Abstract
BACKGROUND: The prevalence of sleep disorders and anxiety is on the rise among high-stress groups like graduate students. Physical activity interventions have revealed effectiveness in improving mental health, yet the effect of specialized badminton training on sleep-disordered populations remains under-researched. Besides, the effects of various forms of badminton training on sleep quality and anxiety in graduate students vary. OBJECTIVE: Our study aims to evaluate the effect of basic skill, advanced skill, and physical conditioning-focused badminton training on sleep quality, anxiety levels, and baseline physiological markers in graduate students with sleep disorders. METHODS: A randomized controlled trial (RCT) was conducted (Clinical Registry Number: TCTR20250119001, 16 January 2025), involving 160 graduate students randomly assigned to one of four groups: Badminton Basic Skills Training Group (BBSTG), Badminton Advanced Skills Training Group (BASTG), Badminton Specialized Physical Training Group (BSPTG), and a Control Group (CG), with 40 participants per group. The experimental groups trained three times weekly for one hour per session over 12 weeks, while the CG received only standard lifestyle guidance. Repeated measurements of sleep quality and anxiety levels were assessed at baseline, 4, 8, and 12 weeks using the Pittsburgh Sleep Quality Index (PSQI) and Self-Rating Anxiety Scale (SAS), with resting heart rate and blood pressure also recorded at each time point. RESULTS: (i) Baseline Measurements: Prior to the intervention, no statistically significant differences were uncovered among groups in terms of sleep quality, anxiety levels, basic physiological data (resting heart rate, blood pressure), or general characteristics (age, height, weight, BMI) (p > 0.05). Attrition rates of 8%- 11% were observed across groups, causing final group sizes of 36, 37, 35, and 36 for BBSTG, BASTG, BSPTG, and CG, respectively. This attrition had minimal impact on statistical analysis. (ii) PSQI Scores: Sleep quality enhanced significantly across all experimental groups over the 12-week period, with the BSPTG group showing the greatest improvement. At week 12, the BSPTG's PSQI score was 5.8 ± 0.8, significantly better than that of the CG (p < 0.001, 95% CI [- 2.7, - 1.4]). The BSPTG consistently outperformed the control group at all time points, with an F-value of 10.32 at week 12 (p < 0.001), stressing the positive effect of badminton training on sleep quality. (iii) SAS Scores: At week 12, the BSPTG's SAS score was 36.3 ± 4.0, significantly lower than that of the CG (p < 0.001, 95% CI [- 6.1, - 3.2]). Anxiety levels reduced significantly across all experimental groups, with the BSPTG demonstrating the most notable reduction, further illustrating the significant effect of physical conditioning training on anxiety relief. (iv) Resting Heart Rate and Blood Pressure: Resting heart rate reduced significantly over the 12-week period, with the BSPTG achieving a final rate of 66.1 ± 4.8, significantly better than that of the CG (p < 0.001, 95% CI [- 6.9, - 3.2]). While blood pressure displayed some reduction post-intervention, differences were not statistically significant (p > 0.05), revealing limited short-term effect of badminton training on blood pressure. (v) Effect Sizes (Cohen's d): In PSQI scores, BSPTG showed a large effect (d = 0.8), BASTG a medium effect (d = 0.5), and BBSTG a small effect (d = 0.3). For SAS scores, BSPTG demonstrated a medium-to-large effect (d = 0.7), BASTG a medium effect (d = 0.5), and BBSTG a small effect (d = 0.3). In resting heart rate, BSPTG showed the most significant improvement (d = 0.6), with BASTG showing a small-to-medium effect (d = 0.4) and BBSTG showing minimal improvement. Effect sizes for blood pressure were not significant. CONCLUSION: Specialized badminton training, in detail, physical conditioning training, can significantly improve sleep quality and reduce anxiety levels in graduate students with sleep disorders and decrease resting heart rate. As a non-pharmacological intervention, specialized badminton training has underlying applications for enhancing mental health and cardiovascular health. TRIAL REGISTRATION: Randomized Controlled Trials, TCTR20250119001, 16 January 2025.