An interventional study of Wearable ring with continuous biometric monitoring and AI health coaching application in Stress (Psychology), Resilience, Psychological and Anxiety, sponsored by Touro University, California. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-11-04.
Sponsored by Touro University, California · Not applicable, Interventional, and Prevention
Medical students often experience high levels of stress, anxiety, and poor sleep, especially during their first year and around exams. This study looked at whether adding hands-on osteopathic manipulative treatment (OMT) to a wellness program built around a wearable ring and an artificial intelligence (AI) health coaching app could help first-year medical students.
Forty-three first-year osteopathic medical students at one college took part. Each student was randomly assigned, by chance rather than by choice, to one of three groups for 23 weeks: a wearable ring alone; a wearable ring plus an AI health coaching app; or a wearable ring, the AI health coaching app, and seven OMT sessions given about every three weeks by osteopathic physicians.
All students wore the ring daily. The ring recorded information such as sleep, heart rate, and heart rate variability, which is a measure of how the nervous system responds to stress. Students also completed questionnaires about resilience and about symptoms of depression, anxiety, and stress at three points: before the semester, in the middle, and at the end. Students answered additional surveys about their experience two months and seven months after the study ended.
This was a small pilot study. Its main purpose was to find out whether a program like this can be carried out successfully and to gather the information needed to plan a larger study, rather than to determine whether OMT works. No harmful effects were reported.
This single-site, parallel-group, three-arm randomized pilot was conducted at one college of osteopathic medicine between December 2024 and May 2025, spanning a full academic semester plus pre- and post-semester baseline periods. It was designed as a feasibility and parameter-estimation study in accordance with published guidance on pilot trials, and is reported using the CONSORT extension for pilot and feasibility trials.
Randomization and participant de-identification were carried out by an independent study coordinator external to the investigative team. The research team remained blinded to group allocation for outcome assessment and analysis, with one unavoidable exception: participants receiving OMT could not be blinded to the physicians treating them.
OMT was delivered from a written protocol by three physicians board-certified in Osteopathic Neuromusculoskeletal Medicine. Sessions lasted no longer than 30 minutes and followed a fixed sequence. Each began with a TART screening examination (assessing Tissue texture change, Asymmetry, Restriction of motion, and Tenderness) with passive range-of-motion assessment of the diaphragms, spine, ribs, and extremities, together with a cranial vault hold assessment. Every participant then received the same six-technique core sequence addressing autonomic and circulatory targets: suboccipital release, rib raising, sacral rocking, and myofascial release of the thoracic inlet, the thoraco-abdominal diaphragm, and the pelvis. Physicians then addressed the most significant remaining somatic dysfunction using techniques from a specified set. Sessions ran from early January to early May on a three-week schedule with five days of permitted flexibility.
Wearable data were collected continuously by a third-generation ring device worn daily, with daily values exported from the device platform at study end. Survey instruments were administered electronically at three timepoints during the study and twice after its conclusion.
To limit contamination, participants in the two non-OMT arms agreed not to seek OMT from the institutional osteopathic manipulative medicine clinic, a licensed OMM physician, or a European-trained osteopath for the study duration. Because all participants were enrolled in the required Osteopathic Principles and Practice curriculum, receipt of OMT from classmates during coursework was permitted and was not restricted or logged.
Analyses compared arms on post-study values adjusted for baseline. Because all arms shared an identical academic calendar, wearable data were additionally examined as within-participant trajectories across the semester. A whole-cohort analysis anchored to the institutional examination calendar was conducted to assess whether continuous biometrics track the academic stress cycle independently of study arm. Analyses of within-semester trajectories and of examination-anchored physiology were developed after data collection and are exploratory. Consistent with the pilot design, no correction for multiple comparisons was applied and no result is interpreted as confirmatory.
This record was created retrospectively. The trial was not registered before participant enrollment began.
8,577 studies on the registry are indexed under Depression; 1,720 are open to participants now.
This study's enrollment of 43 is below the median of 81 across 7,063 interventional studies indexed under Depression.
Browse Depression studies →Touro University, California is the lead sponsor of 7 studies on the registry; 2 are open to participants now.
Compared within Depression, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Anxiety Disorders. The counts are of registry records indexed under each term, refreshed daily. How we classify →
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Participants received a third-generation wearable ring with a one-year membership and were asked to wear it continuously for the 23-week study period. Daily biometrics were collected passively, including nightly heart rate variability, sleep score, readiness score, lowest heart rate, a resting heart rate contributor score, and a daytime stress score. Participants had access to their own data through the device application. No AI health coaching application and no osteopathic manipulative treatment were provided. Participants in this arm agreed not to seek osteopathic manipulative treatment from the institutional osteopathic manipulative medicine clinic, a licensed OMM physician, or a European-trained osteopath for the study duration; receipt of OMT from classmates during required coursework was permitted.
Device: Wearable ring with continuous biometric monitoring
Participants received the wearable ring as in Arm 1, plus access to an AI health coaching application that delivered daily reflection prompts, guided breathing exercises, and behavioral suggestions informed by ring data. Daily use of the application was encouraged but not incentivized or enforced. A major application update was released mid-study following usability problems. No osteopathic manipulative treatment was provided. Participants in this arm agreed not to seek osteopathic manipulative treatment from the institutional osteopathic manipulative medicine clinic, a licensed OMM physician, or a European-trained osteopath for the study duration; receipt of OMT from classmates during required coursework was permitted.
Device: Wearable ring with continuous biometric monitoring · Behavioral: AI health coaching application
Participants received the wearable ring and AI health coaching application as in Arm 2, plus seven sessions of osteopathic manipulative treatment delivered by physicians board-certified in Osteopathic Neuromusculoskeletal Medicine. Sessions ran from early January to early May on an approximately three-week schedule with five days of permitted flexibility, and lasted no longer than 30 minutes each. Each session followed a written protocol beginning with TART screening and cranial assessment, then a fixed six-technique sequence addressing autonomic and circulatory targets: suboccipital release, rib raising, sacral rocking, and myofascial release of the thoracic inlet, thoraco-abdominal diaphragm, and pelvis. Physicians then treated the most significant remaining somatic dysfunction from a specified technique set.
Device: Wearable ring with continuous biometric monitoring · Behavioral: AI health coaching application · Other: Osteopathic manipulative treatment (OMT)
A commercially available ring-worn wearable device providing continuous, passive physiological monitoring. Participants wore the device daily for the 23-week study period and had access to their own data through the accompanying mobile application. Daily metrics collected included nightly heart rate variability (rMSSD), sleep score, readiness score, lowest nightly heart rate, a resting heart rate contributor score, and a daytime stress score. No feedback or coaching beyond the device's standard consumer application was provided as part of this intervention.
Also known as: Oura Ring (generation 3)
A smartphone-based artificial intelligence health coaching application that delivered daily reflection prompts, guided breathing exercises, and individualized behavioral suggestions informed by wearable ring data. Daily engagement was encouraged but was neither incentivized nor enforced, and adherence was not a condition of participation. A major application update was released approximately midway through the study following reported usability problems.
Also known as: Ziva Health AI health coach
Seven protocoled sessions of osteopathic manipulative treatment delivered by physicians board-certified in Osteopathic Neuromusculoskeletal Medicine, each lasting no longer than 30 minutes, from early January to early May on an approximately three-week schedule with five days of permitted flexibility. Each session began with a TART screening examination (tissue texture change, asymmetry, restriction of motion, tenderness) with passive range-of-motion assessment of the diaphragms, spine, ribs, and extremities, plus cranial vault hold assessment. Every participant then received the same six-technique core sequence addressing autonomic and circulatory targets: suboccipital release, rib raising, sacral rocking, and myofascial release of the thoracic inlet, thoraco-abdominal diaphragm, and pelvis. Physicians then treated the most significant remaining somatic dysfunction using techniques from a specified set.
Also known as: Osteopathic manipulative medicine (OMM)
Change in resilience, measured by the Hardiness Resilience Gauge (HRG) Total Hardiness T-score
Standardized T-score derived from the Hardiness Resilience Gauge, reported in a standard score metric with a population mean of 100 and standard deviation of 15. Higher scores indicate greater psychological hardiness; the instrument's average range is 90 to 110. Total Hardiness is reported here; the Challenge, Control, and Commitment subscales are reported as secondary outcome measures.
Time frame: Baseline, Month 3, and Month 6 (end of study)
Change in mood symptoms, measured by the Depression Anxiety Stress Scales-21 (DASS-21)
Three subscale scores (Depression, Anxiety, Stress). Each subscale is the sum of 7 items rated 0 to 3, multiplied by 2, giving a range of 0 to 42 per subscale. Higher scores indicate greater symptom severity.
Time frame: Baseline, Month 3, and Month 6 (end of study)
Change in nightly heart rate variability
Mean overnight root mean square of successive differences (rMSSD), in milliseconds, recorded by the wearable ring. Higher values indicate greater parasympathetic activity.
Time frame: Daily from baseline through month 6
Change in device-derived daytime stress score
Proprietary composite index of daytime physiological stress generated by the wearable device, reported daily. Higher values indicate greater stress. The metric begins reporting only after approximately two weeks of device wear.
Time frame: Daily from baseline through month 6
Change in sleep score
Device-derived nightly composite sleep score ranging from 0 to 100. Higher values indicate better sleep.
Time frame: Daily from baseline through month 6
Change in readiness score
Device-derived daily composite readiness score ranging from 0 to 100. Higher values indicate greater physiological readiness.
Time frame: Daily from baseline through month 6
Change in lowest nightly heart rate
Minimum heart rate recorded overnight by the wearable device, in beats per minute. Higher values indicate greater physiological arousal.
Time frame: Daily from baseline through month 6
Change in resting heart rate contributor score
Device-derived contributor score ranging from 0 to 100, in which higher values indicate a lower and more favorable resting heart rate. This field is a score rather than a rate in beats per minute, and is inversely scaled relative to heart rate.
Time frame: Daily from baseline through month 6
Participant-reported tool use and perceived effectiveness after study completion
Structured survey assessing continued use of each study tool (wearable ring, AI health coaching application), perceived effectiveness on ordinal rating scales, receipt of osteopathic manipulative treatment after study completion, and free-text description of participant experience.
Time frame: 2 months and 7 months after study completion
Plan to share: No — Individual participant data will not be made available to external researchers because informed consent for data sharing was not obtained from study participants.
No publications or documents are linked to this record.
Ran from Nov 2024 to primary completion in May 2025, 5 months.
Of 3,468 non-industry interventional studies with no phase under Depression, half reached primary completion within 21 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 41. This study's 5 months is below that.
Counting every sponsor, half of 3,566 studies reached it within 21 months; a quarter within 9 and three quarters within 41.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is completed, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.
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Touro University, California