Review of Baduanjin and resistance exercise for the mental health of patients with hematologic malignancies

Abstract

Patients with hematological tumors experience physical and psychological stress, and negative psychological states. Baduanjin, an emerging psychological rehabilitation method combined with resistance exercise, has received widespread attention. This study reviews the current status of the application of Baduanjin combined with resistance exercise in improving the negative psychological state of patients with hematological tumors and discusses its problems and prospects. Through a literature review and comprehensive analysis, the application of Baduanjin and resistance exercise in the psychological rehabilitation of patients with hematological tumors was identified and evaluated. The results showed that Baduanjin with resistance exercise had a positive effect on improving negative psychological states of patients with hematological tumors, which can alleviate anxiety, depression, and other adverse emotions, and improve quality of life. However, there is a lack of unified and standardized exercise intervention programs for practical application, and patient participation and compliance must be improved. Baduanjin combined with resistance exercise can potentially improve the negative psychological status of patients with hematological tumors; however, it is still necessary to further standardize and improve the exercise program improving patient participation and compliance. Future studies should strengthen theoretical exploration and empirical research, providing more effective psychological rehabilitation strategies for patients with hematological tumors.

Key Words: Hematological tumors; Baduanjin; Resistance exercise; Negative psychological state; Psychological rehabilitation

Core Tip: Baduanjin and resistance exercise can improve the psychological state of patients with hematological tumors; however, the exercise program needs to be standardized, and patient participation and compliance need to be improved.

INTRODUCTION

With the transformation of medical models and continuous development of rehabilitation medicine, the importance of psychological interventions in the rehabilitation of patients with hematologic malignancies is becoming increasingly prominent[1]. Patients with hematological tumors often suffer from anxiety, depression, and other negative emotions owing to the physical and mental pressure caused by the disease itself and the treatment process, which seriously affect their quality of life and therapeutic effects[2]. Therefore, finding an effective psychological intervention is of great significance for improving the negative psychological state of patients with hematological tumors[3]. In recent years, Baduanjin, combined with resistance exercises, has gradually received attention from clinicians and researchers as a new type of psychological intervention. As a traditional Chinese fitness method, Baduanjin regulates breathing and relaxes the body and mind, whereas resistance exercise improves physical function by increasing muscle strength and endurance, which helps enhance patients’ self-confidence and positive emotions. The combination of the two can jointly improve the negative psychological state of patients with hematological tumors at both the physiological and psychological levels (Figure 1).

Figure 1 Flowchart of Baduanjin.

This review aims to systematically summarize the current status of the application of Baduanjin combined with resistance exercise to improve the negative psychological state of hematological tumor patients, including its application methods, effect assessment, and possible action mechanisms. Summarizing the existing research results provides a reference for clinical practice and suggests future research directions and development trends. We expect that this review will promote a wider application and in-depth study of Baduanjin combined with resistance exercises in the rehabilitation of patients with hematological tumors.

EPIDEMIOLOGY OF HEMATOLOGICAL TUMORS

Hematological neoplasms are a group of malignant tumors originating in the hematopoietic system and include various types, such as leukemia, lymphoma, and myeloma[4]. These diseases are characterized by the proliferation of abnormal cells in the bone marrow or other hematopoietic tissues, leading to the impairment of normal hematopoietic function, which, in turn, affects multiple organ systems throughout the body. In recent years, the prevalence of hematological tumors has shown an increasing trend with the aggravation of factors, such as environmental pollution, lifestyle changes, and population aging[5]. According to data released by the International Agency for Research on Cancer of the World Health Organization, the number of new cases of hematological tumors worldwide in 2023 was approximately 1.28 million, and the number of deaths was 650000[6]. These data show that hematological tumors seriously affect human health, with high morbidity and mortality rates.

The increasing trend in the number of patients with hematological tumors may be related to the interaction of several factors, including environmental pollution, poor lifestyle, hereditary factors, and increased diagnosis of the disease as a result of advances in medical technology[7]. The incidence of hematological tumors shows different characteristics at different age stages[8,9]. Certain types of leukemia are relatively more common in childhood. which may be related to the developmental characteristics of the child’s immune system and environmental factors[10,11]. In adults and older people, the incidence of hematological neoplasms, such as lymphoma and myeloma, gradually increases, which may be related to long-term exposure to carcinogens, aging of the immune system, and chronic diseases[4]. Gender differences are also reflected in the incidence of hematological tumors[12]. For example, certain types of lymphomas are more prevalent in men, whereas certain types of leukemia are more common in women. This may be related to differences in physiology, genetics, and hormone levels by gender. In addition, racial and geographical factors affect the incidence of hematological tumors[13]. There are differences in the incidence rates of hematological neoplasms among different ethnic groups, which may be related to genetic factors, environmental factors, and socio-economic differences among different ethnic groups. Geographical differences are also reflected in the incidence of hematological neoplasms, as certain regions may have a higher incidence of hematological neoplasms because of specific environmental factors or living habits[14].

The treatment of hematological tumors is a complex and difficult process. For example, diffuse large B-cell lymphoma, a common form of non-Hodgkin’s lymphoma, has a high relapse rate after first-line treatment, with 30%-40% of patients experiencing drug resistance or disease relapse[15]. This further highlights the importance and challenges of hematological tumor treatment. Therefore, it is important to pay attention to the clinical treatment and psychological status of patients with hematological tumors.

CURRENT STATUS OF RESEARCH ON THE PSYCHOLOGICAL STATE OF PATIENTS WITH HEMATOLOGICAL TUMORS

Current research on the psychological state of patients with hematologic malignancies is complex and multifaceted. With the transformation of the medical model and the in-depth application of psychology in the medical field, an increasing number of studies have begun to focus on the psychological state of patients with hematological tumors and its relationship with disease processes and therapeutic efficacy. Patients with hematological tumors often face enormous psychological pressure[16,17]. Owing to the severity of the disease, pain during the treatment process and changes in life may cause patients to experience negative emotions such as anxiety, depression, and fear[18].

At this stage of research, attention is also being paid to the dynamics of the psychological state of patients with hematological tumors. As the disease progresses and treatment proceeds, the patient’s psychological state changes[19]. For example, studies have shown that in the early stages of the disease, patients may demonstrate shock, denial, and anger[20]. Previous studies have suggested that factors affecting the mental health of patients with hematological tumors include the severity of the disease, choice of treatment options, the patient’s social support system, and their coping style[21,22]. Therefore, these factors need to be considered comprehensively when studying the psychological status of patients with hematologic malignancies to better understand their psychological needs and provide effective psychological support.

Most studies have used a variety of instruments to assess the psychological status of hematologic malignancies patients[23]. These included questionnaires, psychometric assessments, and interviews. Through these methods, researchers can collect a large amount of data on the psychological state of patients and analyze the relationship between it and the disease process and treatment effects. However, despite the progress made, research on the psychological state of patients with hematologic malignancy still faces some challenges[24]. For example, the psychological state of patients may be affected by a variety of factors, making it difficult to assess the degree of influence of one factor alone. Moreover, there are large individual differences between patients, making it difficult to generalize the results of the study to other populations.

EFFECT OF NEGATIVE PSYCHOLOGICAL STATE ON THE QUALITY OF LIFE AND TREATMENT OUTCOME OF HEMATOLOGICAL TUMOR PATIENTS

Numerous studies have demonstrated the significant impact of negative psychological states on the quality of life and treatment outcomes in patients with hematologic malignancies[19]. For example, one study explored the mental health status, quality of life, and the relationship between the two in patients with advanced hematological tumors[25]. The results of this study showed that patients with advanced hematological tumors generally had poor mental health and poor quality of life, and that there was a correlation between the two. Other studies have investigated the psychological status and treatment of patients with hematological tumors[26]. It was found that failure to provide timely counselling for patients’ psychological problems may lead to a variety of somatic symptoms, adversely affecting the condition and reducing the efficacy of treatment. Patients with hematological tumors face the severity and uncertainty of the disease, which may lead to them developing negative emotions such as anxiety, depression, and fear. These emotions not only affect the patients’ psychological state but also their physical condition and quality of life.

From the perspective of quality of life, negative emotions may cause patients to lose interest in life, reduce social activities, and even experience physical symptoms, such as insomnia and loss of appetite[27]. These symptoms further reduce patients’ quality of life and make it difficult for them to cope with the challenges posed by the disease. In addition, negative emotions may affect patients’ compliance behaviors and reduce their confidence in and cooperation with treatment, thus affecting treatment outcomes. From the perspective of treatment outcomes, negative emotions may directly affect immune system function[28]. The immune system of patients with hematological tumors is already compromised by the disease, and negative emotions may further weaken the function of the immune system, making it more difficult for patients to resist disease attacks. In addition, negative emotions may affect the absorption and utilization of drugs by patients, thereby reducing their efficacy. Therefore, negative emotions may lead to poor treatment outcomes or aggravate the disease[25].

OVERVIEW OF THE BADUANJIN AND RESISTANCE EXERCISE

Origin, development, and modern application of Baduanjin

As an independent and complete fitness gong method, Baduanjin originated in the Northern Song Dynasty and has a history of over 800 years. It combines the essence of ancient guiding techniques, and is highly regarded for its graceful movements and exquisite choreography; it is regarded as a fitness method that “dispels diseases and has excellent effects on health”[29]. The name Baduanjin comes from the eight movements it contains, each of which has unique fitness effects. Ancient people likened this set of movements to “brocade,” which is meant to express its colorful, beautiful, and luxurious characteristics, and also reflect the beauty and harmony of its movements[30]. In the course of its development, the Badaodanjin gradually formed two schools, the Southern and the Northern Schools, which, despite their differences in movements and styles, all originate from the same ancient guiding art, reflecting the vastness and depth of traditional Chinese culture. In modern times, Badaodanjin has changed its content and name, but its core values and fitness effects have been preserved[31].

Modern Baduanjin pays more attention to soft, slow, and coherent movements, taking the waist and spine as the axis to drive the limb’s movement to achieve the effects of soft breathing, quiet mind, and loose body[32]. This kind of exercise is not only suitable for young people to carry out physical exercise but also suitable for middle-aged and old people, as well as weaker people, to carry out health and fitness. In terms of modern applications, Baduanjin has been widely promoted in all types of fitness areas and community activities. Many people insist on practicing Baduanjin in their daily lives to improve their physical condition, enhance their immunity, and relieve stress[33]. In addition, Baduanjin has been applied in the rehabilitation treatment of some chronic diseases, such as hypertension and diabetes, and has achieved remarkable results. Baduanjin has also been valued and promoted by the State General Administration of Sports and other organizations[34]. After re-study and collation, Baduanjin has been officially named “Fitness Qigong - Baduanjin,” and has been promoted and popularized throughout the country. In conclusion, as a traditional fitness gong method, Baduanjin has a long origin, rich development, and wide application in modern times. It is not only an effective way of physical exercise but also a unique cultural phenomenon that reflects the ancient Chinese people’s pursuit of health and a better life[35] (Figure 2).

Figure 2 The clinical effects of Baduajiin.

Definition and classification of resistance exercise

As the name suggests, resistance exercises involves the active movement of muscles as they overcome external resistance[36]. This type of exercise increases muscle density and strength, restores muscle strength, and enhances muscle power and durability. Its main purpose is to train the body’s muscles and promote physical fitness by increasing muscle mass. There are various ways to classify resistance exercises, and the following is a list of some of the major classifications: (1) Freeweight training: Training using free-weight equipment, such as barbells and dumbbells, which can be used to target all parts of the body’s muscles; (2) Machine training: Training with specialized fitness equipment that can precisely exercise specific parts of the muscles by adjusting the resistance and angle of the equipment; (3) Self-weight training: The use of one’s own weight training, such as push-ups and squats, without additional equipment, convenience, and is easy to implement; and (4) Elastic band training: Elastic band are used as a source of resistance to perform a variety of stretching and contraction movements suitable for beginners and rehabilitation patients[36].

Research progress on Baduanjin combined with resistance exercise in improving negative psychological status of patients with hematologic malignancy.

The research progress of Baduanjin combined with resistance exercise in improving the negative psychological state of patients with hematologic malignancies is still in the preliminary exploration stage, but it has already demonstrated positive potential and effects. First, as a traditional health and fitness method, Baduanjin’s unique breathing regulation and mind-body unity practices have been proven to help improve psychological health. By practicing Baduanjin, patients with hematologic malignancies can regulate their breathing, relax their bodies and minds, and alleviate adverse emotions such as tension and anxiety[37]. In addition, Baduanjin can enhance patients’ self-knowledge and self-regulation ability, enabling them to better cope with the psychological pressure brought about by the disease[38]. Some studies have shown that Baduanjin training significantly improved anxiety and depression in patients with non-small cell lung cancer during postoperative rehabilitation and improves the quality of patient survival. These findings indicate suggests that Baduanjin has positive effects on improving the mental health of patients with hematological cancer.

Resistance exercise improves physical function by enhancing muscle strength and endurance, which helps improve the physical state of patients with hematological tumors and, in turn, enhances their psychological state[39]. Resistance exercise not only enhances patients’ self-confidence and self-esteem but also promotes the balance of the body’s endocrine system and relieves negative emotions such as depression and anxiety. The joint application of Baduanjin and resistance exercise can result in a synergistic effect between the two in improving the psychological state. The gentle movements and breathing regulation of Baduanjin can provide good physical and mental preparation for resistance exercise and help patients enter the exercise state better. However, the challenge and sense of achievement of resistance exercises can stimulate patients’ motivation and interest in practicing Baduanjin. Through the combined use of these two types of exercise, patients with hematological tumors can regulate and improve their negative psychological states while exercising.

Preliminary studies have explored the effectiveness of Baduanjin combined with resistance exercises in improving the negative psychological state of patients with hematological malignancies. Most of these studies used questionnaires and psychological assessments to compare and analyze the psychological states of participants before and after exercise. The results showed that Baduanjin combined with resistance exercise can significantly reduce anxiety, depression, and other negative emotions in patients with hematological tumors and improve their quality of life and confidence in treatment. However, it should be noted that the current study is still in its infancy, with a relatively small sample size and a lack of long-term follow-up data. Therefore, further in-depth studies are needed to investigate the exact effects and mechanisms of Baduanjin in combination with resistance exercises to improve the negative psychological state of patients with hematological tumors.

In the future, researchers should expand the sample size and adopt a more rigorous experimental design to comprehensively evaluate the effects of BaDuaJin combined with resistance exercise in patients with hematological tumors. The biological mechanisms and potential targets of this combined exercise modality for improving the psychological state of patients with hematological tumors can also be explored by combining them with modern medical techniques and tools. This will help provide a more comprehensive and effective psychological intervention and treatment plan for patients with hematological tumors.

LIMITATIONS OF EXISTING STUDIES AND FUTURE PROSPECTS

Combining Baduanjin with resistance exercises can give full play to the advantages of both and provide a more comprehensive and effective psychological rehabilitation program for patients with hematological tumors. However, there are still some problems and challenges regarding the application of Baduanjin combined with resistance exercises in the psychological rehabilitation of patients with hematological tumors. First, there is a lack of unified and standardized exercise intervention protocols in previous studies. Current research on the application of Baduanjin and resistance exercises in patients with hematological tumors remains fragmented and lacks unified standards and norms. This makes it difficult to develop an exercise program that is suitable for patients’ physical conditions and effective in improving their psychological state for practical applications. Second, patient participation and compliance should be improved. Because patients with hematological tumors often have poor physical conditions and limited ability to tolerate exercise, it is difficult to ensure that patients can adhere to the exercise for a long period in practical applications. In addition, some patients may be skeptical about the effects of exercise interventions and lack motivation to participate.

Future research can be improved and prospected in the following aspects: (1) Strengthening the theoretical research on Baduanjin combined with resistance exercise in the psychological rehabilitation of patients with hematological tumors and formulating a more scientific and standardized exercise intervention program. Through in-depth research on the physical condition and psychological characteristics of patients with hematological tumors, and combining the characteristics and advantages of Baduanjin and resistance exercise, a more suitable exercise program for patients can be formulated; (2) Enhance the personalized design of exercise interventions. There are differences in the physical and psychological states of patients. Therefore, it is necessary to develop personalized exercise programs for different patients. For example, comprehensive consideration can be given to the patient’s age, gender, type of disease, stage of treatment, and other factors to develop an exercise program that better meets their needs; and (3) Strengthen supervision and evaluation of exercise interventions. In practical applications, it is necessary to strengthen the supervision and assessment of a patient’s exercise situation to discover and solve problems that occur during the exercise process. Simultaneously, it is also necessary to assess the effect of exercise interventions through scientific methods to continuously improve and optimize exercise programs.

CONCLUSION

In summary, Baduanjin combined with resistance exercise has a significant application effect and important practical value in improving the negative psychological status of patients with hematological tumors. We emphasize that this comprehensive exercise protocol should become an important part of the rehabilitation treatment of patients with hematological tumors and provide a strong reference basis for clinical practice. In the future, we expect more studies to deeply explore the mechanisms and optimize protocols in this field to further promote the development and innovation of rehabilitation therapies for patients with hematologic malignancies.