Medical policy: Biofeedback for Miscellaneous Indications

Policy number: MP 2.401

Effective date: 9/1/2026

Policy

Biofeedback is considered investigational as a treatment of the following miscellaneous conditions:

• Anxiety disorders
• Asthma
• Bell palsy
• Depression
• Hypertension
• Insomnia
• Movement disorders, such as motor function after stroke, injury, or lower-limb surgery
• Multiple sclerosis
• Orthostatic hypotension in individuals with spinal cord injury
• Pain management during labor
• Posttraumatic stress disorder
• Prevention of preterm birth
• Raynaud disease
• Sleep bruxism
• Tinnitus

There is insufficient evidence to support a general conclusion concerning the health outcomes or benefits associated with this procedure for the above indications.

Cross-Reference:

• MP 1.033 Sacral Nerve Neuromodulation-Stimulation
• MP 2.029 Neurofeedback
• MP 2.062 Temporomandibular Disorder
• MP 2.064 Biofeedback as a Treatment of Chronic Pain
• MP 2.096 Electromyography (EMG) (Needle and Non-Needle) of the Anal or Urethral Sphincter
• MP 2.304 Medical Treatments of Autism Spectrum Disorders
• MP 2.398 Biofeedback as a Treatment of Fecal Incontinence or Constipation
• MP 2.399 Biofeedback as a Treatment of Urinary Incontinence in Adults
• MP 2.400 Biofeedback as a Treatment of Headache
• MP 4.012 Injectable Bulking Agents for the Treatment of Urinary and Fecal Incontinence
• MP 6.020 Transcutaneous Electrical Nerve Stimulation and Transcutaneous Afferent Patterned Stimulation

Product variations

This policy is only applicable to certain programs and products administered by Capital Blue Cross and subject to benefit variations. Please see additional information below.

FEP PPO - Refer to FEP Medical Policy Manual. The FEP Medical Policy manual can be found at:

https://www.fepblue.org/benefit-plans/medical-policies-and-utilization-management-guidelines/medical-policies.

Description/Background

Biofeedback is intended to teach individuals self-regulation of certain physiologic processes not normally considered to be under voluntary control. The various forms of biofeedback mainly differ in the nature of the disease or disorder under treatment, the biologic variable that the subject attempts to control, and the information that is fed back to the subject.

Biofeedback techniques include peripheral skin temperature feedback, blood-volume-pulse feedback (vasoconstriction and dilation), vasoconstriction training (temporalis artery), and electromyographic biofeedback; they may be used alone or in conjunction with other therapies (e.g., relaxation, behavioral management, medication). Biofeedback training is done either in individual or group sessions. A typical program consists of 10 to 20 training sessions of 30 minutes each.

Biofeedback has been proposed as a treatment for a variety of diseases and disorders, including anxiety, headaches, hypertension, movement disorders, incontinence, pain, asthma, Raynaud disease, and insomnia.

Regulatory Status

A variety of biofeedback devices have been cleared for marketing by the U.S. Food and Drug Administration (FDA) through the 510(k) process. These devices are designated by the FDA as class II with special controls and are exempt from premarket notification requirements. The FDA defines a biofeedback device as “an instrument that provides a visual or auditory signal corresponding to the status of 1 or more of a patient's physiological parameters (eg, brain alpha wave activity, muscle activity, skin temperature, etc.) so that the patient can control voluntarily these physiological parameters."

Evidence pertaining to the use of biofeedback for urinary incontinence is addressed in evidence review MP 2.399.

Evidence pertaining to the use of biofeedback for headaches is addressed in evidence review MP 2.400.

Evidence pertaining to the use of biofeedback for chronic pain is addressed in evidence review MP 2.064.

Evidence pertaining to the use of biofeedback for fecal incontinence or constipation is addressed in evidence review MP 2.398.

Rationale

For individuals with anxiety disorders who receive biofeedback, the evidence includes 2 systematic reviews and 2 randomized controlled trials (RCTs) published after the review. Relevant outcomes are symptoms, functional outcomes, and quality of life (QOL). A systematic review on heart rate variability (HRV) biofeedback (HRVB) and an RCT on diaphragmatic breathing relaxation reported the positive effects of these treatments on anxiety. However, the trials in the systematic review had small sample sizes (median, 14 participants) and study quality was generally poor. Additional limitations included improper randomization, allocation concealment, and inadequate descriptions of randomization or missing data. The other RCT did not find a significant effect of biofeedback, possibly due to lack of power. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with asthma who receive biofeedback, the evidence includes a systematic review of 3 RCTs and 2 RCTs published after the review. Relevant outcomes are symptoms, functional outcomes, and QOL. Each RCT used a different biofeedback technique, which provided patients with information on carbon dioxide, heart rate, and respiratory sinus arrhythmia. While the trials reported improvements in each parameter for which the patients received biofeedback, the improvements did not impact clinical outcomes such as medication use and forced expiratory volume. However, the results of one RCT suggested that biofeedback has promise as a protective approach to aiding lung function and reducing stress-induced asthma exacerbation. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with Bell palsy who receive biofeedback, the evidence includes a systematic review of 4 RCTs. Relevant outcomes are symptoms, functional outcomes, and QOL. The RCTs evaluated the efficacy of adding a mirror and/or electromyography (EMG) biofeedback to facial exercises. The sample sizes were small, and there was heterogeneity across techniques used and length of treatments. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with depression who receive biofeedback, the evidence includes a systematic review and its 2017 update and 2 small RCTs published after the systematic review. Relevant outcomes are symptoms, functional outcomes, and QOL. The review and its update only identified 3 dissertations assessing the use of biofeedback for depression. One RCT found that respiratory and heart rate biofeedback plus usual care reduced Beck Depression Inventory scores compared to usual care alone while the other found that respiratory sinus arrhythmia biofeedback plus usual care was associated with greater improvements in Hamilton Depression Rating Scale scores compared to usual care alone; however, these trials were limited by open-label designs, short follow-up periods, and small sample sizes. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with hypertension who receive biofeedback, the evidence includes 2 systematic reviews and 2 RCTs published after the review. Relevant outcomes are symptoms, functional outcomes, and QOL. The systematic review identified 36 RCTs, though sample sizes were small and overall study quality was poor. Various biofeedback techniques were used: thermal, galvanized skin response, pulse wave velocity, and HRV. Results across trials did not consistently show a benefit of biofeedback. Conclusions were limited due to the shortage of studies isolating the effect of biofeedback, the generally poor quality of trials, and heterogeneity across interventions used. The other systematic review was smaller (20 RCTs) but did find a significant effect of biofeedback on both systolic and diastolic blood pressure. The Mengden 2023 RCT demonstrated an acute change in blood pressure after a 10-min biofeedback session, but no longer term effects were demonstrated over the course of a week. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with motor dysfunction after stroke who receive biofeedback, the evidence includes systematic reviews and RCTs published after the systematic reviews. Relevant outcomes are symptoms, functional outcomes, and QOL. One systematic review identified 18 high-quality trials using the following biofeedback techniques: weight distribution on a platform sensor, muscle activity from EMG, linear gait parameters, and joint angle from a goniometer. Feedback was visual, auditory, or both. Outcome measures primarily assessed motor activity in research settings, rather than clinical outcomes such as rates of falls or the ability to perform activities of daily living. Pooled effects showed improvements in motor function in the short term. The evidence is limited due to the variability in type, duration, intensity of the interventions, and lack of long-term outcomes. The largest available studies published since the systematic reviews found no differences between biofeedback-assisted rehabilitation and conventional rehabilitation in terms of their impact on gait speed, balance, activities of daily living, fall rate, and return to work. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with motor dysfunction after lower-limb injury or surgery who receive biofeedback, the evidence includes 2 systematic reviews. Relevant outcomes are symptoms, functional outcomes, and QOL. One systematic review identified 4 RCTs evaluating the use of EMG biofeedback in patients undergoing postinjury knee rehabilitation. Sample sizes were small, with half of the trials reporting significant benefits of biofeedback and the other half reporting no difference between study groups. The other systematic review identified 6 RCTs evaluating the use of EMG biofeedback in patients undergoing postsurgical knee rehabilitation. Biofeedback was associated with better range of motion outcomes in a meta-analysis of data from 5 RCTs but was not associated with a significant benefit in terms of pain or physical functioning. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with multiple sclerosis who receive biofeedback, the evidence includes 2 RCTs. Relevant outcomes are symptoms, functional outcomes, and QOL. One trial used vibrotactile biofeedback and the other provided patients with breathing rate and muscle tension biofeedback. The sample sizes were small, with no statistically significant differences between the biofeedback groups and control groups. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with orthostatic hypotension due to spinal cord injury who receive biofeedback, the evidence includes a systematic review, which included a case series and a case report. Relevant outcomes are symptoms, functional outcomes, and QOL. The case series and case report collectively provided information on 3 patients given visual and auditory feedback. Patients were able to raise their systolic blood pressure by an average of 39%. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals who need pain management during labor who receive biofeedback, the evidence includes a systematic review of 4 RCTs. Relevant outcomes are symptoms, functional outcomes, and QOL. A Cochrane review graded the 4 trials as having a high risk of bias due to unclear descriptions of blinding and randomization methods. Due to the heterogeneity in biofeedback methods and outcomes measured, pooled analyses could not be performed. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with posttraumatic stress disorder (PTSD) who receive biofeedback, the evidence includes a 2014 systematic review and its 2017 update, and a 2024 systematic review. Relevant outcomes are symptoms, functional outcomes, and QOL. The 2014 systematic review included an RCT, a nonrandomized study, and 2 case series. The studies had small sample sizes and inconsistent results. The reviewers rated the evidence a grade C for conflicting scientific evidence. The 2017 systematic review update included 2 new RCTs, 1 of which demonstrated a faster decrease of PTSD symptoms with biofeedback and cognitive behavioral therapy (CBT) compared to CBT alone. However, the small sample size was a limitation. The other RCT found no differences between biofeedback and other treatment modalities. The 2024 systematic review found a moderate effect of biofeedback but none of the included studies had a control group. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals who are susceptible to preterm birth who receive biofeedback, the evidence includes an RCT. Relevant outcomes are symptoms, functional outcomes, and QOL. In the RCT, women in the treatment group received HRVB. Patients receiving the treatment experienced a decrease in perceived chronic stress, but there was no significant difference in the number of preterm births, gestational duration, or birth weight. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with Raynaud disease who receive biofeedback, the evidence includes a systematic review. Relevant outcomes are symptoms, functional outcomes, and QOL. The systematic review identified 5 RCTs using biofeedback techniques. Pooled analysis was performed on 4 of these trials. The reduction in the frequency of attacks was significantly lower in the sham control group. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with sleep bruxism who receive biofeedback, the evidence includes 2 systematic reviews and an RCT published after the review. Relevant outcomes are symptoms, functional outcomes, and QOL. One systematic review identified 7 randomized and nonrandomized studies using biofeedback techniques, and the most recent systematic review identified 6 additional studies. Studies were generally small, used different techniques, measured different outcomes, and were assessed as having either moderate or high risk of bias. Two studies reported the number of bruxism episodes per hour and a pooled analysis of these studies showed no significant differences between biofeedback groups and sham controls. An RCT published after the reviews tested a full-occlusion biofeedback splint in 41 patients with sleep bruxism and temporomandibular disorder. The trial found that, compared to an adjusted occlusal splint, the biofeedback splint allowed for greater reductions in pain after 3 months of treatment. However, no significant differences in sleep bruxism episodes were observed. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

For individuals with tinnitus who receive biofeedback, the evidence includes a single RCT. Relevant outcomes are symptoms, functional outcomes, and QOL. Treatment consisted of a biofeedback-based behavioral intervention over a 3-month period. The treatment group experienced improvements in tinnitus annoyance, loudness ratings, controllability, coping cognitions, and depressive symptoms. Additional studies are needed to confirm the results of this single trial. The evidence is insufficient to determine that the technology results in an improvement in the net health outcome.

Definitions/Background

Electromyogram (EMG): is the graphic record of resting and voluntary muscle activities as a result of electrical stimulation.

Physiologic: pertains to normal functions of the human body as opposed to pathological.

Disclaimer

Capital Blue Cross’ medical policies are used to determine coverage for specific medical technologies, procedures, equipment, and services. These medical policies do not constitute medical advice and are subject to change as permitted by law or applicable clinical evidence from independent treatment guidelines. Treating providers are solely responsible for medical advice and treatment of members. These policies are not a guarantee of coverage or payment. Payment of claims is subject to a determination regarding the member’s benefit program and eligibility on the date of service, and a determination that the services are medically necessary and appropriate. Final processing of a claim is based upon the terms of contract that applies to the members’ benefit program, including benefit limitations and exclusions. If a provider or a member has a question concerning this medical policy, please contact Capital Blue Cross’ Provider Services or Member Services.

Coding information

Note: This list of codes may not be all-inclusive, and codes are subject to change at any time. The identification of a code in this section does not denote coverage as coverage is determined by the terms of member benefit information. In addition, not all covered services are eligible for separate reimbursement.

Investigational; therefore, not covered:

References

1. Food and Drug Administration. Biofeedback device. 21 CFR - 882.5050 (1998). Accessed September 22, 2025.
2. Goessl VC, Curtiss JE, Hofmann SG. The effect of heart rate variability biofeedback training on stress and anxiety: a meta-analysis. Psychol Med. Nov 2017; 47(15): 2578-2586. PMID 28478782
3. Banerjee S, Argaez C. Neurofeedback and Biofeedback for Mood and Anxiety Disorders: A Review of Clinical Effectiveness and Guidelines [Internet]. Ottawa, ON: Canadian Agency for Drugs and Technologies in Health; 2017.
4. Zhao E, Li Z, Zhang J, et al. The Effect of Electroencephalographic Biofeedback Therapy on Anxiety and Overall Well-being in Patients with Rectal Cancer. Appl Psychophysiol Biofeedback. Sep 2025; 50(3): 395-402. PMID 40072794
5. Ma CH, Chang HY, Lee HC, et al. The psychological and physiological effects of integrated cognitive-behavioral and biofeedback therapy on panic disorder: A randomized controlled trial. J Formos Med Assoc. Dec 2023; 122(12): 1305-1312. PMID 37453901
6. Chen YF, Huang XY, Chien CH, et al. The Effectiveness of Diaphragmatic Breathing Relaxation Training for Reducing Anxiety. Perspect Psychiatr Care. Oct 2017; 53(4): 329-336. PMID 27553981
7. Yorke J, Fleming S, Shuldham C, et al. Nonpharmacological interventions aimed at modifying health and behavioural outcomes for adults with asthma: a critical review. Clin Exp Allergy. Dec 2015; 45(12): 1750-64. PMID 25675860
8. Meuret AE, Ritz T, Wilhelm FH, et al. Targeting pCO(2) in asthma: pilot evaluation of a capnometry-assisted breathing training. Appl Psychophysiol Biofeedback. Jun 2007; 32(2): 99-109. PMID 17564826
9. Lehrer PM, Vaschillo E, Vaschillo B, et al. Biofeedback treatment for asthma. Chest. Aug 2004; 126(2): 352-61. PMID 15302717
10. Lehrer P, Carr RE, Smetankine A, et al. Respiratory sinus arrhythmia versus neck/trapezius EMG and incentive inspiratory biofeedback for asthma: a pilot study. Appl Psychophysiol Biofeedback. Jun 1997; 22(2): 95-109. PMID 9341966
11. Taghizadeh N, Eslaminejad A, Raoufy MR. Protective effect of heart rate variability biofeedback on stress-induced lung function impairment in asthma. Respir Physiol Neurobiol. Apr 2019; 262: 49-56. PMID 30695733
12. Lehrer PM, Irvin CG, Lu SE, et al. Heart Rate Variability Biofeedback Does Not Substitute for Asthma Steroid Controller Medication. Appl Psychophysiol Biofeedback. Mar 2018; 43(1): 57-73. PMID 29124506
13. Cardoso JR, Teixeira EC, Moreira MD, et al. Effects of exercises on Bell's palsy: systematic review of randomized controlled trials. Otol Neurotol. Jun 2008; 29(4): 557-60. PMID 18520590
14. Neurofeedback and Biofeedback for Mood and Anxiety Disorders: A Review of the Clinical Evidence and Guidelines - An Update. Ottawa, ON: Canadian Agency for Drugs and Technologies in Health; 2014.
15. Maynard WHDC, Albuquerque MCDS, Santos RCS, et al. The use of biofeedback intervention in the improvement of depression levels: a randomised trial. Acta Neuropsychiatr. Jun 2021; 33(3): 126-133. PMID 33427129
16. Park SM, Jung HY. Respiratory sinus arrhythmia biofeedback alters heart rate variability and default mode network connectivity in major depressive disorder: A preliminary study. Int J Psychophysiol. Dec 2020; 158: 225-237. PMID 33148502
17. Jenkins S, Cross A, Osman H, et al. Effectiveness of biofeedback on blood pressure in patients with hypertension: systematic review and meta-analysis. J Hum Hypertens. Oct 2024; 38(10): 719-727. PMID 39138350
18. Greenhalgh J, Dickson R, Dundar Y. The effects of biofeedback for the treatment of essential hypertension: a systematic review. Health Technol Assess. Oct 2009; 13(46): 1-104. PMID 19822104
19. Wang MY, Chang NC, Hsieh MH, et al. Effect of Feedback Signal on Blood Pressure Self-regulation Capability in Individuals With Prehypertension or Stage I Hypertension: A Randomized Controlled Study. J Cardiovasc Nurs. 2016; 31(2): 166-72. PMID 25774838
20. Mengden T, Bachler M, Sehnert W, et al. Device-guided slow breathing with direct biofeedback of pulse wave velocity - acute effects on pulse arrival time and self-measured blood pressure. Blood Press Monit. Feb 01 2023; 28(1): 52-58. PMID 36606480
21. Stanton R, Ada L, Dean CM, et al. Biofeedback improves performance in lower limb activities more than usual therapy in people following stroke: a systematic review. J Physiother. Jan 2017; 63(1): 11-16. PMID 27989731
22. Stanton R, Ada L, Dean CM, et al. Biofeedback improves activities of the lower limb after stroke: a systematic review. J Physiother. 2011; 57(3): 145-55. PMID 21843829
23. Zijlstra A, Mancini M, Chiari L, et al. Biofeedback for training balance and mobility tasks in older populations: a systematic review. J Neuroeng Rehabil. Dec 09 2010; 7: 58. PMID 21143921
24. Ambrosini E, Peri E, Nava C, et al. A multimodal training with visual biofeedback in subacute stroke survivors: a randomized controlled trial. Eur J Phys Rehabil Med. Feb 2020; 56(1): 24-33. PMID 31556542
25. Gharbari Ghoshchi S, De Angelis S, Morone G, et al. Return to Work and Quality of Life after Stroke in Italy: A Study on the Efficacy of Technologically Assisted Neurorehabilitation. Int J Environ Res Public Health. Jul 20 2020; 17(14). PMID 32698430
26. Kim JH. The effects of training using EMG biofeedback on stroke patients upper extremity functions. J Phys Ther Sci. Jun 2017; 29(6): 1085-1088. PMID 28626331
27. Yang DJ. Influence of biofeedback weight bearing training in sit to stand to sit and the limits of stability on stroke patients. J Phys Ther Sci. Nov 2016; 28(11): 3011-3014. PMID 27942111
28. Ghomashchi H. Investigating the effects of visual biofeedback therapy on recovery of postural balance in stroke patients using a complexity measure. Top Stroke Rehabil. Jun 2016; 23(3): 178-83. PMID 27077976
29. Silkman C, McKeon J. The effectiveness of electromyographic biofeedback supplementation during knee rehabilitation after injury. J Sport Rehabil. Aug 2010; 19(3): 343-51. PMID 20811082
30. Xie YJ, Wang S, Gong QJ, et al. Effects of electromyography biofeedback for patients after knee surgery: A systematic review and meta-analysis. J Biomech. May 07 2021; 120: 110386. PMID 33794414
31. Miri M, Tahami E, Veisi G. Assessing the effectiveness of EMG-biofeedback on an isometric strengthening program in individuals with multiple sclerosis. Mult Scler Relat Disord. Jan 2025; 93: 106193. PMID 39667127
32. Mackay AM, Buckingham R, Schwartz RS, et al. The Effect of Biofeedback as a Psychological Intervention in Multiple Sclerosis: A Randomized Controlled Study. Int J MS Care. 2015; 17(3): 101-8. PMID 26052255
33. van der Logt RP, Findling O, Rust H, et al. The effect of vibrotactile biofeedback of trunk sway on balance control in multiple sclerosis. Mult Scler Relat Disord. Jul 2016; 8: 58-63. PMID 27456875
34. Gillis DJ, Wouda M, Hjeltens N. Non-pharmacological management of orthostatic hypotension after spinal cord injury: a critical review of the literature. Spinal Cord. Oct 2008; 46(10): 652-9. PMID 18542098
35. Barragán Loayza IM, Solà I, Juandó Prats C. Biofeedback for pain management during labour. Cochrane Database Syst Rev. Jun 15 2011; 2011(6): CD006168. PMID 21678353
36. Wahbeh H, Senders A, Neuendorf R, et al. Complementary and Alternative Medicine for Posttraumatic Stress Disorder Symptoms: A Systematic Review. J Evid Based Complementary Altern Med. Jul 2014; 19(3): 161-175. PMID 24676593
37. Kenemore J, Benham G, Gharak R, et al. Heart Rate Variability Biofeedback as a Treatment for Military PTSD: A Meta-Analysis. Mil Med. Aug 30 2024; 189(9-10): e1903-e1909. PMID 38287778
38. Siepmann M, Hennig UD, Siepmann T, et al. The effects of heart rate variability biofeedback in patients with preterm labour. Appl Psychophysiol Biofeedback. Mar 2014; 39(1): 27-35. PMID 24271650
39. Malemant D, Catton M, Pope JE. The efficacy of complementary and alternative medicine in the treatment of Raynaud's phenomenon: a literature review and meta-analysis. Rheumatology (Oxford). Jul 2009; 48(7): 791-5. PMID 19434334
40. Comparison of sustained-release nifedipine and temperature biofeedback for treatment of primary Raynaud phenomenon. Results from a randomized clinical trial with 1-year follow-up. Arch Intern Med. Apr 24 2000; 160(8): 1101-8. PMID 10789602
41. Wang LF, Long H, Deng M, et al. Biofeedback treatment for sleep bruxism: a systematic review. Sleep Breath. May 2014; 18(2): 235-42. PMID 23756884
42. Jokubauskas L, Baltrušaitytė A. Efficacy of biofeedback therapy on sleep bruxism: A systematic review and meta-analysis. J Oral Rehabil. Jun 2018; 45(6): 485-495. PMID 29577362
43. Bergmann A, Edelhoff D, Schubert O, et al. Effect of treatment with a full-occlusion biofeedback splint on sleep bruxism and TMD pain: a randomized controlled clinical trial. Clin Oral Investig. Nov 2020; 24(11): 4005-4018. PMID 32430774
44. Weise C, Heinecke K, Rief W. Biofeedback-based behavioral treatment for chronic tinnitus: results of a randomized controlled trial. J Consult Clin Psychol. Dec 2008; 76(6): 1046-57. PMID 19045972
45. Jones DW, Ferdinand KC, Taller SJ, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. Nov 04 2025; 86(18): 1567-1678. PMID 40815242
46. Winstein CJ, Stein J, Arena R, et al. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. Jun 2016; 47(6): e98-e169. PMID 27145936
47. Gelenberg A. Practice Guideline for the Treatment of Patients with Major Depressive Disorder. 2010; Accessed October 6, 2025.
48. American Psychiatric Association, Work Group on ASD and PTSD, Ursano RJ, et al. Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder. 2004; Accessed October 3, 2025.
49. American Psychological Association. APA CLINICAL PRACTICE GUIDELINE for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. February 2025. Accessed October 3, 2025.
50. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2025; Accessed October 7, 2025.
51. U.S. Department of Veterans Affairs. VA/DoD Clinical Practice Guidelines. Updated September 15, 2025; Accessed October 3, 2025.
52. U.S. Department of Veterans Affairs. VA/DoD Clinical Practice Guidelines for the management of major depressive disorder. 2022; Accessed October 6, 2025.
53. U.S. Department of Veterans Affairs. VA/DoD Clinical Practice Guidelines for the management of stroke rehabilitation. 2024; Accessed October 5, 2025.
54. U.S. Department of Veterans Affairs. VA/DoD Clinical Practice Guidelines for tinnitus. 2024; Accessed October 4, 2025.
55. Centers for Medicare and Medicaid Services. National Coverage Determination (NCD) for Biofeedback (30.1). n.d.; Accessed October 6, 2025.