Results
Forty-five eligible participants were enrolled in the study, and 42 agreed to participate in this study and underwent baseline measurements. Twenty-one participants were assigned to the laughter yoga group and 21 participants were assigned to the control group (Consolidated Standards of Reporting Trials (CONSORT) diagram of study participants.The baseline characteristics of the 42 participants stratified by groups are shown in Baseline characteristics of the participants.BMI, body mass index; HbA1c, hemoglobin A1c. Data are mean (SD) unless otherwise indicated.
Physiological and psychological changes during the intervention in the laughter yoga and control groups.BMI, body mass index; HbA1c, hemoglobin A1c; SD, standard deviation; 95% CI, 95% confidence interval.P for comparing the difference in outcomes before and after the intervention using paired-samples t test.P for unadjusted between-group difference in changes in outcomes over 12 weeks using independent samples t test.P for adjusted between-group difference (adjustment for age, BMI and each dependent variable value at baseline) using analysis of covariance.Physiological and psychological changes during the intervention in the laughter yoga and control groups using per-protocol analyses.BMI, body mass index; HbA1c, hemoglobin A1c; SD, standard deviation; 95% CI, 95% confidence interval.P for comparing the difference in outcomes before and after the intervention using paired-samples t test.P for unadjusted between-group difference in changes in outcomes over 12 weeks using independent samples t test.P for adjusted between-group difference (adjustment for age, BMI and each dependent variable value at baseline) using analysis of covariance.At baseline and 12-week follow-up, 14 (66.7%) and 19 (90.5%) individuals in the laughter yoga group, and 10 (47.6%) and 8 (38.1%) individuals in the control group reported having exercise at least twice a week, respectively. The number of individuals with exercise habits increased in the laughter yoga group but with no statistical significance. However, the adjusted between-group difference of HbA1c remained statistically significant after adding the change in exercise habits as a covariate. The mean change in HbA1c was 0% in the five participants who reported increased exercise habits and −0.32% in the 16 participants without exercise habit changes. Additionally, the number of individuals who reported eating until full and skipping breakfast was not significantly different between the two groups at baseline and 12-week follow-up (data not shown). The number of individuals who reported eating until full and skipping breakfast remained from baseline to 12-week follow-up in both groups.