Sex-Stratified Effects of a Baduanjin Qigong Program for People with Chronic Schizophrenia: A Multicenter Randomized Controlled Trial

Background: People with schizophrenia have a higher risk of metabolic syndrome because of atypical antipsychotic side effects, a lack of exercise, and dietary intake and lifestyle behaviors. Aim: This study aimed to evaluate the sex-stratified effects of a Baduanjin qigong intervention on body mass index (BMI) and fasting blood glucose (FBG) in individuals with schizophrenia. Methods: This study involved 91 participants from three rehabilitation facilities who were randomly assigned to two groups. The experimental group (EG) practiced Baduanjin for 12 weeks and participated in 60-min sessions three times per week. Each session included a 10-min warm-up, two 20-min Baduanjin sets, and a 10-min cool-down, guided by an instructional video. The control group (CG) received standard care, consisting of 30 min of activities such as walking and dancing. Metabolic parameters and BMI were measured before the intervention, immediately postintervention, and at 3-month follow-up. Analyses were performed using generalized estimating equations (GEEs) stratified by sex. Results: Male participants in the EG exhibited significant improvements in BMI ( p = .009) and FBG levels ( p = .030) immediately after the intervention. In contrast, male participants in the CG experienced significantly worse FBG levels at the 3-month follow-up ( p = .005). No significant group differences were observed among female participants in the GEE analysis immediately after the Baduanjin program or at the 3-month follow-up, even after adjustments were made to account for covariate effects. Conclusion: Baduanjin qigong may effectively improve BMI and reduce FBG levels in male patients with schizophrenia. Trial registration: NCT04069988; www.clinicaltrials.gov .