This integrative philosophy brings an entirely different definition and response to good stress, athletic performance, and everyday life. Learn to harness the power of total body mind synchronicity and showcase your talent and skill under pressure! Terry is an important part of the Gillet Evernham team.
He brings a positive thought process to any situation and keeps our key crew members and drivers focused on what is important - performance! We are pleased to have Dr. Lyles on board with the Doug Herbert racing team. He brings with him principles and ideas that maximize the potential of all our team members and ultimately will help us get to the finish line ahead of our competition at over MPH! Terry Lyles possesses an incredibly unique life gift: He selflessly shares what he has learned in working through his own personal trials, and shows people how to convert challenges, and even tragedies, into inner strength and success.
Defining Sports Specialization
I wholeheartedly endorse this book! Terry Lyles. He pulls this wisdom from his huge pot of life experiences and research and blesses all the people around him with sage advice and wonderful encouragement. Utilizing technology as a tool adds a unique and critical component, broadening the perspective of the process for personal performance management and improved outcomes. He has catapulted me to the next level in my life and in my athletic performance on pit road! Terry Lyles about soldiers coping with the strain of battle in Afghanistan. Terry Lyles holds a Ph. He teaches groups of all ages how to Navigate Life Storms through life balance training.
Lyles has trained hundreds of individuals including Fire Rescue workers in and around Ground Zero, International Forensic Medical teams in the Asian torn Tsunami area and the United States Air Force Space Command, sharing his time-tested, scientifically measured approach to stress utilization. Terry Lyles is the "Stress Coach". This unique technology of stress utilization has been used by companies such as DaimlerChrysler, Estee Lauder, Pfizer, Universal Studios, Tommy Hilfiger, and has been quoted by many within these organizations as providing "a life changing experience" and "the greatest stress management training I have ever seen".
Lyles' book, " Performance Under Pressure ", covers how stress , competition, and chaos can be harnessed to actually increase productivity and performance without causing undue hardship to the body.
How Does Stress Affect Sports Performance?
It offers specific tools on how people can redirect negative stress into positive constructive energy. Redirecting the trauma of stress was at the heart of the training Dr. Lyles used these techniques to do for hundreds of corporate and public safety workers in and around Ground Zero in New York following the tragedy, and in the Tsunami Rescue and Recovery effort. If they have one mental thought that says, 'If I miss this shot we lose' It's all about taking yourself out of the moment, he explains, about using rituals to transport yourself before the shot or point.
They've shot thousands of foul shots, but the issue is not shooting the foul shot, the issue is screaming fans, no time on the clock, and your whole team is looking for you to perform. The issue is focus. Biofeedback data are presented simultaneously in both auditory and visual modalities to enhance the user's perception and improve the usability of the interface.
In EmWave2 , the indicator light works together with an audio cue to show coherence between respiration and heart rhythm Lemaire et al. The auditory and visual modalities can also be used separately to present various types of bio-data. For instance, Adelbach et al. Besides the form-giving, interactive media also play an important role in user interaction with biofeedback systems. Based on the dominant interactive medium in the user interface, the selected studies can be classified roughly into four categories, as shown in Figure 6B.
Screen-based biofeedback systems are used in most of the studies. The ambient medium allows the users to receive biofeedback information through the surroundings in a physical environment. The respiration data can be presented by physical space that changes shape Adelbach et al. In recent years, Virtual Reality VR devices have also been used in biofeedback displays in order to enhance immersive relaxing experiences Gaggioli et al.
Biofeedback techniques are widely used in relaxation training, such as resonant breathing, positive imagery, yoga, and meditation. In these biofeedback-assisted types of training, users typically sit quietly and focus on self-regulation practices using feedback. The biofeedback systems serve as a tool to facilitate the acquisition of particular self-regulation skills. Biofeedback has also been used in imagery relaxation e. Besides assisting with relaxation training, biofeedback techniques are also used to improve users' resilience to acute stress as well as, negative emotional and mental stimuli.
Typically, this type of biofeedback training is performed during or just after a simulated stressful experience, such as a stressful work task e. Here, the biofeedback helps to improve users' awareness of their stress and find a better mostly personalized approach to reducing or moderating stress responses, e. The evaluation of biofeedback training varied widely in the selected studies. These can be broadly divided into five categories, based on the approaches taken and the standards adopted: pre-test post-test design, within-subjects design, between-subjects design, quasi-experiment design, and Randomized Controlled Trial RCT.
Three studies Cutshall et al. A total of 18 studies used within-subjects design and 23 studies used between-subjects design including 20 RCTs. In addition, two studies Wu et al. To investigate the effects of biofeedback training, a control group or a control condition is usually required for comparison. In addition, biofeedback training can also be compared with other relaxation approaches, such as a watching a relaxing video Sanchez et al. Table 4 shows typical metrics used to assess the effectiveness of biofeedback for stress alleviation.
These metrics include four types of measurements: physiological, psychological, performance, and relaxing experience. HRV is the physiological metric that is most commonly used. In an ambulatory recording, HRV can indicate the regulatory capacity of an individual facing a stressful situation or event. In short recordings 5—15 min , HRV is highly related to respiratory cycles.
This is why it provides a better indication of the effectiveness of biofeedback for regulating breathing. HRV includes a series of parameters that are calculated from the IBI analysis in the time or frequency domain. Figure 7. The physiological and psychological measures used to evaluate biofeedback training for stress management A. HRV is the most commonly used physiological measure B. STAI is the most commonly used psychological measure.
In a stressful situation, the body's sympathetic nervous system is activated, which quickly increases heart rate, blood pressure, and respiration rate. So heart rate and respiration rate provide a simple and direct measurement of the body's stress responses. As shown in Table 4 , ten studies measured the average heart rate, and nine studies measured respiration rate.
SCL is also known as tonic level. It is continually changing and closely related to the autonomic regulation. SCRs show that the phasic responses ride on top of the tonic changes. SCRs change fast and are more sensitive to emotionally arousing stimuli and events. One study Bhandari et al. Table 4 lists typical self-report instruments from the selected studies. STAI has 20 items for assessing trait anxiety and 20 items for state anxiety.
It is therefore better suited to experiments that require repeated measurements or have a time limit. Because the questions in PSS ask about feelings and thoughts during the past month, it is more suitable for measuring the general stress level in one's life and the degree to which situations in life are appraised as stressful. Depression, Anxiety, and Stress Scale DASS is designed to measure four related negative emotional states: depression, anxiety, tension, and stress.
Each scale contains 14 items, which measure the average level of emotional states during the past week. This is why they are more suitable for evaluating the effects of a long-term biofeedback intervention. Performance measurements can produce a score of a mentally challenging task including calculation work Yokoyama et al. The measurements can be specialized by tasks, such as a psychomotor vigilance task Lee and Finkelstein, , lactation yield Feijs et al.
In addition, in seven studies, qualitative data about user experience were also collected through a follow-up interview and observations. The qualitative studies were designed to gain more insights into user experience and user opinions on interaction design. The interview data can be used to support the interpretation of quantitative data and provide more information about psychological states.
This systematic review inventories the biofeedback techniques, feedback displays, use scenarios, and evaluation approaches in the selected studies. The use of biofeedback techniques is broadly classified into two types: assistance with training in relaxation and intervention in a stressful task. Based on this review, we found that an increasing number of casual and personal biofeedback systems have been designed for everyday stress management, which does not require a coach or a therapist. This has raised new demands for biofeedback systems in terms of biosensing, information display, HCI design, and evaluation.
Biofeedback information can be classified into two types: that reflecting a physiological process designed to assist in self-regulation performance feedback and that indicating the results of self-regulation training result indices. For the first type, measured bio-signals are usually processed simply and presented immediately, as in the graphic display of IBI data Sutarto et al.
Immediate feedback enables users to learn to regulate their physiological activities through practice in controlling the feedback in real time. This closed-loop mechanism provides the basis for improving self-regulation skills through a process of trial and error. The feedback of results information informs users about their training results and the goals they have achieved e. Biofeedback systems may provide users with one or more types of information.
From our review, it appears that unimodal biofeedback systems are more widely used in everyday stress management. Unimodal biofeedback systems monitor and present a specific physiological activity, such as respiration Morarend et al. Users usually focus on a single self-regulation goal e. Because fewer biosensors are needed, unimodal biofeedback devices are usually portable and easy to operate e.
Multimodal biofeedback systems, such as NeXus 3 from MindMedia , can measure various physiological activities synchronously by using a wide range of biosensors. Such systems provide richer information, indicating both performance levels and the results of practicing self-regulation. For instance, the multimodal biofeedback system makes it possible to calculate the relationship between various physiological processes, such as the resonance score between HRV and respiration Meier and Welch, However, it has also become clear from this review that multimodal biofeedback systems require new designs of information display to enhance user perception and understanding of multiple feedback information and also more advanced biosensing techniques to improve the usability and comfort of the biosensors.
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In this review, we found that most of the current biofeedback applications still use traditional biosensing techniques and approaches, such as using a photoplethysmogram PPG sensor clip on the fingertip to measure IBI McCraty et al. We think this might be because physiological signals are prone to interference from body movements. Traditional biosensing approaches can efficiently avoid motion artifact and improve the signal-to-noise ratio.
Although such biosensors and attachment approaches are acceptable in clinical applications, unobtrusive comfortable data collection is urgently required for everyday use. Especially when it comes to relaxation training, attaching multiple wired sensors restricts the user's posture, degrades the user experience or even may introduce new forms of stress. Interestingly, many wearable contactless biosensors already exist, but these are mostly used for monitoring, and not yet for biofeedback. For instance, the Emaptica's E4 4 wristband offers an ambulatory recording of heart rate, electrodermal activity, and temperature.
The Spire's Stone 5 is a wearable device that monitors respiration via the expansion and contraction of the torso. Adib et al. Droitcour et al. Cho et al. Alongside these new biosensing technologies, traditional biosensors can still be used, but with new wearable designs to improve usability and comfort. For instance, the traditional PPG sensor can be integrated into an earphone Poh et al. These mobile and non-contact sensors and newly-developed wearables are speeding up the application of biofeedback technology in an everyday context.
The presentation of biofeedback information may affect the perception and interpretation of information and also the user experience. Based on the studies reviewed, graphic user interfaces GUI are most commonly used to present information in a clear and precise manner. However, these basic visual or audio displays tend to be difficult to understand when first used and tend not to engage users in long-term use. In everyday use, such displays present a high barrier for non-specialist users and seem less engaging for relaxation training in non-clinical contexts, such as at home or in the workplace.
This is why, in new interfaces, biofeedback data are presented through a richer form of interaction including casual games Al Osman et al. For multimodal biofeedback systems, the concurrent feedback of multi-channel bio-data requires the investment of more effort in visualization and interface design. For instance, different data can be mapped onto various visual elements of the interface De Jonckheere et al.
A biofeedback display can enhance relaxation but may also cause new forms of stress. For instance, in musical biofeedback interfaces e. Fortunately, our review shows that insights from HCI research have been used to address user experience and engagement by exploring new forms of biofeedback, such as musical displays Yokoyama et al. These new interfaces offer users a more comfortable and relaxing condition for biofeedback training. However, they may also require more effort for users to learn about and adapt to them.
As documented in Table 1 , most current biofeedback applications still rely on a pre-scheduled training plan or program. Although a growing number of personal biofeedback devices can be used in daily life with no need for the assistance of a therapist, they were still used in the same way as in clinical training programs. For instance, college students completed an HRV biofeedback training program 20 min per day, 5 days per week in a dedicated office space Henriques et al. Manufacturing operators performed five biofeedback training sessions 20 min once a week in a special training room at their factory Sutarto et al.
Some training programs involve a stress-induction session before the biofeedback session. Users first perform a mentally challenging task to induce a stress response and then learn to control and reduce that stress by means of self-regulation. Biofeedback training may take longer e. On the one hand, biofeedback systems can help users acquire and enhance self-regulation skills. For this purpose, biofeedback techniques are often used in a multi-session training program lasting from 3 days Bouchard et al. On the other hand, biofeedback system can also facilitate relaxation, during which the biofeedback enables users to be aware of their bodily activities and regulate their physiology in a positive direction, e.
In such cases, biofeedback can be used in a one-off relaxation session, which usually takes 5—30 min Moraveji et al. The principles and practice of biofeedback training have been proposed for clinicians Basmajian, , However, most studies have not investigated the optimum duration of biofeedback and the efficiency of learning skills and practicing relaxation. We did not find any suggestions and guidelines for the duration of biofeedback training for everyday stress management.
From another perspective, beyond program-based regular biofeedback training, we believe the potential of biofeedback might be achieved through casual use. We think a stressful situation in real life presents the best opportunity to learn how to control stress. As shown in Table 4 , validation of biofeedback applications depends mainly on two types of metrics: physiological and psychological measures. The physiological data measured for biofeedback can also be stored and further analyzed to generate metrics for use in evaluation.
In most evaluations, physiological measures are required to validate the biofeedback training comprehensively. For instance, to evaluate the effectiveness of an HRV biofeedback system for stress management, blood pressure, and salivary cortisol level Lemaire et al. In these cases, users have to wear more biosensors, which limit evaluations to lab settings. The psychological measures are often collected by applying a survey method involving standardized questionnaires. Users usually complete these surveys before and after a session of biofeedback training. Our review shows that most of these evaluations were conducted in laboratory settings and focused on the effectiveness of biofeedback systems or training programs.
To gain more insights into everyday biofeedback design, we suggest a long-term field evaluation that combines quantitative with qualitative methods. Other researchers have also suggested the need for a transition from laboratory study to field research e. Field evaluations involve collecting users' data outside a laboratory or a training room, where the researchers may monitor, interview, and observe them in a familiar environment. Long-term physiological measurements may offer more robust and reliable metrics which reflect a users' real stress levels.
In addition, interviews during field evaluations can provide high-quality data about user experience because interviewers can adjust their questions based on specific situations to clarify issues or acquire further insights. Moreover, field evaluation makes it possible to observe users' behavior, e.
Based on this review, it appears that a new biofeedback paradigm beyond traditional clinical applications is emerging. This is also creating new demands and challenges. Computer-mediated self-use is gradually replacing therapist-mediated biofeedback training.
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In such cases, users have to perceive and interpret feedback themselves. For long-term use, the systems also need to provide a good user experience and motivate users to engage further in biofeedback training. We believe that these challenges might be addressed by applying new interactive technologies and HCI principles in biofeedback systems.
New interactive technologies may help biofeedback better blend into an everyday context, improving its accessibility, usability, and comfort. For instance, HRV biofeedback using ambient light could improve a user's awareness of stress and trigger behavioral conditioning, such as deep breathing Yu et al. In home environments, biofeedback can be displayed by a Chinese ink painting projected on the wall Zhu et al. An increasing number of everyday objects are being redesigned as handy biofeedback tools so that the users can use them more easily at any time.
For instance, users can take a BioFidget out of their pocket and practice deep breathing when they feel stressed Liang et al. As Internet of Things IoT technology improves, we see that emerging IoT systems can serve as a new platform for biofeedback. Inhabitants' physiological data can be sensed unobtrusively. The collected multiple personal data are then analyzed using deep-learning techniques that generate more useful information, not only about the state of physiology and health but also about the behaviors and lifestyle that lead to that state.
This information can be presented to users through IoT devices that are distributed in the environment, thus both improving their awareness of physiology and further assisting them to regulate it in a healthy direction. To our knowledge, there has not been any research looking at integrating IoT and biofeedback technologies. We suggest that this might be a promising direction for future research. Moreover, we suggest using well-established HCI theories in the design of biofeedback which could enhance engagement as well as the user experience. For instance, when biofeedback is used to improve users' awareness of stress at work, we suggest an interesting direction of peripheral biofeedback, which has been explored preliminarily by Moraveji et al.
In line with the vision of Calm Technology Weiser and Brown, , we believe that leveraging human attention abilities in peripheral interactions Bakker et al. Acquiring self-regulation skills through biofeedback is not easy. It takes time and practice. So how to encourage users to engage in biofeedback training is an issue that deserves study. We suggest combining biofeedback with persuasive technology Intille, And we believe that the ubiquitous biosensing and interactive technologies in everyday environments that are described in this article make it feasible to provide persuasive biofeedback at the right time and place so that users are more likely to change their behavior and practice self-regulation.
The aim of this review was to provide a reference for other researchers and designers so that they can better understand the current status of biofeedback technologies and their application for stress management. The results indicate that HRV and multimodal biofeedback systems are most commonly used and screen-based visual displays are the most common biofeedback interfaces.
Biofeedback applications are mainly based on a pre-scheduled training routine and mostly assessed in laboratory settings, using both physiological and psychological measurements. This review also reveals several challenges arising in biofeedback for everyday stress management, including accessibility, usability, comfort, engagement, and user experience. We expect that new HCI technologies and theories will help meet these challenges.
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Moreover, we suggest a long-term field evaluation method that combines quantitative with qualitative methods in order to better understand the effects of biofeedback in everyday use, and how it influences users' behavior and lifestyle when they engage in stress management. BY and QW carried out the database search, abstract screening, and selection of the final articles for review.
BY processed the literature data, performed the analysis, drafted the manuscript, and designed the figures. Both MF and JH contributed to the final version of the manuscript. LF supervised the study. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. NN the number of pairs of successive inter-beat-intervals that differ by more than 50 ms. Abdelrahman, Y. Google Scholar. Adelbach, H.
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