Ellis, Louise (2016) The use of biofeedback in the remission of pre-competition sickness in athletes: Breathing your way to success. In: Global practices and training in applied sport, exercise and performance psychology: A case study approach. Routledge, New York, USA, pp. 88-94. ISBN 978-1-138-80596-5

Pre-competition sickness, nausea, and gastrointestinal problems are somatic symptoms experienced by a number of elite athletes and performance artists (Lederman, 1999). Whilst there are some very famous and indeed successful athletes who experience heightened anxiety and pre-competition sickness, there are others who find the consequences of pre-competition sickness disruptive and overbearing. Causes of pre-competition sickness have been attributed to changes in psycho-physiological states, such as changes in cognitive thought processes, breathing patterns, and increased adrenaline.
One technology gaining increasing momentum in sport psychology is the application of biofeedback training. Biofeedback modalities have, for example, been effective in applied psycho-physiology to improve breathing (Gilbert, 2005) and reduce panic attacks (Meuret, Wilhem, & Roth, 2001), and in sport psychology to improve imagery (Oishi, Kasai, & Maeshima, 2000) and manage competitive stress (Lagos, Vaschillo, Vaschillo, Lehrer, Bates, & Pandina, 2008). Biofeedback is a process of monitoring physiological responses, such as muscle tension, galvanic skin response, heart rate, respiration rate, body temperature, and electrical activity of the brain – known as neurofeedback . Biofeedback is an effective, objective, and evidence-based approach and can facilitate athlete understanding and self-regulation of psycho-physiological responses.
The following case study presents a five-phase biofeedback protocol utilizing a Pursed Lip Breathing technique (PLB) to assist in the remission of pre-competition sickness. A combination of biofeedback training, cognitive behavioral therapy, and specific transfer of techniques to training and performance were associated with a remission of symptoms, in particular pre-competition sickness.

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