JMIR Publications

ABSTRACT

Background:

Recent advancements in Virtual Reality (VR) and Bio-feedback (BF) technologies have opened new avenues for breath training, particularly in individuals with psychological disorders. This study explores the integration of VR and BF to enhance user engagement in self-help breath training—a multifaceted approach encompassing mindful breathing, guided breathing, and breath counting techniques.

Objective:

Despite the availability of diverse breath training methods, their varying effectiveness and the underlying neuro-mechanisms remain insufficiently understood. We investigated using electroencephalography (EEG) indices across multiple breath training modalities to address this gap.

Methods:

Our VR-based breath training environment incorporated real-time EEG, heart rate, and breath signals monitoring. We examined four distinct breath training conditions in a cross-sectional experiment involving 51 healthy young adults.

Results:

Notably, EEG band power across theta, alpha, low-beta, high-beta, and gamma bands varied significantly over the entire scalp. Outflow analysis identified condition-specific variations in the delta, alpha, and gamma bands, while inflow analysis revealed significant differences across all frequency bands. Connectivity flow analysis highlighted the predominant influence of the right frontal, central, and parietal brain regions in the neuro-mechanisms underlying the breath training techniques.

Conclusions:

This study contributes neurological evidence supporting the effectiveness of self-help breath training through the combined use of VR and BF technologies. Our findings suggest the involvement of internal–external attention focus and the dorsal attention network in different breath training conditions. Furthermore, we propose avenues for future research, emphasizing the exploration of applications and gamification potential in combined VR and BF-guided breath training. Clinical Trial: The data collection process in this study did not meet the criteria of randomized controlled trial registration.