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Autonomic Nervous System FunctionNCT07911215

Effects of Brief Heart Rate Variability Biofeedback on Physiological and Emotional Responses

A study testing Psychoeducational Video Viewing and Heart Rate Variability Biofeedback in people with Autonomic Nervous System Function and Psychophysiological Regulation, run by University of Haifa at 1 site in Israel.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This completed randomized laboratory study investigated the immediate effects of a single 10-minute session of heart rate variability biofeedback (HRV-B) on cardiac activity, forehead physiological signals, and emotional responses in adults. Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
What is being tested?
Psychoeducational Video Viewing and Heart Rate Variability Biofeedback
Could I receive a placebo?
No, everyone receives an active treatment
How many people
32 participants
Where
1 siteIsrael
Study dates
1 Jul 2026to 1 Oct 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Adults aged 18-65 years.
  • Sufficient proficiency in Hebrew to understand the study instructions and questionnaires.
  • Ability to provide written informed consent.
  • Willingness to participate in a single laboratory session lasting approximately 60 minutes.
  • Exclusion Criteria (as specified in the original approved protocol):
  • Pregnancy.
Show all 10Show fewer
  • Psychiatric or neurological diagnosis.
  • History of cardiovascular disease or seizure disorders.
  • Chronic medical illness.
  • Use of medications affecting the nervous system or immune system.

Who cannot join

  • -

Trial locations and contacts

1 site in 1 country.

Israel1 site
  • University of Haifa

    Haifa, Haifa District, 3103301

Other trials in Israel

About this study

Official title: Immediate Effects of a Single HRV Biofeedback Session on Cortical Activity and Systemic Inflammation

This completed randomized laboratory study investigated the immediate effects of a single 10-minute session of heart rate variability biofeedback (HRV-B) on cardiac activity, forehead physiological signals, and emotional responses in adults.

Heart rate variability reflects changes in the time intervals between heartbeats. HRV biofeedback provides real-time information about heart rhythm patterns and allows individuals to adjust their breathing in response to visual feedback.

Read more

Thirty-two adult participants were randomly assigned to one of two groups. Sixteen participants completed HRV biofeedback training using the emWave Pro Plus system, while 16 participants watched educational videos about biofeedback and breathing.

Heart rate variability was measured before, during, and after the intervention. Forehead physiological signals were recorded using hemoencephalography (HEG) before, during, and after the session. Positive and negative affect were assessed using questionnaires completed before and after the intervention.

The purpose was to compare immediate physiological and emotional responses between participants receiving active HRV biofeedback and those receiving psychoeducational information without real-time physiological feedback.

The original ethics-approved research proposal also included a planned non-invasive bioimpedance assessment of systemic inflammation. This component was not implemented, and no inflammation-related measurements were collected.

Read the detailed description

Study Background and Objectives

This randomized, two-arm, single-session laboratory study was conducted at the University of Haifa, Israel, to investigate the immediate cardiac, forehead physiological, and affective responses to heart rate variability biofeedback (HRV-B).

The study examined whether a brief session of HRV biofeedback would produce different physiological and emotional responses compared with a time-matched psychoeducational control condition.

The original research proposal was entitled "Immediate Effects of a Single HRV Biofeedback Session on Cortical Activity and Systemic Inflammation."

The study received approval from the University of Haifa Ethics Committee for Research with Human Participants on December 29, 2025 (Approval No. 518/25). All participants provided written informed consent.

Participants and Study Design

The original research proposal planned the recruitment of up to 50 adult participants. Actual enrollment was 32 participants, randomly assigned to two groups using computerized random-number generation:

  • HRV Biofeedback Group: 16 participants.
  • Psychoeducational Control Group: 16 participants.

Each participant attended a single laboratory session lasting approximately 60 minutes.

Participants completed background and personality questionnaires and baseline assessments before the intervention, followed by physiological and psychological measurements during and after the experimental procedure.

HRV Biofeedback Intervention

Participants in the intervention group received a brief introduction to slow diaphragmatic breathing.

They then completed 10 minutes of HRV biofeedback using the emWave Pro Plus system (HeartMath), including a visual hot-air-balloon feedback game.

Participants were encouraged to regulate their breathing while observing real-time cardiac coherence feedback. Breathing adjustments were self-paced and guided by the visual feedback.

No individualized resonance-frequency determination, externally prescribed respiratory rate, or fixed inhalation-to-exhalation ratio was implemented.

Psychoeducational Control Condition

Participants assigned to the control group watched four consecutive educational videos lasting approximately 10 minutes in total.

The videos introduced general biofeedback principles, heart rate variability biofeedback, diaphragmatic breathing, and variations in breathing patterns.

Control participants did not receive real-time physiological feedback and were not instructed to perform guided biofeedback training during the videos.

Cardiac Physiological Measurements

Heart rate variability measurements were obtained using the emWave Pro Plus system with an earlobe photoplethysmographic sensor.

Measurements were collected during three periods:

  • PRE: approximately 5 minutes before the intervention.
  • DURING: 10 minutes during the intervention or control condition.
  • POST: approximately 5 minutes after the intervention.

Recorded variables included heart rate, SDNN, RMSSD, total spectral power, very-low-frequency power, low-frequency power, high-frequency power, LF/HF ratio, and device-derived cardiac coherence.

Forehead Hemoencephalography Measurements

Forehead physiological signals were assessed using a BioTekna hemoencephalography (HEG) sensor positioned at Fpz.

Four approximately five-minute measurement periods were obtained:

  • PRE: before the intervention.
  • Block 1: first five minutes of the intervention.
  • Block 2: second five minutes of the intervention.
  • POST: after the intervention.

The exported variables included device-derived rCBO2 measures, within-record signal slope, and the proprietary CFB index.

These indices represent device-derived forehead physiological signals and were not independently validated as direct measurements of neuronal activation or absolute cerebral blood flow.

Psychological Measurements

Positive and negative affect were assessed immediately before and after the experimental session using the 10-item short version of the Positive and Negative Affect Schedule (PANAS).

Baseline personality characteristics were assessed using the Ten-Item Personality Inventory (TIPI).

Originally Planned Inflammation Assessment

The original ethics-approved research proposal included a non-invasive bioimpedance-based assessment of systemic inflammation using the BioTekna TomEEX system.

This planned measurement component was omitted from the implemented study. No bioimpedance-based inflammation assessments were performed, and no inflammation-related measurements or outcomes were collected or analyzed.

The completed study therefore included cardiac, forehead HEG, and psychological measurements, without an inflammatory measurement component.

Statistical Analysis and Registration

The original research proposal described a mixed-design analysis focusing on Group-by-Time interactions, with additional analyses of associations between physiological and psychological variables and possible personality-related differences in intervention responses.

The completed study used repeated-measures analyses to examine group-specific trajectories across the measurement periods. Additional exploratory analyses and post hoc sensitivity analyses were conducted.

The present ClinicalTrials.gov record was created retrospectively, after completion of participant enrollment and data collection. No prospective public trial registration was completed before enrollment.

Being tested
Psychoeducational Video Viewing, Heart Rate Variability Biofeedback
Keywords
Heart Rate Variability Biofeedback, Heart Rate Variability, Cardiac Coherence, Hemoencephalography, Diaphragmatic Breathing, Positive Affect

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Psychoeducational Video ViewingBehavioural

    A single 10-minute session consisting of four prerecorded psychoeducational videos about biofeedback, heart rate variability, and breathing. Participants watched the videos without receiving real-time cardiac feedback or guided biofeedback training.

  • Heart Rate Variability BiofeedbackBehavioural

    A single 10-minute session of self-paced, visual-feedback-guided heart rate variability biofeedback using the emWave Pro Plus system. Participants received diaphragmatic breathing instructions and practiced adjusting their breathing in response to real-time cardiac coherence feedback displayed through a balloon game.

Study groups in NCT07911215
Study groupRoleWhat they receive
HRV BiofeedbackExperimentalSixteen participants received a single 10-minute session of heart rate variability biofeedback using the emWave Pro Plus system (HeartMath). Following brief instruction in diaphragmatic breathing, participants practiced self-paced breathing while receiving real-time visual cardiac coherence feedback through a hot-air-balloon game. No individualized resonance-frequency assessment or externally prescribed breathing rate was used.
Receives: Behavioral: Heart Rate Variability Biofeedback
Psychoeducational Video ControlActive comparatorSixteen participants watched four consecutive psychoeducational videos lasting approximately 10 minutes in total. The videos addressed biofeedback principles, heart rate variability biofeedback, diaphragmatic breathing, and variations in breathing patterns. Participants received no real-time physiological feedback and were not instructed to perform guided biofeedback training during video viewing.
Receives: Behavioral: Psychoeducational Video Viewing

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Mean Forehead Hemoencephalography (HEG) rCBO2 Signal

    Change in the mean device-derived rCBO2 signal recorded using a BioTekna HEG sensor at Fpz. Each recording lasted approximately five minutes. The index is not a calibrated measure of neuronal activity or absolute cerebral oxygenation.

    Measured: Baseline (5 minutes), intervention Block 1 (first 5 minutes), intervention Block 2 (second 5 minutes), and immediately post-intervention (5 minutes), within one laboratory visit.

  2. Change in TomEEX-Derived Extracellular Bioimpedance Indices (Not Assessed)

    The original ethics-approved study protocol included assessment of extracellular bioimpedance indices using the BioTekna TomEEX system, including ECR, DECW+, BEC, and DECW, as proposed indicators related to systemic inflammation. This component was omitted from the implemented study. No TomEEX assessments were performed, and no inflammation-related outcome data were collected or analyzed.

    Measured: Originally planned at baseline and immediately after the 10-minute intervention, during one laboratory visit. Measurements were not performed.

Secondary outcomes (4)
  1. Change in Heart Rate Variability (SDNN)

    Standard deviation of normal-to-normal heart period intervals (SDNN), expressed in milliseconds, derived from emWave Pro Plus earlobe photoplethysmography recordings. Values were assessed across baseline, intervention, and immediate post-intervention periods.

    Measured: Baseline (5 minutes), during the 10-minute intervention, and immediately afterward (5 minutes), within one laboratory visit.

  2. Change in Device-Derived Cardiac Coherence

    Normalized cardiac coherence percentage exported by the emWave Pro Plus system. The measure describes the device-derived organization of heart rhythm oscillations during the recording and should not be interpreted as a direct measurement of vagal tone.

    Measured: Baseline (5 minutes), during the 10-minute intervention, and immediately afterward (5 minutes), within one laboratory visit.

  3. Change in Positive Affect Score

    Positive Affect score from the 10-item short form of the Positive and Negative Affect Schedule (PANAS). Five items are summed to yield a score ranging from 5 to 25, with higher scores indicating greater positive affect.

    Measured: Immediately before and immediately after the 10-minute intervention, within one laboratory visit.

  4. Change in Negative Affect Score

    Negative Affect score from the 10-item short form of the Positive and Negative Affect Schedule (PANAS). Five items are summed to yield a score ranging from 5 to 25, with higher scores indicating greater negative affect.

    Measured: Immediately before and immediately after the 10-minute intervention, within one laboratory visit.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Nov 2026
  2. Study start1 Jul 2026
  3. Primary completion1 Oct 2026
  4. Study completion1 Oct 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants were randomly assigned to one of two parallel groups: a single 10-minute session of heart rate variability biofeedback with real-time visual feedback, or a time-matched psychoeducational video control condition. Each participant completed one laboratory session. Cardiac and forehead physiological measurements were obtained before, during, and after the intervention, while affect was assessed before and after the session. No crossover between groups occurred.
Masking
None (open label)
Enrolment
32 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07911215
Sponsor's protocol ID
UHAIFA-HRVB-LAB-2026-01
Status last verified
Oct 2026
First submitted
26 Oct 2026
Last updated
4 Nov 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: There is currently no plan to share individual participant-level data with researchers outside the study team.

Questions about this trial

What is this clinical trial studying?

A study testing Psychoeducational Video Viewing and Heart Rate Variability Biofeedback in people with Autonomic Nervous System Function and Psychophysiological Regulation, run by University of Haifa at 1 site in Israel.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Israel. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Mean Forehead Hemoencephalography (HEG) rCBO2 Signal (time frame: Baseline (5 minutes), intervention Block 1 (first 5 minutes), intervention Block 2 (second 5 minutes), and immediately post-intervention (5 minutes), within one laboratory visit.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Nov 2026; AzTrials last refreshed its copy on 6 Nov 2026.

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