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PhysioYoga as a structured digital detox intervention: sleep quality and perceived stress outcomes among smartphone-addicted young adults: a pre-post feasibility study

Year: 2026

Type: article

Abstract: Smartphone addiction in young adults produces a convergent triad of sensorimotor dysregulation, insomnia, and psychological stress. Despite this multidimensional burden, no published intervention has simultaneously addressed all three dimensions using a structured, physiotherapy-integrated, protocol-driven approach, a critical gap that the present study addresses through PhysioYoga. PhysioYoga is a therapeutic fusion of evidence-based physiotherapy techniques, including proprioceptive exercises and PNF-style sensorimotor facilitation, and yogic practices, including asanas, pranayama, and Shavasana. Its feasibility and preliminary efficacy have not previously been evaluated in this population. This study aimed to evaluate the feasibility, including recruitment rate, session adherence, and retention, as well as the preliminary pre-post changes associated with a structured online PhysioYoga protocol on sleep quality and perceived stress in smartphone-addicted young adults, within a sensorimotor integration-informed conceptual framework. The SAS-SV was employed as a validated screening instrument to confirm smartphone addiction at enrolment, using an inclusion threshold of score ≥ 31, thereby ensuring sample homogeneity. Given the 4-week single-arm feasibility design, SAS-SV was not designated as a post-intervention outcome. The study was specifically designed to evaluate the downstream health consequences of smartphone addiction, namely insomnia and perceived stress. Assessment of SAS-SV change as a primary outcome is recommended for the planned fully powered randomised controlled trial. This single-arm pre-post feasibility study enrolled 20 participants aged 18 to 30 years who met validated criteria for smartphone addiction, with an SAS-SV score ≥ 31, and poor sleep quality, with a PSQI score > 5. The sample size of 20 was selected in accordance with standard precedent for single-arm feasibility studies, which conventionally enroll 15 to 30 participants to assess protocol delivery, adherence, and retention rather than to achieve formal statistical power. A 4-week online PhysioYoga intervention was delivered via secure video conferencing, with three 60-minute sessions per week for a total of 12 sessions, across seven structured segments. Primary outcomes were PSQI global and component scores and PSS score, assessed pre- and post-intervention using the Wilcoxon signed-rank test in IBM SPSS version 29. The study demonstrated a 100% recruitment rate, 100% session adherence, and 95% retention. Statistically significant reductions were observed in five of the seven PSQI component scores: subjective sleep quality, sleep latency, sleep disturbances, use of sleep medication, and daytime dysfunction. In contrast, the sleep duration component score increased from 2.69 ± 0.20 to 3.20 ± 0.18, and the habitual sleep efficiency component score increased from 1.86 ± 0.13 to 2.41 ± 0.21. Under PSQI scoring conventions, higher scores in these domains denote worsening, and these two components therefore deteriorated post-intervention. The global PSQI score decreased from 11.53 ± 0.58 to 9.29 ± 0.45 (Z = − 3.929; p < 0.001). The PSS score decreased from 27.25 ± 0.78 to 23.05 ± 0.81 (Z = − 3.946; p < 0.001), corresponding to a categorical shift from the high-stress to the moderate-stress range. Daytime dysfunction showed the greatest absolute reduction, from 1.96 to 1.07, with Z = − 4.233, p < 0.001, and a 45.4% reduction. A 4-week online PhysioYoga protocol was associated with statistically significant reductions in five of the seven PSQI component scores, as well as in global PSQI and perceived stress scores, in smartphone-addicted young adults, with excellent feasibility and full online delivery. However, the sleep duration and habitual sleep efficiency component scores worsened post-intervention, and the proposed SMI mechanistic pathway remains a theoretical proposition in the absence of direct mechanistic measures. A randomised controlled trial incorporating SAS-SV as a primary outcome, objective sleep and stress measures, SMI-specific assessments, and a dismantling design is now warranted.

Source: BioPsychoSocial Medicine

DOI: 10.1186/s13030-026-00371-1