Effects of Baduanjin on anxiety, depressive symptoms, and quality of life in patients with primary glaucoma: A randomized controlled trial.

BACKGROUND AND PURPOSE: Primary glaucoma is the leading cause of irreversible vision loss worldwide. Beyond visual impairment, it is frequently associated with anxiety, depression, reduced sleep quality, and diminished quality of life (QoL). Baduanjin, a traditional Chinese mind-body exercise, has demonstrated positive effects on psychological well-being and QoL in patients with various chronic conditions. However, evidence from randomized controlled trials (RCTs) regarding its impact on mood, sleep, and QoL in patients with glaucoma remains limited. MATERIALS AND METHODS: A prospective, randomized controlled trial was conducted in the Ophthalmology Department of Chengdu Third People's Hospital from May 2024 to March 2025. A total of 112 patients with primary glaucoma were enrolled and randomly assigned in a 1:1 ratio to either the Baduanjin exercise group (n = 56) or the routine care control group (n = 56). The routine care control group received routine care, including standard glaucoma management and regular follow-up. The Baduanjin group received an 8-week intervention with five 30-min sessions per week, in addition to routine care. Assessments were performed at baseline and after 8 weeks using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI) to evaluate anxiety, depression, and sleep quality, and the Chinese version of the Glaucoma QoL-15 (CHI-GQL-15) to evaluate QoL. RESULTS: A total of 102 patients completed the 8-week intervention and follow-up and were included in the analysis. After the intervention, the Baduanjin group showed significantly greater improvements in anxiety, depressive symptoms, and sleep quality than the control group. Significant group × baseline interactions were observed for the Hospital Anxiety and Depression Scale for anxiety (HADS-A) (F = 66.481, P < 0.001),the Hospital Anxiety and Depression Scale for depression (HADS-D) (F = 37.116, P < 0.001), and PSQI (F = 10.591, P = 0.002), indicating that the intervention effects varied by baseline severity. Conditional analyses showed that the benefits were more pronounced in patients with higher baseline symptom levels. Regarding QoL, the Baduanjin group performed better in the "glare and dark adaptation" (adjusted difference -9.47, 95% CI -13.06 to -5.87, P < 0.001) and "outdoor mobility" dimensions (adjusted difference -8.95, 95% CI -14.57 to -3.34, P = 0.002), while no group differences were found in the "central/near vision" or "peripheral vision" dimensions. The CHI-GQL-15 summary score also favored the Baduanjin group (adjusted difference -4.97, 95% CI -8.19 to -1.76, P = 0.003). Sensitivity analyses using HC3 robust standard errors confirmed the robustness of these findings. CONCLUSION: Baduanjin exercise effectively alleviates anxiety and depressive symptoms, reduces perceived sleep problems, and improves domain-specific QoL (glare/dark adaptation and outdoor mobility) in patients with primary glaucoma. These benefits are more pronounced in those with higher baseline symptom burden. Baduanjin represents a safe, feasible, and scalable non-pharmacological adjunctive intervention that can complement conventional glaucoma care, enhancing mental health and daily functional adaptation.