The present study focuses on comparing the effectiveness of two non-pharmacological interventions, yogic breathing and hand reflexology, in reducing test anxiety among medical sciences students.
Design
This study is a randomized, controlled clinical trial with two parallel intervention groups and no blinding, conducted on 93 nursing students. Randomization will be performed using the Sealedenvelope system.
Settings and conduct
This study will be conducted at Arak University of Medical Sciences among undergraduate nursing students. Participants will be randomly assigned to one of three groups: hand reflexology, yogic breathing, or a placebo control. Reflexology will be delivered individually by trained researchers, while yogic breathing will be conducted in groups using a structured three-stage protocol (abdominal, thoracic, and clavicular breathing). The Sealedenvelope system will be used for randomization. The control group will experience similar environmental conditions and gentle hand contact without receiving active interventions. Anxiety will be measured pre- and post-intervention, and no blinding will be implemented.
Participants/Inclusion and exclusion criteria
Eligible participants included nursing students at Arak University of Medical Sciences who reported test-related anxiety and had no severe psychiatric or medical conditions, no recent experience of bereavement or crisis, no prior exposure to yogic breathing or reflexology, and no use of anxiolytic or psychotropic medications in the past three months. Individuals with active respiratory diseases, hand-related dermatologic or inflammatory conditions, or among female participants pregnancy were excluded.
Intervention groups
Participants in this study will be randomly assigned to three groups: a hand reflexology intervention group, a yogic breathing intervention group, and a control group.
Main outcome variables
Test anxiety
General information
Reason for update
Acronym
IRCT registration information
IRCT registration number:IRCT20220703055351N4
Registration date:2025-11-27, 1404/09/06
Registration timing:prospective
Last update:2025-11-27, 1404/09/06
Update count:0
Registration date
2025-11-27, 1404/09/06
Registrant information
Name
Mahsa Hosseini
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 86 1221 9498
Email address
smahsahosseini99@gmail.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2025-12-21, 1404/09/30
Expected recruitment end date
2026-02-19, 1404/11/30
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
A comparative study of the effects Hand Reflexology and Pranayama on TestAnxiety in nursing Students
Public title
A comparative study of the effects Hand Reflexology and Pranayama on TestAnxiety in nursing Students
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Undergraduate nursing students currently enrolled at Arak University of Medical Sciences
Self-reported test anxiety prior to written examinations or intrusive, future-oriented mental imagery concerning upcoming exams
Absence of any psychiatric disorder or severe physical illness (e.g., depression, anxiety, cardiovascular disease, and other conditions) during the study
ChatGPT said:No experience of bereavement or major crisis within the past month
ChatGPT said:No prior experience with yogic breathing practices or reflexology
Absence of coagulation disorders and immunodeficiency conditions
No use of anxiolytic or psychoactive medications during the past three months
Not being pregnant (for female participants)
Absence of any history of abdominal or pulmonary (lung) surgery
Absence of active respiratory disease and absence of dermatological or inflammatory conditions affecting the hands
Exclusion criteria:
Participants’ refusal to continue participation in the study at any stage
ChatGPT said:Presence of skin rashes, active inflammation, or infection on the hands, as well as any skin lesions
Presence of active respiratory disease with symptoms of cough and dyspnea during the intervention
Students who have previously graduated from any field of medical sciences
Age
From 18 years old
Gender
Both
Phase
N/A
Groups that have been masked
No information
Sample size
Target sample size:
93
Randomization (investigator's opinion)
Randomized
Randomization description
In this study, all individuals who respond to the recruitment announcement and meet the inclusion criteria are first recorded in an initial list based on the order of their enrolment. The following steps are then undertaken:
Initial stratification by gender
The initial list of eligible participants is divided into two separate strata (female/male).
Determination of quota for each stratum
Based on the gender distribution of eligible participants and the total required sample size, the number of participants to be selected from each stratum is determined.
Randomization procedure
Randomization is performed using the SealedEnvelope website. After entering the total sample size, number of study groups, and preferred block sizes, the platform generates a randomized allocation list. Participants are then assigned to the study groups according to this randomized list and in correspondence with their order in the initial enrolment lis
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Arak University of Medical Sciences
Street address
Arak University of Medical Sciences
City
Arak
Province
Markazi
Postal code
3813944438
Approval date
2025-11-16, 1404/08/25
Ethics committee reference number
IR.ARAKMU.REC.1404.298
Health conditions studied
1
Description of health condition studied
Test anxiety
ICD-10 code
F41
ICD-10 code description
Other anxiety disorders
Primary outcomes
1
Description
Test anxiety
Timepoint
A total of two assessments will be conducted: once before the intervention (one hour prior to the exam) and once immediately after the intervention.
Method of measurement
In this study, test anxiety as the outcome variable is measured using the Multidimensional Test Anxiety Scale.
Secondary outcomes
empty
Intervention groups
1
Description
Intervention group: Hand reflexology :In this study, hand reflexology is defined as a relaxation technique performed with the aim of reducing test anxiety. The intervention involves applying pressure to the HT7 point by a trained individual. The reflexology session is delivered individually and lasts approximately 10 to 15 minutes.
Category
Treatment - Other
2
Description
Intervention group: Yogic breathing :In this study, yogic breathing is defined as a relaxation-based respiratory intervention that involves structured practice of slow, deep, and mindful breathing exercises aimed at reducing test anxiety. The yogic breathing session is delivered in a group format and lasts approximately 10 to 15 minutes.
Category
Treatment - Other
Recruitment centers
1
Recruitment center
Name of recruitment center
Arak University of Medical Sciences
Full name of responsible person
Mahsa Hosseini
Street address
Arak University of Medical Sciences
City
Arak
Province
Markazi
Postal code
3813944438
Phone
+98 86 3417 3639
Email
research@arakmu.ac.ir
Sponsors / Funding sources
1
Sponsor
Name of organization / entity
Arak University of Medical Sciences
Full name of responsible person
Mahsa Hosseini
Street address
Arak,Arak University of Medical Sciences,Basij Square, Shazand Boulevard Arak
City
Arak
Province
Markazi
Postal code
3848176341
Phone
+98 86 3417 3639
Email
research@arakmu.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Arak University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic
Person responsible for general inquiries
Contact
Name of organization / entity
Arak University of Medical Sciences
Full name of responsible person
Mahsa Hosseini
Position
**Faculty member**
Latest degree
Master
Other areas of specialty/work
Nursery
Street address
Arak,Arak University of Medical Sciences,Basij Square, Shazand Boulevard
City
Arak
Province
Markazi
Postal code
3848176341
Phone
+98 86 3417 3639
Email
smahsahosseini99@gmail.com
Person responsible for scientific inquiries
Contact
Name of organization / entity
Arak University of Medical Sciences
Full name of responsible person
Mahsa Hosseini
Position
Faculty member
Latest degree
Master
Other areas of specialty/work
Nursery
Street address
Arak,Arak University of Medical Sciences,Basij Square, Shazand Boulevard
City
Arak
Province
Markazi
Postal code
3813944438
Phone
+98 939 084 3233
Email
smahsahosseini99@gmail.com
Person responsible for updating data
Contact
Name of organization / entity
Arak University of Medical Sciences
Full name of responsible person
Mahsa Hosseini
Position
Faculty member
Latest degree
Master
Other areas of specialty/work
Nursery
Street address
Arak University of Medical Sciences
City
Arak
Province
Markazi
Postal code
3813944438
Phone
+98 86 3221 9498
Email
smahsahosseini99@gmail.com
Sharing plan
Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Not applicable
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available