Daoist Zhanzhuang and Human Flourishing

NCT06573034 | Recruiting

• 2 other identifiers: IRB-24-074932539
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

This project investigates the impact of Daoist Zhanzhuang (sometimes spelled as Chan Chuang) on human flourishing, and explores the physiological, psychological, and spiritual mechanisms. This study will be a two-arm randomized controlled trial, with mixed-methods and repeated-measures assessment of outcome variables. The two arms will include an active control condition (i.e., sham wall squat) and the Daoist Zhanzhuang condition. Outcome variables will include physiological measures of heart rate variability and inflammatory biomarkers, psychological scales of human flourishing variables, phenomenological interviews of mystical experiences, and daily ecological momentary assessment of human flourishing and mysticism. Randomly assigned into two conditions, 120 participants will complete a three-week intensive practice phase with 9 in-person sessions, followed by a nine-week self-guided practice phase with 4 in-person check-in sessions, and 3 follow-up practice and assessment sessions. Complete assessment (physiological measures, psychological scales, and phenomenological interviews) will be administered at five time points: T1 at about two weeks before the intervention, T2 at the end of the three-week intensive practice, T3 at the end of the 3-month intervention, T4 at the 6-month follow-up, and T5 at the 12-month follow-up. In addition, daily ecological momentary assessment of flourishing variables and practice-induced experiences will be administered daily after the practice for the entire 3-month intervention period.

Conditions

Stress, Physiological; Stress, Psychological; Inflammatory Response; Well-Being, Psychological

Keywords

Human Flourishing; Daoist Zhanzhuang (Chan Chuang); Heart Rate Variability; Immune Function; Mysticism

Outcome Measures

Primary Outcomes (8)

• Increased heart rate variability

  HRV will be collected using the H10 wear link and chest band (Polar Electro, Kempele, Finland) during several study activities, including 5 minutes of normal breathing at rest, a 5-minute paced-breathing task and during the 30-min intervention practice period. The normal and paced breathing assessments will occur at all data collection visits to estimate basal autonomic nervous system functioning.

  Day 1 in-person session, baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Decreased inflammatory biomarker CRP

  Saliva will be collected via approved methods (IBC BIO-23-0032). Salivary inflammatory biomarkers will be assessed in-house at the Biobehavioral Core Lab. Salivary C-reactive protein (sCRP) will be quantified using commercially available enzyme immunoassays according to manufacturer instructions. CRP is a protein produced by the liver in response to the cell mediated biomarker cytokines.

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Decreased perceived stress

  The 4-item Perceived Stress Scale measured on visual analogue ranging from 0 to 100, higher scores suggesting worse outcome.

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Increased resilience

  Brief Resilience Scale measured on visual analogue ranging from 0 to 100, higher scores suggesting better outcome.

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Decreased fatigue

  The 10-item Fatigue Assessment Scale measured on visual analogue ranging from 0 to 100, higher scores suggesting worse outcome.

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Increased vitality

  The 6-item Subjective Vitality Scale measured on visual analogue ranging from 0 to 100, higher scores suggesting better outcome.

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Increased mystical experiences

  The brief 8-item Mysticism Scale measured on visual analogue ranging from 0 to 100, higher scores suggesting better outcome.

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Increased overall human flourishing

  The 12-item Human Flourishing Measure measured on visual analogue ranging from 0 to 100, higher scores suggesting better outcome.

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

Secondary Outcomes (6)

• Decreased inflammatory biomarker cytokine IL-1ß

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Decreased inflammatory biomarker cytokine IL-6

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Decreased inflammatory biomarker cytokine TNF-a

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Increased interoceptive awareness

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

• Reduced depression

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

Other Outcomes (1)

• Psychological Insight

  baseline T1 (before the intervention), the end of three-week intensive practice (T2), the end of the 3-month intervention (T3), the 6-month follow-up (T4), and the 12-month follow-up (T5).

Study Arms (2)

Daoist Zhanzhuang

EXPERIMENTAL

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.

Behavioral: Daoist Zhanzhuang

Sham Wall Squat

ACTIVE COMPARATOR

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.

Behavioral: Sham Wall Squat

Interventions

Daoist Zhanzhuang BEHAVIORAL

Each session of practice will last 30 minutes, and participants are expected to participate every day for 3 months. During the initial 3 weeks, participants will engage in in-person sessions 3 times a week. On non-session days, they can choose to either attend a Zoom practice session with the coach or submit a recording of their individual practice for fidelity check. In Week 4, participants will attend an in-person session for both practice and assessment. Over the subsequent 8 weeks, participants will either attend in-person or Zoom sessions, with a total of 3 check-in sessions.

Daoist Zhanzhuang

Sham Wall Squat BEHAVIORAL

Same as the Zhanzhuang group.

Sham Wall Squat

Eligibility Criteria

• Age: 18 Years - 25 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• young adults aged between 18 and 25 years old when they enroll;
• be willing and available (e.g., intend to remain in Charlotte or the surrounding area or willing to travel to UNCC campus for in person visits) to participate to 12 month study;
• able to stand for 30 minutes;
• scoring above 18 on the Perceived Stress Scale (moderate stress); and
• able to read, speak and understand English.

You may not qualify if:

• experience of qigong-related practice in the past 5 years;
• reporting regular medication use that directly modulates immune system functioning (e.g., steroids, cytokine inhibitors, high levels of non-steroidal anti-inflammatory medication, chemotherapy, etc.) or sedates the nervous system (e.g., benzodiazepines, anti-epileptics, tranquilizers, etc.) or alters heart rate (e.g., beta blockers, calcium channel blocker, stimulants, etc.);
• self-reported illicit drug use in the past 3 months or substance dependence over the past month (e.g., alcohol binge drinking 2+ days/week, using tobacco or nicotine products 5+ days/week, cannabis and related products 2+ days/week, etc.);
• physical impairment that does not allow them to stand for 30 mins (e.g., severe obesity, need wheel-chair or equipment to assist with walking, recent injury that limits standing, etc.), and
• severe mental health conditions that could prevent regular practice (e.g., hospitalized in the past 12 months for mental health condition).

Sponsors & Collaborators

• University of North Carolina, Charlotte: lead

Study Sites (1)

University of North Carolina at Charlotte

Charlotte, North Carolina, 28223, United States

RECRUITING

Related Links

• Funding Information

MeSH Terms

Conditions

Stress, Psychological; Psychological Well-Being

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Personal Satisfaction

Central Study Contacts

Zhuo Job Chen, PhD

CONTACT

7046877966; job.chen@charlotte.edu

Jeanette Bennett, PhD

CONTACT

7046871966; Jeanette.Bennett@uncc.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participants will be kept unaware of both their assigned condition and the study hypotheses. The research staff responsible for conducting the intervention and assessments will be blinded to the study hypotheses.Different researchers will be assigned to handle the procedures of recruitment, intervention, data collection, and analyses. Outcome assessors and data managers will not participate in participants' screening and allocation, and outcome assessors will maintain blindness to group allocation.
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: The two arms will include an active control condition (i.e., sham wall squat) and the Daoist Zhanzhuang condition.

Study Record Dates

• First Submitted: August 23, 2024
• First Posted: August 27, 2024
• Study Start: August 29, 2024
• Primary Completion (Estimated): February 1, 2027
• Study Completion (Estimated): July 1, 2027
• Last Updated: May 1, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)