Biofeedback's effect on sports performance: a meta-analysis and analysis of moderators
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Since the late 1970s, research and applied work has focused on the use of biofeedback as a technique to assist in the development of sports performance through different means, including improvement of sports skills, reduction of injuries, and improvement of muscle strength, among others. However, there is no scientific work statistically comparing these implementations using biofeedback. A meta-analysis was designed towards this gap in the literature; 33 investigations were gathered and statistically compared. Dependent variables, (e.g. the type of biofeedback, and the number of biofeedback sessions) were treated as moderators and their effect on the overall analysis were calculated. A random effect model was used due to the presence of heterogeneity across studies (I^2 = 54.95 (p<0.001, 95% CI), that included variations on the studies' compared outcomes. The meta-analysis' overall result showed a significant effect of biofeedback interventions on sports performance through a strong effect size, d = 0.72, with a high significance Z= 6.77, p<0.001, (95% confidence interval (CI) 0.51 - 0.93). Significant moderators' effects were found indicating that studies using EMG modality (d= 0.891, 95% CI 0.60 -1.18,p < 0.001, Z= 6.05), studies with the number of sessions higher than 8 (d = 0.84, 95% CI 0.40 -1.27, p<0.001, Z= 3.77), studies targeting outcomes indirectly linked to sports performance (d = 0.91, 95% CI 0.59- 1.22, p<0.001, Z = 5.64), and studies using biofeedback along with other interventions (d = 0.90, 95% CI 0.48 -1.32, p<0.001, Z= 4.18) had higher effect on the overall analysis. The meta-analysis findings are an important reference for researchers and practitioners using biofeedback, because they indicate that biofeedback interventions have a positive effect on sports performance. Moreover, the meta-analysis point to methodological factors playing an important role on interventions using biofeedback, as studies that had a greater effect were those with methods using EMG biofeedback modality, studies with more than eight biofeedback sessions, studies focusing on outcome measures indirectly related to sports performance, and studies that included biofeedback interventions along with other interventions.
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