Effects of a Laughter Yoga Program in Adolescents With Disabilities

NCT05832346 | Completed

• 1 other identifier: 2022.660-T
• Study Type: interventional
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

A pilot randomized controlled trial will be adopted. A total of forty adolescents with intellectual and physical disabilities will be randomly allocated into either intervention group receiving a 4-week laughter yoga programme (8 sessions) or control group receiving routine care in a 1:1 ratio based on computer-generated random schedule. The aim of this pilot study is to preliminarily evaluate the effects of a 4-week laughter yoga programme (8 sessions) on the mood, anxiety and loneliness among adolescents with intellectual and physical disabilities in a special school in Hong Kong. Hypotheses for primary outcomes of this study are as follows: H.1 Participants receiving the 4-week laughter yoga programme (8 sessions) (intervention group) will have a greater improvement on mood level than the participants receiving routine care provided by the special school as usual (control group). H.2 Participants receiving the 4-week laughter yoga programme (8 sessions) (intervention group) will have a greater reduction on anxiety than the participants receiving routine care provided by the special school as usual (control group). H.3 Participants receiving the 4-week laughter yoga programme (8 sessions) (intervention group) will have a greater reduction on loneliness than the participants receiving routine care provided by the special school as usual (control group).

Conditions

Disability, Adolescent Learning; Psychosocial Problem

Keywords

disabilities; adolescents; psychosocial problems; laughter yoga; feasibility studies; randomized controlled trial

Outcome Measures

Primary Outcomes (6)

• Mood

  The Mood Scale includes five different emoji with a 5-points response scale of mood ranging from 1-5: 1-Very bad; 2-bad, 3-so-so, 4-good; to 5-very good. The range of scale score can be from 1 to 5 where higher scores represented very good mood and emotion using emoji.

  Before the intervention

• Mood

  The Mood Scale includes five different emoji with a 5-points response scale of mood ranging from 1-5: 1-Very bad; 2-bad, 3-so-so, 4-good; to 5-very good. The range of scale score can be from 1 to 5 where higher scores represented very good mood and emotion using emoji.

  Immediate after the intervention

• Anxiety

  The STAI-6 contains 6 items which is sensitive to fluctuations in state anxiety. Observers will be asked to answer each item using the following scale (Scale of 1-5; 1 = not at all / very slightly, 2 = a little, 3 = moderately, 4 = quite a bit, 5 = extremely). The range of score from 6 to 24. The highest score shows a high anxiety level of individual. Back translation of the STAI-6 had been performed after obtained the content validity index (CVI=1.0).

  Before the intervention

• Anxiety

  The STAI-6 contains 6 items which is sensitive to fluctuations in state anxiety. Observers will be asked to answer each item using the following scale (Scale of 1-5; 1 = not at all / very slightly, 2 = a little, 3 = moderately, 4 = quite a bit, 5 = extremely). The range of score from 6 to 24. The highest score shows a high anxiety level of individual. Back translation of the STAI-6 had been performed after obtained the content validity index (CVI=1.0).

  Immediate after the intervention

• Loneliness

  The UCLA Loneliness Scale (ULS-8) contains 8 items including two factors: intimate other and social other. There are six items in the intimate factor and two items in the social other factor. Observers are asked to answer each item using the following scale: 1=Never, 2=Rarely, 3=Sometimes, 4=Often. It is a 4-point Likert scale with values from "never" to "always". For each participant, responses on the 4-items were totaled to create a composite loneliness score, with higher scores indicated higher loneliness. Scores ranged from 8 to 32. The 8-item measure demonstrated high internal reliability (α=0.84).

  Before the intervention

• Loneliness

  The UCLA Loneliness Scale (ULS-8) contains 8 items including two factors: intimate other and social other. There are six items in the intimate factor and two items in the social other factor. Observers are asked to answer each item using the following scale: 1=Never, 2=Rarely, 3=Sometimes, 4=Often. It is a 4-point Likert scale with values from "never" to "always". For each participant, responses on the 4-items were totaled to create a composite loneliness score, with higher scores indicated higher loneliness. Scores ranged from 8 to 32. The 8-item measure demonstrated high internal reliability (α=0.84).

  Immediate after the intervention

Study Arms (2)

Laughter yoga programme

EXPERIMENTAL

The intervention group will receive a 4-week laughter yoga programme (8 sessions). This group also receives routine care provided by the special school as usual.

Behavioral: Laughter yoga programme

Routine care

NO INTERVENTION

The control group receives routine care provided by the special school as usual.

Interventions

Laughter yoga programme BEHAVIORAL

Intervention for intervention group: This is a 4-week laughter yoga programme (8 sessions) to help adolescents with intellectual and physical disabilities bring more happiness, laughter and joy to promote their mental health status. As laughter yoga therapy can reduce people's levels of stress, anxiety, depression, loneliness, strengthen the immune system and keep the mind positive. Each laughter yoga session will last for 15 minutes and in total there will be 8 sessions for four weeks (two sessions per week). Each laughter yoga session consists of hand clapping warming-up exercise, followed by deep breathing exercise, childlike playfulness exercise, and then laughter exercise. The intervention group also receives routine care provided by special school.

Laughter yoga programme

Eligibility Criteria

• Age: 10 Years - 19 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Adolescent has been diagnosed with mild and moderate intellectual or/and physical disabilities
• Adolescent is studying between Grade 4 and Grade 12 in the selected special school
• Adolescent aged between 10 and 19 years old in this selected special school during the data collection period
• Adolescent has not received any psychotherapy previously
• Adolescent has the proficiency in understanding instructions for laughter exercises and hands and body movement

You may not qualify if:

• Adolescent has not been diagnosed with mild and moderate intellectual or/and physical disabilities
• Adolescent is studying lower than Grade 4 in the selected special school
• Adolescent aged \< 10 years old and \> 19 years old in this selected special school during the data collection period
• Adolescent has previously received psychotherapy
• Adolescent does not have the proficiency in understanding instructions for laughter exercises and hands and body movement

Sponsors & Collaborators

• Chinese University of Hong Kong: lead

Study Sites (1)

The Nethersole School of Nursing

Shatin, New Territories, 990777, Hong Kong

Location

Related Publications (1)

• Lee RLT, Ho LLK, Lam SKK, Chan DNS, Fung KHK, Hung TTM, Stubbs M, Tang ACY, Choi KC, Leung AWY. The effects of a group-based laughter yoga intervention on mood, anxiety and loneliness in adolescents with mild intellectual or developmental disabilities: A pilot randomized controlled trial. Res Dev Disabil. 2025 Nov;166:105128. doi: 10.1016/j.ridd.2025.105128. Epub 2025 Oct 17.

  PMID: 41109062 RESULT

MeSH Terms

Conditions

Learning Disabilities

Condition Hierarchy (Ancestors)

Communication Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Neurodevelopmental Disorders; Mental Disorders

Study Officials

• Regina Lee, PhD

  Chinese University of Hong Kong

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: masking the participants that they do not know which group will be allocated in this pilot study.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: February 6, 2023
• First Posted: April 27, 2023
• Study Start: January 27, 2023
• Primary Completion: March 26, 2023
• Study Completion: March 26, 2023
• Last Updated: March 30, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: In 6 months after the submission of the final report.
• Access Criteria: Once the personal data management account has been set up.

Locations

HK (1)