Effect of Baduanjin on Individuals With Knee Osteoarthritis

September 15, 2025 updated by: Zeynep HOŞBAY, Biruni University

Effect of Baduanjin on Pain, Balance and Kinesiophobia in Individuals With Knee Osteoarthritis

Osteoarthritis (OA) is the most common rheumatologic disease in the world, primarily resulting in progressive cartilage destruction. It is most common in the knee joint. In this study, it is aimed to determine the effect of Baduanjin to reduce kinesiobia and increase functional exercise capacity by reducing or completely eliminating balance loss and pain in patients with knee osteoarthritis and to shed light on future studies. 60 individuals between 40 and 70 years of age with osteoarthritis will be included in the study. Individuals will be randomized into three groups. In the study, Visual Analog Scale (VAS) was used to assess the severity of pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess physical activity level, Berg Balance Scale (BDS) was used to assess balance, Tampa Kinesiophobia Scale (TKS) was used to assess kinesiophobia, Timed Up and Go Test (TUGT) and 30 Second Sit and Stand Test were used to assess functional levels. In our study, an exercise program accompanied by a physiotherapist will be applied for 12 weeks, 3 days a week. Exercise program will be applied to the first group and Baduanjin exercises will be applied to the second group in addition to the exercise program. Baduanjin exercise will be applied to the third group synchronously with the telerehabilitation method. It is thought that both techniques applied in our study may have positive effects on pain, kinesiophobia and physical function.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Osteoarthritis (OA) is a long-term chronic disease in which stiffness, pain and impaired mobility occur when bones rub against each other as a result of deterioration of the cartilage in the joints. Although the disease most commonly affects the joints in the knees, hands, feet and spine, it can also be observed in the shoulder and hip joints. Clinical symptoms of OA, which is a common joint disease, include pain, joint stiffness, weakened proprioception, impaired balance and dysfunction that severely affect quality of life.

The main aim of osteoarthritis rehabilitation is to prevent functional losses by reducing pain and increasing muscle strength. Conservative treatment, pharmacologic treatment and surgical treatment are applied in osteoarthritis rehabilitation. Exercise practices, which are recommended with a high level of evidence, are the most important building blocks of conservative treatment. In individuals with knee OA, strengthening exercises, which are the leading exercise interventions, increase strength as well as power and endurance. As a result of increased muscle strength, stress on the joint is reduced, resulting in increased correct loading and stabilization. Skeletal muscles contract isometrically, concentrically and eccentrically to support the body weight against gravity and absorb shock. Eccentric strength is an integral part of lower extremity-specific activities of daily living.

When the literature is reviewed, recent studies have shown that OA patients have positive perspectives on traditional aerobic exercise. Tai Chi has been proven to reduce pain and improve physical function. Qigong, which emerged before Tai Chi, is accepted as another traditional aerobic exercise preferred by patients with knee osteoarthritis who cannot tolerate intense physical activities. An important complementary part of qigong, the Baduanjin exercise (Eight-Part Exercises or Eight-Part Brocades) consists of eight separate postures (supporting the chest, drawing arcs to both sides, raising one hand, practicing looking back, waving the hand and wagging the tail, touching the feet with both hands, climbing with both hands and relaxing the back). Baduanjin is a set of exercises, a qigong (chi kung) practice originating in China. The term "Ba Duan Jin" means "eight pieces of brocade" or "eight silk threads" in Chinese. This series of exercises involves a series of movements involving body posture, breath control and mental concentration. The main purpose of Baduanjin is to increase the circulation of energy (chi or qi), promote balance in the body, increase flexibility and improve overall health. According to traditional Chinese medicine, the free circulation of chi and its balanced distribution throughout the body is the key to a healthy life. This exercise series aims to create a physical, mental and energetic balance.

Each can have beneficial effects on different parts of the body or on specific organs. Similar to Tai Chi, Baduanjin exercise is recognized as a multicomponent therapy that combines physical, psychosocial, cognitive and spiritual components. Compared to Tai Chi, Baduanjin exercise has fewer physical and cognitive requirements, which makes it very suitable for application in patients with knee osteoarthritis in a short time. In this study, it is aimed to determine the effect of Baduanjin to reduce kinesiobia and increase functional exercise capacity by reducing or completely eliminating balance loss and pain in patients with knee osteoarthritis and to shed light on future studies.

Study Type

Interventional

Enrollment (Actual)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosed with osteoarthritis of the knee,
  • 40-70 years old,
  • BMI <40 kg/m2,
  • Grade II and Grade III OA according to the Kellgren and Lawrence radiographic classification,
  • Score of 24 and above on the Standardized Mini Mental State Examination

Exclusion Criteria:

  • Underwent surgery involving the lower limbs and spine,
  • History of ligament injury or joint luxation involving the lower extremity,
  • Diagnosed with a neurological disease affecting the lower extremities,
  • Diagnosed with cardiovascular disease,
  • Not receiving any other treatment in the last 3 months
  • Taking anxiolytic and sedative drugs,
  • Psychiatric illness,

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Traditional Exercise Group

The routine exercise program applied to individuals with osteoarthritis who applied to the orthopedic clinic where the data will be obtained is given below.

1st week exercises

  • Isometric quadriceps set
  • Terminal knee extension
  • Knee extension at 90 degrees flexion
  • Isometric gluteus maximus exercises

Exercises added in week 2

  • Four-way straight leg raises
  • Bridge exercise
  • Fingertip elevation

Exercises added in week 4

  • Mini squat (0-30 degrees)
  • Getting up from a chair without support
  • Leg press exercise with Theraband

Exercises added in week 6

  • Stepping up and down
  • Exercises for rising on one leg
  • Semi squat (0-60 degrees)

The exercise program will be taught to the patient and given as a home program.
Other: Traditional Exercise Group

It is important for the therapist to organize a exercise program to provide pain control. The exercise program should be specific and clear to the patient.

Exercises will be applied to this group. The exercise steps will be continued 3 days a week for 6 weeks. All scales and tests will be completed again at week 12 for long-term follow-up.

Other Names:
  • exercise
Experimental: Baduanjin Exercise Group

Standard Physical Therapy Program + Baduanjin exercises

Baduanjin exercises An important complementary part of Qigong, the Baduanjin exercise (Eight Part Exercises or Eight Part Brocades) consists of eight different postures (supporting the chest, drawing arcs to both sides, raising one hand, practicing looking back, waving the hand and wagging the tail, touching the feet with both hands, climbing with both hands and relaxing the back).

The exercise program will be taught to the patient and given as a home program.
Other: Baduanjin Exercise Group

In addition to the standard physical therapy program, Baduanjin will be applied for 30 minutes.

The exercise steps will be continued 3 days a week for 6 weeks. All scales and tests will be completed again at week 12 for long-term follow-up.

Other Names:
  • exercise
Experimental: Telerehabilitation group

Baduanjin exercise will be applied simultaneously with the telerehabilitation method.

Standard Physical Therapy Program + Baduanjin exercises

Baduanjin exercises An important complementary part of Qigong, the Baduanjin exercise (Eight Part Exercises or Eight Part Brocades) consists of eight different postures (supporting the chest, drawing arcs to both sides, raising one hand, practicing looking back, waving the hand and wagging the tail, touching the feet with both hands, climbing with both hands and relaxing the back).

The exercise program will be taught to the patient and given as a home program.
Other: Telerehabilitation Group

Baduanjin exercise will be applied simultaneously with the telerehabilitation method. In addition to the standard physical therapy program, Baduanjin will be applied for 30 minutes.

The exercise steps will be continued 3 days a week for 6 weeks. All scales and tests will be completed again at week 12 for long-term follow-up.

Other Names:
  • exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change from baseline in pain on the Visual Analog Scale (VAS) at week 12. Change from baseline in balance on the Berg Balance Scale (BDS) at week 12.
Time Frame: 12 weeks
The Visual Analog Scale is a one-dimensional scale commonly used to measure pain intensity. The VAS is a 0-10 cm (0-100 mm) long measuring instrument. The scale starts with "no pain" and ends with "unbearable pain".
12 weeks
Change from baseline on the Western Ontario and McMaster Universities Arthritis Index (WOMAC) at week 12
Time Frame: 12 weeks
WOMAC assesses patients' pain, stiffness and physical function in the last 48 hours. A higher score indicates an increase in pain, stiffness and lack of physical function.
12 weeks
Change from baseline in pain on the Berg Balance Scale at week 12
Time Frame: 12 weeks
The Berg Balance Scale (BBS) is a scale that includes 14 instructions and for each instruction, the patient's performance is observed and a score between 0 and 4 is given. A score of 0 is given when the patient cannot perform the activity at all, while a score of 4 is given when the patient completes the activity independently.
12 weeks
Change from baseline in pain on the Timed Up & Go (TUG) Test at week 12
Time Frame: 12 weeks
The Timed Up and Go (TUG) test is a test used to determine dynamic balance and fall risk. The time it takes for a person to get up from a chair, walk three meters, turn 180 degrees, walk back to the chair and sit down while turning 180 degrees is calculated.
12 weeks
Change from baseline in pain on the 30-second Sit-Rise Test at week 12
Time Frame: 12 weeks
30-second Sit-Rise test is a test used to measure leg strength and endurance for 30 s.
12 weeks
Change from baseline in pain on the Tampa Scale of Kinesiophobia (TSK) at week 12
Time Frame: 12 weeks
The Tampa Kinesiophobia scale is a scale to measure patients' avoidance of exercise and fear of movement. A high score on the scale indicates a high level of kinesiophobia.
12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Biruni University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 15, 2024

Primary Completion (Actual)

January 15, 2025

Study Completion (Actual)

February 15, 2025

Study Registration Dates

First Submitted

October 16, 2024

First Submitted That Met QC Criteria

October 17, 2024

First Posted (Actual)

October 21, 2024

Study Record Updates

Last Update Posted (Estimated)

September 19, 2025

Last Update Submitted That Met QC Criteria

September 15, 2025

Last Verified

October 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 145361

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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