Effects of Imagery and Breathing Exercises on Swimmers' Performance, Mental Toughness, and Heart-Mind Coherence

April 8, 2025 updated by: Ankara Yildirim Beyazıt University

The Effect of 10-Week Imagery and Breathing Exercises on 200-Meter Swimming Performance, Mental Toughness, and Heart-Mind Coherence in Swimmers: A Randomized Controlled Trial

This randomized controlled trial aimed to investigate the effects of a 10-week imagery and breathing exercise intervention on 200-meter freestyle swimming performance, mental toughness, and heart-mind coherence in swimmers. Nineteen licensed swimmers aged 13-18 years were randomly assigned to an experimental group (n=9) receiving imagery and breathing exercises or a control group (n=10) receiving only standard physical training. Outcomes were measured using the 200-meter freestyle swimming time, the Sports Mental Toughness Questionnaire (SMTQ), and heart-mind coherence via the Inner Balance HeartMath device. The intervention significantly improved mental toughness and swimming performance in the experimental group compared to the control group, with a trend toward improved heart-mind coherence.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The study was conducted at the facilities of Pamukkale Üniversitesi Mensupları Spor Kulübü Yüzme Takımı in Denizli, Türkiye. Participants underwent a pre-test/post-test design with the following measures: 200-meter freestyle swimming performance, mental toughness (assessed via the Sports Mental Toughness Questionnaire), and heart-mind coherence (measured using the Inner Balance HeartMath device for real-time biofeedback of heart rate variability [HRV]). The experimental group participated in a 10-week intervention involving daily imagery and breathing exercises performed before bedtime, following a structured protocol (4-second inhale through the nose, 4-second exhale through the mouth, while imagining a 200-meter swim with detailed visualization). The intervention included a 6-day training period on techniques, followed by 10 weeks of daily practice, with reminders and feedback provided via a WhatsApp group. The control group continued standard physical training without additional mental training. Data were analyzed using a two-way repeated measures ANOVA, with post-hoc Bonferroni tests, and a significance level of p<0.05.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
19

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Ankara, Turkey
        • Ankara Yildirim Beyazit University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Aged 13-18 years.
  • Licensed and actively engaged in competitive swimming.
  • No serious injuries in the past 6 months.
  • Parental consent obtained for participants under 18 years.

Exclusion Criteria:

  • Diagnosis of heart disease or respiratory system disorders.
  • Psychiatric diagnosis or ongoing psychological treatment.
  • Serious injury or surgery within the past 6 months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Imagery and Breathing Exercises
Participants received a 10-week intervention of imagery and breathing exercises in addition to standard physical training.
Behavioral: Imagery and Breathing Exercises
Participants performed daily imagery and breathing exercises before bedtime for 10 weeks. The protocol involved a 4-second inhale through the nose and a 4-second exhale through the mouth while visualizing a 200-meter freestyle swim with detailed attention to technique and performance. A 6-day training period was provided to teach the techniques, and participants received daily reminders and feedback via a WhatsApp group.
No Intervention: Standard of care
Participants received only standard physical training without additional mental training.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
200-Meter Freestyle Swimming Performance
Time Frame: Baseline (pre-test) and 10 weeks (post-test).
time to complete a 200-meter freestyle swim, measured in seconds.
Baseline (pre-test) and 10 weeks (post-test).
Mental Toughness
Time Frame: Baseline (pre-test) and 10 weeks (post-test).
Assessed using the Sports Mental Toughness Questionnaire (SMTQ), with scores indicating levels of mental toughness. The Sports Mental Toughness Questionnaire (SMTQ) is a 14-item scale measuring mental toughness across the subdomains of confidence, constancy, and control, with scores ranging from 14 to 56. Higher scores indicate greater mental toughness, reflecting a more positive psychological profile in athletes.
Baseline (pre-test) and 10 weeks (post-test).
Heart-Mind Coherence
Time Frame: Baseline (pre-test) and 10 weeks (post-test).
Measured using the Inner Balance HeartMath device to assess heart rate variability (HRV)
Baseline (pre-test) and 10 weeks (post-test).

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Maximum Coherence Values
Time Frame: Baseline (pre-test) and 10 weeks (post-test).
Maximum coherence levels achieved during measurement sessions, assessed via the Inner Balance HeartMath device.
Baseline (pre-test) and 10 weeks (post-test).
Balance Performance
Time Frame: Baseline (pre-test) and 10 weeks (post-test).
Assessed as part of the study hypothesis, though specific measurement tools are not detailed in the manuscript.
Baseline (pre-test) and 10 weeks (post-test).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ankara Yildirim Beyazıt University

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Pamukkale University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 20, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
February 20, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 17, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 16, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 8, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 10, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 10, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 8, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • E-60116787-020-666811

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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