Enhancing Autonomic Regulation and Attention Through Biofeedback in Female Athletes

Optimal performance in elite athletes is shaped by a combination of physical preparedness and psychological readiness, where managing stress and anxiety is as critical as enhancing physical capabilities. Competitive anxiety can disrupt cognitive functioning, attention, and decision-making, affecting athletes' composure and overall performance. Cognitive abilities such as attentional control, mental flexibility, and perceptual-motor coordination are vital during high-pressure moments in sports, especially team sports like volleyball. Emerging approaches in applied sports psychology have started using biofeedback (BFB) to address these psychological and cognitive demands. BFB enables athletes to consciously regulate physiological responses associated with stress, such as heart rate variability (HRV), galvanic skin response (GSR), peripheral temperature (PT), and muscle activity, by providing real-time feedback. These interventions aim to enhance autonomic control, emotional regulation, and ultimately, cognitive performance. Multimodal BFB interventions that simultaneously target several physiological parameters are gaining attention for their potential to support mental readiness and attentional performance in athletes. However, the application of such protocols in team sports remains underexplored. Given the high cognitive demands of volleyball, especially in sustained attention and rapid decision-making under pressure, there is a need to examine whether multimodal BFB can produce meaningful improvements in these areas. This study investigated the effects of a five-week, 15-session multimodal BFB intervention on sustained attention and physiological responses in competitive female volleyball players. It was hypothesized that the intervention would lead to measurable physiological changes-specifically a reduction in GSR and an increase in PT-which in turn would support improved cognitive performance in the form of enhanced sustained attention.