Synergy and Synchrony Between Beta-Theta Neurofeedback, Heart Rate Variability Biofeedback and Breathwork Via Continuous Feedback in Improving Reaction Time.
Mahdi Zolfagharzadeh-Kermani
Applied Psychophysiology and Biofeedback July 15, 2026 DOI: 10.1007/s10484-026-09802-9 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 22 |
| Population | Healthy university students (6 male, 16 female) |
| Interventions | Beta-theta neurofeedback Heart rate variability biofeedback Box-breathing continuous feedback |
| Duration | 10 sessions |
| Topics | Breathwork |
| Keywords | Box-breathing continues feedback Hrv biofeedback Mind-body interaction Neurofeedback Operant conditioning Reaction time |
| Key findings | Combining beta-theta neurofeedback, heart rate variability biofeedback, and box-breathing continuous feedback significantly reduced visual-recognition reaction time compared with the other two training combinations. Group 1 also showed significant within-group changes in beta/theta power ratio, high-beta relative power, and heart rate variability (root mean square of successive differences). The authors conclude this combined training can reduce reaction time through mind-body interaction at a self-aware level. |
Abstract
Recently, the applied psychophysiology community has started to investigate the effectiveness of combining neurofeedback and biofeedback interventions. The training triad of beta-theta neurofeedback, heart rate variability biofeedback, and box-breathing continuous feedback can influence participants' electrophysiological activity and also help healthy individuals decrease reaction time. For this purpose, twenty-two students (6 male, 16 female) were randomly assigned to three experimental groups using block randomization. The first group (N = 7) received 10 sessions of beta-theta neurofeedback, heart rate variability biofeedback, and box-breathing continuous feedback simultaneously. The second group (N = 8) underwent 10 sessions of only box-breathing continuous feedback, while the third group (N = 7) participated in 10 sessions of beta-theta neurofeedback and heart rate variability biofeedback together. A multivariate analysis of covariance was used to compare reaction time scores among the three groups in a pretest-posttest design. Additionally, repeated measures analysis of variance assessed within-group changes in electrophysiological markers across three time points: pre-test, mid-test, and post-test. Results indicated that, compared to groups 2 and 3, the visual-recognition-reaction-time scores in experimental group 1 significantly decreased (P-value < 0.05). In addition, group 1 showed significant within-group changes (P-value < 0.05) in electroencephalography measures (beta/theta power ratio and high-beta relative power) and heart rate variability (root mean square of successive differences). We conclude that the combination of beta-theta neurofeedback, heart rate variability biofeedback, and box-breathing continuous feedback can effectively reduce reaction time through mind-body interaction at a self-aware level.
Comparable studies
Other randomized controlled trials on breathwork, most cited first.
Citations in the library
Cites 4
- The entropic brain: a theory of conscious states informed by neuroimaging research with psychedelic drugs Frontiers in Human Neuroscience 2014
- Brief structured respiration practices enhance mood and reduce physiological arousal Cell Reports Medicine 2023
- Breathwork for Chronic Stress and Mental Health: Does Choosing a Specific Technique Matter? Medical Sciences August 13, 2025
- The entropic brain - revisited. Neuropharmacology November 1, 2018