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VIRGINIA BEACH, Va. — When we think of a heat wave, our physical health usually comes to mind first. But, mental health experts say extreme heat can take a toll on how we feel, emotionally and socially.
From trouble sleeping to heightened anxiety, extreme heat doesn’t just affect our body; it can also affect our minds. 
RELATED: EMTs remind the public how to stay safe amid severe heat wave
A Thriveworks counselor explains how the heat may play a bigger role in our mental health.
“As we experience the discomfort of the rising temperatures, we experience the discomfort of the rising temperatures, we experience symptoms like sweating, like fatigue,” said Michael Scott, the Regional Clinic Director and Counselor with Thriveworks. “We have a hard time sleeping sometimes, and that can cause us distress.”
According to a study, Thriveworks found inclement weather, including extreme heat, is the leading cause of anxiety in 25% of people. Scott said that when the body is in distress, some symptoms can mimic anxiety. 
“A lot of the symptoms of being hot also mirror anxiety, things like anxiety, things like sweating and heart racing,” said Scott.
He said that over time, intense heat could take a toll on you emotionally.
“It can inhibit us from engaging in the activities that reinforce our good state of well-being,” he said. 
RELATED: How to keep your kids safe during a heat wave: advice from local doctor

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SYSTEMATIC REVIEW article
Front. Public Health, 18 June 2025
Sec. Public Health Education and Promotion
Volume 13 – 2025 | https://doi.org/10.3389/fpubh.2025.1565372
This article is part of the Research TopicImpact of Physical Activity on Health and Behavioral Risks in AdolescentsView all 14 articles
Background: Internet Addiction Disorder (IAD) is a recurrent mental illness. It severely impacts both physical and mental health, leading to physiological symptoms such as neurological dysfunction and immunosuppression. This condition significantly affects adolescent development and has become a global public health concern. Scientific evidence supports the beneficial impact of integrative mind–body exercises for treating internet addiction disorders. Though these interventions show promise, their therapeutic efficacy exhibits considerable variation across different modalities. Currently, there exists a significant research gap, as no comprehensive clinical investigations have systematically evaluated the comparative therapeutic outcomes of distinct mind–body practices among individuals diagnosed with internet addiction.
Objective: To conduct a network meta-analytic investigation comparing the therapeutic efficacy of diverse mind–body exercise interventions for addressing symptoms associated with internet addiction disorder.
Methods: Data were retrieved from Web of Science, PubMed, CNKI, and VIP databases. After screening and data extraction, network meta-analysis was performed using STATA 18.0.
Results: Twenty-four studies were included in the analysis. Compared with the control group (Placebo), Mindfulness [SMD = 13.33, 95%CI (7.42,19.25), p < 0.05] and Taichi [SMD = −10.91, 95%CI (−18.71,−3.11), p < 0.05] significantly improved internet addiction symptoms. According to SUCRA values, the interventions were ranked in order of effectiveness: Mindfulness (SUCRA = 76.3%), DanceSport (SUCRA = 64.0%), Yoga (SUCRA = 63.1%), and Taichi (SUCRA = 62.6%).
Conclusion: Mindfulness and Tai Chi significantly reduce and alleviate internet addiction symptoms compared to Placebo. Based on SUCRA rankings, Mindfulness, Dance Sport, Yoga, and Tai Chi show the highest probability of effectiveness in descending order, providing promising options for managing internet addiction symptoms in young adults.
Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025631096.
As “digital natives,” young adults (aged 18–24 years) represent a distinctive developmental period characterized by continued neuroplasticity and incomplete prefrontal cortex maturation, making them particularly vulnerable to Internet addiction (1–3). Neurobiological research has demonstrated that the underdevelopment of the prefrontal cortex, which is critical for impulse control and executive decision-making, combined with heightened sensitivity to social and emotional stimuli, creates a neurological landscape that predisposes university students to addictive behaviors (4–6). This critical neurodevelopmental stage features heightened reward sensitivity and still-developing inhibitory control systems, coupled with increased independence and reduced external monitoring, creating unique susceptibility to problematic Internet use behaviors (2, 7). The convergence of neurological immaturity, digital immersion, and reduced self-regulatory mechanisms significantly elevates the risk of Internet addiction among this demographic, underscoring the urgent need for targeted interventional strategies (1, 8). Internet addiction refers to compulsive Internet use behavior, characterized by an individual’s inability to control their usage, resulting in negative physiological, psychological, and social consequences (9). IAD can not only lead to physiological symptoms such as neurological dysfunction and immunosuppression (10), but also lead to psychological problems such as cognitive decline, anxiety and depression (11, 12). Olson et al.’s (13) research shows that the incidence of Internet addiction disorder in young Adults is increasing year by year, and IAD has become a major public health problem affecting the development of young Adults (14).
Current IAD interventions span a wide range, including pharmacotherapy (15), acupuncture (16), and exercise behavior (17). Growing apprehension regarding pharmaceutical adverse reactions and contraindicated drug combinations has led to heightened interest in treatment approaches that do not rely on medication (18). Research has progressively demonstrated the significant impact of physical activity on psychological well-being (19, 20). Mind–body exercise (MBE) is classified by the National Center for Complementary and Integrative Health at the U.S. National Institutes of Health as a complementary and alternative therapeutic practice (21). Mind–body exercise represents a distinctive form of physical activity that synthesizes breathing techniques, physical movements, and meditative practices (22, 23). These exercises are characterized by their low to moderate-intensity aerobic nature, featuring gentle and precise movements that emphasize the synchronization between physical actions and respiratory patterns (24). These mind–body practices combine physiological and psychological therapeutic elements (25, 26). Compared to traditional aerobic and resistance training programs, these mindfulness-based exercise practices demonstrate extraordinary practicality and contribute to sustained health improvement (27, 28). Their unique value lies in their holistic philosophy, which prioritizes the complex connections between psychological states, physiological functions, and breathing patterns. Moreover, these mind–body exercises require no special equipment (29, 30), have low learning costs, high safety levels, and are suitable for large-scale promotion across diverse populations. For patients with Internet Addiction Disorder (IAD), these comprehensive exercises provide advantages beyond traditional exercise methods, as they not only enhance physical fitness but also effectively reduce anxiety levels and improve overall quality of life. Among various forms of mind–body exercise, this study selected four therapies based on the following considerations: Representativeness; Operability; Safety; Popularity; Preliminary research foundation.
Research has indicated that integrative movement practices like Tai Chi and Dance Sport demonstrate efficacy in alleviating internet dependency symptoms (3, 31, 32). The existing literature predominantly examines therapeutic approaches in isolation (33, 34), with limited comparative studies evaluating multiple mindfulness-based movement interventions for youth internet addiction (35, 36). As highlighted in the review of Pirwani et al. (37), contemporary investigations tend to concentrate on specific demographic segments, leaving broader age-range analyses underexplored (38, 39). Network meta-analysis offers advantages over traditional meta-analytic methods by enabling both direct and indirect effect comparisons, facilitating intervention rankings (40). This investigation examined randomized controlled trials evaluating seven distinct mind–body therapeutic approaches for internet addiction disorder. By implementing network meta-analytic methodology to synthesize both direct and indirect comparative data, this research assessed relative intervention effectiveness, established comparative efficacy metrics, and generated evidence-based rankings. The findings aim to inform clinical decision-making and provide empirical foundation for young adults internet addiction treatment protocols.
This study focused on young adults aged 18–24 years, a developmental period characterized by continued neuroplasticity and heightened vulnerability to internet addiction (41, 42). While this age range extends beyond traditional adolescence, it represents a critical transition period in cognitive and behavioral development.
Prior to initiating research, our systematic analysis protocol received formal registration through PROSPERO, an established global database for systematic review protocols (reference: CRD42025631096). This preregistration step ensured methodological transparency and adherence to standardized review practices (Table 1).
Table 1. PICOS-based eligibility criteria (participation, intervention comparison, outcomes, and study design).
This study strictly followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (43) and established rigorous literature search, inclusion, screening, and exclusion criteria based on the PICOS (Population, Intervention, Comparison, Outcome, Study design) principle of evidence-based medicine. Boolean logic searches were conducted in Elsevier ScienceDirect, Web of Science, PubMed, ProQuest, Scopus, The Cochrane Library, CNKI, WFSDP, and VIP databases. Literature retrieval encompassed publications in both English and Chinese, with Chinese-language sources limited to prominent academic periodicals. The temporal scope of the investigation spanned from the beginning of 2010 through April 1, 2024. Supplementary relevant publications were identified through reference list examination of pertinent studies and alternative search methods. The detailed search protocol employed for the PubMed database is presented in Box 1.
BOX 1. PubMed search strategy
#1 (“Mind”[Title/Abstract] OR “body exercise”[Title/Abstract] OR “Mind–body exercise”[Title/Abstract] OR “Taichi”[Title/Abstract] OR “Baduanjin”[Title/Abstract] OR “Mindfulness”[Title/Abstract] OR “Dance Sport”[Title/Abstract]) OR “Qigong”[Title/Abstract] OR “Yoga”[Title/Abstract] OR “Aerobicdance”[Title/Abstract] AND “Internet Addiction Disorder”[MeSH Terms]
#2 “Sports”[Title/Abstract] OR “Sport”[Title/Abstract] OR “Athletics”[Title/Abstract] OR “Athletic”[Title/Abstract]
#3 #1 OR #2
#4 “Internet Addiction Disorder”[Title/Abstract] OR “Addiction Disorder,Internet”[Title/Abstract] OR “Addiction Disorders,Internet”[Title/Abstract] OR “Disorder,Internet Addiction”[Title/Abstract] OR “Disorders,Internet Addiction”[Title/Abstract] OR “Internet Addiction Disorders”[Title/Abstract] OR “Internet Addiction”[Title/Abstract] OR “Addiction,Internet”[Title/Abstract] OR “Addictions,Internet”[Title/Abstract] OR “Internet Addictions”[Title/Abstract] OR “Internet Gaming Disorder”[Title/Abstract] OR “Disorder,Internet Gaming”[Title/Abstract] OR “Disorders,Internet Gaming”[Title/Abstract] OR “Gaming Disorder,Internet”[Title/Abstract] OR “Gaming Disorders,Internet”[Title/Abstract] OR “Internet Gaming Disorders[Title/Abstract] OR Smartphone Addiction[Title/Abstract] OR Addiction,Smartphone[Title/Abstract] OR Addictions,Smartphone[Title/Abstract] OR Smartphone Addictions[Title/Abstract] OR Social Media Addiction[Title/Abstract] OR Addiction,Social Media[Title/Abstract] OR Addictions,Social Media[Title/Abstract] OR Media Addiction,Social[Title/Abstract] OR Media Addictions,Social[Title/Abstract] OR Social Media Addictions[Title/Abstract]
#5 “randomized controlled trial”[Publication Type] OR “controlled clinical trial”[Publication Type]
#6 #3 AND #4 AND #5 AND #6
The study only included randomized controlled trials (RCTs) examining mind–body exercise interventions for internet addiction. The intervention groups received one of four mind–body exercise forms (Tai Chi, Mindfulness, Baduanjin, or Dance Sport), while the control group engaged in unstructured physical activity. The outcome measure was IAD scale scores (intervention was considered effective if the difference between post-intervention and pre-intervention scores was less than 0 on any type of internet addiction scale used to assess participants’ psychological health).
The research team eliminated investigations that met any of the following conditions: experimental designs lacking randomized control trials; research conducted on non-human subjects; qualitative analyses, questionnaire-based investigations, literature syntheses, meta-analyses, symposium abstracts, or republished materials. Additionally, we removed papers that failed to report statistical measures using mean and standard deviation notation, incorporated supplementary treatments during the research period, or presented incomplete/incompatible datasets. Research papers whose metrics could not be properly extracted were also excluded from consideration.
The evaluation process began with two independent reviewers utilizing NoteExpress V4.X to compile and manage references. After eliminating redundant entries, they assessed publication abstracts and headings. Following preliminary selection, comprehensive manuscript evaluation was conducted according to predetermined eligibility criteria. These criteria included: (1) only randomized controlled trials with human subjects; (2) studies reporting outcomes using mean and standard deviation; (3) research implementing a single intervention without supplementary treatments; (4) complete datasets with compatible metrics; and (5) studies published in peer-reviewed journals with full-text availability. When differences arose in selection outcomes, the reviewers consulted a third expert to reach consensus. Data extraction was performed independently by two team members using standardized documentation forms. The collected information encompassed: (1) Publication details (primary author identification, publication timeline, manuscript title); (2) Study population data (group sizes, demographic information including age distribution and sex ratio); (3) Methodological specifics (intervention protocols, treatment duration and intervals, Internet Addiction Disorder (IAD) measurements—specifically, baseline assessments conducted prior to intervention initiation (pre-intervention) using validated IAD diagnostic instruments such as Young’s Internet Addiction Test (IAT), Chen Internet Addiction Scale (CIAS), or other standardized tools, and follow-up assessments conducted after intervention completion (post-intervention) using identical instruments to evaluate changes in IAD severity, frequency, and associated symptoms); (4) literature quality assessment using the PEDro scale for RCTs; and (5) outcome indicators and main findings. Inter-coder reliability was 94%, with discrepancies resolved through re-checking and discussion.
Two autonomous evaluators employed RevMan 5.4’s evaluation framework to systematically analyze methodological integrity. The assessment encompassed multiple domains: randomization procedures, allocation masking techniques, participant-researcher blinding protocols, outcome evaluation objectivity, data completeness, reporting transparency, and additional potential sources of systematic error. The evaluation system utilized a three-tier classification: investigations fulfilling all methodological requirements received positive marks (+) indicating minimal bias risk; those failing to meet standards were designated with negative marks (−) signifying elevated bias risk; while instances of insufficient methodological documentation were marked with uncertainty indicators (?). When evaluators reached different conclusions, they engaged a third expert reviewer to establish consensus through collaborative deliberation.
The synthesis of data employed STATA 17.0’s networkMeta package to analyze continuous variables across studies. Given the diversity in measurement instruments, effect magnitudes were synthesized using standardized mean differences (SMD), with significance threshold established at α = 0.05. Statistical heterogeneity evaluation incorporated both Q and I² statistics, while potential publication bias underwent examination through Egger’s regression approach. In cases involving closed-loop network configurations, inconsistency evaluation utilized node analysis techniques. When loop testing yielded p > 0.05, researchers proceeded with consistency model computations. Local inconsistency underwent evaluation via node-splitting methodology; instances where p < 0.05 prompted adherence to traditional meta-analytic direct comparison outcomes. Treatment effectiveness rankings were determined through surface under the cumulative ranking curves (SUCRA), yielding values between 0 and 1. To identify optimal therapeutic combinations, cluster analysis was performed based on these SUCRA metrics. The investigation of publication bias utilized adjusted comparison funnel plot visualization techniques.
The systematic search protocol yielded 170 potentially relevant publications. Database management using EndNote software, combined with manual verification, identified 32 duplicate entries, leaving 138 unique manuscripts for evaluation. Comprehensive assessment, including examination of titles, abstracts, and complete manuscripts, resulted in the final selection of 24 publications that satisfied all inclusion parameters. The selected literature includes both English and Chinese publications. A detailed visualization of the selection methodology and outcomes appears in Figure 1.
Figure 1. Literature screening flowchart.
Our systematic review synthesized findings from 24 investigations meeting inclusion parameters. Comprehensive study details appear in Table 2, encompassing research conducted on 1,711 young adults (age range: 18–24). Intervention durations spanned 8–16 weeks for measuring outcomes. Given the exercise-based nature of interventions, implementing blinding presented methodological challenges—a single investigation achieved double-blind conditions, whereas remaining studies demonstrated various methodological constraints regarding blinding protocols. Quality evaluation outcomes for the literature are depicted through Figures 2, 3.
Table 2. Basic characteristics of included studies.
Figure 2. Risk of bias assessment results for included studies.
Figure 3. Bar graph of risk of bias assessment results for included studies.
In Figure 4, the seven nodes represent seven intervention measures, with lines between nodes indicating direct comparisons. Within the network diagram, connecting lines vary in width to reflect frequency of direct analytical comparisons made between intervention pairs. The intervention groups include Tai Chi, Mindfulness, Baduanjin, Qigong, Aerobic dance, Yoga, and Dance Sport, while the control group (Placebo) consisted of unstructured physical activity.
Figure 4. Network evidence graph.
Analysis of consistency revealed several interventions demonstrating superior efficacy in ameliorating IAD symptoms when compared to Placebo (p < 0.05). These interventions included: Mindfulness practices showing [SMD = −13.33, 95%CI(−7.42,19.25)]; Taichi demonstrating [SMD = −10.91, 95%CI(−18.71,−3.11)]; Yoga yielding [SMD = −11.60, 95%CI(−28.20,5.00)]; and Qigong with [SMD = −7.87, 95% CI(−24.61,8.87)].
Comparative analyses between intervention pairs yielded no statistically meaningful differences among the therapeutic approaches. Specifically, Mindfulness showed comparable effectiveness when evaluated against Taichi, Qigong, and Yoga (p > 0.05). Similarly, DanceSport interventions demonstrated equivalent efficacy when compared with Baduanjin and Aerobicdance (p > 0.05). Furthermore, no significant variations in therapeutic outcomes emerged from pairwise comparisons across all mind–body exercise modalities, as evidenced by the high p-values (ranging from 0.978 to 1.000) shown in Table 3. The SUCRA analysis indicated that Mindfulness (76.3%), DanceSport (64%), and Yoga (63.1%) ranked highest in probability of being the most effective interventions for internet addiction symptom improvement, while Placebo ranked lowest (7.4%). Detailed comparative data and visual representations are available in Table 4 and Figure 5, respectively.
Table 3. Local inconsistency test.
Table 4. Cross-comparison results of different mind–body exercise interventions.
Figure 5. Pairwise comparison forest plot (internet addiction).
Local inconsistency testing using the node-splitting method showed p > 0.05 for comparisons between all mind–body exercise therapies, indicating no statistically significant inconsistency and suggesting good consistency (Figure 6).
Figure 6. SUCRA-based effectiveness analysis of mind–body interventions.
Analysis of potential reporting bias employed comparison-adjusted funnel plotting methodology. Examination revealed symmetrical distribution patterns relative to the null axis, suggesting minimal influence of study size variation and limited publication bias concerns. Detailed visual representation appears in Figure 7.
Figure 7. Adjusted comparison funnel plot. A, Aerobicdance; B, Baduanjin; C, DanceSport; D, Mindfulness; E, Placebo; F, Qigong; G, Taichi; H, Yoga.
Based on our network meta-analysis of mind–body interventions for Internet Addiction Disorder (IAD), Mindfulness demonstrated superior efficacy among the evaluated approaches, with a SUCRA value of 76.3%. DanceSport (SUCRA = 64%), Yoga (SUCRA = 63.1%), and Taichi showed comparable therapeutic benefits. Qigong and Baduanjin exhibited moderate effectiveness, while Aerobicdance (SUCRA = 37.3%) displayed more modest outcomes compared to other mind–body practices. All interventions substantially outperformed placebo conditions, indicating the clinical value of these approaches for IAD management (Table 5).
Table 5. Probability rankings and SUCRA values for internet addiction symptom improvement across therapeutic modalities.
The therapeutic effects of these mind–body interventions can be explained through several complementary neurobiological mechanisms:
Mindfulness’s superior efficacy can be attributed to its multifaceted neurobiological effects. At the neuroplasticity level, Tang et al. (8) found that mindfulness training significantly enhances connectivity between the default mode network and executive control network, optimizing attention regulation and self-awareness capabilities; Yang and Zeng (44) further discovered that 8 weeks of continuous mindfulness training significantly improves gray matter density in the prefrontal cortex and anterior cingulate cortex regions, and these structural changes directly enhance cognitive control ability, contributing to improved executive function in IAD patients. At the neurotransmitter regulation level, Zhang et al. (45) systematic review revealed several neurochemical regulatory pathways of Mindfulness: improving emotional state by stabilizing serotonin levels, alleviating anxiety symptoms by promoting GABA release, while reducing chronic stress response by inhibiting cortisol secretion. In terms of social cognition, Xiao et al. (46) research found that Mindfulness can significantly enhance participants’ self-awareness and interpersonal functioning by activating the insula and strengthening the functional connectivity between the anterior cingulate cortex and prefrontal regions.
However, despite these promising findings, several critical limitations of mindfulness interventions for IAD warrant careful consideration. Zhang et al. (47) comprehensive critical evaluation highlights significant methodological challenges in mindfulness research, including inconsistent operational definitions, inadequate control conditions, and limited measurement precision. These issues potentially confound the interpretation of mindfulness efficacy data in IAD treatment. Lan et al. (48) further argue that the neuroplasticity changes attributed to mindfulness practice often lack specificity and may be influenced by expectancy effects or general relaxation responses rather than mindfulness-specific mechanisms. Regarding clinical implementation, Ren et al. (49) identified substantial heterogeneity in individual responses to mindfulness interventions, with factors such as severity of addiction, comorbid conditions, and pre-existing attentional capacities significantly moderating treatment outcomes. This variability suggests that mindfulness may not be universally effective for all IAD patients. Furthermore, Xie (50) longitudinal study revealed significant attrition rates (averaging 25%–30%) in mindfulness programs for addiction disorders, indicating challenges in treatment adherence that may limit real-world effectiveness. Additionally, the cultural adaptability of traditional mindfulness protocols remains questionable when applied across diverse populations with varying cultural conceptualizations of attention training and mental health, as demonstrated by Kirmayer’s cross-cultural analysis (51). From a neurocognitive perspective, Britton’s research suggests that enhanced awareness through mindfulness might temporarily increase distress in some individuals with addiction disorders by heightening consciousness of withdrawal symptoms before therapeutic benefits emerge (52). These limitations underscore the importance of developing personalized approaches to mindfulness intervention for IAD, rather than adopting a one-size-fits-all approach.
Dance Sport, Yoga, and Aerobic Dance exert therapeutic effects on Internet Addiction Disorder (IAD) through distinct yet complementary neurobiological mechanisms. Dance Sport (SUCRA = 64%) enhances frontal-striatal circuit connectivity through complex sequential movements, with Li (53) demonstrating its ability to upregulate dopamine in reward pathways while simultaneously improving cognitive flexibility. This remodeling of reward circuitry provides IAD patients with alternative pleasure stimuli beyond digital engagement. Yoga (SUCRA = 63.1%), as investigated by Lu et al. (54), operates primarily through autonomic nervous system regulation, increasing parasympathetic activation and GABA levels, which directly counters the sympathetic hyperarousal common in excessive internet use. Its emphasis on breath-body integration strengthens interoceptive awareness, addressing the bodily disconnection often experienced during prolonged screen time. Meanwhile, Aerobic Dance (SUCRA = 37.3%), while showing lower efficacy, contributes through enhanced brain-derived neurotrophic factor (BDNF) production as demonstrated by Yang (55), supporting hippocampal neurogenesis and resilience against stress-induced relapse patterns. The rhythmic, synchronized movements across all three modalities also enhance social synchrony circuits, with Dai (56) finding increased mirror neuron system activation, potentially offering a neural substrate for rebuilding real-world social connections that may have atrophied during internet dependency.
Regarding traditional Chinese health-promoting exercises, our study found that Baduanjin, Tai Chi, and Qigong all showed significant effects in improving IAD. The mechanism of these effects can be elaborated from both modern neuroscience and traditional Chinese medicine perspectives. From a neuroscience perspective, Liu (57) found through systematic review and meta-analysis that mind–body exercises like Tai Chi and Qigong can significantly improve executive function, closely related to prefrontal cortex activation. Improved executive function directly affects individual self-control ability, crucial for IAD rehabilitation. Regarding neurotransmitter regulation, Zhang (58) research confirmed that traditional exercise interventions can significantly improve anxiety and depression symptoms, related to the regulation of neurotransmitters like serotonin. From a traditional Chinese medicine perspective, TCM emphasizes the unity of “form, qi, and spirit, “improving overall health by regulating physical form, breathing, and psychological state. As typical TCM exercise therapies, Tai Chi, Baduanjin, and Qigong emphasize training in breathing regulation, movement coordination, and mental focus (59). Yu et al. (60) systematic review and meta-analysis showed that exercises incorporating meditation elements (like Tai Chi and Qigong) have significant emotional regulation effects. Liao et al. (61) found that Qigong interventions specifically target the dysregulated attentional networks often observed in internet addiction, helping practitioners develop greater attentional flexibility and emotional regulation through its meditative movement practices and energy cultivation techniques.
Our findings both align with and differ from related domestic and international research. For instance, Zhu (62) meta-analysis found that Tai Chi’s effect size on improving mental health [SMD = −0.89, 95%CI (−1.40,−0.38)]was smaller than our results [SMD = −10.91, 95%CI (−18.71,−3.11)]. These differences may arise from several factors. First, Liu et al.’s study included both quasi-experimental designs and RCTs, while our study strictly focused on RCTs, which enhanced the methodological rigor of our findings. Second, Liu et al. used depression scale scores as the primary outcome measure, whereas our study directly assessed IAD symptom severity. Although depression and IAD demonstrate certain comorbidity and symptom overlap, they represent distinct psychopathological dimensions. Third, our study implemented more stringent quality evaluation criteria and utilized net change values for baseline adjustment, which contributed to more precise and reliable results. Similarly, Tadpatrikar et al. (63) systematic review confirmed the positive impact of mind–body exercise. However, the intervention effects in these studies were lower than the effect sizes observed in our research, possibly due to factors such as: (1) differences in intervention duration, with previous studies typically lasting 4–6 weeks while ours continued for 8–16 weeks, allowing more time for mind–body exercise effects to fully manifest; (2) differences in assessment tools, as our study employed a more comprehensive IAD evaluation system. Additionally, our study featured relatively higher intervention frequency and single-session duration, potentially enhancing intervention effects.
Meanwhile, Placebo’s significantly lower ranking stems from its lack of structured neural engagement, absence of specific therapeutic mechanisms, and failure to provide consistent activation of the prefrontal circuits necessary to counter IAD’s neurobiological effects. This pronounced difference between active interventions and placebo confirms the clinical value of structured mind–body approaches for IAD treatment.
This ranking aligns with the “Comprehensive Exercise Intervention Theory” proposed by Wu et al. (64), which suggests that intervention effectiveness positively correlates with the following factors: (1) moderate exercise intensity, (2) complexity of cognitive engagement, (3) richness of social interaction, and (4) diversity of emotional regulation. Dance Sport demonstrates clear advantages in all four dimensions, thus achieving the best results. While Tai Chi and Baduanjin also possess multi-dimensional intervention characteristics, they are relatively weaker in intensity and social aspects. Mindfulness training primarily targets a single dimension (attention and emotional regulation), resulting in lower overall effectiveness.
This study has certain limitations. First, although we strictly included RCT studies and none of the included studies involved clinical patients, dietary intake and daily activities were not strictly controlled between the exercise and control groups during the intervention, which may affect the results. Second, literature searches were limited to Chinese and English, not covering research in other languages, potentially affecting the comprehensiveness of the literature and external validity of the research results. Finally, due to the use of different IAD assessment tools across studies, there exists measurement tool heterogeneity. To address this, we used standardized mean difference to combine effect sizes, ensuring comparability of outcome variables and minimizing the impact of measurement tool differences.
Future research could explore the long-term effects of mind–body exercise therapy on IAD while controlling for diet and daily activities. It is also recommended to extend research to special occupational groups (such as military personnel, firefighters, medical staff, and other high-stress occupational groups) and special physical and mental condition groups (such as minors, disabled persons, chronic disease patients, etc.), exploring differentiated effects and intervention strategies of mind–body exercise therapy across different populations. Additionally, expanding literature search scope to include research in other languages would help improve research comprehensiveness and external validity. It is recommended to conduct higher quality multi-center, large-sample RCT studies focusing on: (1) adopting rigorous experimental designs such as stratified randomization and intention-to-treat analysis; (2) conducting dose–response relationship analysis; (3) setting long-term follow-up observation points, which will provide more reliable evidence support for developing evidence-based, personalized IAD intervention strategies.
Although the literature search of this study covers major international databases, a significant limitation is that all included studies are from Chinese population. This geographical distribution bias may reflect the special contributions of Chinese researchers in the field of mind body intervention research, but it also limits the cross-cultural dissemination of the results. Cultural specificity plays an important role in the study of addictive behavior, especially in Internet use patterns and acceptance of mental health interventions. It is worth noting that Tai Chi and Qigong, as traditional practices originating from China, may benefit from enhanced cultural identity and intrinsic motivation among local populations, resulting in greater intervention effects. These socio-cultural factors may partially explain the significant effect we observed. Future research should expand to populations with different cultural backgrounds, evaluate the applicability of these physical and mental interventions on a global scale, and may require appropriate adjustments for different cultural backgrounds to maximize intervention effectiveness.
Current evidence suggests that mind–body exercise therapy can effectively improve IAD symptoms in young adults. Among the interventions studied, Mindfulness demonstrated the strongest therapeutic effect (SUCRA = 76.3%), followed by DanceSport (SUCRA = 64%), Yoga (SUCRA = 63.1%), and Taichi (SUCRA = 62.6%). Given its superior effectiveness, Mindfulness should be prioritized in IAD intervention programs where feasible. However, all seven interventions showed significant improvements compared to controls, suggesting that selection of specific mind–body exercises can be tailored to individual preferences and practical constraints.
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
SJ: Data curation, Methodology, Project administration, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing. DC: Formal analysis, Methodology, Project administration, Supervision, Writing – review & editing. JY: Data curation, Investigation, Project administration, Resources, Writing – original draft. HW: Methodology, Supervision, Validation, Writing – review & editing. WC: Data curation, Methodology, Project administration, Supervision, Validation, Writing – original draft, Writing – review & editing. XZ: Methodology, Supervision, Validation, Writing – original draft, Writing – review & editing. ZD: Project administration, Validation, Writing – review & editing. DZ: Data curation, Methodology, Writing – original draft, Supervision.
The author(s) declare that financial support was received for the research and/or publication of this article. This research was funded by the Fundamental Research Funds of the Central Universities (project name: empirical research on the empowerment of sports industry for common prosperity in the context of Chinese path to modernization; project number: 2024ESJSK12).
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The authors declare that no Gen AI was used in the creation of this manuscript.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2025.1565372/full#supplementary-material
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Keywords: mind–body exercise, young adults, internet addiction, intervention effectiveness, network meta-analysis
Citation: Jia S, Du Z, Chu D, Yao J, Wang H, Chen W, Zhang D and Zang X (2025) A network meta-analysis of mind–body exercise interventions for internet addiction symptoms in young adults. Front. Public Health. 13:1565372. doi: 10.3389/fpubh.2025.1565372
Received: 23 January 2025; Accepted: 16 May 2025;
Published: 18 June 2025.
Edited by:
Reviewed by:
Copyright © 2025 Jia, Du, Chu, Yao, Wang, Chen, Zhang and Zang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Wenjia Chen, Mjc3NDYzODI4QHFxLmNvbQ==; Dazhong Zhang, NTc4MTgxNjI5QHFxLmNvbQ==; Xin Zang, emFuZ3hpbl9tdEAxNjMuY29t
^‡Present Address: Xin Zang, Graduate School Department of Physical Education, Dankook University, Yongin-si, Republic of Korea
^†These authors have contributed equally to this work
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Courtesy Photo | Knowing how and when to sign up for Medicare will help you avoid gaps in coverage and…… read more read more
Courtesy Photo | Knowing how and when to sign up for Medicare will help you avoid gaps in coverage and late enrollment penalties.  see less | View Image Page
Are you approaching the age of 65? Unlock your health by signing up for Medicare as soon as you’re eligible. Medicare Part A and Part B are required to remain eligible for TRICARE, with limited exceptions. Knowing how and when to sign up for Medicare will help you avoid gaps in coverage and late enrollment penalties.
“Signing up for Medicare three or four months before your 65th birthday is important to ensure a seamless transition to TRICARE For Life,” said Anne Breslin, TFL program manager, TRICARE Health Plan, at the Defense Health Agency. “Medicare and TRICARE will then work together to help minimize your out-of-pocket expenses.”

Understanding eligibility
Most people become eligible for Medicare the first day of the month they turn 65. Those with a birthday on the first of a month become eligible the first of the month before they turn 65.
Some become eligible for Medicare before age 65 after receiving Social Security Disability Insurance for 24 months or when diagnosed with certain medical conditions.

TFL is available to military retirees and their family members who qualify for TRICARE, are entitled to Medicare Part A, and have Medicare Part B, regardless of age or place of residence. You can sign up on the Social Security Administration website or by calling SSA to schedule an appointment.

Learn more by reading the TRICARE and Medicare Under Age 65 Brochure.

If you (or your spouse) are still working and have employer-sponsored health coverage when you turn 65, Medicare allows you to delay enrollment in Medicare Part B. But if you do delay enrollment, you won’t have TRICARE coverage. Answer a few questions on the Medicare webpage to find out what’s right for you.

If one family member becomes eligible for Medicare and is now covered by TFL, other family members not yet eligible for Medicare can still use TRICARE Prime or TRICARE Select.

Avoid penalties
It’s important to sign up for Medicare Part A and Part B during your Initial Enrollment Period, which is seven months long. This is when you’re first eligible to sign up for Medicare Part A and Part B. It starts three or four months before you turn 65. Learn more about late enrollment penalties and how to avoid them.
To avoid coverage gaps, keep your information current in the Defense Enrollment Eligibility System. This ensures you receive timely updates and benefits information.

Sign up for Medicare no later than two months before the month you turn 65 to avoid a break in your TRICARE coverage. There are no enrollment forms or fees required for TFL —it begins automatically the first date Medicare Part A and Part B are effective.

To learn more, check out the TRICARE and Medicare Turning Age 65 Brochure.

What parts of Medicare do you need?
To be eligible for TFL, you must have both Medicare Part A and Part B.
Part A typically covers:

• Inpatient hospital care
• Skilled nursing facilities
• Hospice
• Some home health care

Most people get Part A premium-free if they, or their spouse, worked and paid Social Security taxes for at least 10 years.

Medicare Part B covers:

• Outpatient care
• Certain preventive services
• Durable medical equipment

Part B has a monthly premium based on your income.

You don’t need to enroll in Medicare Advantage (Part C) or prescription drug coverage (Part D) to have TFL coverage. Read the TRICARE Newsroom article “Q&A: How Does TRICARE For Life Work With Medicare?” to learn more.

For dental and vision coverage, check to see if you qualify through the Federal Employees Dental and Vision Insurance Program.

Coverage overseas
Medicare only provides coverage in the U.S. and U.S. territories. If you live or travel overseas, TRICARE becomes your primary payer. That means you’ll pay TRICARE’s annual deductible and cost for care abroad. You must still have Medicare Part B to remain eligible for TFL, even though it doesn’t pay for care.
Here’s what else to keep in mind if you have TFL and live or travel overseas:

• You may visit any TRICARE-authorized provider for care.
• If you’re in the Philippines, you must see a Philippine Preferred Provider Network or certified providers.
• Be prepared to pay for services up front. You’ll need to file a claim later.
• You have up to three years to file claims for overseas care.

Which pays first: Medicare or TRICARE?
When both Medicare and TRICARE cover a health care service, Medicare pays first and TRICARE pays second. TRICARE may also cover services that Medicare doesn’t. That’s why it’s important to confirm you’re covered by Medicare, TRICARE, or both—to help avoid costs.
You’ll also need to use Medicare providers. Check out TRICARE’s covered services to learn more.

Coordination with other health insurance
Other health insurance, or OHI, is coverage in addition to Medicare and TFL. This might be offered by an employer, based on current employment or retirement for you or your spouse.
How Medicare coordinates with OHI depends on whether the OHI is based on current employment. In either case, TRICARE pays last.

Unlock your health—and peace of mind—by understanding how TFL and Medicare work together, as described in the Medicare publication How Medicare Works With Other Insurance. You can view or print the booklet or call 800-MEDICARE (800-633-4227) to find out if a copy can be mailed to you.

For more information, check out the TRICARE For Life Handbook and Becoming Medicare-Eligible.
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Vinita Prasad, MD
PPG – Psychiatry
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Last Modified: June 26, 2025
Healthy Mind, Women & Children

This post was written based on an appearance by Vinita Prasad, MD, PPG – Psychiatry, on the WANE15 program Real Talk on Mental Health. 
Maternal mental health refers to the emotional and psychological well-being of women during pregnancy, delivery and after childbirth.
Mothers can experience certain mental health conditions like prenatal depression, which happens during pregnancy, or postpartum depression after childbirth. Postpartum depression isn't just the "baby blues." It can last longer and feel more intense than normal sadness.
Other mood conditions like anxiety disorders, post-traumatic stress disorder (PTSD) after traumatic childbirth, and postpartum psychosis can also occur. These conditions can impact a mom's physical and mental health as well as her ability to take care of themselves and their babies. If left untreated, it can also impact the child's development too.
 
There are some valuable preventative steps moms can take to take care of themselves during this time. First and foremost, I recommend self-reflection and check-ins. Regularly ask yourself these questions:
Am I feeling connected to my baby?
Am I enjoying things that I used to?
Am I excessively overwhelmed?
Some find it helpful to track how they're feeling day to day in a mood diary. This can include describing symptoms of anxiety or depression, how you're sleeping, eating and nutrition habits, and more.
Staying connected to a support group is also important. Talk to your friends, family, and partner about your emotional well-being. Let someone close know that you want them to check on you and ask about your emotional health.
 
Don't hesitate to contact a therapist or mental health provider. Online screening tools like Patient Health Questionnaire 9 (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS) are helpful for assessing symptoms and deciding if additional support is needed.
Again, staying connected to others is very beneficial for maternal mental health. Beyond family and friends, consider joining a local or online support group. Being in community with other moms experiencing similar challenges can help you feel less lonely or burned out.
It's not uncommon for women, especially new moms, to feel guilty for prioritizing their basic needs. Self-care isn't selfish; it's necessary for everyone's well-being. Make sure that you prioritize your diet and nutrition, get adequate sleep and manage stress. Even if it's only for a few minutes at a time, practicing mindfulness exercises like yoga, meditation or deep breathing techniques can help moms stay grounded.
Lastly, if mental health challenges persist, there are pharmaceutical options you can explore to help manage your symptoms. Some mood-stabilizing medications are safe to take during pregnancy and while breastfeeding.
 
If you have concerns, call the PBHI HelpLine at 260-471-9440 or 1-800-284-8439 to receive an assessment or learn more about our services 24 hours a day, seven days a week. You can read more about our substance use disorder services here.
June 24, 2025
People of Parkview, Women & Children
June 13, 2025
Family Medicine, Healthy Mind
June 06, 2025
Family Medicine, Women & Children

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By now, most of us know the basics of how to get good sleep: Stick to a schedule, stop caffeinating early in the day, and keep your bedroom cool and dark. But considering that an estimated one in three Americans1 still aren’t getting enough rest on a regular basis, researchers continue to investigate new and novel sleep tips, including supplementing with vitamin D2.*
This meta-analysis published in the journal Nutrients2 included 19 studies—13 of which were randomized controlled trials, considered a research gold standard. Combined, these studies tracked the vitamin D levels and sleep of 9,397 people of all ages and backgrounds.
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In reviewing this body of research, Myriam Abboud, Ph.D., a nutrition researcher at Zayed University in the UAE, found that there did appear to be a link between adequate vitamin D levels (i.e., vitamin D sufficiency) and high-quality rest.* Specifically, those who took a vitamin D supplement scored better on the Pittsburgh Sleep Quality Index—a list of questions that assesses sleep quality over a one-month period.*
“In conclusion, the evidence presented in this review suggests a beneficial role of VDS [vitamin D supplementation] in enhancing sleep quality,”* Abboud writes in the meta-analysis.
This suggests that in addition to other sleep-promoting habits, making sure your vitamin D levels are up to snuff (30 ng/mL is the cutoff for insufficiency to avoid; ideally at least 50 ng/mL) may go on to support your slumber.*
RELATED READ: The 7 Best Vitamin D Supplements For Immunity, Bone Health & More
There are a few ways that vitamin D and sleep could be connected. For starters, there are binding sites for vitamin D on nearly every cell in our body—including ones in our brain that affect sleep.* The fat-soluble vitamin also appears to play a role in the production of melatonin3—the “hormone of darkness” that tells our bodies when it’s time for bed.* Exposure to sunlight suppresses the production of melatonin but encourages the production of vitamin D, so that’s another potential link.
While researchers are pretty sure that healthy vitamin D levels support healthy sleep (and vice versa), this new analysis notes that we still have more to learn about how exactly vitamin D supplementation plays into things.* However, it’s worth noting that there are plenty of other reasons to take a vitamin D supplement, beyond sleep support.*
Due to factors like diet and geography, many of us don’t get adequate amounts of vitamin D from sunlight and diet alone. Taking a daily supplement of 5,000 IU of vitamin D3 can get levels back to that optimal range—and support bone and muscle health4, thyroid health5, oral health, and much more in the process.*
The best part is that vitamin D supplements are easy to incorporate into your life. While other restful habits like staying off electronics at night and limiting stress levels take effort, taking a D3 gelcap is something you can basically do in your sleep.
If you’re one of 41% of U.S. adults who are vitamin D insufficient6, your sleep quality could be suffering according to a Nutrients meta-analysis.* Count this as yet another reason to take a daily vitamin D supplement. Here are our top picks.
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*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

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