Biofeedback training in rehabilitation of patients with neurological disorders in post-COVID syndrome: a randomized controlled trial

Introduction. The high prevalence of post-COVID syndrome (PCS), which frequently manifests with emotional disturbances, cognitive impairment, and asthenia, necessitates effective rehabilitation methods. One potential approach is electroencephalography (EEG)-based biofeedback (BFB) therapy, though its use in PCS management has been explored in only a few studies to date. The study aimed to evaluate the effects of EEG α-rhythm BFB training on emotional state and cognitive function recovery, and reduction of astheniа symptoms in PCS patients. Materials and methods. Patients diagnosed with U09. Post-COVID-19 condition were randomly assigned to two groups of 10 participants each. The main group underwent 12–15 sessions of EEG α-rhythm BFB training using the NeuroPlay-6C headset with the Neurocorrection of COVID-19 Psychoemotional Consequences protocol, while the control group received identical training without biofeedback. Assessments performed before and after the intervention included: emotional state evaluation (State-Trait Anxiety Inventory STAI, Short Health Anxiety Inventory SHAI, Beck Depression Inventory BDI, Psychological Stress Measure PSM-25), cognitive function assessment (Addenbrooke’s Cognitive Examination III ACE-III, Schulte tables, Stroop test, Tower of London test, N-back test, 10-word memory test), assessment of asthenia (Multidimensional Fatigue Inventory MFI), and sleep quality evaluation (Insomnia Severity Index ISI). Results. In both groups, the training resulted in a significant reduction of personal anxiety, psychological stress, depression, and asthenia. The main group additionally demonstrated decreased health-related anxiety and improved information retention parameters. Intergroup comparison revealed more pronounced dynamics in the main group: greater reduction of general fatigue manifestations, increased immediate word recall volume, and improved retention of verbal information in working memory. The proportion of patients transitioning to milder symptom severity levels on individual scales was comparable between both groups. Conclusion. EEG α-rhythm biofeedback training can be implemented at the outpatient rehabilitation stage for PCS patients.