Effect of Sun Tai Chi on the Cardiopulmonary System and Mental Health in University Students: A Mixed Randomized Clinical Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Enrollment
- 56
- Locations
- 2
- Primary Endpoint
- DASS-21 stress
Study Overview
Brief Summary
Currently, university students face physical and mental health issues, which are reflected in low levels of physical activity, a decline in healthy eating behaviors, and a high prevalence of mental health symptoms such as stress, anxiety, and depression. Therefore, it is necessary to develop safe, effective, and sustainable interventions that support comprehensive health and provide formative experiences that reinforce the importance of developing healthy lifestyle habits and self-care.
In this regard, Tai Chi has been shown to offer physical and mental health benefits. Tai Chi is a low- to moderate-intensity exercise with low joint impact, which facilitates the transition from a sedentary to an active lifestyle.
Considering the health problems experienced by university students, it is proposed that a Tai Chi intervention could help produce beneficial effects on both physical and mental health. In this context, the present study aims to implement Tai Chi classes with the objective of determining their effect on the cardiac autonomic system, mental health, and the perception of benefits, facilitators, and barriers among participating university students compared to a control group.
Detailed Description
In Chile, there are currently over 1.2 million undergraduate university students who exhibit low levels of physical activity and mental health issues such as anxiety and depression. These problems tend to worsen after the first year of higher education, along with the development of unhealthy eating habits and weight gain.
In this context, Tai Chi has shown multiple benefits for overall health. Specifically, the Sun style of Tai Chi is characterized by gentle and accessible movements, making it well-suited to the university setting, and has demonstrated positive effects on both physical and mental health.
Previous studies indicate that regular practice of Tai Chi may positively influence autonomic cardiac control, measured through heart rate variability (HRV), as well as mental health. However, the available evidence is still limited and heterogeneous.
This study aims to evaluate, in university students, the effects of a 12-week Sun Tai Chi program, with 60-minute sessions held twice per week, on the following:
- Heart Rate Variability (HRV), as a marker of cardiovascular health and stress,
- Mental health, assessed with the Depression Anxiety Stress Scales - 21 Items (DASS-21 scale),
- Participants' qualitative perceptions regarding the program's benefits, barriers, and facilitators.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 29 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Undergraduate university students
- •Aged 18 to 29 years
- •Both sexes
- •Present mental health symptoms assessed by the Depression Anxiety Stress Scales - 21 Items (DASS-21) questionnaire, according to cutoff points established by Lovibond et al., ranging from mild to severe in any of the subscales of stress (score 15 to 33), anxiety (score 8 to 19), or depression (score 10 to 27).
- •Report a healthy physical condition suitable for Tai Chi practice (self-reported).
Exclusion Criteria
- •Engage in a high level of physical activity according to the International Physical Activity Questionnaire (IPAQ) or have regularly practiced moderate to high intensity physical activity in the last 3 months.
- •Report chronic illnesses that limit or contraindicate the practice of exercises required in Tai Chi.
- •Present cardiovascular, pulmonary, or neurological diseases.
- •Exhibit either no mental health impairment or severe impairment according to cutoff scores established by Lovibond et al. in the DASS-21 questionnaire (stress subscale score equal to or greater than 14 or equal to or less than 37, anxiety subscale score equal to or greater than 7 or equal to or less than 20, depression subscale score equal to or greater than 9 or equal to or less than 28).
- •Present specific psychiatric diagnoses, such as Attention-Deficit/Hyperactivity Disorder (ADHD), self-reported during the initial telephone interview.
- •Consume medications for mental health treatment.
- •Consume medications or substances that influence cardiac autonomic modulation (e.g., beta-blockers).
Outcomes
Primary Outcomes
DASS-21 stress
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
Stress will be measured using the stress subdomain of the DASS-21, which ranges from 0 to 21 points, with higher scores indicating higher levels of stress.
DASS-21 anxiety
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
Anxiety will be measured using the anxiety subdomain of the DASS-21, which ranges from 0 to 21 points, with higher scores indicating higher levels of anxiety.
DASS-21 depression
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
Depression will be measured using the depression subdomain of the DASS-21, which ranges from 0 to 21 points, with higher scores indicating higher levels of depression.
RMSSD
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
RMSSD (ms) is an index of parasympathetic cardiac autonomic modulation derived from the analysis of RR intervals (iRR).
SDNN
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
SDNN (ms) is an index of overall heart rate variability reflecting the cardiac autonomic modulation derived from the analysis of RR intervals (iRR).
Low frequency (LF)
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
LF (ms2) is an index of parasympathetic and sympathetic cardiac autonomic modulation derived from the analysis of RR intervals (iRR).
High frequency (HF)
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
HF (ms2) is an index of parasympathetic cardiac autonomic modulation derived from the analysis of RR intervals (iRR).
Low frequency/Hight frequency ratio (LF/HF)
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
LF/HF is an index reflecting the balance between the parasympathetic and sympathetic cardiac autonomic modulation derived from the analysis of RR intervals (iRR).
Pattern with no variation (0V)
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
0V (%) is a pattern quantified through symbolic analyses of the RR intervals (iRR) reflecting the sympathetic cardiac modulation.
Pattern with two unlike variation (2ULV)
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
2ULV (%) is a pattern quantified through symbolic analyses of the RR intervals (iRR) reflecting the parasympathetic cardiac modulation.
Qualitative perception
Time Frame: It will be conducted one week after the last Tai Chi class.
The qualitative perception of the participants will consider the perceived benefits, barriers, and facilitators. Data will be collected through semi-structured interviews and focus groups, using a qualitative approach.
DASS-21 stress
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
Stress will be measured using the stress subdomain of the DASS-21, which ranges from 0 to 21 points, with higher scores indicating higher levels of stress.
High frequency (HF)
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
HF (ms2) is an index of parasympathetic cardiac autonomic modulation derived from the analysis of RR intervals (iRR).
Low frequency/Hight frequency ratio (LF/HF)
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
LF/HF is an index reflecting the balance between the parasympathetic and sympathetic cardiac autonomic modulation derived from the analysis of RR intervals (iRR).
Pattern with no variation (0V)
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
0V (%) is a pattern quantified through symbolic analyses of the RR intervals (iRR) reflecting the sympathetic cardiac modulation.
Pattern with two unlike variation (2ULV)
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
2ULV (%) is a pattern quantified through symbolic analyses of the RR intervals (iRR) reflecting the parasympathetic cardiac modulation.
Baroreflex sensitivity (BRS)
Time Frame: Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
Baroreflex sensitivity is an index that assesses the heart rate response to changes in blood pressure and serves as an indicator of cardiovascular health.
LFSAP
Time Frame: Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
The low-frequency index of systolic arterial pressure (LFSAP) reflects the vascular sympathetic autonomic modulation.
Qualitative perception
Time Frame: It will be conducted one week after the last Tai Chi class.
The qualitative perception of the participants will consider the perceived benefits, barriers, and facilitators. Data will be collected through semi-structured interviews and focus groups, using a qualitative approach.
DASS-21 anxiety
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
Anxiety will be measured using the anxiety subdomain of the DASS-21, which ranges from 0 to 21 points, with higher scores indicating higher levels of anxiety.
DASS-21 depression
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
Depression will be measured using the depression subdomain of the DASS-21, which ranges from 0 to 21 points, with higher scores indicating higher levels of depression.
SDNN
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
SDNN (ms) is an index of overall heart rate variability reflecting the cardiac autonomic modulation derived from the analysis of RR intervals (iRR).
RMSSD
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
RMSSD (ms) is an index of parasympathetic cardiac autonomic modulation derived from the analysis of RR intervals (iRR).
Low frequency (LF)
Time Frame: Initial evaluation: Prior to the intervention (week 0) Intermediate evaluation: After 6 weeks of intervention Final evaluation: After 12 weeks of intervention
LF (ms2) is an index of parasympathetic and sympathetic cardiac autonomic modulation derived from the analysis of RR intervals (iRR).
Secondary Outcomes
No secondary outcomes reported
Investigators
Pamela Ling Campos Rojas
kinesiologist
Universidad Católica del Maule