Effect of Baduanjin exercise on executive function in older adults with cognitive frailty: A randomized controlled trial.

OBJECTIVE: To investigate the effectiveness of Baduanjin exercise on executive function in community-dwelling older adults with cognitive frailty. DESIGN: Randomized controlled trial. SETTING: Community residential centers. SUBJECTS: 120 eligible older adults. INTERVENTIONS: Baduanjin training group received supervised Baduanjin training, 60 min sessions three times per week for 24 weeks. The control group did not receive any exercise intervention. MAIN MEASURES: Primary outcome was executive function, assessed using Clock Drawing Test. Secondary outcomes included the subcomponents of executive function (working memory, inhibitory control and cognitive flexibility), attention and cognitive frailty (global cognitive function, physical frailty) assessed using Verbal Fluency Test, Trail Making Test-A/B, Stroop Test, Montreal Cognitive Assessment and Edmonton Frailty Scale, respectively, at baseline and 24 weeks after intervention. RESULTS: After the 24-week intervention, the scores of Clock Drawing Test and Verbal Fluency Test, the Trail Making Test-B time and the Card correct numbers of Stroop Test in Baduanjin training group showed significant improvement compared with control group (all P < 0.05) with small to moderate effect sizes and the significant interaction effect of group by time in the Clock Drawing Test and Trail Making Test-B test (P = 0.003 and P = 0.043); cognitive frailty variables, including Montreal Cognitive Assessment and Edmonton Frail Scale scores, also showed significant improvement (P = 0.002 and P = 0.004) with a moderate effect sizes and a significant interaction effect (P < 0.001, P = 0.013). No adverse events were reported. CONCLUSION: Regular Baduanjin training may be an effective and safe intervention to improve cognitive frailty and executive function in community-dwelling older adults with cognitive frailty. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2100050857. Data of registration: 8/5/2020, https://www.chictr.org.cn/showproj.html?proj = 133037.

Effects of Baduanjin exercise on cognitive function and cancer-related symptoms in women with breast cancer receiving chemotherapy: a randomized controlled trial.

PURPOSE: Cognitive decline is one of the main side effects of breast cancer patients after relevant treatment, but there is a lack of clear measures for prevention and management without definite mechanism. Moreover, postoperative patients also have a need for limb rehabilitation. Whether the cognitive benefits of Baduanjin exercise can improve the overall well-being of breast cancer patients remains unknown. METHODS: This randomized controlled trial was conducted on 70 patients with breast cancer receiving chemotherapy who were randomly assigned and allocated to (1:1) a supervised Baduanjin intervention group (5 times/week, 30 min each time) or a control group for 3 months. The effects of Baduanjin exercise intervention were evaluated by outcome measures including subjective cognitive function, symptoms (fatigue, depression, and anxiety), and health-related quality of life at pre-intervention (T0), 4 weeks (T1), 8 weeks (T2), and 12 weeks (T3). The collected data were analyzed by using an intention-to-treat principle and linear mixed-effects modeling. RESULTS: Participants in the Baduanjin intervention group had a significantly greater improvement in terms of FACT-Cog (F = 14.511; p < 0.001), PCI (F = 15.789; p < 0.001), PCA (F = 6.261; p = 0.015), and FACT-B scores (F = 8.900; p = 0.004) compared with the control group over the time. The exercise-cognition relationship was significantly mediated through the reduction of fatigue (indirect effect: ß = 0.132; 95% CI 0.046 to 0.237) and the improvement of anxiety (indirect effect: ß = - 0.075; 95% CI - 0.165 to -0.004). CONCLUSIONS: This pilot study revealed the benefits of Baduanjin exercise for subjective cognition and health-related quality of life of Chinese breast cancer patients receiving chemotherapy and outlined the underlying mediating mechanism of exercise-cognition. The findings provided insights into the development of public health initiatives to promote brain health and improve quality of life among breast cancer patients. TRIAL REGISTRATION NUMBER: ChiCTR 2,000,033,152.

Beneficial Effects of Baduanjin Exercise on Left Ventricular Remodelling in Patients after Acute Myocardial Infarction: an Exploratory Clinical Trial and Proteomic Analysis.

BACKGROUND: The beneficial effects of physical exercise on cardiac remodelling improvement after myocardial infarction have already been suggested. However, the results of previous clinical trials have not been consistent. Moreover, the putative molecular mechanisms leading to the clinically observed effects of physical exercise still remain elusive. AIM: We aimed to evaluate whether the well-defined and strictly controlled traditional Chinese Qigong Baduanjin exercise (BE) would attenuate the adverse left ventricular (LV) remodelling in patients with ST-elevation myocardial infarction (STEMI). METHODS: A total of 110 clinically stable STEMI patients, following successful revascularization of their infarcted coronary arteries, were randomized and enrolled in two groups: 56 were subjected to a 12-week BE-based cardiac rehabilitation programme (BE group), and the remaining 54 were exposed to the usual physical exercise (control group) for the same time period. The primary outcome was the change from baseline to 6 months in the echocardiographic LV end-diastolic volume index (ΔLVEDVi). Proteomic analysis was also performed to uncover associated mechanisms. RESULTS: Compared with the control group, the BE group showed significantly lower ΔLVEDVi (-5.1 ± 1.1 vs. 0.3 ± 1.2 mL/m2, P < 0.01). Proteomic analysis revealed BE-induced variations in the expression of 80 proteins linked to regulation the of metabolic process, immune process, and extracellular matrix reorganization. Furthermore, correlation analyses between the validated serum proteomes and primary endpoint demonstrated a positive association between ΔLVEDVi and MMP-9 expression, but a negative correlation between ΔLVEDVi and CXCL1 expression. CONCLUSION: This is the first study indicating that BE in STEMI patients can alleviate adverse LV remodelling associated with beneficial energy metabolism adaptation, inflammation curbing, and extracellular matrix organization adjustment.

Effect of Baduanjin exercise on cognitive function in patients with post-stroke cognitive impairment: a randomized controlled trial.

OBJECTIVE: To investigate the effectiveness and safety of Baduanjin training on the cognitive function in stroke survivors with cognitive impairment. DESIGN: A randomized, two-arm parallel controlled trial with allocation concealment and assessors blinding. SETTING: Community centre of Fuzhou city, China. SUBJECTS: A total of 48 participants were recruited and randomly allocated into the Baduanjin exercise intervention or control group. INTERVENTIONS: The control group maintained original medication and rehabilitation treatment. The Baduanjin training group received 24-week Baduanjin training with a frequency of three days a week and 40 minutes a day based on original medication and rehabilitation treatment. MAIN OUTCOME MEASURES: The primary outcome was global cognitive function. Secondary outcome measures included the specific domains of cognition (i.e. memory, processing speed, execution, attention and visuospatial ability) and activities daily living. RESULTS: In total, 41 (Baduanjin n = 22, control n = 19) participants completed 24-week treatment and data collection. Mean differences between groups at 24-week treatment were statistically significant for global cognitive function (MoCA: 2.54 (0.91 to 4.16)), execution (TMT-A: -42.4 (-75.0 to -9.8); TMT-B: -71.3 (-130.6 to -12.1)), memory (immediate recall: 2.11 (0.49 to 3.73); short-term delayed recognition: 2.47 (0.58 to 4.35) and long-term delayed recognition: 1.68(0.18 to 3.17)), attention (response time of alertness: -245.5 (-387 to -104)) and activities of daily living (modified Barthel Index). CONCLUSION: Regular Baduanjin training is associated with less loss of cognitive function in patients after stroke.

Baduanjin exercise for chronic obstructive pulmonary disease: an updated systematic review and meta-analysis.

OBJECTIVE: To objectively evaluate the effectiveness of Baduanjin exercise on cardiopulmonary function and quality of life in chronic obstructive pulmonary disease patients. DATA SOURCES: Articles published in PubMed, EMBASE, China National Knowledge Infrastructure Database, the Cochrane Library, Wanfang Database, and China Biological Medicine Database from inception to March 2020. REVIEW METHOD: Articles on randomized controlled trials about Baduanjin exercise for the treatment of chronic obstructive pulmonary disease were identified. Cochrane handbook was applied to assess the quality of included trials. Stata (version 14.0) and Review Manager (version 5.3) were employed for data analysis. Mean difference with 95% confidence intervals were calculated for pulmonary function, 6-minute walking distance, and the quality of life. RESULTS: Thirty-one randomized controlled trials including 3045 patients were included. The result of meta-analysis indicated that comparing with any other type of treatment alone, Baduanjin exercise combined other type of treatment revealed well efficacy in improving exercise capability on 6-minute walking distance (mean difference = 43.83, 95% confidence interval (29.47, 58.20), P < 0.00001), forced expiratory volume in 1 second (mean difference = 0.23, 95% confidence interval (0.15, 0.31), P < 0.00001), forced volume vital capacity (mean difference = 0.19, 95% confidence interval (0.08, 0.30), P = 0.0007), the ratio of forced expiratory volume in the first second to forced vital capacity (mean difference = 3.85, 95% confidence interval (2.19, 5.51), P < 0.00001), and the quality of life in chronic obstructive pulmonary disease patients regarding the St. George respiratory questionnaire (mean difference = -7.71, 95% confidence interval (-10.54, -4.89), P < 0.00001) and chronic obstructive pulmonary disease assessment test (mean difference = -2.56, 95% confidence interval (-4.13, -1.00), P = 0.001). CONCLUSIONS: Baduanjin exercise could improve exercise capacity, pulmonary function, and quality of life for patients with chronic obstructive pulmonary disease.

Baduanjin Exercise Prevents post-Myocardial Infarction Left Ventricular Remodeling (BE-PREMIER trial): Design and Rationale of a Pragmatic Randomized Controlled Trial.

BACKGROUND: Left ventricular (LV) remodeling following myocardial infarction (MI) is an established prognostic factor for adverse cardiovascular events and the leading cause of heart failure. Empirical observations have suggested that Baduanjin exercise, an important component of traditional Chinese Qigong, may exert potential benefits on cardiopulmonary function. However, the impact of a Baduanjin exercise-based cardiac rehabilitation program for patients recovering from a recent MI has yet to be assessed. The aim of this trial is to evaluate the potential role of Baduanjin exercise in preventing the maladaptive progression to adverse LV remodeling in patients post-MI. METHODS: A total of 110 clinically stable patients following an MI after undergoing successful infarct-related artery reperfusion will be randomly assigned to the Baduanjin exercise group or usual exercise control group. In addition to usual physical activity, participants in the Baduanjin exercise group will participate in a 45 min Baduanjin exercise training session twice a week, for a total of 12 weeks. The primary endpoint will be the percentage change in LV end-diastolic volume index (LVEDVi) assessed using echocardiography from baseline to 6 months. CONCLUSION: The results of this study may provide novel evidence on the efficacy of Baduanjin exercise therapy in post-MI patients in reversing adverse LV remodeling and improving clinical outcome. TRIAL REGISTRATION: Clinical Trials.gov: NCT02693795.

Effects of Baduanjin exercise on the physical function of middle-aged and elderly people: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND PURPOSE: Chinese mind-body exercise-Baduanjin has received increasing attention for health promotion among middle-aged and older adults in China, but there is a lack of high-quality evidence on its effectiveness. This systematic review and meta-analysis was conducted to investigate the effects of Baduanjin on physical function in middle-aged and older adults. METHODS: Seven electronic databases were searched for articles published before 22 June 2021 with the keywords Baduanjin exercise combined with physical-function-related outcomes. Risk of bias was assessed in the included studies, and data were analyzed using Review Manager software V5.3. RESULTS: Fifteen articles, including 14 randomized controlled trials, were included in this study. The results of the meta-analysis showed that Baduanjin significantly improved muscle strength (grip strength: SMD = 0.63, 95% CI 0.22 to 1.04, p = 0.003), balance ability (timed up-and-go test score: MD = -2.21, 95% CI -3.91 to -0.51, p = 0.01; one-leg stand test score: MD = 3.75, 95% CI 1.96 to 5.55, p < 0.0001; Berg balance scale score: MD = 4.16, 95% CI 2.49 to 5.83, p < 0.00001; strengthening Romberg's test result: SMD = 1.02, 95% CI 0.17 to 1.86, p = 0.02); and cardiorespiratory fitness (diastolic blood pressure: MD = -3.62, 95% CI -3.95 to -3.30, p < 0.00001; resting heart rate: MD = -1.30, 95% CI -1.57 to -1.03, p < 0.00001; step test: MD = 4.25, 95% CI 0.76 to 7.74, p = 0.02). No adverse events were reported. CONCLUSIONS: Baduanjin exercise may be an effective intervention to improve physical function in the middle-aged and elderly population. However, more RCTs with larger sample sizes and more rigorous research designs are needed in the future to confirm the results.

Effect of Baduanjin exercise on primary osteoporosis: study protocol for randomized controlled trial.

BACKGROUND: Lack of exercise is often a major cause of chronic disease. Osteoporosis (OP) is a chronic disease with multifactorial co-morbidity. Baduanjin (BDJ) exercise may be a powerful tool for modifying risk factors. The aim is to provide more evidence about the effectiveness of BDJ exercise in improving pain and balance ability in patients with OP. METHODS: In the prospective randomized controlled trial, 160 participants will be recruited and randomized to the treatment group (BDJ exercise combined with Calcium carbonate and D3) or the control group (Calcium carbonate and D3) at 1:1 ratio. Participants in the treatment group will receive 24-week BDJ exercise for 30-60 min, 3 times a week, along with Calcium carbonate and D3 at each day, while participants in the control group will receive Calcium carbonate and D3 only. All outcome indicators will be measured at baseline, after the 6th month of treatment and 6th month after the end of treatment. The primary outcomes include pain and balance ability, as measured by the visual analogue scale (VAS) and Berg balance scale (BBS). The secondary outcomes will primarily include bone mineral density (BMD), laboratory tests (including P1NP, ß-CTX, MSTN, FDF-23, NPY), the timed "up and go" (TUG) test, the morse fall scale (MFS), the five-times sit-to-stand test (FTSST). DISCUSSION: The study will hopefully confirm that BDJ exercise, as a non-drug intervention, should be recommended for patients with OP to prevent bone loss, falls and fractures. TRIAL REGISTRATION: International standard randomized controlled trial number (ISRCTN) registry: ISRCTN76945140 registered on 07/06/2022.

Effects of Baduanjin exercise on quality-of-life and exercise capacity in patients with heart failure: A systematic review and meta-analysis.

PURPOSE: Exercise training is an efficient non-pharmacological intervention for patients with heart failure (HF). This study aimed to objectively evaluate the effects of Baduanjin exercise on the quality of life (QOL) and exercise capacity in patients with HF. METHODS: PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and Wanfang data were searched from the date of their inception until 30 September 2022. All randomised controlled trials (RCTs) evaluating the effects of Baduanjin exercise on QOL and exercise capacity in patients with HF were selected. The primary outcomes were QOL, assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and exercise capacity, evaluated using the 6-min walking test (6-MWT). A meta-analysis was performed by comparing the MLHFQ domain scores. Review Manager 5.3 and Stata 14.0, were used for the data analysis. RESULTS: Baduanjin exercise showed a favourable improvement of the overall QOL (mean difference = -8.25; 95% confidence interval: -13.62 to -2.89; P = 0.003) and exercise capacity (mean difference = 118.49; 95% confidence interval: 52.57 to 184.41; P = 0.0004). Meta-analyses of the MLHFQ domain score indicated that Baduanjin exercise significantly improved the patients' physical (mean difference = -2.83; 95% confidence interval: -3.76, -1.90; P < 0.00001), emotional (mean difference = -2.52; 95% confidence interval: -3.67 to -1.37; P < 0.0001), and general QOL (mean difference = -2.61; 95% confidence interval: -5.17 to -0.06; P = 0.05), based on the decrease in the MLHFQ domain score. Marked statistical heterogeneity (I2> 70%) was observed for all the QOL and exercise capacity outcomes. CONCLUSIONS: Baduanjin exercise is a safe, feasible, and acceptable intervention that can improve the QOL and exercise capacity in patients with HF. However, more RCTs with rigorous research designs are needed to assist in the rehabilitation of such patients.

Value of neutrophil-to-lymphocyte ratio for diagnosing sarcopenia in patients undergoing maintenance hemodialysis and efficacy of Baduanjin exercise combined with nutritional support.

Objective: To investigate the value of neutrophil-to-lymphocyte ratio (NLR) for diagnosing sarcopenia in patients undergoing maintenance hemodialysis (MHD) and efficacy of Baduanjin exercise combined with nutritional support on MHD patients with sarcopenia. Methods: A total of 220 patients undergoing MHD in MHD centers were selected, among which 84 had occurred with sarcopenia confirmed by measurements from the Asian Working Group for Sarcopenia. Data were collected for analyzing the influencing factors that lead to the onset of sarcopenia in MHD patients with the use of one-way analysis of variance and multivariate logistic regression. The role of NLR in the diagnosis of sarcopenia was explored, and its correlation with relevant diagnostic measurement performance such as grip strength, gait speed and skeletal muscle mass index was analyzed. In the end, some 74 patients with sarcopenia that qualify for further intervention and observation standards were divided into observation group (Baduanjin exercise plus nutritional support) and control group (nutritional support only), which were both intervened for 12 weeks. A total of 68 patients finished all interventions, with 33 patients in the observation group and 35 in the control group. The grip strength, gait speed, skeletal muscle mass index as well as the NLR were compared between the two groups. Results: With the employment of multivariate logistic regression analysis, it was found that age, hemodialysis duration and NLR were risk factors for the onset of sarcopenia in MHD patients (P < 0.05). The area under ROC curve for NLR of MHD patients with sarcopenia was 0.695, and NLR was negatively correlated with a biochemical indicator-human blood albumin (P < 0.05). NLR was also negatively correlated with patient's grip strength, gait speed and skeletal muscle mass index, with the same correlation found in sarcopenia patients (all P < 0.05). After intervention, patient's grip strength and gait speed were both higher, and the NLR lower in the observation group than those in the control group (P < 0.05). Conclusion: The occurrence of sarcopenia in MHD patients is associated with patient's age, hemodialysis duration and NLR. Therefore, it has been concluded that NLR has certain values in the diagnosis of sarcopenia in patients undergoing MHD. Moreover, the muscular strength can be enhanced and inflammation decreased in sarcopenia patients through nutritional support and physical exercise, i.e., Bajinduan exercise.

Quantitative Evidence of the effect of Baduanjin exercise on quality of life and cardiac function in adults with chronic heart failure.

BACKGROUND: This study aimed to assess the effects of Baduanjin exercise on the quality of life (QoL), cardiac function, and maximal oxygen consumption (VO2max) in patients with chronic heart failure (CHF). METHODS: A systematic search of relevant literature published from inception until February 2023 was performed in the Scopus, PubMed, MEDLINE, CINAHL, Cochrane Library, SPORTDiscus, and China National Knowledge Infrastructure databases. We included randomized controlled trials (RCTs) that examined the effects of Baduanjin exercise on QoL (Minnesota Living with Heart Failure Questionnaire [MLHFQ]), cardiac function (N-terminal B-type natriuretic peptide [NT-Pro BNP] and left ventricular ejection fraction [LVEF]), and VO2max in patients with CHF. RESULTS: Fifteen studies (1180 participants) were included in this analysis. The synthesized results suggested that Baduanjin exercise contributed to significant improvements in the MLHFQ scores (standard mean difference [SMD] = 1.10, 95% confidence interval [CI]: 0.81 to 1.39, p < 0.001), NT-Pro BNP levels (SMD = 0.62, 95% CI: 0.31 to 0.93, p < 0.01), LVEF (SMD = 0.53, 95% CI: 0.18 to 0.88, p < 0.01), and VO2max (SMD = 0.92, 95% CI: 0.24 to 1.60, p < 0.001) compared with the results of the control groups. Subgroup analyses revealed that engaging in Baduanjin exercise 5-7 times per week was more effective in improving the MLHFQ score compared with 3-4 times per week (p = 0.04). CONCLUSION: Evidence from the meta-analysis support the beneficial effects of Baduanjin exercise on the QoL, cardiac function, and VO2max in patients with CHFin China. For optimal QoL improvements, it is recommended to engage in Baduanjin exercise 5-7 times per week for 30-60 min, over a duration of at least 8 weeks. In terms of NT-Pro BNP, Baduanjin exercise sessions of 30-60 min, 2-7 times per week, for a minimum of 8 weeks are recommended.

Efficacy of traditional Chinese exercise (Baduanjin) on patients with stable COPD: A systematic review and meta-analysis.

BACKGROUND: COPD is a prevalent and intractable chronic airway disease. At present, COPD is one of the diseases with the highest morbidity and mortality in the world; and causes a significant economic burden to patients and society. As a traditional exercise, the Baduanjin exercise has been inherited in China for hundreds of years. However, the treatment effects of Baduanjin exercise are controversial. This systematic review was designed to evaluate the efficacy of Baduanjin exercise in patients with stable chronic obstructive pulmonary disease. METHODS: Published articles were searched in nine English and Chinese databases from inception to December, 2022. Two investigators conducted study selection and data extraction independently. Review Manager software 5.4 were implemented for data synthesis and analysis. Quality assessment for each study was based on the modified PEDro scale. RESULTS: This review included 41 studies with 3835 participants with stable COPD. Compared with the control group, the pooled data of Baduanjin exercise group showed significant improvements in the following outcomes (mean difference, 95 % confidence interval): FVC (0.29, 0.25-0.33), FEV1 (0.27, 0.22-0.33), FEV1% (5.38, 4.38-6.39), FEV1/FVC (5.16, 4.48-5.84), 6MWD (38.57, 35.63-41.51), CAT (-2.30, -2.89 to -1.70), mMRC (-0.57, -0.66 to -0.48), SGRQ (-8.80, -12.75 to -4.86), HAMA (-7.39, -8.77 to -6.01), HAMD (-7.80, -9.24 to -6.37), SF-36 (8.63, 6.31-10.95). CONCLUSIONS: Baduanjin exercise may have the potential to enhance lung function, exercise capacity, health status, mental status, and quality of life for patients with stable COPD. ETHIC AND DISSEMINATION: This study is a systematic review and it does not involve harming the rights of participants. Ethical approval will not be required for this study. The research results may be published in a peer-reviewed journal.

Baduanjin exercise for patients with breast cancer: A systematic review and meta-analysis.

OBJECTIVE: Baduanjin exercise is a traditional Chinese mind-body exercise routine characterized by slow, coordinated, and sequential movements. We have performed the first meta-analysis on the main effect of Baduanjin exercise in patients with breast cancer. METHODS: This study followed the 2020 PRISMA guideline. We searched for randomized controlled trials in PubMed, Embase, Cochrane Library, Web of Science, Clinical Trials.gov, Chinese National Knowledge Infrastructure, Wanfang Data Information Site, Chinese Biomedical Database, and Chinese Science and Technique Journals Database through 31 August 2022. Data were analyzed for the outcomes of quality of life, anxiety, and depression. Review Manager 5.4 software was used for data analysis. RESULTS: Seven randomized controlled trials with a total of 537 patients with breast cancer were examined. Compared with the control therapies, Baduanjin exercise significantly improved the total quality of life score (SMD = 0.83; 95 % CI, 0.58-1.08; P < 0.00001) and in two associated domains: emotional well-being (SMD = 0.67; 95 % CI, 0.26-1.07; P = 0.001), functional well-being (SMD = 0.55; 95 % CI, 0.30-0.79; P < 0.00001) and breast cancer subscale (SMD = 0.39; 95 % CI, 0.02-0.77; P = 0.04). Meanwhile, it significantly reduced anxiety score (SMD = - 0.60; 95 % CI, - 1.15 to - 0.05; P = 0.03) and in depression score (SMD = - 0.70 95 % CI, - 0.97 to - 0.42; P < 0.00001). None adverse event was reported. CONCLUSION: The meta-analysis suggests that Baduanjin exercise is an effective and safe exercise for improving quality of life and alleviating depression and anxiety in patients with breast cancer. Significant methodological concerns of the included studies limit the interpretation of the results. For future trials of Baduanjin exercise on BC, we highlight the importance of adopting more rigorous study design in terms of assessor blinding, hypothesis/purpose blinding, allocation concealment, objective outcome selection and consistent reporting of adverse events.

Baduanjin exercise for balance function in community-dwelling older adults with cognitive frailty: a randomized controlled trial protocol.

BACKGROUND: Balance function provides a physiological link between the physical and cognitive function, and is a potential predictor for cognitive frailty. As a gentle mind-body exercise, Baduanjin can develop flexibility and co-ordination, thus would be is helpful for the improvement of balance function. This trial will evaluate the effect of Baduanjin on balance function in older adults with CF. METHODS/DESIGN: A total of 72 community-dwelling older adults with CF will be recruited and randomly allocated (1:1) into the Baduanjin exercise group or usual physical activity control group. All participants will undergo a health education program on nutrition and diet-related knowledge for 6 sessions (30 min per session) during the intervention period. Moreover, participants in the Baduanjin exercise group will receive a 24-week Baduanjin training course of 60 min per session and 3 sessions per week, while those in the usual physical activity control group will be required to maintain their original physical activity. Primary and secondary outcomes will be measured at baseline and after the 24-week intervention period. A mixed linear model will be constructed to analyse the intervention effects. DISCUSSION: This protocol presents an objective design of a randomized, single-blind trial that will evaluate the effectiveness and safety of traditional Chinese mind-body exercise Baduanjin training on the balance ability of community-dwelling older adults with cognitive frailty. If the results are as expected, this trial will provide evidence of the effect of Baduanjin exercise on balance in an older community-based population. TRIAL REGISTRATION: This trial was registered in the Chinese Clinical Trial Registry with code ChiCTR2100050857 and was approved on 5 September 2021.

Effects of Home-Based Baduanjin Exercise on Left Ventricular Remodeling in Patients With Acute Anterior ST-Segment Elevation Myocardial Infarction: Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Left ventricular (LV) remodeling after ST-segment elevation myocardial infarction (STEMI) is a major pathological basis associated with heart failure and increased mortality. Exercise-based cardiac rehabilitation has been verified to significantly improve prognosis and quality of life. As a traditional Chinese Qigong, Baduanjin exercise has effectively alleviated adverse LV remodeling in STEMI patients. Despite this, participation in exercise rehabilitation remains low, and home-based exercise rehabilitation may be an alternative approach. Besides, anterior STEMI is reported to have higher risk of adverse LV remodeling. However, the efficiency regarding home-based Baduanjin exercise on LV remodeling in anterior STEMI patients remains uncertain currently. METHODS/DESIGN: A single-blind, randomized controlled clinical trial was conducted to explore the efficacy and safety of home-based Baduanjin exercise in anterior STEMI patients compared with moderate intensity aerobic walking. A total of 114 participants were assigned randomly to the Baduanjin group or walking control group at a 1:1 ratio. Eligible participants practiced Baduanjin or walking exercise (5 times a week) for 12 weeks, and then followed up for another 12 weeks. The primary outcome is a relative change in the LV end-diastolic volume. The secondary outcomes include the plasma levels of hypersensitive C-reactive protein and interleukin 6, health-related quality of life measured by EQ-5D-5L, LV ejection fraction, patient health questionnaire-9, generalized anxiety disorder screener-7, short physical performance battery score, and clinical endpoint events. The proportion of circulating regulatory T-cells were also assessed. Adverse events were recorded throughout the trial for safety evaluation. Data were be analyzed by researchers blinded to the treatment allocation. DISCUSSION: This study provided powerful evidence for the use of home-based Baduanjin exercise in anterior STEMI patients in alleviating LV remodeling and improving clinical outcomes. TRIAL REGISTRATION: The Research Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine has approved this study (ZYYECK[2020]045). Written informed consent of patients were required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2100047298). DISSEMINATION: Our results will be published in peer-reviewed journals and disseminated through academic conferences and the Internet.

Exploring the therapeutic mechanism of Baduanjin in the treatment of elderly stable angina pectoris based on the gut microbiota-lipid metabolism spectrum: Study protocol for a randomized controlled trial.

Importance: Stable angina pectoris (SAP) often occurs in the elderly and is relatively stable for 1-3 months; however, if patients do not receive effective treatment, life-threatening acute myocardial infarction could occur. Patients with different clinical types of coronary heart disease have different intestinal flora. Baduanjin, a traditional Chinese Qigong, has been used as adjuvant therapy to improve the symptoms of patients with SAP. Objective: To determine the effect of Baduanjin exercise on the symptoms of patients with SAP and the intestinal flora, explore the action links and targets of Baduanjin intervention in elderly patients with SAP, and explain its mechanism. Design: A single-center, single-blind, randomized controlled trial. Patients and outcome assessors were blinded to group allocation. Setting: The trial will be conducted at Guang'anmen Hospital of China Academy of Chinese Medical Sciences. Participants: One hundred and eighty patients aged 60 to 80 years with stable angina pectoris (I-III) were intervened for 8 weeks and followed up for half a year. Interventions: Among the screened patients, 180 patients will be randomly assigned to either the Baduanjin or the control group at a 1:1 ratio (exercise duration: for 3-5 times a week, for 8 weeks) of moderate-intensity Baduanjin or free activities. Main and secondary results: The main result is the total effective rate for angina pectoris symptoms; secondary results include the duration of angina pectoris, number of angina pectoris episodes per week, nitroglycerin consumption, nitroglycerin reduction rate, Seattle angina score (SAQ), quality of life (SF-36),Traditional Chinese Medicine (TCM) syndrome scores, electrocardiogram (ECG) changes, blood lipid serum hypersensitive C-reactive protein levels, intestinal flora changes, serum changes in the intestinal flora metabolite Trimetlylamine oxide (TMAO), and non-targeted liposome detection. Adverse events will be recorded throughout the experiment, and the data will be analyzed by researchers who did not know about the assignment. Discussion: This study provides compelling evidence for at-home use of Baduanjin exercise to relieve SAP-associated symptoms. Trial registration: This study was approved by the ethics committee of Guang'anmen Hospital of China Academy of Chinese Medical Sciences (2022-121-KY). The trial has been registered in Chinese Clinical Trial Registration Center (ChiCTR2200062450).

Baduanjin exercise ameliorates motor function in patients with post-stroke cognitive impairment: A randomized controlled trial.

BACKGROUND AND PURPOSE: As a traditional Chinese mind-body exercise, Baduanjin has been documented to have a positive effect on cognitive and physical function in a wide range of populations, but it is unclear whether it helps improve motor function in patients with post-stroke cognitive impairment (PSCI). The aim of this two-arm, randomized, parallel controlled study was to explore the rehabilitation effect of Baduanjin exercise on motor function in patients with PSCI. MATERIALS AND METHODS: Forty-eight patients with PSCI were randomly assigned to control and intervention groups. The control group received health education sessions on stroke prevention and rehabilitation. The intervention group received Baduanjin training in addition to the health education intervention. Before and after the 24-week intervention, both groups completed the Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), Manual Muscle Test (MMT), Modified Ashworth Scale (MAS), and Three-Dimensional Gait Analysis (3DGA). RESULTS: After the 24-week intervention, both groups showed significant improvements in the FMA, BBS, MMT and MAS test results, but the Baduanjin group exhibited significantly better FMA, BBS and MMT test results than the control group (all P < 0.05). Furthermore, the Baduanjin exercise group showed significant improvements in spatial gait parameters, including the step length, walking speed and cadence, which were significantly better than the control group (all P < 0.05). No adverse events were reported during the study period. CONCLUSION: The 24-week Baduanjin exercise training may improve the limb motor function, balance, muscle strength and gait function of individuals with PSCI.

Effects of cognitive behavior therapy combined with Baduanjin in patients with colorectal cancer.

BACKGROUND: Cancer-related fatigue (CRF) is the most common concomitant symptom in the treatment of colorectal cancer (CRC). Such patients often present with subjective fatigue state accompanied by cognitive dysfunction, which seriously affects the quality of life of patients. AIM: To explore the effects of cognitive behavior therapy (CBT) combined with Baduanjin exercise on CRF, cognitive impairment, and quality of life in patients with CRC after chemotherapy, and to provide a theoretical basis and practical reference for rehabilitation of CRC after chemotherapy. METHODS: Fifty-five patients with CRC after radical resection and chemotherapy were randomly divided into either an experimental or a control group. The experimental group received the intervention of CBT combined with exercise intervention for 6 mo, and indicators were observed and measured at baseline, 3 mo, and 6 mo to evaluate the intervention effect. RESULTS: Compared with the baseline values, in the experimental group 3 mo after intervention, cognitive function, quality of life score, and P300 amplitude and latency changes were significantly better (P < 0.01). Compared with the control group, at 3 mo, the experimental group had significant differences in CRF, P300 amplitude, and quality of life score (P < 0.05), as well as significant differences in P300 latency and cognitive function (P < 0.01). Compared with the control group, at 6 mo, CRF, P300 amplitude, P300 latency, cognitive function and quality of life score were further improved in the experimental group, with significant differences (P < 0.01). The total score of CRF and the scores of each dimension were negatively correlated with quality of life (P < 0.05), while the total score of cognitive impairment and the scores of each dimension were positively correlated with quality of life (P < 0.05). CONCLUSION: CBT combined with body-building Baduanjin exercise can improve CRF and cognitive impairment in CRC patients after chemotherapy, and improve their quality of life.

Baduanjin exercise: A potential promising therapy toward osteoporosis.

Purpose: Baduanjin (BDJ) exercise is a traditional exercise that combines breathing, body movement, meditation and awareness to help delay the onset and progression of senile degenerative musculoskeletal diseases, such as osteoporosis (OP). The aim of this meta-analysis is to evaluate the efficacy of BDJ exercise, and preliminarily infer its effective mechanism in the treatment of OP. Methods: We identified relevant randomized controlled trials (RCTs) through eight databases, and compared BDJ exercise with the control groups (including blank control and conventional treatment intervention). The main outcome measure was bone mineral density (BMD), the additional outcome measures were visual analogue scale (VAS), Berg balance scale (BBS), serum Calcium (Ca), serum Phosphorus (P), serum Alkaline phosphatase (ALP), and serum bone gla protein (BGP). Meta-analysis and trial sequence analysis (TSA) were performed using RevMan 5.4, Stata 16.0, and TSA 0.9. Results: In total, 13 RCTs involving 919 patients were included in the analysis. For postmenopausal osteoporosis, BDJ exercise alone and BDJ exercise combined with conventional treatment can improve the BMD of lumbar spine. BDJ exercise alone can influence serum Ca and ALP. BDJ exercise combined with conventional treatment can improve balance (BBS) and influence serum BGP. For senile osteoporosis, BDJ exercise alone and BDJ exercise combined with conventional treatment can improve balance (BBS). BDJ exercise combined with conventional treatment can improve the BMD of hip and pain relieve (VAS). For primary osteoporosis, BDJ exercise combined with conventional treatment can improve the BMD of lumbar spine and femoral neck. Conclusion: Baduanjin exercise may be beneficial to improve BMD, relieve pain, improve balance ability, influence serum BGP and serum ALP in patients with OP, but differences occur due to various types of OP. Due to the low quality of research on the efficacy and mechanism of BDJ exercise in the treatment of OP, high-quality evidence-based research is still needed to provide reliable supporting evidence. Systematic Review Registration: [http://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022329022].

Baduanjin's impact on quality of life and sleep quality in breast cancer survivors receiving aromatase inhibitor therapy: a randomized controlled trial.

Purpose: The aim of the current study is to investigate the impact of Baduanjin, a traditional Chinese exercise, on quality of life and sleep quality in breast cancer survivors receiving aromatase inhibitor (AI) therapy. Methods: A total of 72 breast cancer survivors who had received AI treatment for more3 than 6 months were enrolled in the current study using non-probability consecutive sampling procedure. Participants were randomly assigned in a 1:1 ratio to a 12-week Baduanjin exercise program or to a wait-list control group. The Baduanjin exercise group performed two 90-min supervised sessions per week. The primary outcomes were changes in quality of life measured by the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (EORTC QLQ-C30) and in sleep quality evaluated using the Pittsburgh Sleep Quality Index (PSQI). Results: A total of 68 participants completed the trial (Baduanjin exercise group: n = 33; control group: n = 35). Baseline values for quality of life did not differ between groups. Both global quality of life and physical functioning scores increased significantly by 12.39 (P < 0.001) and 8.48 (P < 0.001) in the Baduanjin exercise group compared with those in the control. Overall PSQI score also decreased by 4.85 (P < 0.001) in the Baduanjin exercise group, whereas it increased by 0.34 in the control group. Conclusion: Baduanjin exercise training led to improvement in the quality of life and sleep quality of breast cancer patients undergoing AI therapy.