May 12, 2021Applied Psychophysiology and Biofeedback25 citationsOpen Access

The Effect of Stress Management Programs on Physiological and Psychological Components of Stress: The Influence of Baseline Physiological State

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Stress in military fire fighter recruits (n=180). Intervention: Tactics of Optimized Potential (TOP) and Heart Coherence (HC) programs vs. Placebo pill only (Control group). Primary outcome: Change in log RMSSD (Heart Rate Variability) (Cohen's d 0.56, p=0.01).

VHViolette Hoareau CGChristelle Godin FDFrédéric Dutheil

Key Result

Both the Tactics of Optimized Potential (TOP) and Heart Coherence (HC) programs significantly increased heart rate variability compared to control (Cohen's d 0.56 and 0.51, respectively), but only the TOP program significantly reduced perceived stress and negative mood.

Study Design

Type

RCT (n=180)

Blinding

Single-blind (placebo pill given to all groups)

Randomization

Randomly allocated to one of three groups

Multicenter

Structured PICO

Do stress management programs (TOP and HC) improve heart rate variability and psychological stress in young male military fire fighter recruits?

Population

180 young male military fire fighter recruits, free of chronic illnesses and recent major life stressors, followed for 2 months during their training.

Intervention

Stress management programs: Tactics of Optimized Potential (TOP) and Heart Coherence (HC)

Outcome

Heart rate variability (HRV), perceived stress, and negative moodsurrogate

The TOP stress management program improves both physiological (HRV) and psychological stress markers in military recruits, particularly those with low baseline HRV.

Main Result

Standardized Mean Difference: 0.56

p-value: p=0.01

Limitations

ECG was only measured once pre- and post-program, making HRV measurements susceptible to contextual variation.
Uncertainty regarding whether the daily placebo pill truly mitigated the placebo effect across all groups.
Did not assess how the firefighters perceived the qualifying exam in terms of stress intensity.
The duration of any benefits was not evaluated with long-term follow-up.

Abstract

Military personnel are particularly exposed to stressful events, and overexposure to stress is both physically and mentally unhealthy. While stress management programs, such as the Tactics of Optimized Potential (TOP) and Heart Coherence (HC) have been implemented, their efficiency remains to be evaluated. The objective of this randomized control trial was to evaluate the effectiveness of the two programs among a young male population of 180 military fire fighter recruits. Based on two psychological, and one physiological measurement, namely heart rate variability (HRV), we found that both TOP and HC programs significantly increased HRV. This is promising as we know that higher HRV is consistent with better health, in most cases. Moreover, the TOP program significantly reduced perceived stress and negative mood, unlike the HC program. Combining these results, we conclude that while both TOP and HC programs influence physiological measurements, only the TOP modifies psychological evaluations. Finally, we distinguished the effects of the programs on two samples characterized by their HRV level. For the low HRV group, both programs tended to increase their HRV level, while for the high HRV group neither program had a significant effect.

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