Stress constitutes a complex process that is activated by a physical or mental threat to the individuals’ homeostasis, comprising a set of diverse psychological, physiological and behavioral responses [1]. Although it is usually considered a negative response, stress actually constitutes a key process for ensuring our survival. However, when a stress response is repeatedly triggered in the absence of a challenging stimulus, or if there is constant exposure to challenging situations, stress can become harmful. Evidence suggests that, in either of these two contexts, stress is a persistent factor for the development of psycho-pathological conditions [2,3].
When faced with stressful events, people make autonomic and controlled efforts to reduce the negative impact and maximize the positive impact that every specific situation may provoke. Generally, this process is denominated as emotion regulation, formally defined as the process by which individuals can influence what emotions they have, when they have them and how they experience and express those emotions [4]. It has been suggested that the term emotion regulation can be understood as a broad tag that comprises the regulation of all responses that are emotionally charged, from basic emotions to complex mood states, as well as regulation of everyday life [5]. Failure to address triggers of stress has been shown to lead to chronic stress, anxiety and depression, and attributed to serious physical health conditions such as cardiovascular disease [6]. The World Health Organization concluded that psychological stress is one of the most significant health problems in the 21st-century and is a growing problem [7]. There are various interventions to minimize stress based on individual preferences and requirements. Stress management techniques including ancient practices such as Tai Chi [8] and yoga [9] as well as other physical activities [10] are often cited as being helpful in combating stress. Likewise traditional meditation, mindfulness [11] and cognitive behavioural therapy (CBT) [12] all have established benefits. These techniques are not applicable in office or social environments, or during most daily routines. Therefore, a smart device based stress management application may be of benefit. Recently, smartphone applications such as Calm, Pause, Heartmath and Sway have been developed for indoor environments. However, these applications are not individualized nor do they include biofeedback and studies that validate their effects are limited [13].
In this study, we used the stress level detection scheme using physiological signals and added a physical activity based context analyzer. When the user experiences a high stress level, the system suggests appropriate stress reduction methods (traditional or mobile). We further compare the effects of traditional and mobile stress alleviation methods on physiological data of 15 international Ph.D. students (participants) during eight days of training. In addition, 1440 h of physiological signals from Empatica E4 smart bands were collected in this training event. Stress management techniques based on the emotion regulation model of James Gross [4] were applied to reduce participant stress levels. To the best of our knowledge, this work is the first one suggesting appropriate stress reduction methods based on contextual information and comparing both traditional and mobile stress management interventions in the real-life environment using a commercial smart-band based automatic stress level detection system that eliminates motion artifacts. Using such a system is essential because these offline stress level detection algorithms could be used in real-time biofeedback apps.
Application of our stress level detection algorithm, in a real world context, could allow individuals to receive feedback regarding high stress levels along with recommendations for relaxation methods. Additional continued monitoring may also enable the individual to better understand the effectiveness of any stress reduction methods. However, for our stress detection algorithm to be applied in daily life, the smart device should be unobtrusive (i.e., should not be comprised of cables, electrodes, boards). Our system works on smart-bands which are perfect examples of this type of unobtrusive wearable device.
This paper describes emotion regulation in the context of stress management and how yoga and mindfulness can be used for regulating emotions (Section 2). Methods of detecting stress and analyzing context based on physical activity are described (Section 3) and data are presented related to our method for stress level detection with the use of smart-bands (Section 4). Experimental results and discussion are also presented (Section 5) and we present the conclusions and future works of the study (Section 6).
The major research contributions of this study are the following:
- Developing a physical activity based context analyzer and relaxation method suggestion system
- Comparison of stress reduction methods (mobile mindfulness, traditional mindfulness and yoga) and their effectiveness in the context of stress management with the use of an unobtrusive smartwatch based stress level detection system
- Application of James Gross’s prominent emotion regulation model in the context of stress management and measuring the physiological component with smart bands.
Yoga
Yoga is an ancient Eastern practice that developed more than 2000 years ago. Although its original creator and source are uncertain, the earliest written word ‘Yoga Sutra’ describes the philosophy of yoga focussing on growing spirituality, regulating emotions and thoughts. Initially, the focus was on awareness of breathing and breathing exercises ‘pranayama’ to calm the mind and body, ultimately reaching a higher state of consciousness.
Yoga has become a global phenomenon and is widely practiced in many different forms. Generally, all types of yoga include some elements of relaxation. Additionally, some forms include mainly pranayama and others are more physical in nature. One such practice is vinyasa flow which involves using the inhale and exhale of the breathing pattern to move through a variety of yoga postures; this leads to the movement becoming meditative. The practice often includes pranayama followed by standing postures linked together with a movement called vinyasa, (similar to a sun salutation) which helps to keep the body moving and increases fitness, flexibility and helps maintain linkage with the breath. The practice also often includes a range of seated postures, an inversion (such as headstand or shoulder stand) and final relaxation ‘savanna’.
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