What question did this study set out to answer?

This research focuses on understanding participant experiences with heart rate variability feedback during spinal cord injury rehabilitation.

May 15, 2026Open Access

Patients’ experience of a heart rate variability feedback intervention during spinal cord injury rehabilitation

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Spinal cord injury (SCI). Intervention: Heart rate variability biofeedback (HRV-F). Primary outcome: Mental health and quality of life.

Key Result

Heart rate variability biofeedback resulted in no change in mental health or quality of life at 12 months, though participants reported perceived improvements in relaxation and pain reduction.

Key Points

This research focuses on understanding participant experiences with heart rate variability feedback during spinal cord injury rehabilitation.
Conducted a mixed-methods design including interviews and questionnaire surveys within a randomized controlled trial (RCT).
Facilitators and barriers were identified using the Consolidated Framework for Implementation Research (CFIR v2).
Assessed mental health and quality of life using specific instruments.
Participants valued HRV-F for its adaptability and its potential to reduce pain and stress.
Ease of use and professional support were key facilitators, while technical issues and time constraints posed barriers.
No significant change in mental health or quality of life was observed from baseline to 12 months, but perceived improvements in relaxation and confidence were reported.

Study Design

Type

RCT

Structured PICO

Does heart rate variability biofeedback improve mental health and quality of life in individuals with spinal cord injury?

Population

Individuals living with spinal cord injury (SCI) undergoing rehabilitation

Intervention

Heart rate variability biofeedback (HRV-F)

Outcome

Participants' experiences, facilitators and barriers to implementation, mental health, and quality of lifepatient reported

Heart rate variability biofeedback is well-received by patients with spinal cord injury and may offer subjective benefits in relaxation and pain reduction, despite no quantitative changes in mental health or quality of life scores at 12 months.

Abstract

BACKGROUND: This study examined the implementation of heart rate variability biofeedback (HRV-F) as a non-invasive, self-regulatory rehabilitation technique for individuals living with spinal cord injury (SCI). It aimed to understand participants' experiences in receiving and practicing HRV-F activities and identify facilitators and barriers to implementing HRV-F into usual care. METHOD: A mixed-methods design (interviews, questionnaire surveys) was embedded within a randomized controlled trial (RCT). Facilitators and barriers were identified using the Consolidated Framework for Implementation Research (CFIR v2), and mental health and quality-of-life instruments assessed well-being. RESULTS: Participants valued HRV-F's adaptability, non-pharmacological nature, and the potential to reduce pain and stress. Key facilitators included ease of use, professional support, and motivation to improve health. Barriers included technical issues with equipment, time constraints, and environmental challenges to practicing HRV-F at home. There was no change in mental health or quality of life from baseline to 12 months, although participants reported perceived improvements in relaxation, pain reduction, and confidence CONCLUSION: HRV-F was viewed positively by participants and shows promise for SCI rehabilitation. User-centered design, early integration into care, and ongoing support are essential for successful implementation.