The coronavirus has brought about major changes in society as a whole. In the work environment, telecommuting has increased, and in education, remote teaching has become the norm. Biofeedback therapy has been discontinued in coronavirus infections due to the fact that the treatment is performed in a closed room. I feel that biofeedback therapy is under pressure to change, just as society has changed adaptively in the wake of coronavirus infections. In order to achieve this, it is necessary to establish guidelines for the entire academic community.
In the great epidemic of new coronavirus infections, coronavirus disease 2019 (COVID-19), there are many possibilities that biofeedback can contribute to prevention, diagnosis, and treatment. This review paper addresses the ideal way of biofeedback (BF) using the latest technologies such as artificial intelligence (AI), information and communication technology (ICT), and virtual reality (VR). The useful points of AI and ICT in COVID-19 are as follows : early diagnosis, individual behavior tracking, rapid detection and prediction of prevalent areas, development of new drug and vaccine, monitoring of treatment progress, reduction of burden on medical staff, and early prevention. All of these points can be contributed by BF systems. The possibilities of BF are summarized by focusing on the following five points : reduction of medical burden by utilizing BF, infection prevention by BF, telemedicine using BF, reduction of home stress by BF, and provision of BF information to AI and ICT tools. For example, while the tendency to stay at home is increasing, for those who have mental health problems like fear of going out or difficulty in going to school or work, social training by VR at home, as well as telemedicine with medical institutions, may be a good strategy for treatment. In applying BF to medical and health activities, it is necessary to pay sufficient technical and ethical attention at each stage of data acquisition, research and development, and dissemination of use, and the role of the Japanese Society of Biofeedback is important to apply for BF technology.
The worldwide spread of COVID-19 infection is a serious problem in the field of rehabilitation. Physical therapy and occupational therapy in rehabilitation are therapeutic interventions that are based on intensive contact between therapists and patients in manual therapy and instruction of daily life activities, and it is difficult to practice preventative measures without such unavoidable “contact”. The three challenges of rehabilitation in COVID-19 calamity are the intensive contact work, difficulty in avoiding the “3 Cs” (closed spaces, crowded places, and close contact), and limitations in social activities. We have introduced electromyography BF and heart rate variability BF as BF applications to these problems. In the future, tele-rehabilitation will attract more attention in Japan as a preventative measure against infections, and the potential to apply BF is expected to increase.
Heart rate variability biofeedback (HRVB) refers to a therapy training that helps patients regulate their heart rate variability (variation in the time interval between consecutive normal heartbeats) based on a certain protocol. HRVB stimulates the cardiovascular system with its resonance frequency and enhances autonomic homeostatic function ; respiratory sinus arrhythmia and baroreceptor reflex play important roles in this process. The standard protocol of HRVB consists of regular training sessions about once a week and home practice for 40 minutes (20 minutes×2 times) per day. In the wake of the COVID-19 pandemic, face-to-face intervention in the laboratory and clinic requires sensitive care to prevent the transmission of COVID-19. However, remote HRVB intervention through online devices is fully possible, because biofeedback is by nature a technique for displaying and adjusting physiological responses through information devices. This paper first describes the mechanism and clinical effects of HRVB, and then explores the potential and ethical aspects of remote HRVB. Finally, the implications of future research on HRVB are discussed.
What should we do in order to continue using biofeedback for patients/clients waiting treatment/therapy during the SARS-CoV-2 (COVID-19) pandemic, when many are trying to avoid any unnecessary personal face-to-face contact? The authors have developed a new method of treatment using the web video conferencing system, frequently used these days in Japan. It combines the methodologies used in the three fields ; medicine, technology and psychology of JSBR (Japanese Society for Biofeedback Research). It also utilizes a combination treatment regimen of autogenic training, biofeedback and slow breathing, that the authors have been using in practice since the 1990s. Five female participants, who suffered from hypersensitivity to cold, were treated via the internet, and the positive results were televised on national television in Japan. The use of ICT (Information and Communication Technology) in a treatment/therapy setting is a very fragile one. The authors mention how ICT literacy on both ends (sending and receiving) of the communication is a key element in the “fair” use of communication tools via the internet.