Baduanjin exercise for patients with ischemic heart failure on phase-II cardiac rehabilitation (BEAR trial): study protocol for a prospective randomized controlled trial

Abstract

BackgroundPreliminary evidence based on clinical observations suggests that meditative exercise may offer potential benefits for patients with chronic heart failure (CHF). Cardiac rehabilitation (CR), as a class-IA indication in clinical practice guidelines, has been established as an effective strategy to improve quality of life and prognosis of CHF patients. Baduanjin exercise is an important component of traditional Chinese Qigong exercises. However, its benefits for CHF have not been rigorously tested. We sought to investigate whether Baduanjin, as an adjunct to standard care, improves cardiopulmonary function, exercise tolerance, and quality of life in patients with CHF caused by coronary artery disease (CAD).Methods/designIn this randomized controlled trial, 120 patients will be randomly allocated in a 1:1 ratio to Baduanjin exercise combined with conventional exercise of CR (Baduanjin exercise group) or conventional exercise of CR alone (conventional exercise group). In addition to conventional physical activity, participants in the Baduanjin exercise group will participate in a 45-min Baduanjin exercise training session twice a week, for 12 weeks. The primary outcome is walking distance in the 6-min Walk Test (6MWT), and the secondary outcomes are peak oxygen uptake (VO2 peak), ventilatory anerobic threshold (VAT), The minute ventilation to carbon dioxide production relationship (VE/VCO2 slope), left ventricular end-diastolic volume index (LVEDVi), left ventricular ejection fraction (LVEF), quality of life assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), amino-terminal pro-brain natriuretic peptide (NT-proBNP), hs-CRP, heart rate variability (HRV), New York Heart Association (NYHA) classification, and major adverse cardiovascular events.DiscussionThis is the first trial to evaluate the effects of a Baduanjin exercise-based CR program on cardiopulmonary function and exercise tolerance in ischemic CHF patients. If successful, it will prove the value of Baduanjin exercise in improving cardiopulmonary function and exercise tolerance in patients with ischemic heart failure on phase-II CR, and may further develop a Chinese Qigong exercise-based CR framework.Trial registrationClinicalTrials.gov, ID: NCT03229681. Registered retrospectively on 23 July 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2759-4) contains supplementary material, which is available to authorized users.

Updated Meta-Analysis Assessing Effects of Baduanjin on Cardiopulmonary Functions of Patients with Coronary Heart Disease

“…In addition, the cardiopulmonary exercise test is a practical tool to evaluate the exercise capacity of cardiac failure patients, in which peak VO 2 , VO 2 , VAT, and VE/VCO 2 are important indicators [ 38 ]. Yu et al enrolled 120 patients with ischemic heart failure in CR training and found that patients who received an additional 45 minutes of Baduanjin training showed significant improvement in exercise ability indexes, including 6MWT, peak VO 2 , VE/VCO 2 , LVEF, and NT-proBNP [ 39 ]. This conclusion demonstrates the benefit of Baduanjin in improving cardiopulmonary function in patients with heart failure, which is considered to be an end-stage state of cardiovascular disease, including CHD [ 40 ], thus supporting our findings to a certain degree.…”

Eight-Section Brocade Exercises Improve the Sleep Quality and Memory Consolidation and Cardiopulmonary Function of Older Adults With Atrial Fibrillation-Associated Stroke

“…Eight-section brocade can maintain the stability of LVEF and enhance the contractility of myocardium, thus relieving pressure on the heart and reducing thickness of the LVPW (Mao et al, 2016). The effect of ESB on cardiac function is closely related to the exercise approach (Yu et al, 2018). ESB focuses on movements with the combination of breathing and mind (Li et al, 2015).…”

“…Eight-section brocade (ESB, Chinese name Baduanjin) is a traditional Chinese Qigong and one of the most widely used methods in traditional Chinese health (Spiegel et al, 2009; Liu S.J. et al, 2018; Yu et al, 2018; Atti et al, 2019; Lu et al, 2019; Xie Y. et al, 2019; Ying et al, 2019). ESB brocade consists of eight separate moderate-intensity aerobic exercises (Liu T. et al, 2018), which are intended to be soothing, natural, and easy-to-learn.…”

Effects of Baduanjin exercise on essential hypertension

“…Research has shown that [ 14 ] traditional Chinese exercise can effectively reduce SBP and DBP in patients, thereby improving symptoms in patients with cardiovascular disease. Some studies have shown that Baduanjin exercise as an alternative treatment for cardiovascular patients can improve the health of cardiovascular patients and reduce the occurrence of cardiovascular risk factors.…”