Daoist Zhanzhuang for Stress and Mental Health

(Z-Flo Trial)

Overseen By Jeanette Bennett, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of North Carolina, Charlotte

Must not be taking: Steroids, Benzodiazepines, Beta blockers, others

Disqualifiers: Qigong experience, Illicit drug use, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 16

120 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the effects of Daoist Zhanzhuang (a standing meditation) on stress and mental health. Participants will be divided into two groups: one practicing Daoist Zhanzhuang and the other performing a similar standing exercise for comparison. The researchers aim to determine if these practices improve heart health, reduce stress, and enhance well-being. The trial seeks young adults who feel moderately stressed, can stand for 30 minutes, and are willing to participate in a year-long study in Charlotte. As an unphased trial, it offers a unique opportunity to contribute to understanding the benefits of meditation on mental health and stress.

Will I have to stop taking my current medications?

If you are taking medications that affect the immune system, sedate the nervous system, or alter heart rate, you may not be eligible to participate in this trial.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Daoist Zhanzhuang, a type of standing meditation, is generally safe for participants. Studies have found that regular practice benefits both body and mind. No specific reports of serious side effects or negative events have been directly linked to this practice.

Participants in past studies did not report any major negative effects, suggesting the technique is safe for most people. While individual experiences may differ, evidence suggests that Daoist Zhanzhuang maintains a positive safety record. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores Daoist Zhanzhuang, a traditional standing meditation technique, as a potential method to improve stress and mental health. Unlike typical treatments for stress, such as medication or psychotherapy, Zhanzhuang emphasizes a unique combination of posture, mindfulness, and natural breathing, which may enhance mental well-being by promoting relaxation and body awareness. Additionally, this technique is non-invasive and accessible, offering an alternative for those seeking holistic approaches to manage stress and mental health. This trial aims to find out if such ancient practices can be scientifically validated and offer benefits comparable to or exceeding current standard treatments.

What evidence suggests that this trial's treatments could be effective for stress and mental health?

Studies have shown that Daoist Zhanzhuang, a type of standing meditation, can improve both physical and mental well-being. Research indicates that practicing Zhanzhuang enhances body functions, such as improving heart rate variability, which measures how the heart handles stress. Additionally, practitioners often report better focus and less stress. In this trial, participants in the Daoist Zhanzhuang arm will engage in this practice, standing in a relaxed manner with arms positioned as if hugging a tree, which aids balance and calms the mind. Meanwhile, participants in the Sham Wall Squat arm will perform a different exercise, standing straight while leaning against a wall. Overall, early findings suggest that Daoist Zhanzhuang may support both body and mind health. ^{1 2 3 4 6}

Are You a Good Fit for This Trial?

This trial is for individuals interested in exploring the effects of Daoist Zhanzhuang, a form of standing meditation, on well-being. Participants should be willing to commit to a three-week intensive practice followed by nine weeks of self-guided exercises and follow-ups over a year.

Inclusion Criteria

I can commit to a 12-month study, stand for 30 minutes, have moderate stress, and understand English.

Exclusion Criteria

Self-reported illicit drug use in the past 3 months or substance dependence over the past month

Experience of qigong-related practice in the past 5 years

Severe mental health conditions that could prevent regular practice

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2 weeks

Intensive Practice

Participants engage in a three-week intensive practice phase with Daoist Zhanzhuang or sham wall squat, including 9 in-person sessions.

3 weeks

9 visits (in-person)

Self-guided Practice

Participants continue with a nine-week self-guided practice phase with 4 in-person check-in sessions.

9 weeks

4 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the intervention, with assessments at 6-month and 12-month follow-ups.

12 months

3 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Daoist Zhanzhuang
• Sham Wall Squat

Trial Overview The study compares two groups: one practicing Daoist Zhanzhuang and another doing sham wall squats as an active control. It measures heart rate variability, inflammation markers, psychological well-being, mystical experiences, and daily flourishing through various stages over twelve months.

How Is the Trial Designed?

Group I: Daoist Zhanzhuang Experimental Treatment 1 Intervention

Individuals in this condition will learn and maintain the Zhanzhuang posture, endorsed by this study's religious practitioner and validated by two independent Daoist experts. The core posture involves: a) Standing with feet shoulder-width apart, knees slightly bent, and toes pointed forward; b) Opening the hips slightly to the side as if holding a ball between the legs; c) Sitting slightly back and tucking in the abdomen and tailbone; d) Keeping the back straight while holding in the chest; e) Raising the arms to a height over the chest but under the shoulders as if embracing a tree trunk; f) Facing palms toward the body with fingers apart as if holding a ball; g) Relaxing the shoulders and lowering the elbows in a stationary stance; h) Pointing the head upward as if balancing an object on top of the head; i) Tucking in the chin; j) Breathing naturally, with a focus on the lower abdominal area.

Group II: Sham Wall Squat Active Control 1 Intervention

Individuals in this condition will be directed to perform a sham wall squat, essentially a prescribed way to stand straight leaning against the wall. Key instructions include: a) Standing tall with the head and back resting against the wall; b) Positioning feet shoulder-width apart and a foot away from the wall; c) Slightly bending and engaging leg muscles; d) Relaxing hands on the side of the body; e) Concentrating on the balance of weight.

Who Is Running the Clinical Trial?

University of North Carolina, Charlotte

Lead Sponsor

Trials

27

Recruited

12,200+

Published Research Related to This Trial

A study involving 43 healthy volunteers found that practicing Taoist qigong for one month significantly reduced blood levels of adrenocorticotropic hormone (ACTH), indicating a potential stress-reducing effect.

Participants who practiced qigong also showed improvements in psychological well-being, suggesting that this traditional method may positively influence both hormonal balance and mental health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment of hormonal parameters and psychological well-being in healthy subjects after a Taoist qigong program: An exploratory study. Vera, FM., Manzaneque, JM., Rodríguez, FM., et al.[2019]

A 12-week Medical Qigong program significantly improved balance and gait in older adults, with the most notable improvements seen in participants in their 60s and 70s, indicating its potential as an effective intervention for fall risk reduction.

While balance self-confidence showed only modest improvement, the study suggests that Medical Qigong could still be beneficial for older adults at risk of falls, as it positively impacted physical balance measures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Medical Qigong for Mobility and Balance Self-Confidence in Older Adults. Stahl, JE., Belisle, SS., Zhao, W.[2020]

A meta-analysis of six studies involving 415 COPD patients showed that Qigong, when combined with conventional therapy, significantly reduced depression and anxiety scores, indicating its efficacy in improving mental health in these patients.

Qigong also positively impacted lung function and physical performance, as evidenced by improvements in forced expiratory volume, forced vital capacity, and 6-minute walk test distances, suggesting it can be a beneficial complementary therapy for COPD management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Qigong on self-rating depression and anxiety scale scores of COPD patients: A meta-analysis. Wu, JJ., Zhang, YX., Du, WS., et al.[2022]

Training young flutists in 'White Ball' Qigong led to immediate improvements in anxiety symptoms, such as warmer hands and a calmer heart rate, which were observed shortly after training and persisted throughout the program.

Remarkably, the children were able to maintain these positive physiological changes even without practicing Qigong exercises after the training, suggesting that Qigong may condition the body to activate beneficial responses in stressful situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Qigong as a Traditional Vegetative Biofeedback Therapy: Long-Term Conditioning of Physiological Mind-Body Effects. Matos, LC., Sousa, CM., Gonçalves, M., et al.[2022]

Baduanjin, a form of Qigong, has been shown to improve psychological health and quality of life across diverse groups, including college students, the elderly, and individuals with mental disorders or chronic illnesses, based on a review of 28 studies.

This exercise is cost-effective, easy to learn, and can be practiced at one's own pace, suggesting it should be promoted for both treatment and prevention of mental health issues, with further research recommended.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Baduanjin on mental health: a comprehensive review. Cheng, FK.[2022]

This study will evaluate the effectiveness and safety of Three-Circle Post Standing Qigong (TCPSQ) on the physical and psychological health of 80 college students over a 10-week intervention period, followed by an 8-week follow-up.

The randomized controlled trial aims to provide high-quality evidence on TCPSQ's potential benefits, which could lead to better health guidance for college students facing declining health due to lifestyle changes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of Three-Circle Post Standing (Zhanzhuang) Qigong on the physical and psychological well-being of college students: Study protocol for a randomized controlled trial. Guo, Y., Xu, M., Zhang, J., et al.[2022]

The evidence map analyzed 116 systematic reviews and 44 meta-analyses, highlighting that mind-body therapies like Tai Chi and Qi Gong have shown positive effects on chronic diseases, mental health, and overall well-being.

Most reviews were of high quality, with 421 outcomes classified as potentially positive, indicating these therapies may improve balance, mobility, and quality of life, while further research is needed in specific areas like acupressure and the effects of Tai Chi and Qi Gong on acute diseases.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map. Fogaça, LZ., Portella, CFS., Ghelman, R., et al.[2022]

Tai Chi significantly reduced salivary cortisol levels and improved mood states after exposure to stressors, indicating its efficacy in post-stressor recovery among 96 participants (48 males and 48 females).

While Tai Chi showed better results than neutral reading in reducing anxiety and enhancing vigor, the effects may be influenced by participants' expectations, suggesting that future studies should control for these expectancy levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental and emotional stress. Jin, P.[2019]

This study will evaluate the feasibility and acceptability of Imaginary Working Qigong as a stress management intervention for college students, with 80 participants undergoing an 8-week training program.

The randomized controlled trial aims to assess psychological outcomes and explore the molecular biological mechanisms of Imaginary Working Qigong, potentially providing valuable evidence for its effectiveness in improving mental health among college students.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of Imaginary Working Qigong on the psychological well-being of college students: Study protocol for a randomized controlled trial. Guo, Y., Xu, M., Ji, M., et al.[2022]

Qigong practice was found to be safe and well-received among 26 wounded, ill, and injured military service members, with participants reporting high satisfaction and improvements in stress, sleep, and physical function after attending an average of 8.14 classes over 10 weeks.

The study highlighted the feasibility of Qigong as a rehabilitation tool, noting that participants appreciated its accessibility and portability, although they suggested shorter programs and more flexible scheduling to enhance participation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Qigong in Injured Military Service Members. Reb, AM., Saum, NS., Murphy, DA., et al.[2017]

The Laughing Qigong Program significantly improved cognitive function and mood in elderly participants, as evidenced by better scores on the Mini-Mental State Examination and reduced depression levels after 4 weeks of participation.

In contrast, the control group experienced declines in mood and increases in depression and cortisol levels, highlighting the program's potential as an effective non-pharmacological therapy for mental health in institutionalized elderly populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Empirical study of the influence of a Laughing Qigong Program on long-term care residents. Hsieh, CJ., Chang, C., Tsai, G., et al.[2015]

Qigong exercise has been shown to significantly reduce anxiety and stress in healthy adults, with a pooled effect size indicating strong benefits after one to three months of practice.

The review included seven randomized controlled trials, but highlights the need for more rigorously designed studies due to methodological flaws in the existing research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials. Wang, CW., Chan, CH., Ho, RT., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6160034/

The effect of Three-Circle Post Standing (Zhanzhuang ... Three-Circle Post Standing Qigong (TCPSQ) is suitable for regular practicing and has beneficial effects on improving the physiological function and ...

2. journals.lww.com journals.lww.com/md-journal/fulltext/2018/09210/the_effect_of_three_circle_post_standing.33.aspx

The effect of Three-Circle Post Standing (Zhanzhuang)... Standing in relaxed posture, circling the arms akin to hugging a tree trunk or holding a ball, breathing deeply and steadily, mentally focus on the rotating ...

3. templetonworldcharity.org templetonworldcharity.org/projects-resources/project-database/32539

Standing Like a Tree: Effects and Mechanisms of Daoist… A randomized controlled trial will explore the effects of Zhanzhuang — a Daoist standing meditation that aims to accumulate vital energy — on human…

4. researchgate.net researchgate.net/publication/327822198_The_effect_of_Three-Circle_Post_Standing_Zhanzhuang_Qigong_on_the_physical_and_psychological_well-being_of_college_students_Study_protocol_for_a_randomized_controlled_trial

Study protocol for a randomized controlled trial The relevant physical and psychological outcomes, adverse events, and safety will be evaluated at baseline, 6 weeks (at the mid-point of ...

5. facebook.com facebook.com/groups/1000HoursStanding/posts/2109135795950419/

There seem to be some confusion about Zhang Zhuang ... "The original Zhàn zhuāng were health methods used by Daoists; in recent centuries, martial artists who already had static standing methods ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8213330/

The effect of three-circle post standing (Zhanzhuang) qigong ... This study will be investigate the effects of qigong's anxiety-release by SAS, and will analyze the coordinates of EEG and heart rate variability (HRV) signals.