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Updated: Jul 27, 2026

Psychophysiological Stress Assessment Using Biofeedback
Published on: July 31, 2009
The effects of biofeedback training on athletes' mental health and performance: a systematic review and Bayesian
Xuda Zhang1, Zhizhao Chang2, Shiao Zhao1
1Faculty of Health Sciences and Sports, Macao Polytechnic University, Macau, Macao SAR, China.
Background:
Biofeedback and neurofeedback are increasingly used in sports psychology, yet their overall effectiveness for athletes' mental health, athletic performance, and cognitive performance remains unclear.
Methods:
We conducted a systematic review of randomized controlled trials across eight databases and performed Bayesian random-effects meta-analyses. Study selection used ASReview with the SAFE rule; full-text screening was done in Covidence; risk of bias followed Cochrane guidance; certainty of evidence was appraised with GRADE.
Results:
Forty-one studies met inclusion. Pooled effects were statistically significant across domains: mental health µ(SMD)=0.76 (95% CrI 0.44-1.09), athletic performance µ(SMD)=0.88 (0.69-1.05), and cognitive performance µ(SMD)=0.81 (0.48-1.14).
Conclusion:
Biofeedback and neurofeedback benefit athletes across mental, athletic, and cognitive outcomes. Given heterogeneity and sample sizes, further rigorous trials are warranted to refine the estimates.
Systematic Review Registration:
PROSPERO registration CRD420251015094.
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