Effect of Conventional Exercise and Tai Chi Exercise on College Students

Effect of Conventional Exercise and Tai Chi Exercise in College Students With Internet Addiction: A Randomized Clinical Trial

Internet addiction disorder (IAD) is an impulse-control disorder of Internet behavior in the absence of addictive substances. Exercise has been found to have significant advantages in improving the severity and depressive symptoms of IAD. The purpose of this study was to observe the efficacy of conventional exercise and tai chi in the treatment of Internet addiction and to observe the changes in each group. Subjects diagnosed with IAD were randomly assigned to the exercise group, the tai chi group, or the control group. The exercise group and tai chi group received conventional exercise and tai chi for 8 weeks. The Internet Addiction Test (IAT), the Pittsburgh sleep quality index (PSQI), the Zung Self-rating Depression Scale (SDS), the Zung Self-rating Anxiety Scale (SAS), and Fatigue Scale-14 (FS-14) were evaluated for all subjects at baseline and postintervention.

Over the past decade, with the rapid growth and popularity of the Internet, Internet addiction (IA) has increased. Nowadays, Internet addiction disorder (IAD) has become a significant social problem, especially among teenagers and young adults. IAD is an impulse-control disorder of Internet behavior in the absence of addictive substances, its typical symptoms are involved, including tolerance, withdrawal symptoms, large amounts of time spent online, interruption of social relations, and disorder of the biological clock. Western scholars have developed interventions for Internet addiction based on cognitive behavioral therapy (CBT). Besides applying CBT treatment, Chinese psychologists also have developed trials to apply psychoanalytic group intervention, family therapy, sports exercise prescriptions, and Naikan therapy. Physical exercise (PE) interventions are known to facilitate cerebral blood and oxygen supply, enhance brain metabolism and neurotransmitter function and improve the balance of the nervous system, which in turn helps improve physical and mental adaptability. Active physical exercise is helpful to improve the symptoms of Internet addiction. Tai chi is a mind-body exercise that originated in China. It is a form of physical and mental training combining Chinese martial arts and meditative movements involving a series of slowly performed, continuous, and rhythmic movements that put a minimal impact on the joints of the body. This study aimed to validate the use of tai chi as an alternative approach to Internet addiction and compare the effectiveness of tai chi with conventional exercise. With both primary and secondary outcome measures, the effects of tai chi and exercise on Internet addiction can be more comprehensively analyzed, which will provide a basis for its future establishment as a non-pharmacological method for the treatment of Internet addiction.

Participants in the conventional exercise group attended an 8-week conventional exercise program, which consisted of the track, field, ball games et al. If the participant chooses to run, the mileage shall be more than 4km and the pace shall be within 10min. The conventional exercise treatment was performed 3 times a week, 1 hour each time.

Participants in the tai chi exercise group attended an 8-week Yang-style 24-form tai chi training program and tai chi (8 trigrams 5 steps) which was the tai chi style most commonly adopted and studied in the literature. The tai chi exercise treatment was performed 3 times a week, 1 hour each time.

Subjects diagnosed with IAD were randomly assigned to the exercise group, the tai chi group, or the control group. The exercise group and tai chi group received conventional exercise and tai chi for 8 weeks.

The IAT is composed of 20 items with a 5-point scale (1 = "very rarely", 5 = "very frequently"). IAT scores range from 20 to 100, with higher scores indicating higher levels of IA. Scores over 50 indicated a tendency of IA.

The PSQI version used in the current study was a 19-item self-report retrospective questionnaire of the past 7 days designed to measure 7 domains called component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medications, and daytime dysfunction. Component scores range from 0 (no difficulty) to 3 (severe difficulty). PSQI scores range from 0 to 21. Scores over 7 indicated a tendency for a sleep disorder.

The SDS is composed of 20 items with a 4-point scale (1 = "none or a little of the time", 4 = "most or all of the time"). A standardized scoring algorithm is used to define symptoms of depression, with a total score range of 20-80. The final index score was converted by multiplying the raw score by 1.25 and then rounding off decimal places. The severity of depression was categorized according to the index score: nil depression (index score < 50), mild depression (index score 50-59), moderate depression (index score 60-69), and severe depression (index score≥70).

The SAS is composed of 20 items with a 4-point scale (1 = "none or a little of the time", 4 = "most or all of the time"). A standardized scoring algorithm is used to define symptoms of anxiety, with a total score range of 20-80. The final index score was converted by multiplying the raw score by 1.25 and then rounding off decimal places. The severity of anxiety was categorized according to the index score: nil anxiety (index score < 50), mild anxiety (index score 50-59), moderate anxiety (index score 60-69), and severe anxiety (index score≥70).

The FS-14 consists of 14 items, each of which is a fatigue-related question. The maximum total score is 14, and the higher the score, the more severe the fatigue.

Inclusion Criteria: participants were diagnosed with IAD according to the Internet Addiction Test; the physical activity level of participants was low; participants had no history of medication or psychotherapy. Exclusion Criteria: participants had a history of severe mental illness; participants had a history of drug addiction; participants regularly practiced moderate-intensity exercise.

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