Scientific Publications Related to Stress, Recovery, Sleep, and Wellbeing

The publications section presents studies where Firstbeat solutions have been exploited.  The different scientific contexts include for example occupational health care, sleep research, psychotherapy, behavioral research, and sports coaching. Firstbeat methods have been used for research in over 100 universities and research institutions across Europe, North America, and Australia.

Title Author Year Journal/Proceedings Study design & Population Category Physiological parameter(s) Insights on findings
Women’s embodied experiences of using wearable digital self-tracking health technology: a review of the qualitative research literature Del Busso L, Brottveit G, Torp Løkkeberg S & Glubbe G 2021 Helth Care for Women International Review of scientific literature Review Firstbeat stress data was described as one case in a review study aiming to identify and synthesize the existing qualitative research literature on women’s experiences of using wearable digital self-tracking health technology.
Mobile health solutions for atrial fibrillation detection and management: a systematic review Hermans ANL, Gawalko M, Dohmen L, van der Velden RMJ, Betz K, Duncker D, Verhaert DVM, Heidbuchel H, Svennberg E, Neubeck L, Eckstein J, Lane DA, Lip GYH, Crijns HJGM, Sanders P, Hendriks JM, Pluymaekers NAHA & Linz D 2021 Clinical Research in Cardiology Systematic review of 208 studies Review The study represented results of Firstbeat Bodyguard 2 within a systematic review on the available mobile Health (mHealth) solutions, including handheld and wearable devices, implantable loop recorders, as well as mobile platforms and support systems in atrial fibrillation (AF) detection and management.
Evidence for the association between physiological and emotional states in adolescents and young adults without psychopathology under ecologically valid conditions Zenker M, Venz J, Koenig J, Voss C, Beesdo-Baum K & Pieper L 2021 Psychophysiology, Vol. 58, Issue 10 Cohort study; young subjects, n = 549 Applied use RR-intervals; HRV The association between ANS activity via RMSSD and emotional states occurring under natural conditions in daily life was investigated. The subjects’ mood and optimism/pessimism were assessed over 4 days simultaneously with Firstbeat Bodyguard 2 recording. Lower vagal activity was found in mood states accompanied by high arousal (wakefulness, mania) and greater vagal activity in mood states with low arousal (calmness, pessimism).
Parents at the sport competition: How they react, feel and cope with the event Prosoli R, Lochbaum M & Baric R 2021 Pedagogy of Physical Culture and Sports, 25 (2): 114-2. Case study; parents, n = 2 Applied use HR; energy expenditure; Training effect This case study used Firstbeat Bodyguard 2 to collect HRV data and Firsbeat Sports for data analysis when observing the cardiovascular, metabolic and emotional responses of parents to watching their child compete in Taekwondo.
Sleep-time physiological recovery is associated with eating habits in distressed working-age Finns with overweight: secondary analysis of a randomised controlled trial Järvelä-Reijonen E, Järvinen S, Karhunen L, Föhr T, Myllymäki T, Sairanen E, Lindroos S, Peuhkuri K, Hallikainen M, Pihlajamäki J, Puttonen S, Korpela R, Ermes M, Lappalainen R, Kujala UM, Kolehmainen M & Laitinen J 2021 Journal of Occupational Medicine and Toxicology, Vol 16: 23 Cross-sectional study; psychologically distressed adults with overweight, n = 252 Applied use; lifestyle intervention Stress and recovery; HRV The study used Firstbeat’s stress assessment when investigating whether physiological recovery during sleep relates to eating habits, i.e., eating behaviour and diet quality.
Influence of Non-Occupational Physical Activity on Burnout Syndrome, Job Satisfaction, Stress and Recovery in Fitness Professionals Marín-Farrona M, Léon-Jiménez M, García-Unanue J, Gallardo L, Liguori G & López-Fernández J 2021 International Journal of Environtal Research and Public Health, 18 (18), 9489 Cross-sectional study; fitness professionals, n = 26 Applied use Stress and recovery; HRV The study used Firstbeat in examining the effect of non-occupational physical activity on the stress and recovery levels of fitness professionals, and association on physiological metrics on burnout symptoms, working conditions and job satisfaction.
Heart Rate Variability and Firstbeat Method for Detecting Sleep Stages in Healthy Young Adults: Feasibility Study Kuula L & Pesonen A 2021 JMIR Mhealth Uhealth 2021;9(2):e24704 Validation study; healthy adults, n = 20 Validation Sleep The study validated Firstbeat’s sleep stage analysis method, and concluded that Firstbeat is a feasible method with sufficient validity to measure nocturnal sleep stage variation.
Exploring Stress and Recovery Among High-Achieving Career Development Event Teams: A Mixed Methods Study Bowling AM & Thieman EB 2020 Journal of Agricultural Education, 61(2), 142-161 Case study; Teachers, n = 3 Applied use Stress and recovery The study used Firstbeat system for assessing stress among School Based Agricultural Education (SBAE) teachers.
Assessing the user experience and usability of the PRECIOUS system: a randomized controlled trial in obese patients Castellano-Tejedor C, Moreno J, Knittle K, Nurmi J et al. 2020 Informatics for Health and Social Care, 45 (4) Intervention study; Adults, n = 31 Applied use Stress and recovery The study used Firstbeat metrics as a biofeedback method in a PRECIOUS system to promote behavior change toward healthier lifestyles.
The health impact of nature exposure and green exercise across the life course: a pilot study Wood CJ & Smyth N 2020 International Journal of Environmental Health Research, 30 (2) Cross-sectional study; Adults, n = 45 Applied use Stress and recovery; HRV The study used Firstbeat metrics for exploring the associations between childhood and adulthood nature exposure and green exercise on stress and well-being.
Virtual Reality in Education: Focus on the Role of Emotions and Physiological Reactivity Vesisenaho M, Juntunen M, Häkkinen P, Pöysä-Tarhonen J, Fagerlund J, Miakush I & Parviainen T 2019 Journal of Virtual Worlds Research, 12: 1 Empirical pilot study; Students, n=6 Applied use Stress and recovery The study used Firstbeat Bodyguard 2 together with Firstbeat stress and recovery analysis to study psychophysiological reactions in educational contexts using virtual reality (VR) tools. The researchers also offer a vision for future research and development enabled by emerging methodological advancements (neurophysiological and psychophysiological measurements) to capture learning, performance, and emotions in VR.
Personalized intervention to improve stress andsleep patterns for glycemic control and weightmanagement in obese Emirati patients with type 2diabetes: a randomized controlled clinical trial Mussa BM, Schauman M, Kumar V, Skaria S & Abusnana S 2019 Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2019:12, 991–999 Randomized controlled study; Emirati patients with type-2 diabetes, n=51 Applied use Stress and recovery; sleep The study used Firstbeat measurement and feedback as an wellbeing intervention for type-2 diabetics. The findings of the study show that personalized approaches that reduce stress levels, increase recovery levels, and promote healthy sleep habits play an important role in weight management and glycemic control in type-2 diabetics management.
Acute Effect of Alcohol Intake on Cardiovascular Autonomic Regulation During the First Hours of Sleep in a Large Real-World Sample of Finnish Employees: Observational Study Pietilä J, Helander E, Korhonen I, Myllymäki T, Kujala U & Lindholm H 2018 JMIR Ment Health 2018 5 (1) Cross-sectional study; Employees, n=4098 Firstbeat database RR-intervals; HRV; stress and recovery Firstbeat’s real-life database was used to assess the impact of alcohol on sleep and HRV, using data from days with and without reported alcohol consumption. Alcohol intake had a dose dependent effect on increased sympathetic regulation, decreased parasympathetic regulation and insufficient recovery. Being physically fit and young provides no protection from alcohol-induced suppression of recovery.
Cardiodynamic Associations With Mental Health And Resilience In Undergraduate Students Knetsch R, Klassen SA & Shoemaker JK 2018 FASEP journal 32: 1, supplement (abstract only) Cross-sectional study; Healthy undergraduate students, n=77 Applied use RR-intervals; HRV The objective of the study was to analyze the relationship between cardiac autonomic control and mental health scores in undergraduate students. HRV data was collected and analyzed with Firstbeat system. The results of the study suggest that higher HRV may indicate greater psychological resilience, and lower anxiety amongst undergraduate students.
Executive Stress Management: Physiological Load of Stress and Recovery in Executives on Workdays. Crespo-Ruiz B, Rivas-Galan S, Fernandez-Vega C, Crespo-Ruiz C & Maicas-Perez L 2018 International Journal of Environmental Research and Public Health, 15 (12) Explorative study; Senior managers of multinational companies, n=48 Applied use Stress and recovery Firstbeat analytics was used for analyzing stress and recovery balance for work, after work, and night in a workday in executives. The study found that stress generated or maintained outside working hours correlates significantly with a lower quality of recovery during the 24 h workday. The authors concluded it is necessary to prioritize strategies that help improve stress management in executives through the improvement of tools and strategies that promote greater relaxation outside working hours.
Collecting and Using Students’ Digital Well-Being Data inMultidisciplinary Teaching Moilanen H, Äyrämö S, Susanne Jauhiainen S & Kankaanranta M 2018 Education Research International, Article ID 3012079 Explorative study; 13-17 y students, n=198 Applied use Stress and recovery The study used Firstbeat sensors and analytics to examine how students experience the new methods for sensor-based learning inmultidisciplinary teaching in lower and upper secondary education that combine the use of new sensor technology and learningfrom self-produced well-being data.
The Effect of using Noise Cancellation Earplubs in Open-plan Offices on the Work Wellbeing and Work Performance of Software Professionals
Kari T, Makkonen M, Frank L 2017 The 11th Mediterranean Conference on Information Systems (MCIS), Proceedings, Genoa, Italy, 2017 Experimental study; Adults, n = 28 Applied use Stress and recovery; oxygen consumption; energy expenditure; respiration rate; RR-intervals This explorative study investigated both objectively measured and subjectively perceived effects of adopting noise cancellation earplugs by open-plan office workers in a software company, and used Firstbeat Lifestyle Assessment for physiology analytics.
Social rhythms of the heart
Pantzar M, Ruckenstein M & Mustonen V 2017 Health sociology review 26(1): 22-37 Cross-sectional study; Adults, n = 35 Applied use Stress and recovery Firstbeat was used to describe and visualize social rhythms of stress and recovery in the everyday life.
Recovery of rescuers from a 24-h shift and its association with aerobic fitness
Lyytikäinen K, Toivonen L, Hynynen E, Lindholm H & Kyröläinen H 2017 International journal of occupational medicine and environmental health 30(3): 433-444 Cross-sectional study; Adults, n = 14 Applied use Stress and recovery Firstbeat was used to study changes in autonomic control during a 24-hour work shift and its recovery period among rescuers. Also relation of aerobic fitness on recovery was studied.
Short-term physiological strain and recovery among employees working with agile and lean methods in software and embedded ICT systems
Tuomivaara S, Lindholm H & Känsälä M 2017 International journal of human-computer interaction Cross-sectional study; Adults, n = 36 Applied use Stress and recovery Firstbeat method and Bodyguard device were used to assess short-term physiological stress and recovery associated with agile and lean work working methods. Results showed that agile work could even out workload during a working period.
Physiological load and psychological stress during a 24-hour work shift among Finnish firefighters
Kaikkonen P, Lindholm H & Lusa S 2017 Journal of occupational and environmental medicine 59(1): 41-46 Cross-sectional study; Adults, n = 25 Applied use Stress and recovery; VO2; Energy expenditure Firstbeat method was used to describe physiological load and psychological stress of firefighters during a 24-hour work shift
Physical activity, heart rate variability-based stress and recovery, and subjective stress during a 9-month study period
Föhr T, Tolvanen A, Myllymäki T, Järvelä-Reijonen E, Peuhkuri K, Rantala S, Kolehmainen M, Korpela R, Lappalainen R, Ermes M, Puttonen S, Rusko H & Kujala UM 2017 Scandinavian journal of medicine & science in sports 27: 612-621 Intervention study; Adults, n = 221 Applied use Stress and recovery Firstbeat method was used to objectively measure stress and recovery to study association between physical activity and objective stress and recovery with subjective stress
Effects of using standing versus sitting workstations on the well-being at work of software professionals
Makkonen M, Silvennoinen M, Nousiainen T, Pesola A & Vesisenaho M 2016 Versendaal et al. (eds), BLED 2016: Proceedings of the 29thBled eConference “Digital economy”: 419-433 Intervention study; Adults, n = 29 Applied use Physical activity; Stress and recovery Firtsbeat method was used to examine potential effects of using standing versus sitting workstations on the well-being at work
Eustress – findings concerning the indication and interpretation of positive stress among entrepreneurs – a case study
Oksman V, Ermes M & Tikkamäki K 2016 The business and management review 7 (3): 342-347 Case study; Adults, n = 9 Applied use Stress and recovery Firstbeat method was used to get information of entrepereneurs’ physiological reactions. Afterwards positive and negative stress reactions were discriminated based on subjective feelings.
An After-School, high-intensity, interval physical activity programme improves health-related fitness in children
Martinez S, Rios L, Tamayo I, Almeida L, Lopez-Gomez M & Jara C 2016 Motriz, Rio Claro 22 (4): 359-367 Intervention study; Children, n = 94 Applied use EPOC; Physical activity Firstbeat method was used to assess workload of children aged 7-9 years participating in programmed physical activity in intervention group vs. control group setting
Physical activity, body mass index and heart rate variability-based stress and recovery in 16 275 Finnish employees: a cross-sectional study
Föhr T, Pietilä J, Helander E, Myllymäki T, Lindholm H, Rusko H & Kujala UM 2016 BMC Public Health 16:701 Cross-sectional study; Adults, n = 16 275 Firstbeat database Stress and recovery Firstbeat database was used to explore associations between PA level and BMI, and Firstbeat stress and recovery. High PA level was associated with better stress recovery balance whereas higher BMI were associated with poorer results. The study emphazises benefical effects of PA for stress balance.
Sympathetic nervous system synchrony in couple therapy
Karvonen A, Kykyri V-L, Kaartinen J, Penttonen M & Seikkula J 2016 Journal of Maritla and Family Therapy 42(3): 383-395 Cross-sectional study; Adults, n = 30 Applied use Stress and recovery Firstbeat method was used to assess stress level of therapists and clients in psychotherapy
Soft proposody and embodied attunement in therapeutic interaction: A multimethod case study of a moment of change Kykyri V-L, Karvonen A, Wahlström J, Kaartinen J, Penttonen M & Seikkula J 2016 Journal of Constructivist Psychology 30(3): 211-234 Case study; Adults, n = 3 Applied use Stress and recovery Firstbeat method was used to assess stress level of therapist and client in psychotherapy
Subjective stress, objective heart rate variability stress, and recovery on workdays among overweight and psychologically distressed individuals: a cross-sectional study
Föhr T, Tolvanen A, Myllymäki T, Järvelä-Reijonen E, Rantala S, Korpela R, Peuhkuri K, Kolehmainen M, Puttonen S, Lappalainen R, Rusko H & Kujala U 2015 Journal of Occupational Medicine and Toxicology 10(30) Cross-sectional study; Adults, n = 221 Validity Stress and recovery Subjective stress was directly associated with objective stress and inversely with objective recovery measured with the Firstbeat method. The authors suggested that objective stress assessment provides an additional aspect to stress evaluation.
Predictors of increase in physical activity during a 6-month follow-up period among overweight and physically inactive healthy young adults
Mutikainen A, Föhr T, Karhunen L, Kolehmainen M, Kainulainen H, Lappalainen R & Kujala U 2015 Journal of Exercise Science and Fitness 13(2): 63-71 Cohort study; Adults, n = 51 Applied use; Intervention Stress and recovery The study examined how psychological and physiological variables at baseline predicted increase of PA level during a 6-month intervention period in overweight and physically inactive young adults who participated in lifestyle counselling without supervised PA sessions.
Exploratory analysis of associations between individual lifestyles and heart rate variability -based recovery during sleep Pietilä J, Helander E, Myllymäki T, Korhonen I, Jimison H & Misha P 2015 EMBC’15. 37th Annual International Conference ot the IEEE Engineering in Medicine and Biology Society (peer reviewed) Cross-sectional study; Adults, n = 6288 Firstbeat database Stress and recovery; Sleep The study explored the importance of different lifestyle factors on Firstbeat’s HRV-based recovery during sleep on a large sample. Alcohol consumption, physical activity, fitness, and sleep duration play significant role in recovery.
The embodied attunement of therapists and a couple within dialogical psychotherapy: An introduction to the realtional mind research project Seikkula J, Karvonen A, Kykyri V-L, Kaartinen J & Penttonen M 2015 Family Process 54: 703-715 Case study; Adults, n = 4 Applied use Stress and recovery Firstbeat method was used to assess stress level of therapists and clients in psychotherapy
Associations of physical activity, fitness, and body composition with heart rate variability-based indicators of stress and recovery on workdays: a cross-sectional study Teisala T, Mutikainen S, Tolvanen A, Rottensteiner M, Leskinen T, Kaprio J, Kolehmainen M, Rusko H & Kujala UM 2014 Journal of Occupational Medicine and Toxicology 9:16 Cross-sectional study; Adults, n = 81 Applied use; Usability Stress and recovery Physical activity, fitness level and body composition were associated with Firstbeat stress and recovery, and stress was associated with self-reported occupational burnout symptoms. The authors concluded that the results support the usability of the Firstbeat method in the evaluation of stress and recovery
The effectiveness and applicability of different lifestyle interventions for enhancing wellbeing: the study design for a randomized controlled trial for persons with metabolic syndrome risk factors and psychological stress Lappalainen R, Sairanen E, Järvelä E, Rantala S, Korpela R, Puttonen S, Kujala UM, Myllymäki T, Peuhkuri K, Mattila E, Kaipainen K, Ahtinen A, Karhunen L, Pihlajamäki J, Järnefelt H, Laitinen J, Kutinlahti E, Saarelma O, Ermes M & Kolehmainen M 2014 BMC Public Health 14:310 Randomized controlled trial Adults, n = 339 Applied use; Usability Stress and recovery Firstbeat Lifestyle Assessment was used as an objective method for measuring stress and recovery in RCT examining the effectiveness, applicability, and acceptability of different lifestyle interventions with individuals having symptoms of metabolic syndrome and psychological distress
Effects of daily intake of yoghurt enriched with bioactive components on chronic stress responses: a double-blinded randomized cotrolled trial Jaatinen N, Korpela R, Poussa T, Turpeinen A, Mustonen S, Merilahti J & Peuhkuri K 2014 International Journal of Food Sciences and Nutrition 65(4):507-514 Randomized Controlled Trial; Adults, n = 72 Applied use Stress and recovery The study used Firstbeat method as objective physiological method to assess stress when investigating whether yoghurt enriched with bioactive components have stress reducing effects as compared to normal yoghurt
Feasibility of a personal health technology-based psychological intervention for men with stress and mood problems: randomized controlled pilot trial Lappalainen P, Kaipainen K, Lappalainen R, Hoffrén H, Myllymäki T, Kinnunen M-L, Mattila E, Happonen A, Rusko H & Korhonen I 2013 JMIR Res Protoc 2(1):e1 Cohort study; Adults n = 23 Applied use; Usability Stress and recovery Firstbeat lifestyle assessment was used in a well-being intervention utilizing several technology tools and rated as the most useful intervention component by the participants
Heart rate variability measurements in mobile work
Hyrkkänen U & Vartiainen M 2012 Communications in Computer and Information Science 313:60-67. 4th International Conference on Well-Being in the Information Society. Eriksson-Backa K, Luoma A, Krook E (Eds.) Cross-sectional study; Adults, n = 10 Applied use; Usability Stress and recovery HRV-based Firstbeat assessment was found to be especially suitable for mobile employees with mobile working mode who have difficulties on controlling their work–life balance
Effects of exercise intensity and duration on nocturnal heart rate variability and sleep quality Myllymäki T, Rusko H, Syväoja H, Juuti T, Kinnunen M-L & Kyröläinen H 2012 European Journal of Applied Physiology 112(3): 801-809 Experimental study; Adults, n = 14 Applied use Stress and recovery; Sleep Firstbeat relaxation was decreased during sleep after demanding exercises [vigorous or long] compared to control sleep without changes in actigraphy or subjective sleep quality
Heart rate variability related to effort at work Uusitalo A, Mets T, Martinmäki K, Mauno S, Kinnunen U & Rusko H 2011 Applied Ergonomics 42(6): 830-838 Cross-sectional study; Adults, n = 19 Validity Stress and recovery Firstbeat relaxation was negatively associated with effort at work measured with effort-reward imbalance questionnaire [ERI] assessing chronic work stress
Web, mobile and monitoring technologies in self-management of psychophysiological wellbeing: usage and user experiences Kaipainen K, Mattila E, Väätänen A & Lappalainen R 2010 Proceedings of the IADIS International Conference eHealth, Freiburg, Germany, 167-177 Randomized Controlled Trial; Adults, n = 24 Applied use; Usability Stress and recovery; Sleep The study explored a concept in which large amount of different technologies were utilized for improving well-being of participants, and where face-to-face intervention meetings and Firstbeat measurements with personal feedback were perceived as the two most important components of the whole concept
Effects of vigorous late-night exercise on sleep quality and cardiac autonomic activity Myllymäki T, Kyröläinen H, Savolainen K, Hokka L, Jakonen R, Juuti T, Martinmäki K, Kaartinen J, Kinnunen M-L & Rusko H 2010 Journal of Sleep Research 20: 146-153 Experimental study; Adults, n = 11 Applied use Stress and recovery; Sleep Firstbeat relaxation was diminished during sleep after intensive late-evening exercise without changes in polysomnographic or movement-based sleep quality
P4Well concept to empower self-management of psychophysiological wellbeing and load recovery
Happonen A, Mattila E, Kinnunen M-L, Ikonen V, Myllymäki T, Kaipainen K, Rusko H, Lappalainen R & Korhonen I 2009 Proceedings of the 3rd International Conference on Pervasive Conputing Technologies for Healthcare, London, UK, 1-3 Intervention study; Adults, n = 34 Applied use; Usability Stress and recovery; Sleep The study described a well-being concept that utilized also Firstbeat methods [mobile coach and lifestyle assessment] and which was designed with a driving principle that an individual is the best master of his/her own wellness and targeted to empower his/her for realizing the fact
The association between self-rated affective well-being and physiological indicators of stress and relaxation among cleaning staff Feldt T, Rönkä T, Rusko H, Kinnunen M-L & Kinnunen U 2007 European Congress of Work and Organizational Psychology Cross-sectional study; Adults, n = 38 Applied use Stress and recovery Contentment at work indicating subjective experiences of relaxation was linked to low physiological stress and high physiological relaxation measured with Firstbeat method
The associations between physiological recovery indicators during sleep and self-reported work stressors Rönkä T, Rusko H, Feldt T, Kinnunen U, Mauno S, Uusitalo A & Martinmäki K 2006 Nordic Ergonomics Society Congress Cross-sectional study; Adults, n = 17 Validity Stress and recovery; Sleep Firstbeat method was used to investigate relaxation time during sleep. Longer relaxation time was associated with less perceived work stressors on the next day.
Stress and relaxation based on heart rate variability: Associations with self-reported mental strain and differences between waking hours and sleep Kinnunen M-L, Rusko H, Feldt T, Kinnunen U, Juuti T, Myllymäki T, Laine K, Hakkarainen P & Louhevaara V 2006 Nordic Ergonomics Society Congress, abstract Cross-sectional study; Adults, n = 27 Validity Stress and recovery Firstbeat method is a promising tool for occupational health care sector as it provides general scoring describing stress and relaxation state for work, leisure time, and sleep
Stress and relaxation during sleep and awake time, and their associations with free salivary cortisol after awakening Rusko H, Rönkä T, Uusitalo A, Kinnunen U, Mauno S, Feldt T, Kinnunen M-L, Martinmäki K, Hirvonen A, Hyttinen S & Lindholm H 2006 Nordic Ergonomics Society Congress, abstract Cross-sectional study; Adults, n = 17 Validity Stress and recovery; Sleep Significant correlations were found between awakening cortisol variables and variables of stress and relaxation with Firstbeat method during sleep
Associations of psychological self-assessments and heart rate variability in long term measurements at home Antila K, van Gils M, Merilahti J & Korhonen I 2005 European Medical & Biological Engineering Conference Experimental study; Adults, n = 12 Validity Stress and recovery The study revealed significant associations between stress measured with Firstbeat method and self-assessments of stress