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

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. 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. 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 to 1.08; P<0.00001) and in two associated domains: emotional well-being (SMD=0.67; 95% CI, 0.26 to 1.07; P=0.001), functional well-being (SMD=0.55; 95% CI, 0.30 to 0.79; P<0.00001) and breast cancer subscale (SMD=0.39; 95% CI, 0.02 to 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. 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. • This is the first meta-analysis on the main effect of Baduanjin exercise in patients with breast cancer. • Our main finding is Baduanjin is an effective and safe exercise for improving quality of life and alleviating depression and anxiety in patients with breast cancer. • We also found Baduanjiin alleviates anxiety and depression symptoms of breast cancer patients. • For future trials of Baduanjin exercise on breast cancer, 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.