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Diaphragmatic and Box Breathing on Heart Rate Variability and Perceived Stress

Sponsor: Cairo University • ClinicalTrials.gov ID: NCT07698652

Registry updated: 2026-09-28

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Description

The goal of this clinical trial is to learn if diaphragmatic breathing and box breathing work to enhance resilience and manage stress in physical therapy students. It will also learn about their effects on overall physiological and psychological parameters. The main questions it aims to answer are: Do these breathing techniques improve heart rate variability (HRV)? How do these interventions affect participants' perceived stress levels, cognitive performance, and academic achievement? Researchers will compare diaphragmatic breathing and box breathing to a control group to see if these non-invasive methods work to improve physiological adaptation and manage stress. Participants will: Be randomly assigned to practice diaphragmatic breathing, practice box breathing, or join a control group Have their heart rate variability (HRV) measured as a primary sign of physiological adaptation Complete assessments to evaluate their perceived stress, cognitive performance, and academic achievement

Interventions

Diaphramatic Breathing Training (Behavioral)
Diaphragmatic Breathing Group: Participants will sit comfortably with their hands in their abdomen. They will: * Inhale through the nose for 4 seconds * Exhale through the mouth for 6 seconds * Focus on abdominal expansion and relaxation * Continue for 15 minutes, 6 sessions/week, for 4 weeks
Box Breathing Training (Behavioral)
Box Breathing Group: Participants will perform a structured breath cycle: * Inhale for 4 seconds * Hold for 4 seconds * Exhale for 4 seconds * Hold for 4 seconds

Eligibility criteria

Inclusion Criteria: * Academic Status: Currently enrolled, full-time undergraduate Physical Therapy students * Age Range: 18-25 years * Health Status: Generally healthy individuals with no known chronic respiratory or cardiovascular diseases. * Informed Consent: Ability and willingness to provide written informed consent and commit to the 4-week protocol (6 sessions/week). * Stress Level: A baseline score on the Perceived Stress Scale (PSS) indicating at least moderate stress. Exclusion Criteria: * Pre-existing Breathing Expertise: Individuals with professional training in yoga (Pranayama), formal meditation, or advanced breath work that might bias the baseline results. * Medical Conditions: Diagnosed respiratory conditions (e.g., Asthma, COPD). * Cardiovascular issues (e.g., Arrhythmias, Hypertension). * Clinical psychological disorders (e.g., Generalized Anxiety Disorder or Panic Disorder) that may require medication. * Pharmacological Factors: Use of medications that influence the Autonomic Nervous System (e.g., Beta-blockers, antidepressants, or heavy use of stimulants/sedatives). * Substance Use: Smokers/Vapers * Excessive Caffeine "Participants consuming more than 400 mg of caffeine per day (equivalent to approximately 4 standard cups of brewed coffee) will be excluded. * Recent Acute Illness: Any respiratory tract infection or fever within two weeks prior to the start of the study

Conditions

Stress Psychological Resilience Healthy Students

Locations

Faculty of Physical Therapy, Deraya University — Minya, Minya Province, Egypt

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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