Effects of Heart Rate Variability Biofeedback on Enhancing Self-Efficacy, Quality of Life and Six-Minute Walking Test in Patients with Chronic Obstructive Pulmonary Disease.

Heart rate variability biofeedback (HRVB) is a bio-behavioral intervention applied to patients with chronic obstructive pulmonary disease (COPD), and improves their autonomic activation and pulmonary function. This study explored the effects of HRVB on self-efficacy, quality of life, depression, anxiety, and heart rate variability (HRV) indices under the Six-Minute Walking Test (6MWT) in patients with COPD. The study hypothesizes that HRVB can improve self-efficacy and quality of life, reduce depression and anxiety, and decrease HRV reactivity while enhancing HRV recovery during the 6MWT. A total of 53 patients with COPD were assigned to either an HRVB group (n = 26) or a control group (n = 27), both received standard medical care. The HRVB group also participated in one hour weekly for six weeks. All participants completed assessments using the COPD Self-Efficacy Scale, St. George's Respiratory Questionnaire, Beck Depression Inventory-II, and Beck Anxiety Inventory pre-test and post-test. The 6MWT was administered to measure HRV during baseline, walking, and recovery stages. Significant improvements in self-efficacy and quality of life for the HRVB group, with a significant increase in post-test compared to pre-test and the control group. However, there were no significant differences in changes in depression and anxiety between the two groups. Additionally, the HRVB group exhibited a significant decrease in HRV reactivity and increased HRV recovery at the post-test compared to the pre-test. These findings indicated that HRVB effectively enhances self-efficacy and quality of life in patients with COPD while improving autonomic function. Therefore, HRVB could be a valuable component of pulmonary rehabilitation for patients with COPD.