Department of Psychiatry, University of North Carolina at Chapel Hill, 388 Med School, Chapel Hill, NC, 27599, USA.
RTI International, Research Triangle Park, NC 27719, USA.
Mil Med. 2021 Jan 25;186(Suppl 1):17-24. doi: 10.1093/milmed/usaa395.
Heart rate variability (HRV) is a biological marker that reflects an individual's autonomic nervous system regulation. Psychological resilience is an individual's ability to recover from an adverse event and return to physiological homeostasis and mental well-being, indicated by higher resting HRV. The Biofeedback Assisted Resilience Training (BART) study evaluates a resilience-building intervention, with or without HRV biofeedback. This article evaluates the feasibility of remote psychophysiological research by validating the HRV data collected.
The BART platform consists of a mobile health application (BART app) paired to a wearable heart rate monitor. The BART app is installed on the participant's personal phone/tablet to track and collect self-report psychological and physiological data. The platform collects raw heart rate data and processes HRV to server as online biofeedback. The raw data is processed offline to derive HRV for statistical analysis. The following HRV parameters are validated: inter-beat interval, respiratory sinus arrhythmia, low-frequency HRV, biofeedback HRV, and heart period. Bland-Altman and scatter plots are used to compare and contrast online and offline HRV measures. Repeated-measures ANOVA are used to compared means across tasks during the stress (rest, stress, and recovery) and training (rest and paced breathing) sessions in order to validate autonomic nervous system changes to physiological challenges.
The analyses included 245 participants. Bland-Altman plots showed excellent agreement and minimal bias between online and offline unedited inter-beat interval data during the stress session. RMANOVA during the training session indicated a significant strong effect on biofeedback HRV, F(11,390) = 967.96, P < .01. During the stress session, RMANOVA showed significant strong effect on respiratory sinus arrhythmia and low-frequency HRV, and a significant but weak effect on heart period.
The BART digital health platform supports remote behavioral and physiological data collection, intervention delivery, and online HRV biofeedback.
心率变异性（HRV）是反映个体自主神经系统调节的生物标志物。心理弹性是个体从逆境中恢复并恢复生理平衡和心理幸福感的能力，表现为静息 HRV 较高。生物反馈辅助韧性训练（BART）研究评估了一种增强韧性的干预措施，包括或不包括 HRV 生物反馈。本文通过验证所收集的 HRV 数据，评估远程心理生理学研究的可行性。
BART 平台由一个移动健康应用程序（BART 应用程序）和一个可穿戴心率监测器组成。BART 应用程序安装在参与者的个人手机/平板电脑上，以跟踪和收集自我报告的心理和生理数据。该平台采集原始心率数据并处理 HRV 以提供在线生物反馈。原始数据离线处理以得出 HRV 进行统计分析。验证的 HRV 参数包括：心搏间期、呼吸窦性心律失常、低频 HRV、生物反馈 HRV 和心动周期。使用 Bland-Altman 图和散点图比较和对比在线和离线 HRV 测量。使用重复测量方差分析比较和对比应激（休息、应激和恢复）和训练（休息和 paced 呼吸）期间任务之间的平均值，以验证自主神经系统对生理挑战的变化。
分析包括 245 名参与者。在应激期间，Bland-Altman 图显示在线和离线编辑前心搏间期数据之间具有极好的一致性和最小的偏差。在训练期间的 RMANOVA 表明生物反馈 HRV 有显著的强影响，F（11,390）=967.96，P<.01。在应激期间，RMANOVA 显示呼吸窦性心律失常和低频 HRV 有显著的强影响，而心动周期有显著但较弱的影响。
BART 数字健康平台支持远程行为和生理数据采集、干预措施的提供以及在线 HRV 生物反馈。
