Abstract

Context In sport, the occurrence of an injury is almost inevitable and the rehabilitation process can take a toll on athletes' emotions and contribute to psychological distress. Objective To examine the effects of heart rate variability biofeedback (HRV BFB) training on pain catastrophizing and the psychological response variables of injured athletes. As a manipulation check, HRV BFB effects on athletes physiological indices including frequency-domain HRV and respiration rate were also assessed. Design A pilot randomized controlled trial. Setting University laboratory. Participants Twenty-eight athletes (Mage = 20.82, SD = 3.41, Male = 19) who sustained a moderate to severe musculoskeletal sports injury and underwent rehabilitation were randomized into HRV BFB experimental, placebo, or control conditions. Intervention Participants in the experimental condition received six 30-min HRV BFB training sessions over a 3-week period. Main outcome measures Psychological responses to sport injury, pain catastrophizing, and physiological indices were assessed at Baseline, Week 1, Week 2, and Week 3 (post-intervention). Results Significant training effects on respiration rate and low frequency HRV at rest were found in favour of the experimental group. For pain catastrophizing constructs and psychological responses to sport injury, group differences over time were non-significant; however, the effects were medium to large and consistently favoured the experimental group (η2 range 0.06 - 0.13). Only isolation reached significance with a large effect in favour of the experimental group (p = 0.024, η2 = 0.17). Significant, positive associations were found between change in respiration rate-rest and changes in rumination, magnification, devastation, restlessness, and isolation.

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