Botulinum toxin type A injection combined with biofeedback in the treatment of spastic pelvic floor syndrome

BACKGROUND Spastic pelvic floor syndrome(SPFS)is a refractory pelvic floor disease characterized by abnormal(uncoordinated)contractions of the external anal sphincter and puborectalis muscle during defecation,resulting in rectal emptation and obstructive constipation.The clinical manifestations of SPFS are mainly characterized by difficult defecation,often accompanied by a sense of anal blockage and drooping.Manual defecation is usually needed during defecation.From physical examination,it is commonly observed that the patient's anal muscle tension is high,and it is difficult or even impossible to enter with his fingers.AIM To investigate the characteristics of anorectal pressure and botulinum toxin A injection combined with biofeedback in treating pelvic floor muscle spasm syndrome.METHODS Retrospective analysis of 50 patients diagnosed with pelvic floor spasm syndrome.All patients underwent pelvic floor surface electromyography assessment,anorectal dynamics examination,botulinum toxin type A injection 100 U intramuscular injection,and two cycles of biofeedback therapy.RESULTS After the botulinum toxin A injection combined with two cycles of biofeedback therapy,the patient's postoperative resting and systolic blood pressure were significantly lower than before surgery(P<0.05).Moreover,the electromyography index of the patients in the resting stage and post-resting stages was significantly lower than before surgery(P<0.05).CONCLUSION Botulinum toxin A injection combined with biofeedback can significantly reduce pelvic floor muscle tension in treating pelvic floor muscle spasm syndrome.Anorectal manometry is an effective method to evaluate the efficacy of treatment objectively.However,randomized controlled trials are needed.

Study on the treatment of dysphagia after stroke with electromyographic biofeedback intensive training

BACKGROUND Dysphagia,or swallowing disorder,is a common complication following stroke,significantly impacting patients'quality of life.Electromyographic biofeedback(EMGBF)therapy has emerged as a potential rehabilitation technique to improve swallowing function,but its efficacy in comparison with conventional treatments remains to be further explored.AIM To investigate the effects of different treatment intensities of EMGBF on swallowing function and motor speed after stroke.METHODS The participants were divided into three groups,all of which received routine neurological drug therapy and motor function rehabilitation training.On the basis of routine swallowing disorder training,the EMGBF group received additional EMGBF training,while the enhanced EMGBF group received two additional training sessions.Four weeks before and after treatment,the degree of swallowing disorder was evaluated using the degree of swallowing disorder score(VGF)and the Rosenbek penetration-aspiration scale(PAS).RESULTS Initially,there was no significant difference in VGF and PAS scores among the groups(P>0.05).After four weeks,all groups showed significant improvement in both VGF scores and PAS scores.Furthermore,the standardized swallowing assessment and videofluoroscopic dysphagia scale scores also improved significantly post-treatment,indicating enhanced swallowing function and motor function of the hyoid-bone laryngeal complex,particularly in the intensive EMGBF group.CONCLUSION EMGBF training is more effective than traditional swallowing training in improving swallowing function and the movement rate of the hyoid laryngeal complex in patients with post-stroke dysphagia.

Galvanic Skin Response—Extinction Biofeedback Training for Psychogenic Abdominal Pain: A Validation Protocol

Abdominal and pelvic pain of psychogenic origin is a widespread, disabling, difficult to identify, and often inadequately treated medical condition. This condition is often associated with poor quality of life due to high pain interference with daily activities. Cognitive behavioral psychological therapy and neuromodulation with biofeedback are validated therapies for the treatment of this condition. Aim of the present research work is the validation of a therapeutic protocol that involves the use of both techniques in combination. 20 patients diagnosed with psychogenic abdominal pain, of both sexes, aged between 18 and 60 years who had not benefited from pharmacological therapies were enrolled. 10 patients were randomly assigned to the control group (psychological treatment only), another 10 patients were assigned to the study group (neuromodulation with biofeedback-Galvanic skin response-extinction in combination with psychological therapy). For both groups, the pain score, interference of pain with daily living activities, pain relief, and the share of anxiety associated with the pain condition were evaluated (pre- and post-treatment). The patients who underwent the combined treatment achieved statistically significant better scores than patients in the control group, respectively −4.9 ± 0.9 vs −1.0 ± 0.4 for Pain;−5.1 ± 1.1 vs −0.9 ± 0.3 for Interference with life;−7.2 ± 3.7 vs −2.2 ± 2.1 for HAMA;4.6 ± 1.2 vs 1.1 ± 0.6 for Relief.

The Efficacy of Electromyographic Biofeedback Combined with Swallowing Training on Post- Stroke Dysphagia

Objective:This paper focuses on the research and discussion of the efficacy of electromyographic biofeedback combined with swallowing training on post-stroke dysphagia.Methods:This study randomly sampled and analyzed 68 patients with post-stroke dysphagia from January 2023 to December 2023,34 cases of swallowing training intervention were grouped as the control group,and 34 cases of electromyography biofeedback combined with swallowing training intervention were grouped as the study group,and the clinical therapeutic effects of the two groups of patients after receiving the two different modes of intervention were compared.Results:The swallowing function of patients in both groups improved,and the VFSS score of patients in the seminar group was significantly higher than that of the control group,indicating that the clinical efficacy of the seminar group was more significant.The nasal feeding tube extraction rate,extraction time,and quality of life scores of the seminar group were better than those of the control group(P<0.05),which is of research value.Conclusion:For patients with post-stroke dysphagia,treatment with electromyography biofeedback combined with swallowing training mode can significantly improve their swallowing function.This effective intervention can not only shorten the time for patients to remove the nasal feeding tube but also help to improve the quality of life of patients,which is worth using.

Psychological Nursing Combined with Biofeedback to Promote the Rehabilitation of Patients with Anxiety Disorders

Objective:To explore the effect of psychological nursing combined with biofeedback on the rehabilitation of patients with anxiety disorders.Methods:100 patients with anxiety disorders in our hospital from January to December 2021 were randomly divided into two groups:control group(n=50)and study group(n=50).The control group was given routine nursing,while the study group was given psychological nursing combined with biofeedback.The changes of self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score,symptom score,and quality of life of the two groups were compared before and after nursing.Results:Before nursing,there was no significant difference in the scores of SAS and SDS between the two groups,but after nursing,the scores of SAS and SDS in the study group were lower than those in the control group,and the degree of improvement in the study group was higher than that of the control group.Before nursing,there was no significant difference in the scores of symptoms between the two groups(P>0.05),but after nursing,the scores of stress,crying spells,tremor,and general discomfort in the study group were lower than those of the control group(P<0.05).Besides,before nursing,there was no significant difference in the quality of life between the two groups(P>0.05),but after nursing,the scores of physical function,psychological activity,social ability,and material life in the study group were higher than those in the control group(P<0.05).Moreover,the degree of improvement after nursing in the study group was better than that of the control group.Conclusion:Psychological nursing combined with biofeedback to promote the rehabilitation of patients with anxiety disorders effectively improves the negative emotion of patients,reduces stress,depression,tremor,and general discomfort,and improve the overall quality of life.Therefore,it is worth further popularization.

Visual function and biofeedback training of patients with central vision loss:a review

Older individuals with macular diseases,such as age-related macular degeneration,experience central vision loss(CVL)due to degeneration of their photoreceptors and retinal cells.Patients with CVL may experience various vision impairments,including of visual acuity,fixation stability,contrast sensitivity,and stereoacuity.After CVL,most patients develop a preferred retinal locus outside the affected macular region,which serves as a new visual reference.In this review,we provide an overview of the visual function and impairment in individuals with CVL.In addition,the important role of biofeedback training on the visual function and activity of individuals with CVL is also reviewed.Accordingly,the location and development of the preferred retinal loci are discussed.Finally,this review discusses how to conduct biofeedback training to treat individuals with CVL.

Vision rehabilitation using microperimetric biofeedback training in age-related macular degeneration

·AIM: To determine the impact of microperimetric biofeedback training(MBFT) on the quality of vision in patients with age-related macular degeneration(AMD).·METHODS: This study was a prospective, interventional, comparative study with subjects of patients diagnosed with AMD in the National Eye Center Cicendo Eye Hospital, Indonesia. Patients were randomly divided into two groups, intervention and non-intervention with 18 patients in each group. The intervention group would receive six MBFT training sessions of 10-minute time duration each.·RESULTS: A statistically significant improvement of best corrected visual acuity(BCVA) was found after the intervention, from 1.24±0.416 to 0.83±0.242(log MAR;P<0.001). A statistically significant improvement for near vision acuity(NVA) was also observed, from 1.02±0.307 log MAR to 0.69±0.278 log MAR(P<0.001). In addition, reading rate increased, from 40.83±30.411 to 65.06±31.598 words/min(P<0.001). Similarly, a comparison of changes in BCVA, NVA, and reading rate between intervention and non-intervention groups showed a significant difference(P<0.001).·CONCLUSION: MBFT significantly and positively impacts visual acuity, NVA, and reading rate in patients with AMD.

Biofeedback therapy for dyssynergic defecation

Dyssynergic defecation is one of the most common forms of functional constipation both in children and adults; it is defined by incomplete evacuation of fecal material from the rectum due to paradoxical contraction or failure to relax pelvic floor muscles when straining to defecate. This is believed to be a behavioral disorder because there.are no associated morphological or neurological abnormalities, and consequently biofeedback training has been recommended for treatment. Biofeedback involves the use of pressure measurements or averaged electromyographic activity within the anal canal to teach patients how to relax pelvic floor muscles when straining to defecate. This is often combined with teaching the patient more appropriate techniques for straining （increasing intra-abdominal pressure） and having the patient practice defecating a water filled balloon. Tn adults, randomized controlled trials show that this form of biofeedback is more effective than laxatives, general muscle relaxation exercises （described as sham biofeedback）, and drugs to relax skeletal muscles. Moreover, its effectiveness is specific to patients who have dyssynergic defecation and not slow transit constipation. However, in children, no clear superiority for biofeedback compared to laxatives has been demonstrated. Based on three randomized controlled studies in the last two years, biofeedback appears to be the preferred treatment for dyssynergic defecation in adults.

Biofeedback-guided pelvic floor exercise therapy for obstructive defecation: An effective alternative

AIM: To compare biofeedback-guided pelvic floor exercise therapy (BFT) with the use of oral polyethylene glycol (PEG) for the treatment of obstructive defecation.

Botulinum toxin type-A injection to treat patients with intractable anismus unresponsive to simple biofeedback training

AIM: To evaluate the efficacy of botulinum toxin type A injection to the puborectalis and external sphincter muscle in the treatment of patients with anismus unresponsive to simple biofeedback training.

Biofeedback therapy for chronic pelvic pain syndrome

<abstract>Aim: To evaluate the efficacy of biofeedback therapy in patients with chronic pelvic pain syndrome (CPPS). Methods: From November 2001 to April 2002, patients visiting the Urological Outpatient Clinic of this Hospital were evaluated by means of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and classified by the NIH classification standard. Sixty-two patients of CPPS category Ⅲwere involved in this study. All patients had been treated by conventional approaches such as antibiotics and alpha-blockers for more than half a year without any improvement. The expressed prostatic secretion results were as follows: WBC 5 to 9/high power field, lipid +-+++and bacterial culture negative. Their NIH-CPSI were 12-40. All the 62 cases complained of micturitional irritation (frequency, urgency, splitted stream and sense of residual urine), 32 cases, of pain or discomfort at the testicular, penile, scrotal, pelvic or rectal region and 13 cases, of white secretion-dripping. The patients were treated by the Urostym Biofeedback equipment (Laborie Co., Canada) 5 times a week for 2 weeks with a stimulus intensity of 15 mA-23 mA and duration of 20 minutes. Results: Sixty patients were significantly improved or cured, while no significant improvement in the remaining 2. No apparent side effect was observed. The NIH-CPSI dropped to 6 to 14 with an average reduction of 21 (P<0.01). In the 60 improved cases, pain was relieved after 2-3 treatment courses and other symptoms disappeared after 4-5 courses. Conclusion: Biofeedback therapy is a safe and effective treatment for CPPS. Large randomized clinical trials are needed to confirm its efficacy and to explore the mechanism of action.

Efficacy of biofeedback therapy via a mini wireless device on sleep bruxism contrasted with occlusal splint:a pilot study

The putative causes of bruxism are multifactorial and there are no definite measures for bruxism management.The aim of this study was to evaluate the efficacy of biofeedback therapy on sleep bruxism,compared with occlusal splint.Twenty-four volunteers with sleep bruxism were divided into two groups：the GTB group that were treated with biofeedback therapy（n 512） and the GTO group that were treated with occlusal splint（n 512）.A mini pressure sensor integrated with a monitoring circuit by use of a maxillary biofeedback splint was fabricated.To foster the relaxation of the masticatory muscles and the nervous system,the wireless device received signals from bruxism events and vibrations alerted the bruxer when the threshold was exceeded.Total episodes and average duration of bruxism events during8 hours of sleep were analyzed with the monitoring program（TRMY1.0）.After 6 and 12 weeks,the episodes（P 50.001） and duration（P,0.05） in the GTB group declined dramatically.In contrast,there were no significant differences in the GTO group after the treatment（P.0.05）.Furthermore,the episodes had significant differences between the GTB group and the GTO group after the same period of treatment（P 5 0.000）.The results suggest that biofeedback therapy may be an effective and convenient measure for mild bruxers,when compared with occlusal splint therapy.The mini wireless biofeedback method may be of value for the diagnosis and management of bruxism in the future.

Biofeedback therapy improves motor function following stroke Meta-analysis of 14 articles from Chinese Medical Institutions

OBJECTIVE： To evaluate feasibility of biofeedback therapy in China Medical Institutions to improve dysfunction following stroke. DATA SOURCE： A computer-based online search of publications was conducted using the Vip and PubMed Databases to identify publications that addressed biofeedback. The search key words included ＂electromyogram＂, ＂biofeedback＂, and ＂stroke＂. In total, 81 articles were retrieved. DATA SELECTION： Studies closely related to biofeedback, or studies with contents recently published in the same study field or in authorized journals, were included. Duplicated articles were excluded. Following full-text retrieval of selected articles, a total of 14 articles were collected, which addressed randomized, controlled trials of biofeedback therapy for dysfunction after stroke. Methodological quality was assessed for randomized, controlled trials using criteria from Cochrane reviewers＇ handbook. Results were analyzed using Revman 4.2 software. MAIN OUTCOME MEASURES： Outcomes and evaluation indices were expressed by odds ratio （OR）, weighted mean difference （WMD）, and 95% confidence interval （95% CO. Potential publication bias was presented using the funnel plot. RESULTS： The study included 14 randomized, controlled trials of 1 147 patients. Following biofeedback therapy, meta-analysis results demonstrated that： （1） The total effective rate was significantly greater in the biofeedback therapy group compared with the control group [OR = 3.46, 95% Cl （2.09, 5.73）, P = 0.62]. （2） Electromyogram changes were better in biofeedback therapy patients compared to the control group [WMD= 22.31, 95% C/（17.19, 27.43）, P〈 0.001]. （3） Motor function was better in biofeedback therapy patients compared with the control group [WMD = 12.43, 95% CI （6.71, 18.16）, P 〈 0.001]. （4） Daily living activities were better in biofeedback therapy patients compared with the control group [WMD= 18.11, 95% C/（15.77, 20.44）, P= 0.36]. （5） Joint range of motion was better in biofeedback therapy patients compared with the control group [WMD = 6.43, 95% Cl （4.44, 8.41）, P = 0.77]. Sensitivity analysis also demonstrated similar results after eliminating articles that described unknown diagnostic criteria and statistical methods. CONCLUSION： Following stroke, biofeedback therapy for dysfunction was shown to result in significant and valid outcomes, increased motor function and electromyogram values, improved joint range of motion, and improved daily living activities.

A Controlled Study of the Effectiveness of EEG Biofeedback Training on Children with Attention Deficit Hyperactivity Disorder

In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the effectiveness of electroencephalogram (EEG) biofeedback training. Of all the 60 children with ADHD aged more than 6 years, the effective rate of EEG biofeedback training was 91.6 % after 40 sessions of EEG biofeedback training. Before and after treatment by EEG biofeedback training, the overall indexes of IVA were significantly improved among predominately inattentive, hyperactive, and combined subtype of children with ADHD (P<0.001). It was suggested that EEG biofeedback training was an effective and vital treatment on children with ADHD.

Effect of biofeedback combined with high-quality nursing in treatment of functional constipation

BACKGROUND Functional constipation(FC)is a common functional gastrointestinal disease with various clinical manifestations.It is a physical and mental disease,which seriously affects patient physical and mental health and quality of life.Biofeedback therapy is the treatment of choice for FC,especially outlet obstructive constipation caused by pelvic floor dysfunction.High-quality nursing is a new nursing model in modern clinical work and a new concept of modern nursing service.AIM To explore the effect of biofeedback combined with high-quality nursing in the treatment of FC.METHODS A total of 100 patients with FC admitted to our hospital from March 2015 to July 2019 were selected for clinical observation.These patients were randomly divided into two groups of 50:Experimental group(biofeedback combined with highquality nursing treatment group)and control group(biofeedback group).RESULTS The constipation symptom score of the experimental group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The anal canal resting pressure and initial defecation threshold of the experimental group were significantly lower than those of the control group,and the maximum squeeze systolic pressure of the anal canal of the experimental group was significantly higher than that of the control group(P<0.05).The Self-Rating Anxiety Scale and Zung’s Self-Rating Depression Scale scores of the two groups were significantly lower than before treatment.The Self-Rating Anxiety Scale and Self-Rating Depression Scale scores of the experimental group were significantly lower than those of the control group(P<0.05).The patient satisfaction score of the experimental group was significantly higher than that of the control group(P<0.05).CONCLUSION The application of biofeedback combined with high-quality nursing in the treatment of FC has significant advantages over pure biofeedback treatment,and it is worthy of promotion in clinical work.

Research on Combined Rehabilitation Method and Its Mechanism of Traditional Chinese Medicine Daoyin Technique with Biofeedback Technique

Objective: To study an anti resistance active exercise training method which is consistent with the principle of “transcendental goal power” to promote the plasticity change of central nervous system (CNS) in order to recover the motor function after CNS injury, observe its clinical effect and explore its mechanism. Methods: The potential of CNS was induced by six-step Daoyin technique of Chinese medicine, and the potential signal was received in real time by bio-electrical signal receiving equipment and displayed in curve form. Combined with the Operant conditioning biofeedback technique, targeted guidance was given to patients to continuously enhance the action muscle signal intensity and weaken the antagonistic muscle signal intensity, so that the motor program was gradually re-established. Sixty-four patients with hemiplegic elbow dysfunction of old cerebral infarction who had been trained but could not be improved further and had a history of more than 1 year were treated for one course, 90 times and 45 minutes each time. Lovett, Elbow Rom, Fugl-Meyer, program signal intensity and proportion were evaluated before and after treatment. The data were analyzed statistically. Before and after treatment, Lovett MMT, ROM of elbow joint, Fugl Meyer, motor program signal intensity and proportion were assessed, and the data were statistically analyzed. Results: After treatment and before treatment, there was a significant difference between the functional evaluation data (P < 0.01). The function of elbow joint was improved;this is the result of reconstructing the motor program on the basis of developing the potential of CNS by means of the “transcendental goal power” mechanism of the method. There was no recurrence after 6 months of follow-up. Conclusion: The Chinese Medicine Daoyin feedback rehabilitation technique is an effective method to improve elbow joint function of hemiplegia patients with cerebral infarction.

Technical Innovation of Electrostimulation Biofeedback Combined with Vaginal Dumbbell in the Treatment of Postpartum Pelvic Floor Dysfunction

Objective: To investigate the application value of electrostimulation biofeedback therapy in combination with vaginal dumbbell therapy to postpartum pelvic floor dysfunction. Methods: Retrospective analysis of 200 cases of postpartum pelvic floor dysfunction patients discharged from the hospital from January 2016 to March 2019 as study subjects who were excluded other underlying diseases and were randomly divided into two groups of 100 cases per group, using electrostimulation biofeedback therapy combined vaginal dumbbell therapy as a treatment group. The treatment of electrostimulation biofeedback therapy in combination with kegel was treated as a control group. Then the curative effects of the two groups were compared and statistically analyzed. Results: There was no significant difference in EMG value of postpartum pelvic floor treatment, type I muscle strength, type II muscle strength, muscle type I fatigue, type II fatigue and POP-Q detection results between the two groups before treatment, p > 0.05. There were significant differences in type I muscle strength, type II muscle strength and muscle type I fatigue between the pelvic floor muscles and the muscles at the end of the treatment day, the sixth month and one year after treatment, p ?There was no statistically significant difference at?the end of muscle type II fatigue?treatment day, p > 0.05;while after the treatment of six months and one year, the difference was statistically significant, p 0.05. In addition, the treatment group and the control group were compared before and after treatment, the difference of myoelectric potential value, pelvic floor muscle type I muscle strength, type II muscle strength, muscle type I fatigue degree, type II fatigue degree and POP-Q test result were significant, and the changes in the indicators before and after treatment in the treatment group were significantly higher than the control group. Comparison of urinary incontinence between the two groups before and after treatment, the difference between pre-treatment and the end of treatment day was not statistically significant, p > 0.05;there was significant difference between half a year and one year after treatment (p 0.05, respectively). Comparing?the satisfaction with sexual life after the time of treatment day, half a year and one year after the end of treatment, the difference was statistically significant (p ?Conclusion: Electrical stimulation biofeedback therapy combined with vaginal dumbbell therapy has a good effect in the treatment of postpartum pelvic floor dysfunction, and it is worthy of popularization and application.

Biofeedback Enhanced Lifestyle Intervention: Exploring the Experience of Participants in a Novel Intervention for Disinhibited Eating and Obesity

Obesity increases risks for heart disease, diabetes, and some cancers. Disinhibited Eating (DE) is an inconsistent ability to control overeating in the absence of hunger and is related to obesity and failed weight loss attempts. However, there are no effective interventions for simultaneously treating DE and obesity, so the Biofeedback Enhanced Lifestyle Intervention (BELI) was developed. BELI included novel techniques and some that could be considered burdensome and uncomfortable. Evidence of acceptability and feasibility of BELI should be established before resources are devoted to an efficacy study. This study aimed to evaluate the acceptability and feasibility of BELI. Overweight/obese (OW/Ob) women with a tendency toward DE were recruited. BELI consisted of five counseling sessions, hunger biofeedback, child role modeling, and self-monitoring. Focus group data, process evaluation data, a satisfaction survey, and objective measures of weight and eating behaviors were collected. In exit focus groups participants reported BELI facilitated positive changes. Process evaluation data showed modest attrition (20%), good compliance, and feasibility of delivery. 100% of BELI completers reported high satisfaction. There were trends in improvements in weight status, eating behaviors, mood, and stress. Implications of this study are to conduct a pilot study of BELI to establish efficacy.

A preliminary study on the treatment of bruxism by biofeedback therapy

Objective: To evaluate the effect of wireless biofeedback therapy on bruxism. Methods: Fifteen bruxiers participated to be treated by this therapy. The abnormal movements of teeth during sleep were monitored by a maxillary splint with an electric resistance strain gauge. Meanwhile, the receiver device recorded these details and analyzed the data, including the value of the biting force, occurring time and duration. If the value of biting force or duration exceeds the threshold, a vibrating device like a watch style will alert the patient to relax the masticatory muscles and nervous system to stop the abnormal grinding or clenching. Data were recorded during 8 hours’ sleep and analyzed after the 12 weeks’ treatment and 24 weeks’ treatment. Results: The average episodes of bruxism have declined from (10.60 ± 1.23) to (6.60 ± 0.75) after 12 weeks’ treatment (p < 0.05), and the average duration of bruxism events was reduced from (13.2 ± 0.74) s to (6.50 ± 0.40) s (p < 0.05). The average episodes of bruxism have declined to (3.80 ± 0.64) after 24 weeks’ treatment, and the average duration of bruxism events was reduced to (3.37 ± 0.34) s (p < 0.05). Conclusions: The results suggest that biofeedback therapy can be effective for bruxism treatment.

Examination of the Impact of Condensed Biofeedback Training on Acute Stress Responses

The objective of this study was to measure the effects of a condensed 90 minute Biofeedback Training (BFT) method on stress response and decision making performance under stress. Forty one novice male participants received either BFT training, which incorporated diaphragmatic breathing with Stress Inoculation Training (SIT), or a control training task. Participants completed pre- and post-training assessments which incorporated a socio evaluative stress induction method followed immediately by performance of a simulation-based decision making under stress scenario. Stress was assessed using real-time physiological measures of the Autonomic Nervous System (ANS) response and cortisol measures of the Hypothalamic-Pituitary-Adrenal (HPA) axis stress response. Perceived stress was measured using the state portion of the State Trait Anxiety Inventory and decision making performance was assessed during scenario performance. Results showed that participants in the BFT condition experienced a significant reduction in cortisol from pre-training to post-training, while the control group did not. However, BFT participants did not experience statistically significant reductions in ANS stress response or in perceived stress compared to the control group. Participants in the biofeedback group experienced greater improvements in performance from pre-training to post-training compared to the control group;however, these results only approached statistical significance (p = 0.09). These results suggest that the condensed BFT method has the potential to impart the knowledge and skills necessary to implement the biofeedback-based coping mechanisms;however, it may require additional practice time to allow the technique to be utilized more effectively.