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

Author: Xiaolin Wei1,2, Ruzhen Yuan2,3, Juan Yang4, Wei Zheng5, Yongmei Jin6, Mingyue Wang2, Jieting Jiang2, Caiqin Wu7, Kunpeng Li8
Affiliation: <sup>1</sup> Department of Gynaecology, Obstetrics and Gynaecology Hospital, Fudan University, Shanghai, China. <sup>2</sup> School of Nursing, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China. <sup>3</sup> Department of Nursing, East Hospital Affiliated to Tongji University, Shanghai, China. <sup>4</sup> Department of Breast Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China. <sup>5</sup> Department of Breast Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China. <sup>6</sup> Department of Nursing, the Seventh People&#x27;s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China. <sup>7</sup> School of Nursing, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China. yuwuchina@aliyun.com. <sup>8</sup> School of Rehabilitation Medicine, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China. 312523418@qq.com.
Conference/Journal: Support Care Cancer
Date published: 2022 Apr 13
Other: Special Notes: doi: 10.1007/s00520-022-07015-4. , Word Count: 291


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: β = 0.132; 95% CI 0.046 to 0.237) and the improvement of anxiety (indirect effect: β = - 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.

Keywords: Baduanjin exercise; Breast cancer; Cancer-related symptoms; Cognitive function; Quality of life.

PMID: 35416502 DOI: 10.1007/s00520-022-07015-4