This paper discusses the clinical applications of heart rate variability (HRV) data in the treatment of clients who have experienced traumatic brain injuries (TBIs). In the authors' clinical practice, HRV data is collected at the initial assessment, at progress assessments, and again after the completion of a course of neurofeedback combined with HRV biofeedback treatment. This paper describes HRV seen in healthy individuals compared to HRV in individuals known to have experienced a TBI. Three clinical case examples are discussed that explore the changes in heart rate variability following traumatic brain injury as well as improvements noted during, and following, a course of neurofeedback combined with HRV biofeedback training. The cases illustrated in this paper demonstrate the impressive changes in heart rate variability that can occur following a traumatic brain injury and also highlight how neurofeedback combined with biofeedback training can be used to improve heart rate variability and ameliorate related cognitive symptoms.

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