Jiping Chen1
Yanyu Lu2*- 1School of Physical Education, Shandong University, Jinan, China
- 2School of Innovation Design, Guangzhou Academy of Fine Arts, Guangzhou, Guangdong, China
1 Introduction
Baduanjin is a traditional Chinese exercise that integrates physical movement, breathing techniques, and mental focus for overall wellness (1). It originated during the Song Dynasty (10th to 13th centuries AD) and is a form of Qigong, which is a broader practice aimed at cultivating “Qi” (energy) through exercises designed to promote health (2). Baduanjin consists of eight limb movements that focus on both body movement and breath control (3). In ancient times, millions of Chinese people practiced Baduanjin to improve and maintain their health. Recently, this exercise has gained worldwide popularity because of its many health benefits, ease of learning, and time efficiency (4). Studies have shown that joining a Baduanjin program can provide participants with various health benefits, such as a lower disease burden (5), improved sleep quality (6), and enhanced cognitive function (7). There is, however, limited information regarding the effects of Baduanjin on mood disorders.
The objectives of this opinion article are: 1 to gather clinical studies on Baduanjin for treating mood disorders, identify any evidence gaps, and guide future research; and 2) to summarize the potential mechanisms through which interventions may treat mood disorders based on existing research.
2 Potential of Baduanjin intervention in mood disorders—results from clinical studies
Current research suggests that Baduaniin positively affects individuals with mood disorders. To better understand its effectiveness and applicability across different types of mood disorders, this article will analyze patient responses from three key perspectives: physiology, psychology, and lifestyle habits.
Many studies have explored the effects of Baduanjin on individuals with mood disorders related to various underlying conditions. For instance, Wang et al. examined the impact of Baduanjin combined with five-element music therapy on 96 asymptomatic patients suffering from anxiety and depression due to COVID-19 (8). The results showed a significant reduction in scores on the 7-item Generalized Anxiety Disorder Scale (GAD-7) from baseline following treatment (Mean difference = 2.7, 95% CI = 2.3, 3.2, p < 0.001). This clinical trial sought to assess the feasibility and safety of Baduanjin in treating patients experiencing low mood due to COVID-19 infection during isolation. However, the study lacked blinding, meaning participants were aware of their assigned treatment group (treatment or control). This design flaw may have introduced a psychological expectancy effect, potentially influenced participants’ responses and skewed self-reported outcomes, such as anxiety and sleep quality. Future studies should consider employing a blinded design to mitigate bias and ensure more reliable results. In a follow-up study, Zhang and colleagues looked at how Baduanjin affects blood flow in the brain, risk factors for heart disease, and related mental health in 85 older adults at risk of having a stroke (9). The study found that older adults who practiced Baduanjin for one hour, five times a week for 12 weeks showed significant improvements in their mental health. They reported better mood, increased self-confidence, higher self-esteem, and an improved quality of life, both right after the program and during a follow-up 12 weeks later, compared to those who did not practice Baduanjin. This study is the first to show that Baduanjin, a traditional Chinese exercise, can help improve mental well-being in older adults at risk for stroke. However, the study did not use a blinded randomized controlled trial, which could have affected the results. Even if the effect size is estimated in the research report, small samples may not be representative of the entire high-risk population, limiting the universality of the research results.
Liu et al. examined the effects of Baduanjin exercise combined with rational emotive behavioral therapy (REBT) compared to escitalopram oxalate treatment paired with REBT on sleep and mood in stroke patients suffering from depression (10). At week 4, the Baduanjin group showed significantly better results in sleep latency, arousal index, Hamilton Anxiety Scale scores, Hamilton Depression Scale scores, and IL-6 levels compared to the control group (P < 0.05). After 8 weeks of treatment, the Baduanjin group demonstrated further improvements in these measures compared to the control group (P < 0.05), while both groups experienced significant enhancements from their baseline measurements (P < 0.001). These findings suggest that Baduanjin, when combined with cognitive-behavioral therapy, may provide greater psychological benefits than antidepressant medication, highlighting its potential role in improving mental health. The study primarily used the Hamilton Anxiety Rating Scale (HAMA) and the Hamilton Depression Rating Scale (HAMD) to assess emotional changes. Although these tools are widely used in clinical settings, they rely on subjective scoring and may be influenced by assessor bias. In the future, diversified assessment tools, such as a combination of physiological indicators and psychological assessments, could be introduced to enhance the reliability and comprehensiveness of the results.
From a psychological well-being perspective, two studies investigated the effects of the Eight-Section Exercise on the mental state of healthy university students. A study conducted by Chen et al. in 2016 assessed the impact of Baduanjin on mood states and executive function in 21 college students (11). The study found that an 8-week Ba Duan Jin intervention significantly reduced total mood disorder (TMD) scores when compared to a control group that participated in traditional relaxation training. Paired t-tests were conducted to analyze pre- and post-training mood states within each group. The results indicated a significant reduction in TMD scores for the Ba Duan Jin group [t = 6.45, p < 0.001]. In contrast, the control group showed no significant changes [t = −0.47, p = 0.64]. This research was among the first to explore the effects of Ba Duan Jin on mood disorders, yielding positive and statistically significant findings. However, the study had some limitations, including a small sample size and potential performance bias. The former may lead to insufficient statistical power of the research results, affecting the reliability and generalizability of the results. The latter may lead to experimenter bias or participant expectation effects influencing the experimental results. Li et al. investigated the effects of 12 weeks of Baduanjin on symptom intensity, stress, self-esteem, and mood in 101 college students, comparing them to those of regular physical activity (1). Both Baduanjin and regular exercise improved psychological outcomes like stress, self-efficacy, and mood, with no significant differences between the groups. These results suggest that Baduanjin has a similar effect on psychological well-being to traditional sports. The study employed a randomized, parallel-controlled design with a large sample. However, the control group in this study was only required to maintain their usual lifestyle and did not receive any intervention. This design may not be sufficient to clearly distinguish the effects of Baduanjin exercise from other potential factors (such as natural changes in lifestyle). If a more active control intervention (e.g., other forms of exercise or behavioral change interventions) could be added, it would help to better assess the unique effects of Baduanjin exercise.
In terms of lifestyle habits, Li et al. employed electroencephalography (EEG) and psychometric tools to systematically investigate differences in brain emotion regulation and the mechanisms underlying skill mastery in long-term versus short-term Baduanjin (12). The results revealed that engaging in long-term Baduanjin practice allowed participants to develop more effective cognitive reappraisal strategies, which significantly enhanced their ability to regulate emotions. This study was cross-sectional in design and could only reflect differences between groups at a given point in time. It did not examine the long-term effects of Baduanjin training on emotional regulation abilities. Although this type of design can reveal differences in training duration at a specific point in time, it cannot prove causality. From a neuroscientific standpoint, Baduanjin exercise promotes left frontal alpha lateralization, suggesting changes in the brain’s neuroplasticity associated with mood disorders. These findings deepen our understanding of how the prolonged practice of Baduanjin influences emotional management within the brain. Ultimately, this research may provide a solid theoretical foundation for promoting and popularizing the Baduanjin exercise.
3 Mechanisms of action of Baduanjin on mood disorders
Chemokines are a vital class of molecules in the immune system and have been thoroughly reviewed for their role in the development of mood disorders (13, 14). Various chemokines in the blood, including CCL2, CCL3, CCL4, CCL11, CXCL4, CXCL7, and CXCL8, have been shown to distinguish between patients with depression and those without (15). In particular, levels of CCL2, CXCL4, CXCL7, and CXCL8 were significantly higher in the blood of non-depressed patients compared to those with depression, while CCL4 showed the opposite trend (15). A recent clinical study by An et al. observed an increase in the expression of two chemokines, CXCL8 and CXCR4, in depressed patients after a 12-week Baduanjin intervention (16). CXCL8 is linked to neuroendocrine regulation and dysfunction of the hypothalamic-pituitary-adrenal axis (17, 18), whereas CXCR4 has been repeatedly identified as playing a role in neurogenesis (17, 19). Based on these findings, we hypothesize that Baduanjin may help regulate the function of the HPA axis and promote neurogenesis by upregulating the expression of these key chemokines, thus alleviating depressive symptoms.
Patients with depression often show deficits in the dopaminergic system, which may stem from dysfunction within affective frontal-limbic circuits. These circuits include the prefrontal cortex and various limbic structures, such as the hippocampus, amygdala, and anterior cingulate (20). NR4A2, a nuclear receptor and transcription factor with unique physiological properties, is recognized as a crucial regulator of the differentiation, survival, and maintenance of dopaminergic neurons (21). Initially, the NR4A2 gene polymorphism was suggested as a potential predictor of how effective antidepressants would be (22). Further research indicated a significant increase in NR4A2 expression in patients who underwent treatment with Baduanjin (FD = 3.448, P < 0.05). This suggests that the antidepressant effects of Baduanjin may be linked to the upregulation of NR4A2 expression, which supports the development of dopaminergic neurons in the midbrain and helps restore function within the frontal-limbic circuits (16).
A clinical study found that practicing Baduanjin for 12 weeks significantly impacted resting-state functional connectivity (rsFC) in the dorsolateral prefrontal cortex (DLPFC), a key area within the cognitive control network responsible for attention (23). The study also revealed that Baduanjin practice influenced connections in the insula, a brain region crucial for cognitive functions such as attentional reorientation triggered by stimuli, self-monitoring, and emotional awareness (23). These findings suggest that Baduanjin may help alleviate mood disorders by modulating the functions of cognitive control networks and enhancing cognitive performance. Additionally, previous research indicates that depression can inhibit the activity of the IL-17 pathway (24, 25). Research findings indicate a significant enhancement in IL-17 pathway activity following the Baduanjin in individuals diagnosed with depression. This suggests that Baduanjin may exert its antidepressant effects by upregulating the IL-17 pathway (16).
4 Discussion
Current evidence suggests that Baduanjin treating mood disorders by upregulating chemokines (CXCR4, CXCL8), NR4A2 expression, the IL-17 pathway, and modulating cognitive (attentional) control networks (Table 1, Figure 1). However, the current study is subject to several limitations. Firstly, as a non-pharmacological intervention, there are issues with the methodology of the research. Specifically, many studies have small sample sizes, which may affect the statistical significance and generalizability of the results. In addition, many studies did not use a blinded design, which may have led to the experimenter or participant’s expectations influencing the results, thereby reducing the objectivity of the research. More importantly, many studies lacked effective control groups, making it difficult to confirm causality and potentially overestimating the effectiveness of the treatment. Secondly, this study analyzed clinical data based on a Chinese population, which makes the results of the study may not be fully applicable to populations from other regions or different ethnic groups. Although the Chinese population is representative of the characteristics of certain diseases and health problems, factors such as genetics, environment, culture and lifestyle in different regions may lead to differences in study results. Therefore, the results of studies limited to a single population may not be widely generalizable. Lastly, prior research predominantly emphasizes short-term interventions and follow-up assessments, thereby complicating the evaluation of the long-term effects of Baduanjin on mood disorders.
Table 1. Characteristics of included studies.
Figure 1. The mechanisms of action of Baduanjin on mood disorders.
Future research should focus on extending both the intervention and follow-up periods to more comprehensively evaluate the long-term effects of Baduanjin on mood disorders and associated clinical outcomes. In order to further validate the results of this study and to improve its generalizability, future studies should be conducted in different populations, including but not limited to other Asian countries, European and American countries, and populations of different ethnic backgrounds. Genetic, lifestyle and environmental differences among different populations may have an important impact on the results of clinical studies. Therefore, cross-cultural and multinational multicenter clinical studies will contribute to a more comprehensive understanding of the manifestations and treatment effects of related diseases. Moreover, increasing the sample size and refining the design of randomized controlled trials would be instrumental in confirming the sustained efficacy and elucidating the underlying mechanisms of Baduanjin. Additionally, enhancing blinding procedures and diversifying the sample population are essential steps to ensure greater objectivity and broader applicability of the findings across diverse demographic groups.
Author contributions
JC: Conceptualization, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing. YL: Conceptualization, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that no financial support was received for the research, and/or publication of this article.
Acknowledgments
Thank you to the collaborators of this study for their time and effort in our research.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement
The author(s) declare that no Generative AI was used in the creation of this manuscript.
Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
References
1. Li M, Fang Q, Li J, Zheng X, Tao J, Yan X, et al. The effect of chinese traditional exercise-baduanjin on physical and psychological well-being of college students: A randomized controlled trial. PloS One. (2015) 10:e0130544. doi: 10.1371/journal.pone.0130544, PMID: 26158769
2. Zeng Z-P, Liu Y-B, Fang J, Liu Y, Luo J, and Yang M. Effects of Baduanjin exercise for knee osteoarthritis: A systematic review and meta-analysis. Complementary therapies Med. (2020) 48:102279. doi: 10.1016/j.ctim.2019.102279, PMID: 31987253
4. Zhou J, Yu Y, Cao B, Li X, Wu M, Wen T, et al. Characteristic of clinical studies on baduanjin during 2000-2019: A comprehensive review. Evidence-Based complementary Altern medicine: eCAM. (2020) 2020:4783915. doi: 10.1155/2020/4783915, PMID: 33149753
5. He D, Zhang C, Li R, and Zhang X. Baduanjin exercise for negative emotion of patients undergoing chemotherapy: a systematic review and meta-analysis. Supportive Care cancer: Off J Multinational Assoc Supportive Care Cancer. (2024) 32:608. doi: 10.1007/s00520-024-08804-9, PMID: 39172232
6. Hasan F, Tu YK, Lin CM, Chuang LP, Jeng C, Yuliana LT, et al. Comparative efficacy of exercise regimens on sleep quality in older adults: A systematic review and network meta-analysis. Sleep Med Rev. (2022) 65:101673. doi: 10.1016/j.smrv.2022.101673, PMID: 36087457
7. Zheng G, Zheng Y, Xiong Z, and Ye B. Effect of Baduanjin exercise on cognitive function in patients with post-stroke cognitive impairment: a randomized controlled trial. Clin Rehabil. (2020) 34:1028–39. doi: 10.1177/0269215520930256, PMID: 32517490
8. Wang X, Yin X, Liu P, Wang A, Mu W, Xu J, et al. The effect of Baduanjin Qigong combined with five-elements music on anxiety and quality of sleep in asymptomatic patients with COVID-19 infection: A randomised controlled trial. Heliyon. (2023) 9:e18962. doi: 10.1016/j.heliyon.2023.e18962, PMID: 37636423
9. Zheng G, Chen B, Fang Q, Lin Q, Tao J, and Chen L. Baduanjin exercise intervention for community adults at risk of ischamic stroke: A randomized controlled trial. Sci Rep. (2019) 9:1240. doi: 10.1038/s41598-018-37544-0, PMID: 30718622
10. Liu Y, Chen C, Du H, Xue M, and Zhu N. Impact of Baduanjin exercise combined with rational emotive behavior therapy on sleep and mood in patients with poststroke depression: A randomized controlled trial. Med (Baltimore). (2024) 103:e38180. doi: 10.1097/MD.0000000000038180, PMID: 38728460
11. Chen T, Yue GH, Tian Y, and Jiang C. Baduanjin mind-body intervention improves the executive control function. Front Psychol. (2016) 7:2015. doi: 10.3389/fpsyg.2016.02015, PMID: 28133453
12. Li X, Leng Y, Xiong Z, and Liu J. The effect of long-term learning of baduanJin on emotion regulation: evidence from resting-state frontal EEG asymmetry. Psychol Res Behav management. (2024) 17:2391–401. doi: 10.2147/PRBM.S436506, PMID: 38912161
13. Eyre HA, Air T, Pradhan A, Johnston J, Lavretsky H, Stuart MJ, et al. A meta-analysis of chemokines in major depression. Prog Neuropsychopharmacol Biol Psychiatry. (2016) 68:1–8. doi: 10.1016/j.pnpbp.2016.02.006, PMID: 26903140
14. Trojan E, Ślusarczyk J, Chamera K, Kotarska K, Głombik K, Kubera M, et al. The modulatory properties of chronic antidepressant drugs treatment on the brain chemokine - chemokine receptor network: A molecular study in an animal model of depression. Front Pharmacol. (2017) 8:779. doi: 10.3389/fphar.2017.00779, PMID: 29163165
15. Leighton SP, Nerurkar L, Krishnadas R, Johnman C, Graham GJ, and Cavanagh J. Chemokines in depression in health and in inflammatory illness: a systematic review and meta-analysis. Mol Psychiatry. (2018) 23:48–58. doi: 10.1038/mp.2017.205, PMID: 29133955
16. An T, He ZC, Zhang XQ, Li J, Chen AL, Tan F, et al. Baduanjin exerts anti-diabetic and anti-depression effects by regulating the expression of mRNA, lncRNA, and circRNA. Chin Med. (2019) 14:3. doi: 10.1186/s13020-019-0225-1, PMID: 30733823
17. Callewaere C, Banisadr G, Rostène W, and Parsadaniantz SM. Chemokines and chemokine receptors in the brain: implication in neuroendocrine regulation. J Mol endocrinology. (2007) 38:355–63. doi: 10.1677/JME-06-0035, PMID: 17339398
18. Rostène W, Guyon A, Kular L, Godefroy D, Barbieri F, Bajetto A, et al. Chemokines and chemokine receptors: new actors in neuroendocrine regulations. Front neuroendocrinology. (2011) 32:10–24., PMID: 20624414
19. Li M and Ransohoff RM. Multiple roles of chemokine CXCL12 in the central nervous system: a migration from immunology to neurobiology. Prog neurobiology. (2008) 84:116–31. doi: 10.1016/j.pneurobio.2007.11.003, PMID: 18177992
20. Belujon P and Grace AA. Dopamine system dysregulation in major depressive disorders. Int J Neuropsychopharmacol. (2017) 20:1036–46. doi: 10.1093/ijnp/pyx056, PMID: 29106542
21. Ruano D, Macedo A, Dourado A, Soares MJ, Valente J, Coelho I, et al. NR4A2 and schizophrenia: lack of association in a Portuguese/Brazilian study. Am J Med Genet Part B Neuropsychiatr genetics: Off Publ Int Soc Psychiatr Genet. (2004) 128b:41–5. doi: 10.1002/ajmg.b.30031, PMID: 15211629
22. Song X, Sun N, Zhang A, Lei L, Li X, Liu Z, et al. Association between NR4A2 gene polymorphism and depressive symptoms and antidepressant effect. Neuropsychiatr Dis Treat. (2021) 17:2613–23. doi: 10.2147/NDT.S319548, PMID: 34408421
23. Tao J, Chen X, Egorova N, Liu J, Xue X, Wang Q, et al. Tai Chi Chuan and Baduanjin practice modulates functional connectivity of the cognitive control network in older adults. Sci Rep. (2017) 7:41581. doi: 10.1038/srep41581, PMID: 28169310
24. Strober BE, Langley RGB, Menter A, Magid M, Porter B, Fox T, et al. No elevated risk for depression, anxiety or suicidality with secukinumab in a pooled analysis of data from 10 clinical studies in moderate-to-severe plaque psoriasis. Br J Dermatol. (2018) 178:e105–e7. doi: 10.1111/bjd.16051, PMID: 28991372
Keywords: exercise, mood, Baduanjin, intervetion, mechanism
Citation: Chen J and Lu Y (2025) Baduanjin as an innovative intervention for mood disorders: evaluating efficacy and mechanisms. Front. Psychiatry 16:1647619. doi: 10.3389/fpsyt.2025.1647619
Received: 16 June 2025; Accepted: 15 September 2025;
Published: 24 September 2025.
Edited by:
Yueheng Tang, Huazhong University of Science and Technology, ChinaReviewed by:
Xiaopeng Shi, Fourth Military Medical University, ChinaRabia Farooqi, Nur International University, Pakistan
Thamizhoviya Gangadharan, National Institute of Siddha, India
Copyright © 2025 Chen and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Yanyu Lu, bHV5YW55dUBnemFydHMuZWR1LmNu