Research on biofeedback
What is biofeedback and why is it being researched?
Biofeedback is used to measure the body's physiological signals, such as heart rate variation, temperature and muscle tension. By viewing these signals in real time, you can learn how your body responds to breathing, stress and relaxation. The method has been studied since the late 1960s, particularly in psychology, neuroscience and physiology. The European and American scientific community defines biofeedback as a learning process in which technological measurements make it easier to understand and influence one's own bodily reactions (AAPB 2025).
International research on self-regulation and HRV training
Much of today's research examines how biofeedback affects the autonomic nervous system and processes such as stress reactions and physiological regulation. Several meta-analyses show that heart rate variability (HRV) biofeedback, which combines calm breathing with real-time heartbeat measurements, can strengthen the body's ability to regulate stress (Goessl et al. 2017; Lehrer et al. 2020). Studies have also been published that point to connections between biofeedback and factors such as emotion regulation, sleep quality and sense of control (Pizzoli et al. 2021). These studies investigate physiological
processes and perceived effects.
Norwegian research: Ten years of development at NTNU and St. Olavs hospital
In Norway, the research on biofeedback has been thorough and long-lasting. The work started with a meta-analysis in 2016 that investigated the use of biofeedback to reduce migraines in children (Stubberud et al. 2016). This was followed by the development of early app prototypes that assessed both the technology's functionality, usability studies and how sensors worked in practice (Stubberud et al. 2018; Stubberud et al. 2020; Ingvaldsen et al. 2021). In parallel, sensor technology was tested against standardized clinical equipment to ensure the accuracy of the measurements.
From pilot studies to a large randomized trial
The research gradually progressed from development and testing to pilot studies investigating how home-based biofeedback could be implemented over time as a treatment for episodic migraine in adults (Poole et al. 2025). The pilot work laid the groundwork for a larger randomized trial, which was conducted in 2024 with 286 participants. The study is described in detail in a published protocol (Poole et al. 2025), and the results were presented at the European Headache Congress in 2024. The findings show that app-based biofeedback can be carried out at home over several weeks and that the participants found the method relevant and useful in everyday life.
Participants' experiences support the knowledge base
In qualitative feedback, many participants described how biofeedback made it easier to understand their own stress reactions. Several found it meaningful to see the signals on the screen while exercising. Participants also said that short sessions were feasible in a busy schedule. Such experiences are in line with international literature on how real-time feedback can strengthen learning in the nervous system and promote self-regulation (AAPB 2025; Nestoriuc et al. 2008).
An established method in international literature
Biofeedback is currently mentioned in review articles, textbooks and guidelines in applied psychophysiology. Several leading institutions, such as the Mayo Clinic in the USA, describe the method as a tool for learning more about your own physiology. Overall, the research shows that biofeedback is a well-researched method for understanding and training the body's own regulatory processes. Cenli is building on this knowledge base by making the technology available as a home-based training tool.
References
AAPB. 2025. What is biofeedback. Association for Applied Psychophysiology and Biofeedback. https://aapb.org/
Goessl VC, Curtiss JE, Hofmann SG. The effect of heart rate variability biofeedback training on stress and anxiety: a meta-analysis. Psychol Med. 2017;47:2578-86.
Ingvaldsen SH, Tronvik E, Brenner E, et al. A Biofeedback App for Migraine: Development and Usability Study. JMIR Form Res. 2021;5:e23229.
Lehrer P, Kaur K, Sharma A, et al. Heart Rate Variability Biofeedback Improves Emotional and Physical Health and Performance: A Systematic Review and Meta Analysis. Appl Psychophysiol Biofeedback. 2020;45:109-29.
Nestoriuc Y, Martin A, Rief W, et al. Biofeedback treatment for headache disorders: a comprehensive efficacy review. Appl Psychophysiol Biofeedback. 2008;33:125-40.
Pizzoli SFM, Marzorati C, Gatti D, et al. A meta-analysis on heart rate variability biofeedback and depressive symptoms. Sci Rep. 2021;11:6650.
Poole AC, Stubberud A, Simpson M, et al. Biofeedback therapy using Cerebri for the
prevention of migraine attacks in adults with episodic migraine (BioCer): a randomized, wait-list controlled trial - the study protocol. F1000Res. 2025;13:775.
Poole AC, Winnberg IG, Simpson MR, et al. Feasibility of a 12-Week, Therapist-Independent, Smartphone-Based Biofeedback Treatment for Episodic Migraine in Adults: Single-Center, Open-Label, 1-Armed Trial. JMIR Hum Factors. 2025 Jun;12:e59622.
Stubberud A, Varkey E, McCrory DC, et al. Biofeedback as Prophylaxis for Pediatric Migraine: A Meta-analysis. Pediatrics. 2016;138:e20160675.
Stubberud A, Omland PM, Tronvik E, et al. Wireless surface electromyography and skin temperature sensors for biofeedback treatment of headache: validation study with stationary control equipment. JMIR Biomed Engineering. 2018;3:e1.
Stubberud A, Tronvik E, Olsen A, et al. Biofeedback Treatment App for Pediatric Migraine: Development and Usability Study. Headache. 2020;60:889-901.
