Efficacy of Baduanjin Exercise in COVID-19 Contraction Patients With Idiopathic Chronic Fatigue

Post-COVID recovery is associated with reduced functional fitness/capacity, low quality of life, and physical disabilities in those who survived after contracting the disease. The unpleasant symptoms of chronic post-viral/post-COVID syndrome (chronic fatigue perception, variant nonspecific myalgia, bad mood or depression, and insomnia or sleep disturbances) usually magnify the symptoms of already existing previously diagnosed concurrent untreatable chronic disorders , including the idiopathic chronic fatigue (ICF).(Leszczak et al., 2024)

Baduanjin exercise training (BET) is one of the Chinese traditional Health-Qigong exercises that not only integrate slow coordinating postures/positions, breathing techniques, musculoskeletal stretching movements/positions, and meditative mind but also plays a strong role concerning health benefits (e.g. musculoskeletal pain-reducing, sleep disturbance-enhancing effects, and fatigue-reducing effects) (Zou et al., 2018).

Study Overview

• Status: Recruiting
• Conditions: Chronic COVID-19 Syndrome
• Intervention / Treatment: Other: Baduanjin exercise training (BET)

Detailed Description

forty idiopathic chronic fatigue (ICF) patients will be randomly assigned into two equal groups (n=20)

1. Study group (20 patients) this group will be supervised daily, except Fridays, during the 60-minute session of 12-week BET) or waitlist group
2. Control group (20 patients)

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Alaa El-Moatasem, lecturer; Phone Number: 01006625054; Email: alaamotasem@cu.edu.eg
• Study Contact Backup: Name: Rania ali, assistant professor; Phone Number: 010015931155; Email: roni.diamond8@gmail.com

Study Locations

• Egypt
  • Cairo, Egypt, 11432
    • Recruiting
    • Cairo University
    • Contact: Alaa El-Moatasem, lecturer; Phone Number: 01006625054; Email: alaamotasem@cu.edu.eg
    • Principal Investigator: Alaa El-Moatasem, lecturer

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• • 40 patients will be recruited in the study.

  • age ≥ 18 to ≤ 50 years old
  • achieved three diagnostic items/criteria of ICF will be included in this BET trial: Fatigue lasting over 6 months, which significantly limits daily activities, reducing the person's usual activity level by more than 50%, as confirmed by a doctor.

At least three of the following symptoms:

Generalized muscle weakness Difficulty sleeping Frequent headaches A painful throat Muscle tenderness throughout the body Migratory joint pain Swollen lymph nodes in the neck or armpits Fatigue lasting more than a day after typical activities

Exclusion Criteria:

• Patients with a history of medical or complementary treatments for ICF disorder in the 6 months before contracting COVID or after recovery.
• Individuals who have engaged in therapeutic exercise, pharmacological treatments, or complementary therapies for post-COVID symptoms within the last six months prior to enrollment.
• ICF patients regularly using antidepressants or antipsychotics were excluded.
• Those who take sleeping pills regularly were also excluded.
• Patients with autoimmune diseases, malignant conditions, anemia, endocrine disorders, systemic diseases, or osteoarthritis affecting the cervical spine, lumbar region, or limbs were excluded.
• Individuals with abnormal results in laboratory tests, including neurological, neurophysiological, cardiological, liver/kidney function tests, or urine/stool analyses (as determined by a physician) were excluded.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Baduanjin exercise training; Each BET session consisted of a 10-minute warm-up and a 10-minute cool-down period [Xia et al., 2023]. These were followed by a 40-minute BET segment, which typically involved eight distinct body postures. These postures are based on the "Health Qigong Baduanjin Standard," as outlined in Zhao et al. [2019] and Koh [1982]. The eight postures are: (1) Support the Heaven, (2) Draw a Bow to Each Side, (3) Hold Up a Single Hand, (4) Practice Looking Back, (5) Shake the Hand and Wag the Tail, (6) Touch the Feet with Both Hands, (7) Climbing with Both Hands, and (8) Relax the Back, as explained in Zeng et al. [2020]	Other: Baduanjin exercise training (BET); Baduanjin Exercise Training (BET) is a traditional Chinese exercise focused on improving physical health, flexibility, balance, and mental well-being. It involves a 10-minute warm-up, a 40-minute core session practicing eight distinct postures, and a 10-minute cool-down. The postures, based on the Baduanjin form, target different body parts and promote strength, flexibility, and circulation. The exercises are synchronized with deep breathing to enhance relaxation and stress reduction. BET is especially beneficial for joint health, mobility, and mental clarity, making it suitable for individuals of all ages and fitness levels
No Intervention: waitlist; this group will receive no intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pulmonary function: By Spirometry Device:	• Pulmonary function: By Spirometry Device: it measure ventilatory functions. forced vital capacity (FVC)	By Spirometry Device: forced vital capacity will be measured at baseline, and it will be measured after twelve weeks again

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pulmonary function: By Spirometry Device:	Pulmonary function: By Spirometry Device: it measure ventilatory functions forced expiratory volume in one second (FEV1)	By Spirometry Device forced expiratory volume in one second (FEV1) will be measured at baseline, and it will be measured after twelve weeks again
Measuring functional capacity: By Six-minute walk test (6MWT)	Measuring functional capacity: By Six-minute walk test (6MWT): is a self paced submaximal field exercise test , It will be performed according to the standard procedure is administered in a 30 meter hallway. (Launois et al., 2012 and ATS statement2002)	Measuring functional capacity: By Six-minute walk test (6MWT)::will be measured at baseline, and it will be measured again after twelve weeks
Modified Borg dyspnea scale (MBDS)	Modified Borg dyspnea scale (MBDS) is patient self-reported measures of one's difficulty in breathing upon exertion	Modified Borg dyspnea scale (MBDS) will be measured at baseline, and it will be measured again after twelve weeks
Strength of lower limb muscles By a thirty-second sit-to-stand test	thirty-second sit-to-stand test was designed for testing leg strength and endurance it is the number of repetitions of sit-to-stand action executed in thirty seconds	thirty-second sit-to-stand test will be measured at baseline, and it will be measured again after twelve weeks
Endurance of upper limb muscles: by the maximal repetitions of push-ups (MRPU).	Endurance of upper limb muscles: by the maximal repetitions of push-ups (MRPU) is commonly used to assess upper body strength, muscular endurance, and overall fitness levels.	the maximal repetitions of push-ups (MRPU). will be measured at baseline, and it will be measured again after twelve weeks
Cardiorespiratory fitness:by the index of Ruffier test (IRT).	Cardiorespiratory fitness: by the index of Ruffier test (IRT). is a simple, non-invasive method used to assess the recovery capacity of the heart after exercise and can be used to monitor fitness improvements over time.	Cardiorespiratory fitness:by the index of Ruffier test (IRT). will be measured at baseline, and it will be measured again after twelve weeks
Quality of life: by the short form 36 questionnaire (SF)	Quality of life: by the short form 36 questionnaire (SF) is a set of generic, coherent, and easily administered quality-of-life measures. These measures rely upon patient self-reporting and have been widely used	Quality of life: by the short form 36 questionnaire (SF) will be measured at baseline, and it will be measured again after twelve weeks
sleep quality by Pittsburgh sleep quality index (PSQI):	sleep quality by Pittsburgh sleep quality index (PSQI): This is a 19 item widely used self-report questionnaire designed to assess sleep quality and disturbances	sleep quality by Pittsburgh sleep quality index (PSQI):will be measured at baseline, and it will be measured again after twelve weeks
Beck Depression Inventory (BDI):	Beck Depression Inventory (BDI):widely used self-report questionnaire designed to assess the presence and severity of depressive symptoms	Beck Depression Inventory (BDI):will be measured at baseline, and it will be measured again after twelve weeks
fatigue assessment by Buzhongyiqi-Tang questionnaire (BZTQ):	Buzhongyiqi-Tang questionnaire (BZTQ): Fatigue syndrome's severity can be rated via this validated 16-item questionnaire (every item was rated 7-Likert scale responses starting from zero to seven).	Buzhongyiqi-Tang questionnaire (BZTQ)::will be measured at baseline, and it will be measured again after twelve weeks

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Principal Investigator: Alaa El-moatasem, lecturer, Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): October 9, 2024
• Primary Completion (Estimated): February 22, 2025
• Study Completion (Estimated): March 1, 2025

Study Registration Dates

• First Submitted: February 14, 2025
• First Submitted That Met QC Criteria: February 14, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 14, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Infections; Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Diseases; Lung Diseases; Pneumonia, Viral; Pneumonia; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; COVID-19
• Other Study ID Numbers: P.T.REC/012/005517

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No