Effectiveness of mind-body exercise via Baduanjin on physical and psychological outcomes in patients with pulmonary ground-glass nodules: A non-randomized controlled pilot study
Affiliation:
1. Chinese Qigong Laboratory, Shanghai Qigong Research Institute, Shanghai, China;2. Taiji Health Center, Shanghai University of TCM/Shanghai Academy of TCM, Shanghai, China;3. Department of Respiratory Medicine, Pudong Branch, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China;4. Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China;5. Sports Training Department, Shanghai Martial Arts Sports Management Center/Shanghai Health Qigong Management Center, Shanghai, China;6. Inpatient Department, Shanghai Civil Affairs Geriatric Hospital, Shanghai, China;1. University of Missouri Sinclair School of Nursing, Columbia, MO, USA;2. Ellis Fischel Cancer Center, University of Missouri, Columbia, MO, USA;3. Beyster Institute of Nursing Research, University of San Diego Hahn School of Nursing and Health Services, University of San Diego, California, USA;1. Istanbul Medipol University, Institute of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey;2. Istanbul Medipol University, Faculty of Medicine, Department of General Surgery, Istanbul, Turkey;3. Istanbul Medipol University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey;1. Yong In University, Yong In, South Korea;2. Shenzhen College of International Education, China;3. Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong-Shenzhen, Shenzhen, China;1. Department of Rehabilitation, Ningbo Zhenhai Longsai Hospital, Ningbo, 315299, China;2. The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China;3. Department of Acupuncture, Zhejiang Hospital, Hangzhou, 310013, China;4. Department of Acupuncture, Hangzhou Geriatric Hospital, Hangzhou, 310000, China;5. Rehabilitation Department, Mianyang Hospital of TCM, Sichuan, 621063, China;6. Department of Manipulation, Zhejiang Hospital, Hangzhou, 310030, China;7. Department of Acupuncture, Tonglu Hospital of TCM, Hangzhou, 311599, China;1. Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan;2. Department of Rehabilitation and Physical Medicine, Mito Clinical Education and Training Center, University of Tsukuba Hospital, Mito, Japan;3. Department of Rehabilitation, Nippon Medical School Chiba Hokusoh Hospital, Inzai City, Chiba, Japan;4. Department of Rehabilitation, Kagoshima University Hospital, Kagoshima, Japan;5. Department of Rehabilitation, Acras Central Hospital, Kagoshima, Japan;1. School of Health and Rehabilitation Science, Department of Physical Therapy, University of Pittsburgh, USA;2. UPMC Health Plan – Department of Health Economics, USA;3. Physical Medicine & Rehabilitation Services, Butler VA Healthcare System, USA;4. VA Pittsburgh Healthcare System, Pittsburgh, PA, USA;5. Department of Medicine, Health Science Library System, University of Pittsburgh, USA
Abstract:
BackgroundWith the increasing incidence and mortality of lung cancer, ground-glass nodules (GGNs) have become an ongoing public health concern. In clinical practice, the physical and psychological distress of GGN patients is easy to overlook during the follow-up after diagnosis. Such patients typically have limited medical options and few of these options involve mind-body exercises.ObjectiveThe purpose of this pilot study was to explore the effectiveness of the mind-body exercise Baduanjin on physical and psychological outcomes among GGN patients.DesignWe conducted a prospective, non-randomized, controlled, assessor-blinded trial (ClinicalTrials.gov: NCT03420885).SettingThis trial was conducted at three medical sites, both located in Shanghai, China, between April 2017 and January 2020.ParticipantsPatients with GGN.InterventionSixty GGN participants were divided into a health education control group only receiving health education (n = 30) and a Baduanjin intervention group receiving health education plus a Baduanjin training program (n = 30). Both groups were treated for 16 weeks.Outcome measurementsOutcomes were assessed at baseline and week 16. The primary outcomes included pulmonary function (FVC, FVC%, FEV1, FEV1/FVC, PEF) and psychological condition (SAS score, SDS score). The secondary outcome was quality of life (SF-36).ResultsCompared with the health education control group, the Baduanjin intervention group had significant improvements in pulmonary function (FVC, FVC%, FEV1), psychological outcomes (SAS score, SDS score), and quality of life (SF-36). The significant differences in pre-intervention and post-intervention between groups were as follows: FVC (MD = 0.21, 95%CI: 0.10 to 0.33, P = 0), FVC% (MD = 6.90, 95%CI: 3.10 to 10.70, P = 0.001), FEV1 (MD = 0.18, 95%CI: 0.07 to 0.29, P = 0.001); SAS score (MD = −4.90, 95%CI: −8.28 to −1.52, P = 0.005), SDS score (MD = −5.83, 95%CI: −9.46 to −2.21, P = 0.002); physical component summary (PCS) of SF-36 (MD = 5.03, 95%CI: 2.54 to 7.51, P = 0), mental component summary (MCS) of SF-36 (MD = 5.78, 95%CI: 2.64 to 8.92, P = 0.001). Linear regression analysis was performed to study the influence of confounder variables on the improvements of primary outcomes, and no significant change was found. Moreover, Pearson correlation coefficient analysis demonstrated that ameliorations in lung function (FVC, FVC%, FEV1, FEV1/FVC, and PEF) were significantly associated with a decrease in anxious symptoms and depressive symptoms.ConclusionGGN patients in the Baduanjin intervention group showed greater benefits in pulmonary function and psychological outcomes than those in the health education control group, and the effectiveness was stable. The findings support Baduanjin as an effective, safe, enjoyable, and promising complementary intervention for management of GGN in patients with physical and psychological distress.
