Gastric Biofeedback in Virtual Reality: Feasibility, Efficacy and Self-Reported Experience

Normal gastric functioning (normogastria) is characterized by rhythmic gastric myoelectric activity, while dysrhythmic gastric activity (bradygastria and tachygastria) is associated with symptoms such as nausea, epigastric discomfort and fullness. Gastric biofeedback using electrogastrography (EGG) has emerged as a promising tool to regulate gastric rhythm, but research remains limited with few experimental studies. The current study (N = 94) tested a novel gastric biofeedback training in virtual reality (VR). We used a randomized controlled study design with three groups: (1) VR gastric biofeedback training, (2) the same training on a 2D screen and (3) a relaxation control group. We examined (1) the trajectory of gastric activity before, during, and after training (2) participants' ability to increase normogastria and reduce dysrhythmic activity and (3) self-reported experiences (motivation, attention, mood, presence, user acceptance, etc.). Results showed the expected peak in normogastria and a nadir in dysrhythmic activity during training, with a significant reduction in dysrhythmic gastric activity across sessions. Participants reported an improved ability to handle physical discomfort over time. VR and 2D groups reported faster time perception and better concentration than controls. Spatial presence (i.e., the feeling of "being there") was higher in the VR group than in the 2D group. Enjoyment, concentration, and alertness were initially high but declined over time in all groups. The results demonstrate the general technical feasibility of the paradigm and positive evaluations. Further research is needed to better understand the underlying mechanisms and to determine whether and how training success may relate to beneficial outcomes in clinical populations.