Effects Of Aerobic Exercise And Tai Chi Chuan On College Students With Mobile Phone Addiction And The Potential Role Of Gut Microbiota: A Randomized Controlled Trial

Background:In recent years,Mobile phone addiction(MPA)among college students has attracted much attention,and prior evidence suggests that MPA has adverse effects on college students’ learning,life,thinking,and physical and mental health.Exercise therapy is accessible,easy to implement,low cost,and highly acceptable,and there is evidence that exercise can be used as an intervention for many behavioral addiction problems;however,there is a lack of high-quality intervention trials of different types of exercise for MPA.Therefore,this study aimed to explore the intervention effects of an eight-week aerobic exercise(AE)or Tai Chi Chuan(TCC)on addiction symptoms,psychological-related symptoms,and physical-related symptoms among college students with MPA;and to analyze the structural distribution of gut microbiota in the three groups to explore the correlation between addiction symptoms and flora species.Methods:This study was a parallel three-arm randomized controlled trial and has completed registration(Clinical Trials.gov Identifier: NCT05843591).Ninety college students with MPA were randomly assigned to aerobic exercise(AE),Tai Chi Chuan(TCC),and wait-list control(WLC)groups.Participants in the intervention groups performed Aerobic Exercise and Tai Chi Chuan for eight weeks,three times a week,each exercise lasting 1 hour.Participants in the WLC group maintained their daily routine without receiving any intervention.Changes in mobile phone addiction symptoms,psychological-related symptoms(depression,anxiety,low self-esteem,and low self-control efficacy,etc.),and physical-related symptoms(poor sleep quality,dizziness,eye discomfort,neck pain and gastrointestinal discomfort,etc.)were analyzed by Generalized Estimated Equation(GEE).Differences in the diversity and richness of the study subjects’ gut microbiota were explored by 16 S r DNA sequencing analysis of their stools at the post-intervention,and a preliminary analysis of the correlation between exercise-induced changes in gut microbiota and addiction scores was conducted.Results:1.GEE analysis showed a significant decrease in MPA levels in the AE and TCC groups at the post-intervention compared to the WLC group(AE vs WLC:-6.000;95% CI,-8.936 to-3.060;P?<0.001;TCC vs WLC:-4.767;95% CI,-8.496 to-1.040;P=0.012);however,the two intervention groups were not significantly different from each other.2.GEE analysis revealed significantly higher levels of self-esteem in the TCC group compared to the WLC group at the post-intervention(TCC vs WLC: 1.333;95% CI,0.048 to 2.619;P=0.042).Both the AE and TCC groups showed reductions of physical-fatigue(AE vs WLC:-0.933;95% CI,-1.766 to-0.101;P=0.028;TCC vs WLC:-1.033;95% CI,-2.042 to-0.025;P=0.045),brain-fatigue(AE vs WLC:-1.167;95% CI,-1.945 to-0.389;P=0.003;TCC vs WLC:-0.933;95% CI,-1.630 to-0.237;P=0.009)and the incidence of dizziness(AE vs WLC:-2.020;95% CI,-3.878 to-0.162;P=0.033;TCC vs WLC:-2.525;95% CI,-5.039 to-0.011;P=0.049)at the post-intervention,with no significant differences between the AE and TCC groups.3.16 S r DNA sequencing analysis after the exercise intervention revealed no significant differences in α-diversity and β-diversity of the three groups of gut microbiota.The strains with total mean relative abundance ≥ 0.01 were selected and LEf Se analysis revealed that compared to WLC group,the relative abundance of Bacteroidaceae(P=0.016)and Bacteroides(P=0.016)was lower in the AE group;the relative abundance of Erysipelotrichaceae(P=0.008)and Alistipes(P=0.040)was lower in the TCC group.4.The results of Spearman analysis indicated that the relative abundance of Bacteroides(r=-0.213,P=0.044),Bacteroides(r=-0.213,P=0.044),and Alistipes(r=-0.267,P=0.011)were significantly and negatively correlated with the decline in MPA levels.Conclusion:Eight weeks of either Aerobic Exercise and Tai Chi Chuan significantly reduced the levels of MPA,fatigue,and incidence of dizziness among college students;in addition,TCC significantly increased the level of self-esteem among college students with MPA.Exercise interventions may reduce MPA levels by reducing the relative abundance of Bacteroides,Bacteroides and Alistipes.