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Meta-Analysis
. 2025 Jul 1:13:e19640.
doi: 10.7717/peerj.19640. eCollection 2025.

Integrating mindfulness and physical activity: a meta-analysis of mindful movement interventions for symptoms of anxiety and depression among university students

Xinjian Xu  1   2 , Borhannudin Bin Abdullah  1 , Shamsulariffin Bin Samsudin  1 , Yongneng Tan  3
Affiliations
Meta-Analysis

Integrating mindfulness and physical activity: a meta-analysis of mindful movement interventions for symptoms of anxiety and depression among university students

Xinjian Xu et al. PeerJ. .

Abstract

Background: University students are increasingly vulnerable to mental health problems, such as anxiety and depression, which have been associated with academic stress, job market uncertainty, and lifestyle-related factors such as physical inactivity and poor sleep habits. Mindful movement, defined as structured programs integrating mindfulness practice with physical movement, offers a holistic approach to reducing anxiety and depression, though its effectiveness and specific intervention differences-such as duration, delivery mode, and behavior change techniques-remain underexplored. This study evaluated the effects of mindful movement interventions on anxiety and depression among university students.

Methods: A systematic search of six databases up to August 2024 identified 19 randomized controlled trials involving a total of 1,697 participants. A random-effects model was employed to pool effect sizes; subgroup analyses were conducted to explore sources of heterogeneity, and sensitivity analyses were performed to test the robustness of the results.

Results: The meta-analysis indicated that mindful movement interventions significantly reduced anxiety (standardized mean difference (SMD) = -0.42, 95% confidence interval (CI) [-0.52 to -0.31], p < 0.0001, I 2 = 70%) and depression (Standardized Mean Difference (SMD) = -0.61, 95% CI [-1.01 to -0.20], p < 0.0001, I 2 = 87%) compared to control groups. Subgroup analyses demonstrated no significant differences in effect sizes across different mindful movement types (yoga, tai chi, qigong). Meta-regression indicated that intervention type did not significantly explain heterogeneity (p = 0.495). Publication bias was not observed in most subgroups, except for potential bias in the tai chi group due to limited studies.

Conclusion: Mindful movement interventions are associated with enhanced mental health among university students, with no significant differences in the effects of yoga, tai chi, and qigong on reducing symptoms of anxiety and depression. It supports treating mindful movement as a unified approach to analyzing its impact on mental health. Residual heterogeneity highlights the need for further research on specific intervention elements and intervention and participant-related factors. PROSPERO registration number (CRD42024569238).

Keywords: Anxiety; Depression; Meta-analysis; Mindful movement; University students.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Flow diagram of systematic literature search.
Figure 2
Figure 2. The forest plot of anxiety-related outcomes.
Notes. Albracht-Schulte & Robert-McComb (2018), Alzahrani et al. (2023), Brandão et al. (2024), Caldwell et al. (2016), Castellote-Caballero et al. (2024), Erdoğan Yüce & Muz (2020), Falsafi (2016), Fu et al. (2019), Gong et al. (2019), Hua & Sun (2021), Jiao, Ji & Chen (2021), Li et al. (2023), Li, Yang & Zhang (2023), Papp et al. (2019), Xiao et al. (2021), Zhang & Jiang (2023), Zheng et al. (2018).
Figure 3
Figure 3. The sensitivity analysis of anxiety-related outcome.
Figure 4
Figure 4. Subgroup analysis of anxiety.
Notes. Albracht-Schulte & Robert-McComb (2018), Alzahrani et al. (2023), Brandão et al. (2024), Caldwell et al. (2016), Castellote-Caballero et al. (2024), Erdoğan Yüce & Muz (2020), Falsafi (2016), Fu et al. (2019), Gong et al. (2019), Hua & Sun (2021), Jiao, Ji & Chen (2021), Li et al. (2023), Li, Yang & Zhang (2023), Papp et al. (2019), Xiao et al. (2021), Zhang & Jiang (2023), Zheng et al. (2018).
Figure 5
Figure 5. The forest plot of depression-related outcomes.
Notes. Brandão et al. (2024), Caldwell et al. (2016), Castellote-Caballero et al. (2024), Falsafi (2016), Fu et al. (2019), Hua & Sun (2021), Jiao, Ji & Chen (2021), Li et al. (2023), Li, Yang & Zhang (2023), Papp et al. (2019), Zhang & Jiang (2023).
Figure 6
Figure 6. Subgroup analysis of depression.
Notes. Brandão et al. (2024), Castellote-Caballero et al. (2024), Falsafi (2016), Fu et al. (2019), Hua & Sun (2021), Jiao, Ji & Chen (2021), Li et al. (2023), Li, Yang & Zhang (2023), Papp et al. (2019), Zhang & Jiang (2023).
Figure 7
Figure 7. The sensitivity analysis of depression.
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