The Effectiveness of a Neurofeedback-assisted Mindfulness Training using Mobile Application on Stress Reduction in Employees: A Randomized Controlled Trial (Preprint)

BACKGROUND Mindfulness-based training programs are known to be effective in reducing stress levels. OBJECTIVE This study examines the effectiveness of a 4-week neurofeedback-assisted mindfulness-based training program delivered via a mobile application for employees. METHODS Participants (n = 92) with a full-time job were assigned to one of three groups: Group 1 (n = 29) receiving mobile neurofeedback-assisted mindfulness training; group 2 (n = 32) receiving mobile mindfulness training without neurofeedback function; and group 3 (n = 31) receiving self-learning with paper materials about stress management. The primary outcome measures were perceived stress scale and brief resilience scale. Heart rate variability and two-channel electroencephalography were utilized as physiological measurements. These measurements were collected at three different times; at baseline, post-training, and one-month follow-up. Generalized estimating equation was used for the analysis. RESULTS In regard to the resilience scale, a significant interaction (time × group) was observed. In the post-hoc analysis, a significant difference between groups 1 and 3 was found at the post-training assessment, and the significant change remained at 1-month follow-up assessment in group 1. As for physiological measurements, relaxation index showed a significant interaction (time × group difference), and group 1 showed the highest improvement compared to group 2 and group 3 at 1-month follow-up assessment. CONCLUSIONS During the 4-week mindfulness-based training program delivered via mobile application, group 1 with neurofeedback-assistance showed better outcomes on resilience and relaxation compared to the other groups. Further research with a larger sample and a longer follow-up period is needed for generalizing our results. CLINICALTRIAL NCT 03787407