Neurofeedback in Sport

In  recent  years,  there  has  been  an  increase  in research  and  practical  applications  concerning the use of biofeedback training for athletic performance  enhancement.  It  is  important  to  be  aware that the terms biofeedback and biofeedback training  are  not  identical,  and  therefore  need  to  be defined separately. Biofeedback (BFB) is the output from  an  electronic  device  with  sensors  and  electrodes, which allows immediate and objective measurements  of  personal  biological  functions.  This information  is  monitored  on  a  computer  screen and is transformed into auditory and visual signals, helping in learning to regulate body–mind activity in line with a basic psychophysiological principle. The  main  idea  of  this  principle  is  that  for  every physiological  change  there  is  a  parallel  change in  an  emotional  or  mental  component  of  human behavior,  and  vice  versa.  Biofeedback  training (BFBT) is a process of learning psychophysiological self-regulation  skills  using  information  from  a feedback  device.  Possible  models  of  BFBT  are  as follows:

  • One-to-one model: Sport psychologist or consultant and athlete work together throughout the sessions.
  • Group model: Sport psychologist or consultant and several athletes with BFB equipment for each athlete work in one laboratory.
  • Home practice: Athlete trains with portable BFB equipment at home, following sport psychologist or consultant’s written instructions.

Biofeedback Modalities

Biofeedback modalities refer to the types of physiological indicators used for feedback during BFBT:

  1. Cardiovascular or heart rate (HR) feedback measures heart activity using beats per minute (bpm) by electrocardiography. In addition, practitioners use measurements of interbeat interval (IBI), the time between heart beat and msec-heart rate variability (HRV). HR generally increases with an increase in stress, and vice versa.
  2. Muscle or surface electromyographic feedback measures muscle activity in microvolts (µV). In cases of an increase in stress, electromyography (EMG) usually increases, as does muscle tension, and vice versa.
  3. Temperature or thermal (T) feedback is a measurement of skin temperature as an indication of peripheral blood flow. Temperature feedback is measured in Fahrenheit (F) or Celsius (C) degrees. During an increase in stress, skin temperature decreases, and vice versa.
  1. Blood pressure (BP) feedback is the measurement of the force exerted by circulating blood on the walls of blood vessels. BP is measured in terms of the systolic pressure over diastolic pressure (mmHg), and it usually increases with increases in stress.
  2. Electrodermal activity (EDA) feedback is a measurement of changes in the electrical activity of the skin surface. It can be measured by skin resistance (historically known as galvanic skin response [GSR], units of kohms, kΩ), by skin conductance (SC, units of microsiemens, µS), and by skin potential (SP, units of millivolts, mV). SC is the preferred method in psychophysiology research. SC increases with higher arousal, and vice versa.
  1. Respiration (R) feedback is a measurement of the respiration rate, which is the number of breaths taken within a set amount of time (breaths per minute). Respiration rate can be recorded using a tensometric sensor inserted into a cuff that is fixed around the individual’s chest. R increases with increased stress, and vice versa.
  2. Electroencephalograph (EEG) feedback, more recently known as neurofeedback (NFB), is a measurement of brain wave activity. EEG frequency groups are: Delta (1–4 Hz), Theta (4–7 Hz), Alpha (8–12 Hz), Beta (13–36 Hz), and Gamma (36–44 Hz). The response range under stress increases from sleep states (Theta waves) to excitement (Beta waves).

Research and Applications

Biofeedback  research  and  applications  can  be dated  back  to  the  1960s,  when  the  focus  was  on the medical and clinical field. The primary modalities  used  in  research  in  health  care  and  cases  of trauma  and  injury  were  EMG,  EEG,  and  HR, especially in the laboratory setting.

The  main  goals  of  the  BFB  studies  in  this period  were  to  demonstrate  self-regulation  skills and  symptom  reduction.  Moreover,  researchers attempted to describe an optimal model of BFBT and  its  applications  in  clinical  practice.  Later, in  1975,  Leonard  Zaichkowsky,  the  pioneer  of biofeedback  application  in  sport,  described  the positive effect biofeedback had on athletic performance. Research on BFB (usually EMG) efficiency in  sport  focused  on  reducing  anxiety,  increasing muscle  strength,  and  decreasing  muscle  fatigue and  pain  in  different  kinds  of  sports.  The  EEG BFB  (neurofeedback)  studies  focused  on  psychomotor  efficiency  and  skilled  motor  performance; for example, enhanced performance in golf, shooting, and archery was shown to be associated with an increase in alpha (decreased cortical activation) activity in the left hemisphere. An additional trend in research and application of BFBT in sport was to  include  BFBT  as  part  of  a  larger  package  of psychological interventions. A major limitation of this period was the inability to transfer the results from sterile laboratory conditions to a field setting and  integrating  BFBT  into  the  training  process.

The  Wingate  Five-Step  Approach  (W5SA)  was developed to overcome this limitation.

The Wingate Five-Step Approach (W5SA)

The W5SA consists of five steps and a self-regulation test  (SRT).  Three  of  the  steps  are  provided  in  a laboratory setting and the last two under field and training conditions. The steps are as follows:

  1. Introduction: The main goal is to teach the athlete basic  self-regulation  techniques,  such  as relaxation,  imagery,  self-talk,  and  concentration. At the end of this step, EMG, HR, and GSR BFB are  used  as  part  of  the  athlete’s  mental  training, especially the use of auditory or visual signals. The duration of this step can last up to 10 to 15 sessions, while each session can last approximately 45 to 50 minutes.
  1. Identification: In this step, most of the work that is done focuses on identifying and strengthening   the   most   suitable   biofeedback   modality. Different   sports   require   different   biofeedback modalities.  For  example,  in  combat  sports,  EMG and GSR BFB are the most efficient modalities for measuring and practice. In contrast, EEG and HR are more suitable for sports such as golf, archery, and  shooting.  Additionally  in  this  step,  personal characteristics  and  the  specific  demands  of  the sport discipline should be taken into account. The duration of this step is approximately 15 sessions, each lasting 45 to 50 minutes.
  1. Simulation: The main goal of this step is to practice self-regulation and concentration skills in the  laboratory  setting  using  BFB  in  the  natural environment, such as watching video scenes under competitive situations. In addition, the basic self regulation  techniques  are  modified  according  to the  sport’s  demands.  In  this  step  relaxation  is shorter,  imagery  is  set  according  to  competition length,  and  self-talk  is  specific  to  the  competitive situation. This step lasts about 15 sessions, each of them approximately 50 to 60 minutes.
  1. Transformation: The  athlete  mentally  prepares for the upcoming competition. All the skills that the athlete learned and rehearsed in the laboratory are transferred and integrated into the actual training  setting  by  using  a  portable  BFB  device. This process allows the athlete to be prepared for future  competitions  by  acquiring  self-regulation abilities and mental readiness. This step lasts about 15 sessions and is provided during different parts of the training.
  1. Realization: In this step, BFB is used in different  settings,  such  as  the  field,  pool,  gym,  bus, and boat at sea. In addition, the BFB is accompanied with relaxation, concentration, and imagery, which  are  used  in  different  parts  of  the  competition,  such  as  before  the  start,  between  combats, after warm-up, and at the end of competition. The process  of  this  step  begins  by  applying  the  skills during less significant competitions, and gradually requesting  the  athlete  to  apply  the  skills  in  more significant events.

Self-regulation test (SRT) is given to the athlete before  the  beginning  of  the  program  and  before each step. The goal is to examine the self-regulation  level  of  the  athlete.  Recently,  practitioners have been integrating the W5SA with the athlete’s physical training, incorporating it within the periodization concept.


Neurofeedback  (NFB)  or  EEG  BFB  relates  to changes  in  electrocortical  activity  of  the  brain  as the physiological measure of emotional and cognitive processes. The historical development of NFB began in clinical settings using alpha-type training. Later,  research  focusing  on  performance  enhancement using neurofeedback of alpha activity in the left  hemisphere,  which  is  usually  associated  with expertise. Moreover, some research suggested that alpha range can be used as an indicator of attention processing. In sport, NFB is applied for the purpose of  optimizing  athletic  performance  by  the  athlete being able to master self-control and self-regulation strategies. For example, the first NFB study in sport examined the left–right hemispheric activity in rifle marksmanship. Neurofeedback training in sport is used in models for decreasing arousal or increased relaxation  skills  (alpha–theta  type  training)  and for increasing attention–performance relationships (theta–beta type training).

BFB in Exercise Psychology

The major goal of using BFB in exercise psychology  is  to  understand  exercise  behavior  and  the mechanisms  that  have  an  effect  on  participation rate  and  exercise  adherence.  In  line  with  this goal,  research  has  focused  on  the  effect  of  self-monitoring and self-regulation of exercise intensity

for  fitness  enjoyment,  as  well  as  adherence  rate. Results have indicated that the positive effects of BFBT  on  achieving  optimal  exercise  intensity  for health and well-being can be accomplished during a relatively short time period.

Professional BFB Organizations, Journals, and Equipment

Professional Organizations

There are four major international BFB organizations that provide annual meetings, workshops, and publications: (1) The Association for Applied Psychophysiology  and  Biofeedback  (AAPB)  in North America (; (2) The Biofeedback  Foundation  of  Europe  (BFE;; (3)  The  International  Society  for  Neurofeedback and  Research  (ISNR;;  and  (4)  The Biofeedback  Certification  International  Alliance (BCIA;,  which  provides  biofeedback  certification  according  to  the  Professional Standards and Ethical Principles.

Professional Journals

There  are  two  major  scholarly  journals:  (1) Applied   Psychophysiology   and   Biofeedback (APB),  formerly  known  as  Biofeedback  and  Self-Regulation,  and  (2)  Biofeedback.  Both  are  supported by the AAPB.

BFB Equipment

There  is  a  variety  of  biofeedback  equipment that can be used in laboratory and field settings, depending  on  the  intervention  goal.  Advanced technology  and  awareness  of  the  possibilities  of BFBT have led to the innovative and improvement of  BFB  electrodes,  noncontact  monitor  tools, telemetric  systems,  and  computer  programs.


  1. Association for Applied Psychophysiology and Biofeedback. (2011). Innovations in the application of biofeedback and neurofeedback for optimal performance [Special issue]. Biofeedback, 39(3).
  2. Blumenstein, B., Bar-Eli, M., & Tenenbaum, G. (Eds.). (2002). Brain and body in sport and exercise: Biofeedback applications in sport performance enhancement. New York: Wiley.
  3. Edmonds, A., & Tenenbaum, G. (Eds.). (2012). Case studies in applied psychophysiology: Neurofeedback and biofeedback treatments for advances in human performance. Chichester, UK: Wiley-Blackwell.
  4. Leonards, J. (2003). Sport psychophysiology: The current status of biofeedback with athletes. Biofeedback, 31(4), 20–23.
  5. Vernon, D. J. (2005). Can neurofeedback training enhance performance? An evaluation of the evidence with implications for future research. Applied Psychophysiology and Biofeedback, 30(4), 347–364.
  6. Wilson, V., & Gunkelman, J. (2001). Neurofeedback in sport. Biofeedback, 29(1), 16–18.
  7. Zaichkowsky, L. (2009). A case for new sport psychology: Applied psychophysiology and fMRI neuroscience. In R. Schinke (Ed.), Contemporary sport psychology (pp. 21–32). New York: Nova Science.

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