Cardiopulmonary and Hemodynamic Responses to Baduanjin Exercise and Cycle Ergometer Exercise among Chronic Heart Failure Patients: A Comparison

Xiankun Chen^1,2*Xiaoyue Hu³Thomas P Olson⁴Yaqi Qiu³Huiying Zhu²Zehuai Wen²Huayang Cai²Weihui Lu²Wei Jiang²

• ¹Karolinska Institutet (KI), Solna, Sweden
• ²The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
• ³Guangzhou University of Chinese Medicine, Guangzhou, China
• ⁴Mayo Clinic and Foundation, Rochester, United States

Objective: Baduanjin is a traditional Chinese exercise and serves as an alternative to conventional cardiac rehabilitation in China. In this study, we compare the cardiopulmonary and hemodynamic responses of Baduanjin to those of cycle ergometer exercise in chronic heart failure (CHF) patients. Methods: For this cross-sectional study design, following baseline data collection, participants underwent a series of tests including impedance cardiography (ICG) and a maximal cardiopulmonary exercise test (CPET) to determine peak exercise capacity. Participants then engaged in 9-minutes of Baduanjin exercise. The average oxygen consumption (EqualVO2) during Baduanjin was calculated. Participants then engaged 9 minutes of constant-load cycling at 60 rpm at an intensity which elicited the EqualVO2. Cardiopulmonary and hemodynamic data were measured continuously during both Baduanjin and cycling exercise. Results: A total of 30 participants were included. Although Baduanjin and cycling exercise showed similar VO2 levels (8.2±1.3 vs. 8.4±1.4, p=0.339, respectively), there was a bimodal distribution during Baduanjin exercise compared to a unimodal distribution during cycling exercise. Compared to conventional cycling, Baduanjin demonstrated lower respiratory burden which is associated with greater ventilatory efficiency as evidenced by lower respiratory rate values (p=0.003), minute ventilation (p<0.001), end-tidal carbon dioxide pressure (p<0.001), and minute ventilation to carbon dioxide production ratio (p<0.001). In terms of hemodynamic response, Baduanjin is demonstrated significantly lower cardiac output (p=0.017) and elevated arterial-venous oxygen difference (p= 0.036). Conclusion: Our study offers novel insight into the cardiopulmonary and hemodynamic differences between Baduanjin and cycling when performed at consistent intensity levels. Baduanjin demonstrates an intermittent intensity pattern and increased peripheral oxygen utilization, which is attributed to more pronounced muscle activation. Furthermore, Baduanjin has been linked to a reduction in both cardiac and respiratory burdens.