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Stress, PhysiologicalZ-FloNCT06573034

Daoist Zhanzhuang and Human Flourishing

A study testing Daoist Zhanzhuang in people with Stress, Physiological and Stress, Psychological, run by University of North Carolina, Charlotte at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial 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. Read more about this study

Who is it for?
Ages 18 to 25 yearsHealthy volunteers can take part
What is being tested?
Daoist Zhanzhuang
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
1 siteUnited States
Study dates
29 Aug 2024to Jul 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 25 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • 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.

Who cannot join

  • 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).

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Zhuo Job Chen, PhD contact

7046877966

job.chen@charlotte.edu

Jeanette Bennett, PhD contact

7046871966

Jeanette.Bennett@uncc.edu

United States1 site, 1 recruiting
  • University of North Carolina at Charlotte

    Charlotte, North Carolina, 28223

    Zhuo Job Chen, PhD, 7046877966, job.chen@charlotte.edu

    Zhuo Job Chen, PhD

    Recruiting

Other trials in United States

About this study

Official title: Standing Like a Tree: Effects and Mechanisms of Daoist Zhanzhuang on Human Flourishing

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.

Read the detailed description

Zhanzhuang, "standing like a tree," is a standing meditation rooted in Daoism, with its earliest form documented on a Chinese silk manuscript called Daoyintu, dating back two thousand years. By aligning the human body, Zhanzhuang promotes the circulation and accumulation of qi, fostering enhanced energy, health, and healing. In Daoist theology, qi acts as an intermediary connecting physical energy (jing) and the spirit (shen). Zhanzhuang serves as a foundational practice that establishes conditions for the convergence of the physical and non-physical aspects of human being. One of the greatest Daoist spiritual achievements lies not in transcending the body but in the harmonious integration of body and spirit. While many definitions of spirituality emphasize transcendence and non-physicality, the study of Zhanzhuang suggests that immanence and embodiment are equally significant in defining spirituality.

Data from eight clinical trials demonstrate that Zhanzhuang can improve physical endurance, reduce fatigue, enhance body awareness and emotional regulation, and promote better quality of life. However, none of the studies included an active control group, so it is difficult to dissect the effects from merely extra exercise. Overall, existing studies have construed Zhanzhuang (or more generally qigong) as an out-of-the-box alternative behavioral medicine approach, without trying to understand why and how it works. None have examined its spiritual underpinnings. This decontextualized scholarly work can be a disservice to both the Daoist community, where Zhanzhuang practice originates and is taught, and to the public they serve. Zhanzhuang could offer more than being another complementary therapy. Among many benefits, the practice shows that there is a spiritual aspect that resides within one's physical body, and the spirit and the body can join each other to make genuine flourishing possible.

In addition to documenting the effects of Zhanzhuang on human flourishing, the current study will show why and how Zhanzhuang works. Primary hypotheses posit that Zhanzhuang fosters enhanced energy, resilience, and healing. These effects will be evidenced through physiological changes, such as increased parasympathetic activity and improved immune functioning, as well as psychological responses, including elevated vitality, enhanced stress coping abilities, and overall well-being. These effects may be partially attributed to an augmented interoceptive awareness and a deepened psychological insight into previously avoided emotions. Furthermore, the study explores the potential moderation of these effects by acquired mystical experiences, serving as indicators of spiritual progress within the practice of Zhanzhuang. Lastly, the research will delve into the trajectory of change and within-subject causal processes, examining the relationship between mystical experiences and human flourishing over the 3-month practice period through intensive longitudinal measures.

Being tested
Daoist Zhanzhuang, Sham Wall Squat
Keywords
Human Flourishing, Daoist Zhanzhuang (Chan Chuang), Heart Rate Variability, Immune Function, Mysticism
Medical subject headings
Stress, Psychological, Psychological Well-Being

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Daoist ZhanzhuangBehavioural

    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.

  • Sham Wall SquatBehavioural

    Same as the Zhanzhuang group.

Study groups in NCT06573034
Study groupRoleWhat they receive
Daoist ZhanzhuangExperimentalIndividuals 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.
Receives: Behavioral: Daoist Zhanzhuang
Sham Wall SquatActive comparatorIndividuals 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.
Receives: Behavioral: Sham Wall Squat

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 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.

    Measured: 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).

  2. 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.

    Measured: 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).

  3. Decreased perceived stress

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

    Measured: 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).

  4. Increased resilience

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

    Measured: 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).

  5. Decreased fatigue

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

    Measured: 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).

  6. Increased vitality

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

    Measured: 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).

  7. Increased mystical experiences

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

    Measured: 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).

  8. Increased overall human flourishing

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

    Measured: 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)
  1. Decreased inflammatory biomarker cytokine IL-1ß

    Saliva will be collected via approved methods (IBC BIO-23-0032). Salivary inflammatory biomarkers will be assessed in-house at the Biobehavioral Core Lab. Plates will be read with a QuickPlex SQ 120 imager and data analyzed using the Discovery Workbench 4.0 for cytokines, including Interleukin (IL)-1ß.

    Measured: 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).

  2. Decreased inflammatory biomarker cytokine IL-6

    Saliva will be collected via approved methods (IBC BIO-23-0032). Salivary inflammatory biomarkers will be assessed in-house at the Biobehavioral Core Lab. Plates will be read with a QuickPlex SQ 120 imager and data analyzed using the Discovery Workbench 4.0 for cytokines, including Interleukin (IL)-6.

    Measured: 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).

  3. Decreased inflammatory biomarker cytokine TNF-a

    Saliva will be collected via approved methods (IBC BIO-23-0032). Salivary inflammatory biomarkers will be assessed in-house at the Biobehavioral Core Lab. Plates will be read with a QuickPlex SQ 120 imager and data analyzed using the Discovery Workbench 4.0 for cytokines, including TNF-a.

    Measured: 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).

  4. Increased interoceptive awareness

    The subscales Noticing, Attention Regulation, Emotional Awareness, Self-Regulation, and Body Listening of Multidimensional Assessment of Interoceptive Awareness - 2 measured on visual analogue ranging from 0 to 100, higher scores suggesting better outcome.

    Measured: 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).

  5. Reduced depression

    Patient-Reported Outcomes Measurement Information System measured on visual analogue ranging from 0 to 100, higher scores suggesting worse outcome.

    Measured: 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).

  6. Reduced anxiety

    Patient-Reported Outcomes Measurement Information System measured on visual analogue ranging from 0 to 100, higher scores suggesting worse outcome.

    Measured: 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).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Aug 2024
  2. Study start29 Aug 2024
  3. Primary completionFeb 2027 (estimated)
  4. Study completionJul 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Model description
The two arms will include an active control condition (i.e., sham wall squat) and the Daoist Zhanzhuang condition.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06573034
Sponsor's protocol ID
IRB-24-0749
Other IDs
32539
Acronym
Z-Flo
Status last verified
Apr 2026
First submitted
23 Aug 2024
Last updated
1 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Daoist Zhanzhuang in people with Stress, Physiological and Stress, Psychological, run by University of North Carolina, Charlotte at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 1 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Zhuo Job Chen, PhD (7046877966, job.chen@charlotte.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Increased heart rate variability (time frame: 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).). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 May 2026.

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