Heart rate variability biofeedback for competitive anxiety: a golf case study.

The question.

Heart rate variability (HRV) is the beat-to-beat change in the time between heartbeats. Higher HRV reflects a flexible nervous system that responds quickly to physical and emotional demands. The study asked whether training an athlete to raise HRV, by breathing at his own resonance frequency, would change how he handled the stress of competition.

What the athlete did.

• A 14-year-old competitive golfer met once a week at a university lab for ten consecutive sessions of 45 to 60 minutes.
• In the first session his resonance frequency was measured at 0.1 Hz, about six breaths per minute.
• He learned to breathe slowly at that rate, using abdominal and pursed-lip breathing, and practiced at home for two 20-minute sessions a day.
• He received no golf instruction during the training. He logged his competition scores each week.

What the researchers found.

• Mood: negative mood states fell on four of five measures. By week ten he reported no tension, depression, anger or fatigue.
• Anxiety and confidence: cognitive and somatic anxiety scores of 14 and 21 fell to zero by the final session, and self-reported confidence rose from 4 to 26.
• Physiology: total and low-frequency HRV rose sharply during training, and the effect grew stronger across sessions, which the authors read as a strengthening of the baroreflex, the reflex that keeps heart rate and blood pressure stable under load.

The honest limits.

This is a single-athlete case study. The authors note that it is not yet known how long the effects last after training ends, that people learn the skill at different rates, and that the automatic transfer of skills learned in a lab to competition is not yet supported by evidence. They call for larger, longer studies.

Why it matters for training.

The protocol in this paper is the foundation of the 10-week program taught at 505 Park Avenue today, built one-to-one around each client’s real competitive or professional conditions. See HRV training for athletes, HRV biofeedback in NYC, or sport performance consultations in NYC.

The paper.

Lagos L, Vaschillo E, Vaschillo B, Lehrer P, Bates M, Pandina R. Heart rate variability biofeedback as a strategy for dealing with competitive anxiety: a case study. Biofeedback. 2008;36(3):109-115. Association for Applied Psychophysiology & Biofeedback.

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