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

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.