| Study Ⅰ:Effects of Exercise or Tai Chi Training on Internet Addiction in College StudentsObjective This study aimed to explore the effect of exercise or tai chi intervention on IA among college students and provide a more theoretical basis for the prevention of IA.Methods This study was a three-arm randomized controlled trial.A total of 93 subjects diagnosed with IA who met the inclusion and exclusion criteria were randomly assigned to the exercise group(n=31),the tai chi group(n=31),and the control group(n=31).The comprehensive exercise group conducted an 8-week comprehensive exercise intervention,the tai chi group conducted a Yang-style 24-form tai chi training program and tai chi(8 trigrams 5 steps)intervention for 8 weeks,and the control group did not conduct any form of intervention.Baseline and post-test questionnaires were performed to collect the basic demographic characteristics of the participants.The primary outcome for the severity of IA assessment was Internet Addiction Test(IAT).The score of IAT ≥40 indicates IA.Participants were grouped according to the changes in IAT scores after the intervention,scores decreased by ≥12 points and were grouped into the improved group and scores decreased by<12 points were grouped into the no-improved group.Other indicators include self-rating symptoms,sleep,depression,anxiety,fatigue,Internet addiction knowledge and behavior motivation,self-esteem,Internet control self-efficacy,general self-efficacy,and social anxiety.The one-way ANOVA and χ2 test were used to compare the baseline data of each group.Generalized Linear Mixed Model(GLMM)and Generalized estimating equation(GEE)methods were used to compare the difference among groups before and after the intervention and to evaluate the intervention effect.Results(1)The results showed that the difference between the improved group and no-improved group was significant(χ2=6.212,P=0.045).(2)Results of the GLMM analysis showed that compared with the control group,the exercise group showed a significant decrease in IAT scores[Exercise vs control:ITT-8.84,95%CI(-15.41,-2.27),P=0.004;PP-9.10,95%CI(-15.65,-2.55),P=0.003].Compared with the control group,the tai chi group showed no significant decrease in IAT scores(ITT:P=0.112;PP:P=0.137).(3)Among symptoms reported by participants,a significant interaction effect was observed in dizziness symptoms(P=0.049).Exercise and tai chi training could effectively relieve dizziness(exercise:OR=0.21,P=0.050;tai chi:OR=0.08,P=0.049).As to eye discomfort,neck discomfort,and gastrointestinal problems,no interaction effects were observed according to the outcomes of the GEE analysis.(4)Significant interaction terms with FS-14 were observed.A pairwise comparison showed that a significant difference was observed between the exercise and control group,and also a significant difference was observed between the tai chi group and the control group.[Exercise vs control:ITT-2.23,95%CI(-4.16,-0.30),P=0.018;PP-2.32,95%CI(-4.25,-0.39),P=0.012;Tai chi vs control:ITT-2.00,95%CI(-3.80,-0.20),P=0.026;PP-1.90,95%CI(-3.71,-0.10),P=0.036].But no significant difference was observed between the exercise and tai chi groups.With the exception of the FS-14 scale,no significant inter-group differences were observed on the other self-rating scales.Conclusion(1)Exercise intervention has a considerable effect on treating IA.However,tai chi has not been observed a significant effect on improving IA.(2)Exercise and tai chi have effectiveness in relieving the symptoms of dizziness.(3)Exercise and tai chi training can effectively relieve the fatigue symptoms of college students with IA,and there is no significant difference in efficacy between exercise and tai chi.Study Ⅱ:The Role of Gut Microbiota in Exercise Intervention of College Students with Internet AddictionObjective This study aimed to explore the role of gut microbiota in exercise intervention of college students with IA,and provide the basis for the research on the treatment mechanism of IA.Methods A total of 93 subjects diagnosed with IA who met the inclusion and exclusion criteria were included in the study.After an 8-week intervention in study I,fresh feces from each group were collected for biological analysis based on 16S rDNA amplicon sequencing.This study used the Kruskal-Wallis test to analyze the difference among three groups of the alpha diversity indexes and the relative abundance of gut microflora.To find the relationship between exercise,microbiota,and addiction,the Wilcoxon test was used to compare differences in the relative abundance of microflora between the improved group and the no-improved group.Results(1)There were significant differences in the index of Shannon(P=0.047)and Simpson(P=0.036)among groups.Compared with the control group,the exercise group represented a decreased diversity estimated by the Shannon index(Adj.PShannon=0.043)and the exercise group represented an increased diversity estimated by Simpson index(Adj.Psimpson=0.031).(2)The relative abundance of the class Betaproteobacteria,family Porphyromonadaceae,family Sutterellaceae and genus Alistipes were significantly decreased in the exercise group compared with the control group.While the relative abundance of the genus Escherichia was significantly increased in the exercise group.This study also observed a significant decrease in the relative abundance of class Erysipelotrichia,order Erysipelotrichales,family Erysipelotrichaceae in the tai chi group compared with the control group.(3)The relative abundance of Class Betaproteobacteria(P=0.042),Family Sutterellaceae(P=0.046)and Genus Escherichia(P=0.041)had significant differences between the improved group and no-improved group.Conclusion(1)Exercise and tai chi training decreased the relative abundance of harmful bacteria and increased the abundance of beneficial bacteria and produced significant health benefits for college students with IA.(2)The improvement of Internet addiction symptoms was associated with the change of the gut microbiota while this change was attributed to exercise intervention. |
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