Search Results (158)

Background/Objective: Mind–body programs teaching mindfulness-based techniques have benefits for incarcerated people, as do programs in which individuals teach yoga to their incarcerated peers. However, there are no studies of comprehensive programs that combine a variety of self-care techniques with group support and enable people in prison to enhance their own well-being and then share what they have learned with their peers. This study evaluated the effects of such a training program in the United States. Methods: Thirty-eight incarcerated men and women began the 8-day mind–body medicine training and 31 completed the training. Mind–body techniques taught included soft belly breathing, meditation, autogenics and biofeedback, guided imagery, mindful eating, self-expression through drawings and writing, and genograms. Outcomes included resilience, depression, anxiety, stress, coping self-efficacy, optimism, meaning in life, and purpose in life. Outcomes were measured before and after the training, and at a 6-month follow-up. Results: There were significant improvements in resilience, depression, anxiety, stress, coping self-efficacy, optimism, the presence of meaning in life, and purpose in life after the training. All of these improvements were maintained at follow-up. The most frequently practiced skills both after the training and at follow-up were soft belly breathing, meditation, and mindful eating. Conclusions: The training provided participants with skills that had a lasting positive benefit on numerous aspects of their own well-being and trained them to teach the skills to their incarcerated peers. The results of this uncontrolled study suggest that the mind–body medicine training program may be helpful to incarcerated people in other prison systems. Full article

Post-stroke rehabilitation integrates technological feedback systems to enhance motor relearning and autonomic regulation. Among these, physiological biofeedback—based on electromyography (EMG), heart rate variability (HRV) and electrocardiography (ECG)—represents a multimodal approach for restoring neuromotor control and autonomic balance. EMG biofeedback enables patients to visualize and voluntarily modulate muscle activation, supporting cortical reorganization and improving movement precision through real-time feedback. Recent meta-analyses confirm that EMG biofeedback significantly improves upper- and lower-limb function in stroke survivors, particularly when combined with task-oriented physiotherapy. EMG biofeedback demonstrates improvements in swallowing function, motor control, and patient motivation. Beyond the motor domain, HRV biofeedback has shown substantial benefits lately, especially in regulating the autonomic nervous system (ANS) activity, improving vagal tone, and reducing sympathetic overdrive: a major contributor to fatigue and cardiovascular instability post-stroke. By targeting the sympathetic–parasympathetic balance, HRV biofeedback not only enhances autonomic flexibility but also supports emotional and cognitive recovery. Together, these modalities integrate neuromuscular and autonomic rehabilitation, offering a path toward individualized, feedback-driven recovery protocols. This narrative review synthesizes recent evidence on the mechanisms, the clinical outcomes, and translational potential of EMG- and HRV-based biofeedback in stroke rehabilitation, highlighting their role in advancing physiotherapy toward an adaptive, data-driven, and neuroplastic paradigm, as from now on, the emerging directions will include integrating physiological biofeedback with immersive or AI-driven platforms for enhanced personalization and motivation. Full article

Background: Walking cadence is commonly adjusted in sport and rehabilitation, yet its effects on spatiotemporal gait parameters and regional plantar pressure distribution under controlled speed conditions remain incompletely characterized. Therefore, this study aimed to determine whether imposed cadence increases at a constant walking speed would (i) systematically reduce temporal gait parameters while preserving inter-limb symmetry and (ii) be associated with region-specific increases in forefoot plantar loading, representing the primary novel contribution of this work. Methods: Fifty-two adults walked at three imposed cadences (110, 120, 130 steps·min⁻¹) while maintaining a fixed treadmill speed of 1.39 m·s⁻¹ via auditory biofeedback. Spatiotemporal parameters were recorded with an OptoGait system, and plantar pressure distribution was measured using in-shoe pressure insoles. Normally distributed variables were analyzed using repeated-measures ANOVA, whereas plantar pressure metrics were assessed using the Friedman test, followed by Wilcoxon signed-rank post-hoc comparisons with false discovery rate (FDR) correction. Associations between temporal parameters and plantar loading metrics (peak pressure, pressure–time integral) were examined using Spearman’s rank correlation with FDR correction (α = 0.05). Results: Increasing cadence produced progressive reductions in gait cycle duration (~8–10%), contact time (~7–8%), and step time (all p < 0.01), while inter-limb symmetry indices remained below 2% across conditions. Peak plantar pressure increased significantly in several forefoot regions with increasing cadence (all p_FDR < 0.05), whereas changes in the first ray were less consistent across conditions. Regional forefoot pressure–time integral also increased modestly with higher cadence (p_FDR < 0.01). Spearman’s correlations revealed moderate negative associations between temporal gait parameters and global plantar loading metrics (ρ = −0.38 to −0.46, all p_FDR < 0.05). Conclusions: At a constant walking speed, increasing cadence systematically shortens temporal gait components and is associated with small but consistent region-specific increases in forefoot plantar loading. These findings highlight cadence as a key temporal constraint shaping plantar loading patterns during steady-state walking and support the existence of concurrent temporal–mechanical adaptations. Full article

Background/Objectives: Biofeedback therapy is a technique that trains individuals to change their physiological activity for the purpose of improving their health. Despite its proven efficacy in 70 to 80% of patients in clinical trials, biofeedback is significantly underutilised in clinical practice worldwide. This scoping review aims to synthesise the current evidence on clinicians’ attitudes, knowledge, and experiences with anorectal biofeedback, highlight gaps in the existing literature, and guide future research directions. These findings are compared with new local Australian data. Methods: Systematic searches were conducted on five electronic databases including MEDLINE, Embase, CINAHL, Scopus, and APA PsycInfo. Eight articles were retrieved from title and abstract, full text, and reference list screening using Covidence. Results: The scoping review revealed substantial heterogeneity in the clinical indications for biofeedback. Both the scoping review and Australian study reported that over half of clinicians could not accurately define biofeedback or report familiarity with the technique, and that barriers to the implementation of biofeedback included long wait times, lack of trained personnel, and limited access to equipment. In the Australian study, proposed ways to improve the uptake of biofeedback included education of health professionals, government funding, and increased access to facilities. Conclusions: This scoping review and Australian cross-sectional study demonstrate that clinicians have limited knowledge of biofeedback and that a complex interplay between systemic barriers to access hinder its implementation. Further research into clinicians’ attitudes towards biofeedback should be conducted in more countries to build a more robust body of evidence. Full article

Geographic atrophy (GA) is a progressive cause of central vision loss with limited rehabilitation options. This prospective case series aimed to evaluate the effects of biofeedback fixation training (BFT) on visual function and vision-related quality of life (QoL) in patients with GA. Eighteen patients with total central vision loss in one eye underwent BFT on the fellow eye (study eye) using the Macular Integrity Assessment (MAIA) system, which was used to select a new, previously chosen preferred retinal locus (PRL) to stabilize fixation or adopt a new fixation locus. Patients were followed for an average of 13.2 months (range 3–26 months). Functional outcomes included best corrected visual acuity (ETDRS chart), reading performance (Radner test), and contrast sensitivity (Spot Checks test). MAIA parameters comprised average retinal sensitivity, fixation distance and stability (P1, P2), and changes in the bivariate contour ellipse area (BCEA). Vision-related quality of life was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25). Following BFT, visual acuity, reading ability and contrast sensitivity improved significantly (p value: p < 0.02), and fixation stability and NEI-VFQ-25 scores showed a positive trend. These findings indicate that BFT is a feasible and promising rehabilitation approach for patients with GA. Full article

Smart virtual reality (VR) systems are becoming central to media production education, where immersive practice, real-time feedback, and hands-on simulation are essential. This review synthesizes the integration of artificial intelligence (AI) into human-centered, interactive VR learning for television and media production. Searches in Scopus, Web of Science, IEEE Xplore, ACM Digital Library, and SpringerLink (2013–2024) identified 790 records; following PRISMA screening, 94 studies met the inclusion criteria and were synthesized using a systematic scoping review approach. Across this corpus, common AI components include learner modeling, adaptive task sequencing (e.g., RL-based orchestration), affect sensing (vision, speech, and biosignals), multimodal interaction (gesture, gaze, voice, haptics), and growing use of LLM/NLP assistants. Reported benefits span personalized learning trajectories, high-fidelity simulation of studio workflows, and more responsive feedback loops that support creative, technical, and cognitive competencies. Evaluation typically covers usability and presence, workload and affect, collaboration, and scenario-based learning outcomes, leveraging interaction logs, eye tracking, and biofeedback. Persistent challenges include latency and synchronization under multimodal sensing, data governance and privacy for biometric/affective signals, limited transparency/interpretability of AI feedback, and heterogeneous evaluation protocols that impede cross-system comparison. We highlight essential human-centered design principles—teacher-in-the-loop orchestration, timely and explainable feedback, and ethical data governance—and outline a research agenda to support standardized evaluation and scalable adoption of smart VR education in the creative industries. Full article

Background: Polyneuropathies impair sensory, motor, and autonomic functions, affecting functional status, cognition, and quality of life. This pilot study investigated the effects of exergame with biofeedback training (Riablo system) versus standard rehabilitation on these outcomes in outpatients with mixed-etiology polyneuropathies. Methods: Seventeen outpatients were assigned to standard rehabilitation (Group 1, n = 9) or combined standard plus Riablo training (Group 2, n = 8) over three weeks. Functional status, pain, cognition, quality of life, and psychological well-being were assessed pre- and post-intervention, with a 6-month follow-up. Outcome measures included the Morse Fall Scale, Visual Analogue Scales for pain and autonomy, Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Stroop Test, Frontal Assessment Battery (FAB), Verbal fluency test, the Short-Form Health Survey-12 (SF-12), and the Patient Health Questionnaire-4 (PHQ-4). Longitudinal changes and between-group differences were analyzed using nonparametric statistics. Results: Both groups showed significant improvements in functional status and global cognition at post-intervention. Group 2 demonstrated greater improvements in executive functions and attention, with significant reductions in pain and fall risk. At 6-month follow-up, Group 2 maintained post-intervention gains in QoL and psychological outcomes, while Group 1 showed a significant decline. Technology evaluation revealed high usability and positive psychosocial impact in Group 2, with strong correlations between executive function improvements and device usability. Conclusions: Integrating exergames with biofeedback into standard rehabilitation may provide broader and longer-lasting benefits for polyneuropathy patients. These findings support further large-scale trials to confirm efficacy and optimize technology-assisted rehabilitation protocols. Full article

Background: After unilateral total knee arthroplasty (TKA), patients place more weight on the nonsurgical limb than the surgical limb. The objective of this study was to determine the possibility of providing live biofeedback during early recovery of patients undergoing unilateral TKA and to determine the necessary sample size for future trials. Methods: Twenty patients with unilateral TKA were randomized into two groups: a feedback group and a control group. Inclusion criteria included no contralateral knee pain and aid-free walking before surgery. There were 8 patients in the feedback group and 10 in the control group. Compliance with the recommended training was 91%. The feedback group trained with an insole device for 15 min a day for 4 weeks, along with normal physiotherapy. The control group received normal physiotherapy only. Gait parameters were recorded on level ground at two and six weeks. The primary outcome was the percent loading rate. The secondary outcomes included gait speed, cadence, percent peak force, and pain. Results: Patients within the feedback group showed a small, non-significant trend toward a higher precent load rate at 6 weeks compared to the control group in level walking (p = 0.92). Conclusions: Our findings indicate that live biofeedback on a gait parameter, like percent load rate, can be provided by the mentioned system and may support immediate changes in gait parameters. The compliance of 91% with training and no reported adverse events indicates that the system was easy to use. Following TKA, there may be a potential exploratory use of mobile, real-time biofeedback to help address gait abnormalities and accelerate rehabilitation. This clinical trial was registered at clinicaltrials.gov (Identifier: NCT03673293) on 14 September 2018. This study was conducted in accordance with the Declaration of Helsinki and approved by the institutional review board of the University of Utah (IRB_00110935) on 10 September 2018. Full article

Smart assistive technologies such as sensor-based footwear and walking aids offer promising opportunities for gait rehabilitation through real-time feedback and patient-centered monitoring. While biofeedback applications show great potential, current research rarely explores integrated closed-loop systems with device- and modality-specific feedback. In this work, we present a modular sensor-based system combining a smart foot orthosis and an instrumented forearm crutch to deliver real-time vibrotactile biofeedback. The system integrates plantar pressure and motion sensing, vibrotactile feedback, and wireless communication via a smartphone application. We conducted a user study with eight participants to validate the system’s feasibility for mobile gait detection and app usability, and to evaluate different vibrotactile feedback types across the orthosis and forearm crutch. The results indicate that pattern-based vibrotactile feedback was rated as more useful and suitable for regular use than simple vibration alerts. Moreover, participants reported clear perceptual differences between feedback delivered via the orthosis and the forearm crutch, indicating device-dependent feedback perception. The findings highlight the relevance of feedback strategy design beyond hardware implementation and inform the development of user-centered haptic biofeedback systems. Full article

This paper contains an analysis of methods for person classification based on signals from wearable IMU sensors during sports. While this problem has been investigated in prior work, existing approaches have not addressed it within the context of few-shot or minimal-data scenarios. A few-shot scenario is especially useful as the main use case for person identification in sports systems is to be integrated into personalised biofeedback systems in sports. Such systems should provide personalised feedback that helps athletes learn faster. When introducing a new user, it is impractical to expect them to first collect many recordings. We demonstrate that the problem can be solved with over 90% accuracy in both open-set and closed-set scenarios using established methods. However, the challenge arises when applying few-shot methods, which do not require retraining the model to recognise new people. Most few-shot methods perform poorly due to feature extractors that learn dataset-specific representations, limiting their generalizability. To overcome this, we propose a combination of an unsupervised feature extractor and a prototypical network. This approach achieves 91.8% accuracy in the five-shot closed-set setting and 81.5% accuracy in the open-set setting, with a 99.6% rejection rate for unknown athletes. Full article

This study researches the effects of a biofeedback-based Dynamic Difficulty Adjustment (DDA) system on player stress management in a survival-horror video game. For this purpose, a game titled Code: Terror was developed, in which players’ psychophysiological data—such as heart rate, stress level, and voice level—were collected in real time through a smartwatch. Based on these data, game parameters were dynamically adjusted. The adaptation process was guided by the “Relax-to-win” model, which aims to make the game easier as players remain calm, using their level of relaxation as a baseline. A total of 40 participants were recruited and divided into two reciprocal groups: one group experienced the game solely with the DDA system activated, while the other played first with the DDA system disabled and then with it enabled. Player experience was evaluated using the Intrinsic Motivation Inventory (IMI) and the Challenge Originating from Recent Gameplay Interaction Scale (CORGIS). Results showed that the dynamic biofeedback system significantly enhanced intrinsic motivation and perceived challenge, while also reducing physiological arousal, indicating its effectiveness in promoting emotional regulation—the inclusion of both gameplay conditions for participants allowed for the collection of more consistent and meaningful data. The results suggest that biofeedback-driven DDA systems have the potential to enrich player experience both emotionally and motivationally. Furthermore, the findings highlight the potential of such adaptive biofeedback mechanisms to serve as intelligent medical decision support tools for stress management, mental health monitoring, and personalized intervention strategies. Full article

To address the limitations of traditional mirror therapy in stroke rehabilitation, such as rigid movement mapping and insufficient personalization, this study proposes a robot-assisted mirror rehabilitation framework integrating multimodal biofeedback. By synchronously capturing kinematic features of the unaffected upper limb and surface electromyography (sEMG) signals from the affected limb, a dual-modal feature fusion network based on a cross-attention mechanism is developed. This network dynamically generates a time-varying mirror ratio coefficient $\lambda$, which is incorporated into the exoskeleton’s admittance control loop. Combining a trajectory generation algorithm based on dynamic movement primitives (DMPs) with a compliant control strategy incorporating dynamic constraints, the system achieves personalized rehabilitation trajectory planning and safe interaction. Experimental results demonstrate that, compared to traditional mirror therapy, the proposed system exhibits superior performance in bilateral trajectory covariance metrics, the mirror symmetry index, and muscle activation levels. Full article

This study investigates how Iyengar yoga postures influence autonomic nervous system (ANS) activity by analyzing multimodal physiological signals collected via wearable sensors. The goal was to explore whether subtle postural variations elicit measurable autonomic responses and to identify which sensor features most effectively capture these changes. Participants performed a sequence of yoga poses while wearing synchronized sensors measuring electrodermal activity (EDA), heart rate variability, skin temperature, and motion. Interpretable machine learning models, including linear classifiers, were trained to distinguish physiological states and rank feature relevance. The results revealed that even minor postural adjustments led to significant shifts in ANS markers, with phasic EDA and RR interval features showing heightened sensitivity. Surprisingly, micro-movements captured via accelerometry and transient electrodermal reactivity, specifically EDA peak-to-RMS ratios, emerged as dominant contributors to classification performance. These findings suggest that small-scale kinematic and autonomic shifts, which are often overlooked, play a central role in the physiological effects of yoga. The study demonstrates that wearable sensor analytics can decode a more nuanced and granular physiological profile of mind–body practices than traditionally appreciated, offering a foundation for precision-tailored biofeedback systems and advancing objective approaches to yoga-based interventions. Full article

Virtual reality (VR) has emerged as a transformative tool in the treatment of phobias and the cultivation of emotional resilience. This study aims to explore the potential of VR to create controlled, immersive environments that facilitate exposure therapy, enabling individuals to confront and desensitize themselves to their fears in a safe and personalized manner. The flexibility of VR systems allows therapists to tailor scenarios to the unique needs of patients, addressing specific phobias such as acrophobia, arachnophobia, and social anxiety disorders. Beyond phobia treatment, VR’s capacity to simulate challenging or stress-inducing scenarios presents opportunities for fostering emotional resilience by building adaptive coping mechanisms and reducing stress responses over time. The integration of biofeedback and machine learning further enhances VR applications, enabling real-time adjustments based on physiological and psychological responses. In this article, the current advancements, underlying mechanisms, and challenges in leveraging VR technology for therapeutic purposes are discussed with a focus on its implications for mental health care. By combining immersive technology with evidence-based practices, VR offers a promising pathway for improving mental health outcomes and expanding the accessibility of therapeutic interventions. Full article

As mental health issues such as stress, anxiety, and depression become increasingly prevalent in urban populations, there is a critical need to embed restorative functions into the built environment. Urban parks, as integral components of ecological infrastructure, play a vital role in promoting psychological well-being. This study explores how diverse park environments facilitate mental health recovery through multi-sensory engagement, using integrated psychophysiological assessments in a wetland park in Zhengzhou, China. Electroencephalography (EEG) and perceived restoration scores were employed to evaluate recovery outcomes across four environmental types: waterfront, wetland, forest, and plaza. Key perceptual factors—including landscape design, spatial configuration, biodiversity, and facility quality—were validated and analyzed for their roles in shaping restorative experiences. Results reveal significant variation in recovery effectiveness across environments. Waterfront areas elicited the strongest physiological responses, while plazas demonstrated lower restorative benefits. Two recovery pathways were identified: a direct, sensory-driven process and a cognitively mediated route. Biodiversity promoted physiological restoration only when mediated by perceived restorative qualities, whereas landscape and spatial attributes produced more immediate effects. Facilities supported psychological recovery mainly through cognitive appraisal. The study proposes a smart park framework that incorporates environmental sensors, adaptive lighting, real-time biofeedback systems, and interactive interfaces to enhance user engagement and monitor well-being. These technologies enable urban parks to function as intelligent, health-supportive infrastructures within the broader built environment. The findings offer evidence-based guidance for designing responsive green spaces that contribute to mental resilience, aligning with the goals of smart city development and healthy life-building environments. Full article