Feasibility and Acceptability of a Virtual Single-Session Biofeedback Intervention Targeting Circulation, Heart Rate, and Anxiety for Rural Patients With Chronic Pain.

BACKGROUND

Chronic pain affects one in five Americans, yet rural patients face significant barriers to evidence-based interventions like biofeedback due to geographic isolation and provider shortages.

OBJECTIVE

This pilot study evaluates the feasibility, acceptability, and preliminary effectiveness of Mind Meter, a virtual neuroscience-based biofeedback group intervention, for rural adults with chronic pain.

METHODS

Twenty-nine rural-dwelling adults (mean age 44.9, SD 11.8) with chronic pain (≥3 months) were recruited from a pain management program and twenty-one participants completed a single-session virtual Mind Meter group, integrating pain neuroscience education and biofeedback via affordable equipment (pulse oximeters, skin thermometers). Feasibility was assessed by enrollment (target ≥50%), adherence (≥80%), and completion rates (≥75%); acceptability via a 10-item questionnaire (target ≥80% rating ≥4/5); and preliminary effectiveness via pre-post changes in heart rate, temperature, pain, and anxiety, analyzed with paired t-tests (adjusted P < 0.05).

RESULTS

Enrollment was 22% (29/132 eligible), below target, while adherence reached 100%, exceeding goals. Acceptability was high, with 90.5% rating the intervention ≥4/5 (mean 4.3, SD 0.9), particularly for clarity of directions (95.2% ≥ 4). Statistically significant pre-post improvements occurred in anxiety (mean change -2.2, SD 2.4, P < 0.001, Hedge's g = -0.886) and temperature (mean increase 4.6°F, SD 6.1, P = 0.003, g = 0.726); pain decreased (mean -0.8, SD 1.5, P = 0.025) but lost statistical significance after correction for multiple comparisons. Heart rate showed no change (P = 0.615).

CONCLUSION

Virtual Mind Meter is feasible and highly acceptable for rural patients with chronic pain, with promising reductions in anxiety and temperature. Lower than hypothesized enrollment warrants recruitment strategy-adjustments, while preliminary outcomes support further development.