Relaxation App Helps Children Cope with Procedural Pain

A new study describes how a biofeedback‐assisted relaxation application helps children control procedural pain, such as during peripheral blood collection and cannulation.

Researchers at Children's Hospital at Westmead (Australia), the University of Sydney (Australia), and other institutions conducted a study involving 30 children (7 to 18 years of age) who underwent peripheral blood collection, botulinum toxin injection, or intravenous cannula insertion. The study was designed to evaluate BrightHearts, a biofeedback mediation relaxation app designed for mobile phones and tablet computers that responds to changes in heart rate, and which can be used to teach children biofeedback-assisted relaxation.


For the study, BrightHearts was delivered via an iPad, with heart rate measured via a pulse oximeter worn on the ear or thumb. Feasibility was assessed through observations and patient, parent/carer, and healthcare professional feedback surveys developed by the researchers. The results revealed that 83% of the children reported that they found the relaxation helpful during the procedure, and that they would use it again, as did 64% of healthcare providers. All parents and 96% of healthcare professionals indicated they would use BrightHearts again. The study was published on April 17, 2018, in Pain Practice.

“This is an innovative collaboration between art and medicine that we hope will improve the lives of children living with chronic illness. Children at the hospital contributed to the design of BrightHearts, so it’s very much about creating something that will make their experience in hospital less frightening,” said corresponding author Angela Morrow, MD, of Children's Hospital at Westmead and the University of Sydney. “Future studies are required to evaluate BrightHearts’ efficacy in reducing pain and anxiety during painful procedures and distinguish the effects of a biofeedback mediated app from distraction.”

BrightHearts, developed by artist George Khut, PhD, of the University of Sydney, combines standard distraction methods with the principals of biofeedback relaxation training in order to focus children’s attention away from their object of their anxiety and fear, and help them develop skills for observing and regulating their response during painful procedures. Both before and during such anxiety provoking procedures, children are rewarded with sounds and visuals that respond to decreases in heart rate over different periods of time, which they learn to influence with their breathing and relaxation techniques.

Related Links:
Children's Hospital at Westmead
University of Sydney