From sensing to self-regulation: a systematic review of biofeedback and neurofeedback interventions for mental health and stress regulation in athletes

  • Nilma Zola
    Center for Educational Neuroscience, Trauma, and Human Behavior, Universitas Negeri Padang
    Indonesia
    https://orcid.org/0000-0002-8128-3975
  • Ifdil Ifdil 
    Center for Educational Neuroscience, Trauma, and Human Behavior, Universitas Negeri Padang
    Indonesia
  • M. Fahli Zatrahadi
    Universitas Islam Negeri Sultan Syarif Kasim
    Indonesia
  • Nur Adila Wafiqoh Zulvi
    Center for Educational Neuroscience, Trauma, and Human Behavior, Universitas Negeri Padang
    Indonesia

Abstract

Competitive sport puts a lot of stress on both the body and mind, and biofeedback and neurofeedback techniques are new ways to help with stress regulation and athlete mental health support by using sensors and tailoring a personal plan. This systematic review is summarizing the research evidence from these areas that show the impact on mental health aspects and psychophysiological stress regulation. Alongside modalities like HRV biofeedback and modalities of psychological indicators were also examined in the study. By applying the guidelines of a PRISMA systematic review, a Scopus database search 2015, 2026 revealed 629 records. Only one duplicate was removed, 628 titles and abstracts were checked, 31 full papers were critically reviewed, leading to 18 studies that were purely data based. The quality of those included studies was assessed by means of the Mixed Methods Appraisal Tool and their results were thematically combined. HRV biofeedback was the most commonly used technique (7 studies), followed by peripheral multi-modal biofeedback (6), combination HRV-EEG method (2), EEG/scpneurofeedback (2), and paced breathing (1). The most common positive changes were stress and cortisol levels (8), anxiety (5), attention/cognition (5), autonomic regulation (4), and recovery-stress balance (3). In general, the interventions demonstrated good results, such as the lowering of anxiety and perceived stress and the enhancement of autonomic flexibility. Nevertheless, the small number of participants, the different nature of the methods, and very few trials of this type with an active control make one cautious. Well-designed clinical trials with random allocation, appropriate sample sizes, and validated outcome measures are required.

Keywords
  • Biofeedback, Neurofeedback, Heart rate variability, Athlete mental health, Psychophysiological self-regulation
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