Key result
Participants trained in breathing techniques while playing the FitLab Game showed significant differences in RR mean (p=0.020) and RMSSD (p=0.037) compared to the control group.
Why the study?
Heart rate variability biofeedback is an established intervention for increasing heart rate variability, and the authors aimed to develop a serious game applying this technique to teach self-regulation of heart rate variability and evaluate it in a pilot study.
Does the FitLab Game with breathing techniques improve heart rate variability parameters in young participants?
Does the FitLab Game with breathing techniques improve heart rate variability parameters in young participants?
p-value: p=0.020
A serious game utilizing heart rate variability biofeedback combined with breathing techniques significantly improved HRV parameters, suggesting potential for arousal management.
May support gaming-based HRV biofeedback for arousal management in youth; leaves open clinical translation and needs randomized validation.
BACKGROUND Heart rate variability biofeedback (HRVB) is an established intervention for increasing heart rate variability (HRV) in the clinical context. Using this technique, participants become aware of their HRV through real-time feedback and can self-regulate it. OBJECTIVE The aim of this study was 2-fold: first, to develop a serious game that applies the HRVB technique to teach participants to self-regulate HRV and, second, to test the app with participants in a pilot study. METHODS An HRVB app called the FitLab Game was developed for this study. To play the game, users must move the main character up and down the screen, avoiding collisions with obstacles. The wavelength that users must follow to avoid these obstacles is based on the user’s basal heart rate and changes in instantaneous heart rate. To test the FitLab Game, a total of 16 participants (mean age 23, SD 0.69 years) were divided into a control group (n=8) and an experimental group (n=8). A 2 × 2 factorial design was used in each session. Participants in the experimental condition were trained in breathing techniques. RESULTS Changes in the frequency and time domain parameters of HRV and the game’s performance features were evaluated. Significant changes in the average RR intervals and root mean square of differences between adjacent RR intervals (RMSSD) were found between the groups (P=.02 and P=.04, respectively). Regarding performance, both groups showed a tendency to increase the evaluated outcomes from baseline to the test condition. CONCLUSIONS The results may indicate that playing different levels leads to an improvement in the game’s final score by repeated training. The tendency of changes in HRV may reflect a higher activation of the mental system of attention and control in the experimental group versus the control group. In this context, learning simple, voluntary strategies through a serious game can aid the improvement of self-control and arousal management. The FitLab Game appears to be a promising serious game owing to its ease of use, high engagement, and enjoyability provided by the instantaneous feedback.
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Estrella et al. (2023) studied Healthy volunteers (n=16). FitLab Game with breathing techniques vs. FitLab Game without breathing instructions was evaluated on Change in RR mean between baseline and test (p=0.020). Participants trained in breathing techniques while playing the FitLab Game showed significant differences in RR mean (p=0.020) and RMSSD (p=0.037) compared to the control group.
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