Biofeedback use of heart rate variability during radiotherapy as a method of cognitive distraction and self-regulation in a pediatric patient: A case report

Abstract

Aim: To assess the effectiveness of heart rate variability (HRV) biofeedback during radiotherapy as an intervention to promote cognitive distraction and emotional regulation un a paediatric patient. Method: Patient is an 11 years old female with Ewing Sarcoma on left leg. She recieved 28 radiotherapy sessions. Before initiating treatment, the patient was assessed with Mini International NeuropsychiatricInterview KID (MINI KID). She did not have a psychiatirc diagnostic, nor significative anxiety asrated by these instruments. Two weeks prior initiating radiotherapy, Heart rate (HR) and heart ratevariability (HRV) (measures that have been used previously as physiologic corralates of stress andrelaxation) were measured with a specialized software called EmWave. Results identified that there wasa psysiologic activation related to stress. At the same session, the patient was trained in diaphragmaticbreathing assisted with HRV biofeedback. The day the radiotherapy treatment started, HR and HRVwere assessed an hour before. During radiotherapy, patient was instrumented to the software and thedisplay was projected on the ceiling so that she could interact with the program at the same time sherecieved radiotherapy. Patient was asked to choose the display she prefered (presented as interactivegames by EmWave) and HR as well as HRV were measured during treatment. Results: Changes in HRVduring radiotherapy were presented, these changes have been reported as indicative of self regulation,reflecting that the patient learned this behavior and was able to implement it during her treatment.Conclussion: The use of biofeedback is innovative in treatment with radiotherapy; it allows the patientto integrate the two most used methods for psychological preparation: attentional distraction andself regulation methods. It’s suggested to amplify the sample in order to learn more about the use ofbiofeedback in radiotherapy and generalize results.