A traditional Chinese Yijinjing mind-body training program improves balance and gait in stroke survivors: A randomized controlled trial

BACKGROUND: Balance and gait impairments are prevalent after stroke, leading to increased fall risk and reduced independence. While conventional rehabilitation offers benefits, there is a need for effective adjunctive therapies. Yijinjing, a traditional mind-body exercise, may address these impairments by improving postural control and movement symmetry, but robust evidence from randomized trials is lacking. METHODS: We conducted a randomized, controlled trial to determine whether a Yijinjing program could improve balance and walking function in patients with stroke. Seventy stroke patients were randomly assigned to either Yijinjing group receiving Yijinjing training (30 min/session, 5 sessions/week for 5 weeks) or control group receiving stretching training of the same duration. All patients underwent hospital-based conventional rehabilitation therapy throughout the study period. The primary outcome was the change after the 5-week intervention (estimated by a GEE model) in the Berg Balance Scale (BBS). Secondary outcomes included spatiotemporal gait parameters, Fugl-Meyer Assessment (FMA) and the Modified Barthel Index (MBI). Analyses were performed on an intention-to-treat basis. RESULTS: The two groups were comparable in demographic characteristic and motor impairment. After 5 weeks of intervention, the Yijinjing group [11.94 (10.05-13.83)] demonstrated significantly greater improvement in BBS scores than the control group [6.51 (5.38-7.64)], with a between-group mean difference [95% Confidence Intervals (CI)]: 5.51 (3.92-7.10), P < 0.001. Relative to the control group, the Yijinjing group also achieved superior gains in step length, gait speed, and gait asymmetry index (GAI) (P < 0.05), as well as in FMA and MBI scores (P < 0.01). Both groups demonstrated significant within-group improvements across all primary and secondary outcomes from baseline to post-treatment (P < 0.05). No serious adverse events were reported. CONCLUSIONS: This randomized controlled trial demonstrated that a 5-week Yijinjing training program, when added to conventional rehabilitation as a standalone behavioral intervention, appeared to be safe and effective in accelerating improvements in balance, gait, motor function, and activities of daily living in stroke survivors, with short-term benefits exceeding those of stretching training. These findings support integrating traditional Chinese mind-body training into contemporary neurorehabilitation practice. REGISTRATION: The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2100042302), Registered on 17 January 2021.