Abstract
Breathing exercises with biofeedback have benefits over breathing exercises without biofeedback. However, the traditional measurement of respiratory signals that is required as part of feeding back the breath incurs high cost and effort. We propose a novel virtual reality (VR) based approach to respiratory biofeedback that utilizes the positionally tracked hand controllers integrated into modern VR systems to capture and feedback the respiration-induced abdominal movements. In a randomized controlled laboratory study, we investigated the feasibility and efficacy of the developed biofeedback algorithm. In total, 72 participants performed a short breathing exercise in VR with or without respiratory biofeedback. The feedback integration resulted in a satisfactory user experience, a heightened breath awareness, a greater focus on slow diaphragmatic breathing and an increased respiratory sinus arrhythmia. This evidences that the novel biofeedback approach is low-cost, unobtrusive, usable and effective in increasing breath awareness and promoting slow diaphragmatic breathing in the context of VR-based breathing exercises. Future studies need to investigate the broader applicability and long-term effects.
Highlights
In our fast-paced society, stress-related symptoms and disorders are prevalent (American Psychological Association 2018; Jarczok et al 2013)
We present a virtual reality (VR)-based respiratory biofeedback paradigm that aims to deliver the benefits associated with respiratory biofeedback while avoiding the common critique by providing an integrated, cost-effective, easy to use and fairly unobtrusive approach
While there are no norm values for the User Experience Questionnaire (UEQ), the fact that all items are 7-point semantic differentials suggests that mean values above 4 indicate a satisfying user experience
Summary
In our fast-paced society, stress-related symptoms and disorders are prevalent (American Psychological Association 2018; Jarczok et al 2013). Modulation and increased activation of the parasympathetic nervous system through slow regular breathing calms the body and leads to mental relaxation (see research on heart rate variability biofeedback, e.g., Gevirtz, 2013; Goessl et al 2017; Kennedy and Parker 2018; Wheat and Larkin 2010). Whether with breathing meditation or focused breathing exercises, people often struggle to sustain their motivation, fail to keep their focus on the breath, or lack sufficient self-awareness (Pisa et al 2017; Soyka et al 2016). All of this may hinder continuous practice or may lead to frustration. Struggling with an adequate performance due to boredom or uncertainty as to the correct behavior may keep many people from establishing the desired routine
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