Diaphragmatic and Box Breathing on Heart Rate Variability and Perceived Stress

NCT07698652 | Not Yet Recruiting

• 1 other identifier: CU-AN-19052026
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

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

Conditions

Stress; Psychological Resilience; Healthy Students

Outcome Measures

Primary Outcomes (3)

• Heart Rate Variability

  HRV will be measured using the Polar H10 sensor and analyzed through Kubios HRV software to evaluate physiological resilience and autonomic nervous system regulation.

  Baseline (pre-intervention) and at the end of the 4-week training period (post-intervention).

• Perceived Stress

  Stress will be measured using the Perceived Stress Scale (PSS-10). The total score ranges from a minimum of 0 to a maximum of 40. Higher scores indicate higher levels of perceived stress, representing a worse outcome

  Baseline (pre-intervention) and at the end of the 4-week training period (post-intervention).

• Resilience

  Resilience will be measured using the Brief Resilience Scale (BRS). The score ranges from a minimum of 1 to a maximum of 5. Higher scores indicate higher levels of resilience, representing a better outcome

  Baseline (pre-intervention) and at the end of the 4-week training period (post-intervention).

Secondary Outcomes (2)

• Cognitive Performance

  Baseline (pre-intervention) and at the end of the 4-week training period (post-intervention).

• Academic Achievement

  Baseline (pre-intervention) and at the end of the 4-week training period (post-intervention).

Study Arms (3)

Diaphragmatic Breathing Group

EXPERIMENTAL

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

Behavioral: Diaphramatic Breathing Training

Box Breathing Group

EXPERIMENTAL

Participants will perform a structured breath cycle: * Inhale for 4 seconds * Hold for 4 seconds * Exhale for 4 seconds * Hold for 4 seconds Sessions will last 15 minutes, 6 sessions/week, for 4 weeks

Behavioral: Box Breathing Training

Control Group

NO INTERVENTION

Participants will continue their normal daily routines and will not receive any breathing intervention during the study period

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

Diaphragmatic Breathing Group

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

Box Breathing Group

Eligibility Criteria

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

You may qualify if:

• 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.

You may not qualify if:

• 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

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of Physical Therapy, Deraya University

Minya, Minya Province, Egypt

Location

Study Officials

• Rana H Elbanaa, Assoiate Professor

  Cairo University

  STUDY CHAIR

• Fatma Y Abdelsalam, Lecturer

  Cairo University

  STUDY DIRECTOR

Central Study Contacts

Alaa N Abdelhameed Abdelmohsen, B.Sc. in Physical Therapy

CONTACT

+201061382864; alaa.nasser@deraya.edu.eg

Abdelrahman A Mohamed, B.Sc. in Physical Therapy

CONTACT

+201124079292; abdelrahmanayman199810@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Teaching Assistant

Study Record Dates

• First Submitted: July 7, 2026
• First Posted: July 13, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): December 30, 2026
• Study Completion (Estimated): March 1, 2027
• Last Updated: July 14, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)