., evaluating HRV at rest and in response to stress) (Study ІІІ).

The main findings from the four studies demonstrated aberrant ANS regulation in the NSP group compared to CON, which was predominantly characterized by diminished parasympathetic cardiac activity during rest and sleep, and altered sympathetic reactivity to laboratory stressors (Studies І, ІІ and IV). Different patterns in physical activity were observed between the NSP and CON groups, with reduced physical activity during leisure time in the NSP group (Studies ІІ and IV). Physical activity was found to be positively associated with HRV. Positive effects of HRV-biofeedback were found on perceived health, including social function, vitality and bodily pain, and improved HRV (Study ІІІ).

In conclusion, imbalanced ANS regulation was demonstrated among persons with chronic NSP at both the systemic and local levels. Diminished parasympathetic activity in NSP was modulated by lower levels of physical activity in leisure time. Interventions targeting ANS functions might benefit persons with chronic NSP.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 68 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 851
Autonomic imbalance, Daily physical activity, Trapezius myalgia, Treatment, Parasympathetic, Sympathetic
National Category
Medical and Health Sciences
urn:nbn:se:uu:diva-187613 (URN)978-91-554-8561-0 (ISBN)
Public defence
2013-02-08, Hus 33, Sal 202, Högskolan i Gävle, Kungsbäcksvägen 47, Gävle, 10:00 (English)
Available from: 2013-01-18 Created: 2012-12-10 Last updated: 2013-02-11Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Olsson, Erik M. G.
By organisation
Family Medicine and Preventive MedicinePsychosocial oncology and supportive careDepartment of Psychology
In the same journal
Applied Psychophysiology and Biofeedback
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 303 hits
ReferencesLink to record
Permanent link

Direct link