This week, we have the honor to have Len Zaichkowsky, PhD, world’s class expert in biofeedback/psychophysiology, and cognitive fitness, write another article on “Biofeedback Applications in Sports”. Of note, Len has worked with many elite pro teams (Warriors (NBA), Penguins (NHL), Vancouver Canucks (NHL), Real Madrid, National Spanish soccer team…) over the years. Len is going to write a series of articles for the Upside on biofeedback, psychophysiology, and cognitive fitness. Today we are publishing his second article.

Title: Biofeedback Applications in Sports

By Len Zaichkowsky, PhD

The application of biofeedback (BFK) or applied psychophysiology to the field of sports science is a rather recent phenomenon, although I published my first peer reviewed paper on using biofeedback in sport back in 1977.  For the purposes of this article I will briefly describe what biofeedback is, followed by the historical development of this technology, then describe my experiences with biofeedback and conclude with current applications that are being used globally.

What is Biofeedback?

Biofeedback is a technology and technique that utilizes instrumentation that includes sensors, transducers, and displays of some type, which allows immediate measurement of biological functions that humans are typically not aware of and not typically under voluntary control (e.g. heart rate, brain waves). (See Figure 1 below that shows an athlete connected to a medical device called ProComp infiniti developed by Thought Technology-Montreal).   This biological information is displayed and “fed back” to the individual, usually in the form of a visual display on a monitor or auditory sound.  It is usually the case that a “clinician”, sport psychologist or sport scientist assists the individual to develop strategies for gaining self-control over a particular modality.

The major biofeedback modalities that have been used in sports are:

1. Muscle (EMG),
2. Thermal (T),
3. Electrodermal (SC or GSR),
4. Cardiovascular (HR, HRV),
5. Respiration (R),
6.  Brain Wave (EEG), although EEG biofeedback has come to be known as Neurofeedback.

Figure 1: Athlete receiving feedback

Most studies published on biofeedback and sports have focused on the use of biofeedback to control performance anxiety/arousal.  Initially EMG was used in the field of physical medicine by physiotherapists to measure and monitor muscle tension throughout the body. Psychologists then began to use EMG biofeedback help train relaxation of muscles most impacted by psychological stress.  The early thinking was that tension appeared first in the forehead, so why not teach individuals to relax the frontalis muscle.  However, it was quickly learned that there were huge individual differences in response to stress and that the frontalis was not the “master” muscle for stress.  The use of respiration feedback (with chest strain gauges) shortly followed, then heart rate biofeedback, electrodermal feedback, temperature, and some EEG.

So why is the application of biofeedback important to the world of sport?

Biofeedback offers tremendous advantages to coaches, trainers, and athletes who are interested in becoming more aware of how thoughts and feelings affect the body and performance.  Specifically this technology allows sport scientists to perform two critical functions, 1. Measure biological stress reactions, and 2. Train the athlete to self-regulate these stress reactions.

  1. Measurement: BFK enables the objective assessment of an individual’s stress profile.  This is usually done by recording baseline psychophysiology from the modalities of interest.  Following several minutes of baseline recording, a stressor is presented to the individual (such as counting backwards by 7’s), and changes in psychophysiology are recorded. Later I will describe the protocol I used with the Vancouver Canucks in the “Mindgym” that I developed (Figure 2).

Figure 2: Mindgym at the Vancouver Canucks (NHL).

  1. Self-Regulation Training

In order for us to learn any skill (cognitive or motor), two conditions are necessary.  First you need to receive feedback and this usually comes from a teacher, a coach, or video. The second essential condition is practice.  So with feedback and practice anyone can learn a skill including the self-regulation of distant biological functions, once thought to be impossible.  In Vancouver, I used biofeedback self-regulation training to help hockey players better self-regulate their emotions, muscle tension, and levels of fatigue (after training and competition).

Following is the protocol I used with Canucks players to develop a “stress profile”.  First they would sit comfortably in the reclining chair (Figure 1 and 2), and my assistant or I would attach sensors that detected their brain waves (EEG), muscle tension (EMG) Skin Temperature (T) skin conductance or sweat (SC), heart rate and heart rate variability (HR/HRV).  I asked them to simply relax with eyes closed and I would get a baseline of their relaxation response for 3 minutes.  I would then tell them to watch their monitor and follow instructions for a 2 minute task.  The first stress task was usually doing a serial 7’s task, that is, counting backwards by 7 from say the number 93 as fast as they could.  Then I would ask them to relax again for 2 minutes so that I could record their recovery from the stressor.  I would then ask them to do task 2 and this was usually the Stroop test for 2 minutes.  The Stroop test is a challenging neuropsychological task where the subject is shown a colored word.  The response needs to say the color of the word and not the word itself.  We concluded the profile with another 3 minute relaxation or stress recovery session.  All of us respond differently to cognitive stressors. Some respond with extreme sweat responses, others with heart rate increase, muscle tension, etc. and that is the reason to measure all psychophysiological metrics.  Knowing this I could focus on a particular set of measures for training stress regulation.

Self-Regulation Training Protocol

Many of the players on the Canucks roster were intrigued by this biofeedback technology and wanted to use it to better master emotional control, focus of attention and recovery. However,  I quickly discovered recovery from training and competition was the most important factor for individual and team success.  As such I used a simple 10 minute HR/HRV protocol that trained “resonance breathing”.  Resonance breathing involves learning to breath at 6 respirations per minute and lowering heart rate (see Figure 3).  The use of the “Pacer” quickly taught the athletes to breath at a rate of 6 respirations per minute.  They would breath in and follow the ball that rolled to the top of the pacer then slowly dropped with expiration. The athletes attempted to synchronize their heart beat with respiration rate by watching the monitor and get the red and blue lines to move in near synchrony (see top of the photo below).   When they could do this they were in “resonance”.  Amazingly the hockey players could learn this skill in 2-3 training 10 minute sessions.

Figure 3  Training software

The concept of the “Mindroom” was coined by Dr. Bruno DeMichalis at AC Milan several decades ago.  Of course a great deal of the AC Milan success was attributed to the use of the Mindroom in the late 90’s and early 2000 years.  Dr. DeMichaelis and head coach/manager Carlo Ancelotti continued to incorporate the Mindroom laboratory when they moved to Chelsea FC in 2009.  Shortly after I assisted Real Madrid FC in setting up their Mindroom or what I relabeled the “Mindgym”.  I then established the Mindgym with the Vancouver Canucks the first of its kind in North American professional sport. I also consulted with the ASPIRE Academy and Dr. Valter DeSalvo in Doha Qatar to assist in setting up their Mindgym.  Today it is without question the most sophisticated biofeedback setup in high performance sport around the world.

It is worth mentioning several other success stories in high performance sport that could be attributed to the use of biofeedback technology.  Back in 2007, Tim Harkness of South African trained Indian shooter Abhinev Bindra for the 2008 Beijing summer Olympic games using a variety of modalities to train relaxation, steadiness, and awareness necessary to win the gold in 10 meter air rifle shooting. Bindra became India’s first ever individual Olympic gold medal winner. (see Figure 4).  Harkness also effectively used EMG (muscle) feedback to train golfers to better replicate their swing.  My fellow sport psychology colleagues associated with the Canadian winter Olympic team in 2010 (Vancouver), and 2014 (Sochi) also utilized biofeedback to train a number of individual sport athletes with a great deal of medal success.

Figure 4: Abhinev Bindra

The Evolution of Biofeedback/Neurofeedback Technology

When I first started researching and applying biofeedback to sport, the equipment was extremely large and expensive. (See Figure 5). Training was limited to a laboratory with the usual concern by coaches of transfer of training, i.e. Did laboratory training transfer to the playing field?

Figure 5: Early biofeedback days

Wearables that we have today were limited except for the Polar HR monitor that I used extensively with athletes with it first appeared on the market.  Today wearable technology companies have emerged all over the globe, feeding back psychophysiological data with Apps and devices to the athlete user.  A limitation of the many wearables is the accuracy of their measurement compared to laboratory based medical grade equipment.  Nevertheless, I believe this explosion in the development of biofeedback/neurofeedback technology will continue to have a positive impact on the fields of medicine, psychology, education, neuroscience, and sport.

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